Annales françaises d'anesthèsie et de rèanimation
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Ann Fr Anesth Reanim · Nov 2002
Comparative Study[Training for adult subclavian venous catheterization: use of real-time echography].
To assess the training in adult subclavian venous catheterization of an inexperienced operator, with two different procedures: ultrasound guidance vs anatomic landmark technique. ⋯ Ultrasound guidance makes the training in adult subclavian venous catheterization easier, and allows inexperimented operator to be rapidly efficient. The use of ultrasound would decrease the incidence of complications by a real time visualization of anatomical structures, and by a more external approach of the vein than in the Aubaniac's technique.
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Ann Fr Anesth Reanim · Nov 2002
Case Reports[Severe complications after a translaryngeal tracheotomy].
We report the case of a 71-year-old man receiving anticoagulant treatment because of a mechanical aortic valve. Because of an unsuccessful weaning after abdominal surgery, a translaryngeal tracheostomy was realised without incident. The patient died few days later after a hypoxic cardiac arrest due to a severe haemorrhage after the first recannulation. This case illustrates a severe complication because of the recannulation after a translaryngeal tracheostomy and how cautions one should be before realizing a percutaneous tracheostomy in a patient under anticoagulant treatment.
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We report a case of pupilloplasty under peribulbar anaesthesia complicated by a brainstem anaesthesia requiring tracheal intubation and mechanical ventilation. Immediate outcome was good. ⋯ The use of short needles should theoretically decrease the risk. Despite all these precautions, peribulbar anaesthesia should not be considered as an ordinary procedure.
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We report two cases of myocardial infarction, in young HIV positive patients seen in the Emergency Department. These patients were under treatments: for one, an association of nucleosidic inhibitors, and for the other one, the combination of nucleosic analogue inhibitor with a non nucleosic analogue; in the last case, the patient underwent, few months before, a treatment containing a protease inhibitor. ⋯ The diagnosis has been made quickly and allows a coronary angioplasty with a favourable issue. Authors are arguing the characteristics of this cardiac pathology, recently discovered in HIV positive patients, and do insist on the need to think at a coronary heart disease in front of any chest pain symptom even unusual.