Annales françaises d'anesthèsie et de rèanimation
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Ann Fr Anesth Reanim · Apr 2001
Case Reports[Barotrama during apnea testing for the determination of brain death].
We describe three cases of tension pneumothorax occurring during apnea testing for the determination of brain death. Every case needed needle thoracostomy for emergency chest deflation and/or a chest tube to be inserted rapidly. ⋯ This was uneventful for the two first patients (organs harvesting was contra-indicated or not consented by the patient's family), but might be responsible for damaging lungs in the third patient and consequently loosing the pulmonary graft. Limitation of oxygen insufflation up to 8 L.min-1 with a 12 F oxygen supply tubing inserted within 5 cm into the endotracheal tube should be recommended to avoid this iatrogenic complication.
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Ann Fr Anesth Reanim · Apr 2001
Case Reports[Esophageal bezoar resulting from nasogastric enteral feeding in an intensive care unit].
We report two cases of oesophageal bezoar in patients given enteral nutrition by nasogastric tubing in an intensive care unit. These two complications occurred during the year following the replacement of our standard enteral feed by a new preparation enriched in proteins. In both patients, the bezoar could be endoscopically removed. The enteral feeding solution is likely to be responsible for the development of this complication because no other factor known to favour this complication such as concomitant administration of sulfacrate or anti-acid agents was given to the patients; and the bezoar developed shortly after the new enteral feeding solution was used, a hypothesis supported by several similar case reports in the medical literature.
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To analyse the results of the immediate evaluation of an European teaching session using a questionnaire provided by the French College of anaesthesiologists. ⋯ The analysis of medical evaluation should allow to determine an acceptable zone of quality which may be useful for accreditation. However, distorting results according to the professional mode of exercise and the own medical practise should encourage the development of adapted continuous medical education. Delayed evaluation may be necessary to objective the putative benefits of CME on medical practise.
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The aim of this study was to evaluate the different techniques of percutaneous tracheostomies, their advantages, drawbacks, complications and to compare them to standard surgical tracheostomies. This study will consider only elective (non emergency) bedside procedures in intensive care units. ⋯ Since there has been a great deal of percutaneous tracheostomy in the intensive care units, the incidence of tracheostomy have increased in those services. There is a trend to replace the surgical procedure by the percutaneous one. However, according to the potentially jeopardizing complications, percutaneous tracheostomy should be done by an experienced operator with the help of a continuous endoscopic guidance.
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Ann Fr Anesth Reanim · Mar 2001
Randomized Controlled Trial Comparative Study Clinical Trial[Addition of clonidine to 0.5% lidocaine for intravenous locoregional anesthesia].
Evaluate the effect of the addition of clonidine to lidocaine on postoperative pain after intravenous regional anaesthesia. ⋯ The addition of clonidine (150 micrograms) to lidocaine for intravenous regional anaesthesia improved postoperative analgesia but in a limited and short-lasting manner.