Annales françaises d'anesthèsie et de rèanimation
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Ann Fr Anesth Reanim · Jul 2010
[Activity and the available human resources working in 66 French Southern intensive care units].
The aim of the study was to determine the activity and the available human resources working in 66 intensive care unit (ICU). ⋯ In this study, more than 75% patients had at least two organ dysfunctions within their ICU stay and 88% required a billing procedure and had an admission SAPS II greater or equal to 15. Nevertheless, the staff resource remained below the 2002 decree in 27% ICUs.
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The purpose of this review is to draw up a statement on current knowledge available on the more recent hydroxyethyl starch (HES). ⋯ The first HES was made available in the United States in 1970. The development of a new generation of HES restarted the discussion on clinical interest and the limits in the use of these macromolecules. This interest is also strengthened today by the recent data attached to plasma substitution in intensive care or perioperative resuscitation. The interest for crystalloids and colloids is still widely debated, and among the latter, the relative interest of the HES last generation compared to older ones. Recent HES development is in line with a decrease molecular weight, change rate molar substitution and to amend the glucose to hydroxyethyl report. The ultimate goal is to reduce the side effects of these molecules preventing their use. Side effects are dominated by haemostasis and renal dysfunction. The latest developments are the so-called HES "balanced" solutions.
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Ann Fr Anesth Reanim · Jul 2010
Continuous non-invasive arterial pressure measurement: evaluation of CNAP device during vascular surgery.
Standard non-invasive blood pressure (BP) monitoring is an intermittent, discontinuous procedure. Beat-to-beat BP monitoring requires invasive measurement via an arterial catheter and may be associated with serious complications. The Infinity CNAP SmartPod (Dräger Medical AG & Co. KG, Lübeck, Germany) has recently been proposed for non-invasive continuous beat-to-beat BP measurements. The present study was designed to compare BP obtained with the CNAP and with an invasive method in the operating room. ⋯ Despite low accuracy for SAP and DAP measurements, CNAP system seems more accurate for MAP measurement in patients undergoing vascular surgery.
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Ann Fr Anesth Reanim · Jul 2010
Case Reports[Bedside pretransfusion compatibility testing fiability with cold agglutinins during cardiopulmonary bypass associated hypothermia for cardiac surgery].
This case report is an example of a bedside pretransfusion compatibility testing issue. An 81-years-old woman was admitted in the operating room for aortic valve replacement under cardiopulmonary bypass. ⋯ Afterwards, the patient was diagnosed with cold agglutinins. It might have produced false positive results with the anti-A and anti-B reagents.
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Ann Fr Anesth Reanim · Jul 2010
[Impact of Express study on clinical practice in ARDS patients: a single French ICU experience].
The French Express study compared two alveolar recruitment managements (maximal versus standard) in Acute Respiratory Distress Syndrome (ARDS) patients ventilated with 6 ml/kg of ideal body weight (IBW). The objective of the present study was to assess in a single intensive care unit, the impact of Express study on the mechanical ventilation settings in non-included ARDS patients. ⋯ The participation in Express study led physicians to modify their mechanical ventilation settings. The maximal tidal volume decreased and the minimal respiratory rate increased in the ARDS eligible but non-included patients.