Annales françaises d'anesthèsie et de rèanimation
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Ann Fr Anesth Reanim · Jan 2009
[Evaluation of the haemostasis before a central block in children: what is the French anaesthesiologist's attitude?].
Because of the lack of controlled studies, there is no consensus regarding the practice of routine haemostasis tests before neuraxial blockade in children. The purpose of this study was to describe the French surgical practice about the preoperative evaluation of coagulation in children who were scheduled for paediatric neuraxial anaesthesia. ⋯ While numerous data suggest that routine testing does not to provide much extra information in the absence of a positive history, a systematic strategy is still widely applied in children. Guidelines need to be developed to insure the safety of oriented tests.
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Ann Fr Anesth Reanim · Jan 2009
Case Reports[Helium-sevoflurane association: a rescue treatment in case of acute severe asthma].
We report the case of a severe acute asthma, which required, after optimal medical therapy, helium and sevoflurane CO-administration after tracheal intubation. The Anesthetic Conserving Device allowed sevoflurane use with intensive care unit's ventilator. The helium-sevoflurane association was maintained during 9 days to decrease the bronchospasm, waiting for the efficiency of an aetiologic treatment. We discuss the suitability of this association to treat severe acute asthma, and its administration modalities.
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Ann Fr Anesth Reanim · Jan 2009
Case Reports[Labour epidural analgesia for a woman with a factor XI deficiency: an illconsidered risk?].
Inherited bleeding disorders contraindicate epidural analgesia because of the risk of epidural haematoma. However, there is no consensus about a minimal rate of factor XI required for its performance. ⋯ Indeed, the factor XI deficiency results in a haemorrhagic risk which is variable and not easily foreseeable. Nevertheless, no neurological after-effect or excessive bleeding occurred although no specific prophylaxis had been performed.
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Ann Fr Anesth Reanim · Jan 2009
Case Reports[Extracorporeal membranous oxygenation in severe infant pertussis: a case report].
Pertussis is a leading cause of death from community infections in infant. Life-threatening clinical presentations of pertussis can associate multiple organ system failure with respiratory distress. The question of the optimal management of these severe forms of pertussis, in order to reduce the high mortality rate, is raised by the clinicians caring for such patients. ⋯ Weaning from mechanical ventilation was possible on D15 and the total length of stay in PICU was 20days. While the analysis of the literature, through limited experiences on the use of ECMO in children with severe pertussis does not allow concluding definitively on the utility of ECMO in this situation, the contribution of ECMO in the favourable outcome for our patient was considerable. This is an argument, to our opinion, for considering ECMO in the management of those very instable patients.