Midterm effects of fluid resuscitation strategies in an experimental model of lung contusion and hemorrhagic shock.

Background: This study compared three different fluid resuscitation strategies in terms of respiratory tolerance and hemodynamic efficacy in a pig model of blunt chest trauma with lung contusion and controlled hemorrhagic shock. We hypothesized that the choice of fluid resuscitation strategy (type and amount of fluids) may impact differently contused lungs in terms of extravascular lung water (EVLW) 20 h after trauma.

Methods: Anesthetized female pigs (n = 5/group) received five bolt shots to the right thoracic cage and allowed to hemorrhage for 30 min, with 25 to 30 mL/kg of blood loss.

Leaks can dramatically decrease FiO2 on home ventilators: a bench study.

Background: Long term oxygen therapy improves survival in hypoxemic patients with chronic obstructive pulmonary disease (COPD). Because pressure support ventilation with a home care ventilator is largely unsupervised, there is considerable risk of leakage occurring, which could affect delivered FiO2. We have therefore conducted a bench study in order to measure the effect of different levels of O2 supply and degrees of leakage on delivered FiO2.

Evaluation of early mini-bronchoalveolar lavage in the diagnosis of health care-associated pneumonia: a prospective study.

Introduction: Health care-associated pneumonia (HCAP) has been proposed as a new category of respiratory infection to identify patients at risk of multidrug-resistant (MDR) pathogens. The American Thoracic Society's recommendation for HCAP treatment is to use broad-spectrum and multiple antibiotics. However, this strategy may be economically expensive and promote antimicrobial resistance when a multisensitive pathogen is not identified.

Prognostic significance of blood lactate and lactate clearance in trauma patients.

Background: Lactate has been shown to be a prognostic biomarker in trauma. Although lactate clearance has already been proposed as an intermediate endpoint in randomized trials, its precise role in trauma patients remains to be determined.

Methods: Blood lactate levels and lactate clearance (LC) were calculated at admission and 2 and 4 h later in trauma patients.

[Upper airway management during anesthesia for reconstructive surgery in patients with noma].

Noma causes tissue degeneration of the face resulting in impaired mouth opening with secondary malnutrition and metabolic disorders. Reconstructive plastic surgery for noma can be lifesaving but requires special airway and ventilation techniques because of limited mouth opening. In addition, the African context imposes logistic and budgetary constraints.

Bedside percutaneous tracheostomy: a prospective randomised comparison of PercuTwist versus Griggs' forceps dilational tracheostomy.

Tracheostomy is considered the airway management of choice for patients who require prolonged mechanical ventilation. The development of percutaneous techniques offers many advantages including the ability to perform the procedure in the intensive care unit. The aim of this study was to compare the controlled rotating dilation method (PercuTwist) and the Griggs' forceps dilational tracheostomy.

Maintenance of normothermia during burn surgery with an intravascular temperature control system: a non-randomised controlled trial.

Background: Hypothermia remains one of the major factors limiting surgery in extensively burned patients. We evaluated the effectiveness of an intravascular rewarming technique using CoolGard 3000™ system and Icy™ catheter to maintain normothermia during surgeries of severe burned patients and compared these findings to a historical control group.

Methods: This was a controlled non-randomised trial conducted between March 2008 and August 2009.

Iatrogenic post-intubation tracheal rupture treated conservatively without intubation: a case report.

Background: Tracheal rupture is a rare but life-threatening complication that most commonly occurrs after blunt trauma to the chest, but which may also complicate tracheal intubation. We report a case of post-intubation tracheal rupture after cataract surgery under general anesthesia treated conservatively.

Case Presentation: Four hours after extubation, a 67 year-old woman developed subcutaneous emphysema of the facial, bilateral laterocervical and upper anterior chest.

Protective ventilation in ARDS: as soon as possible. An immediate use of HFOV.

Objective: To report the immediate use of High-Frequency Oscillatory ventilation in an adult acute respiratory distress syndrome.

Design: Case report.

Setting: Intensive care unit at the Military Teaching Hospital of Toulon.

A prospective randomized trial of two safety peripheral intravenous catheters.

Background: To reduce the risk of accidental needlestick injuries, first active then passive safety devices were developed on IV catheters. However, whether these catheters are easy to implement and really protect personnel from accidental needlestick is untested.

Methods: In this prospective randomized survey, we compared a passive safety catheter with an active safety catheter and a nonsafety classic catheter.

Hyperventilation and cerebrospinal fluid acidosis caused by topiramate.

Objective: To report a case of hyperventilation caused by topiramate therapy and propose a pathophysiologic mechanism for this disorder.

Case Summary: A 52-year-old woman with refractory seizure disorder was admitted to the burn care unit with burns over 10% of her body. Her seizure medications, unchanged and well tolerated for several months, included carbamazepine 1200 mg, lamotrigine 500 mg, phenobarbital 80 mg, and topiramate 150 mg per day.

A non-surgical device for faecal diversion in the management of perineal burns.

Background: Burns to the perineal, buttock and upper thigh areas are frequently exposed to continual faecal contamination which results in sepsis, graft loss, delayed wound healing and shrinkage of scars. A temporary diverting colostomy may be required. Two specifically designed intrarectal catheters were evaluated for their safety and ability to divert faeces away from the burn and allow wound healing.