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E. Querellou J. Leyral C. Brun D. Lvy J. Bessereau D. Meyran P. Le Dreff 《Annales fran?aises d'anesthèsie et de rèanimation》2009,28(9):769-778
Cardiac arrest is a frequent emergency for doctors and resuscitation teams. Patients displaying asystole or pulseless electrical activity are non-shockable. They have extremely poor outcomes. The use of sonographers might contribute to a better understanding of cardiac arrest (CA) etiology and facilitate its treatment. A systematic search in databases (NLM-Gateway®, CNRS-INIST/Pascal®, Science Direct®, Ovid®, and Bibliovie®) of primary documents and notices allowed us to select clinical trial studies. Editorials, case report and animals studies were excluded from the analysis. The various physiopathological and semiological status revealed by echocardiography are useful to detect the aetiology of cardiac arrest. In the very first minutes following the arrest, a significant increase of right ventricle (RV) volume suggests a pulmonary thromboembolism or a RV infarction. After 4 min of CA, a physiological increase of RV volume is observed, in relation with the pressure balance between high and low arteriovenous pressures. RV and/or left ventricle collapses are straightaway pathological whichever due to pericardic effusion, pneumothorax or schock. A synthesis algorithm dedicated to care of CA, including transthoracic echocardiography for search of curable causes, is proposed. This algorithm fulfills the ILCOR, ERC and AHA recommendations. The echocardiography should be part of ACLS, nevertheless clinical studies are needed to assess its impact on morbimortality. 相似文献
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M. Cannesson O. Desebbe V. Piriou J.-J. Lehot 《Annales fran?aises d'anesthèsie et de rèanimation》2010
Objectives
To describe preload dependence monitoring tools currently available as well as their limits and potential applications in the anaesthesiology setting.Data source
References were obtained from PubMed data bank (http://www.ncbi.nlm.nih.gov/entrez/query.fcgi) using the following keywords: fluid responsiveness, cardiopulmonary interactions, preload dependence, hypovolemia, cardiac output.Data synthesis
When measured in optimal conditions, dynamic parameters are the best predictors of fluid responsiveness as compared to static indicators in patients under general anaesthesia and mechanical ventilation. These dynamic parameters rely on cardiopulmonary interactions and allow evaluating preload dependence and the ability of the heart to transform an increase in preload into an increase in cardiac output. Recently, it is possible to monitor these dynamic parameters either invasively (from the arterial pressure waveform) or noninvasively (from the plethysmographic waveform). These tools have intrinsic limitations. However, they have potential to be used for fluid optimization during anaesthesia. 相似文献7.
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During normal pregnancy, renal blood flow and GFR increase gradually until they reach a peak of about 150% of their normal values by the end of the 1st trimester. 相似文献
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A. Challan Belval A. Chéron B. Floccard A.-S. Lienhart B. Allaouchiche 《Annales fran?aises d'anesthèsie et de rèanimation》2010
Acute pancreatitis is frequently associated with electrocardiographic abnormalities, including arrhythmias and repolarization. We briefly describe a male patient with a severe acute pancreatitis who presented several bradycardias during his hospitalization in our intensive care unit. The aim of this case report is to underline the probability of severe arrhythmias during acute pancreatitis, which can increase morbidity of this pathology. Despite many publications or reports, causes of increased EKG abnormities during severe pancreatitis remained unclear and are probably multifactorial. To prevent accidents or complications, patients with severe acute pancreatitis should have a continuous EKG monitoring. 相似文献
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HELLP syndrome complicates PE in 5 to 20 % of cases. 相似文献
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