Annales françaises d'anesthèsie et de rèanimation
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Traumatic brain injury leads to primary and secondary brain injuries. Primary brain injury results from mechanical forces applied to the head at the time of impact. Secondary brain injury occurs at some time after the primary impact. ⋯ The endogenous neuroinflammatory response after traumatic brain injury contributes to the development of blood-brain barrier breakdown, cerebral oedema and neuronal cell death and this has led to various pharmacological therapies to try to limit this type of damage. Studies employing glutamate receptor antagonist for cerebral protection have yielded promising results in laboratory animals but failed to produce clinically significant improvements. The present review will summarize the mechanisms of post traumatic cerebral inflammation with a special focus on the anti-inflammatory drug targets.
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To describe the new procedures applied for interventional radiology leading to specific anaesthetic care and organization. ⋯ As advances in interventional radiology are obvious, general organisation as well as anaesthetic procedures should be adapted to these specific techniques.
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Ann Fr Anesth Reanim · Jun 2006
Review[Patient-controlled epidural analgesia for labour: in practice].
Update on patient controlled epidural analgesia for labour. ⋯ The use of PCEA improves the quality of analgesic management offered to the parturients who are more and more willing to have a "more natural" childbirth. The PCEA gives them more autonomy and, in fine, enables them to better enjoy this unique event. The main barrier to a more widespread diffusion of PCEA in many institutions remains the financial issue, although a well-selected device and low cost disposables allow a reduction of indirect costs by decreasing care giver workload.
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Ann Fr Anesth Reanim · Jun 2006
Review[Meticillin-resistant Staphylococcus aureus: incidence, risk factors and interest of systematic screening for colonization in intensive-care unit].
To summarize recent international and national epidemiological data of methicillin-resistant Staphylococcus aureus (MRSA) colonization in ICU. ⋯ Systematic screening for colonization on ICU admission and during hospitalization is essential for many authors to control the spread of MRSA. Other policies such as implementation of isolation precaution and antibiotic use also contribute to decrease the MRSA incidence rate observed for several years in French ICU.
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Ann Fr Anesth Reanim · May 2006
Review[Inflammatory response and haematological disorders in cardiac surgery: toward a more physiological cardiopulmonary bypass].
The systemic inflammatory response in cardiac surgery is closely related to the haemostasis disturbances. It is responsible of a significant morbidity and mortality that was previously suspected to be caused by cardiopulmonary bypass alone. However, it is time now to clearly identify the factors that are material-dependent from that material-independent. ⋯ The tissue pathway of the coagulation system, through tissue factor, is of major importance and has to be surgically considered in order to reduce the whole body inflammatory response postoperatively. The quality of the extracorporeal perfusion through its consequences on organ perfusion, particularly in the splanchnic area, also participates to this pathophysiological process. Beyond the progress of technology provided by the industry, particularly the minimally extracorporeal circulation derived from off-pump surgery evolution, the surgical approach is of major importance in the control of the systemic inflammatory response and must not be ignored yet.