Annales françaises d'anesthèsie et de rèanimation
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Necrotizing soft tissue infections represent a group of rapidly progressive diseases requiring early and repeated debridement, associated with broad spectrum antibiotics. Delay in surgery or inadequate therapy are the main risk factors for death. ⋯ A plastic surgeon can help debridement in order to preserve possibilities of later myocutaneous or rotational skin flaps. Intravenous immunoglobulins are an efficacious adjunctive therapy for severe group A streptococcal infection.
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Ann Fr Anesth Reanim · Sep 2006
[Necrotizing skin and soft tissue infections: definitions, clinical and microbiological features].
Among the three types of soft tissue and skins infections (cellulitis, necrotising cellulitis and necrotising fasciitis) only the necrotising injuries are commonly managed in intensive care unit. Location, depth and severity of these potentially life threatening infections may vary and cannot be predicted on clinical grounds No microbiological deduction can be made from clinical signs. A mixed aerobic-anaerobic flora is cultured in 40 to 80% of the cases. ⋯ However, these exams should not delay surgical treatment. Fifteen to 30% of the patients die. Three parameters play a key role in the prognosis: ability of the physician to recognise the disease and to evaluate the severity of infection, early onset of antimicrobial therapy, and most of all early surgical debridement.
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Sepsis-associated encephalopathy is a global cerebral dysfunction induced by the systemic response to inflammation and infection, without a liver or renal injury. Alteration of consciousness, from confusion to coma, is the main clinical symptom. This encephalopathy is associated with an increase in mortality due to sepsis. ⋯ Changes in neurotransmitter release or concentrations (norepinephrine, serotonin, dopamine, GABA) have been reported. There is not any specific treatment of septic encephalopathy. In most cases, this syndrome is rapidly reversible after the treatment of sepsis.
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Ann Fr Anesth Reanim · Aug 2006
Case Reports[Oropharyngeal ulcers following anaesthesia with the laryngeal tube S].
We report a case of acute tongue and uvula ulcerations consecutive to the use of a laryngeal tube Sonda (LTS) for airway management. The LTS was used during general anaesthesia for hysteroscopy and resection of endometrial hyperplasia. ⋯ Symptomatic treatment provided complete resolution within a few days. This event points out the potential risk of more serious lesions.
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Postobstructive pulmonary oedema is a complication after extubation that occurs rarely. It can be associated with haemoptysis. We report two cases of haemoptysis occuring in ASA 1 otherwise healthy patients who underwent uncomplicated anaesthesia. Understanding of the mechanism and prompt treatment lead to rapid recovery of this dramatic complication.