[Can one use probabilistic protocols for antibiotic therapy in intensive care units?].

Due to a large spectrum, empiric antibiotics treatments participate to the increase in bacterial resistance. In order to improve its indications, the implementation of therapeutic guidelines in an ICU was studied. Empiric therapy was administered in 30% of the 178 patients receiving antimicrobial agents.

[Acute intestinal ischemia after voluntary drug poisoning].

A case is reported of a patient who suffered from ischaemic enteritis after having taken an overdose of several drugs. The 42-year-old woman was found out no more than 7 h after she had taken a mixture of benzodiazepines, tricyclic antidepressants and barbiturates (4 mg.l-1 blood level on admission).

[Practical aspects of indirect calorimetry in post-anesthesia recovery].

The application of indirect calorimetry among intensive care patients is usually considered as a complicate technique, owing to the difficulties to interpret the bulk of obtained data. As a matter of fact, the variability of energy expenditure (EE) among these patients leads to prefer continuous measurements. This variability is related to interindividual variations as well as variations in the same patient (variations due to body temperature, activity state, diet-induced thermogenesis.

[Regional anticoagulation with citrate in hemodialysis in patients with a high risk for hemorrhage].

During haemodialysis in the patient at high risk for bleeding, heparin cannot be safely used to prevent clotting in the dialysis assembly. Among numerous procedures proposed to reduce the risk for bleeding, Pinnick et al. (N Engl J Med, 308: 258, 1983) proposed the use of citrate as the sole anticoagulant.

Corynebacterium JK: surgical infections in non-immunosuppressed patients.

Infection caused by Corynebacterium JK (CJK) has been recently described in immunocompromised patients. To evaluate the frequency of CJK infection among surgical and trauma intensive care patients, all patients with CJK isolations at clinical sites were reviewed. The criteria used were the presence of bacterial infection symptoms, isolation from significant sites and the efficiency of a vancomycin treatment.

[Evaluation of the Engstrom metabolic computer].

The Engstrom Metabolic Computer (EMC), in association with the Erica Ventilator, uses indirect calorimetry to carry out continuous on-line gas exchange measurements. A laboratory assessment of the different parts of this equipment is described. The variability of FIO2 was less than 0.

[A severe form of heat stroke in a long-distance runner].

A case of a severe heat stroke is reported in a 30 yr old white man while running a long-distance race. At the time of admission, moderate hyperthermia (40 degrees C) and coma were two major symptoms found at physical examination. Within 24 h, the clinical picture evolved to multiple organ failure with marked rhabdomyolysis, acute renal failure with hyperkalaemia and lactic acidosis.

[Fibroscopy and pulmonary burns. Preliminary study, apropos of 44 cases].

A fiberoptic bronchoscopy was performed in 44 out of 1160 burnt patients. The indications for this investigation were dictated by the kind of accident suffered by the patient: explosion or fire; in 16 patients, the face was spared. The clinical, radiological and biological signs could be absent on arrival, and occur later.

[Pheochromocytoma and pregnancy. Report of two cases (author's transl)].

We found in the literature 119 cases of pheochromocytoma manifested during pregnancy and observed 2 personal cases. Pheochromocytoma and pregnancy show reciprocal influences. Unsuspected diagnosis is frequent and followed by a high maternal mortality.

[Bacteriologic study of indwelling central venous catheters. Factors influencing the risk of microbial colonization and sepsis (author's transl)].

The mechanism of microbial colonization and sepsis is disputed. For many authors, catheter contamination results from poor aseptic technic during insertion or removal or from the descent of organisms along the catheter from the skin puncture site; we think with Michel that endogenous colonization of the thrombus at the tip of the catheter must be considered: a statistical correlation between infected foci remote from the catheter allows this hypothesis; tracheostomy may be considered as well as a percutaneous contaminant as a deep infected focus. The correlation between non specific immunity and contamination is another finding which allows the ability of endogenous colonization.

[Hysteria: an etiology of post-operative accident (author's transl)].

Hysteria can explain some immediate post-operative accidents. We report some cases observed during these late years; all were troublesome for the anesthesiologist.

[Leukocyte migration. Clinical study (author's transl)].

The authors present a new method to study leukocyte migration with a skin window. The method uses a new leukocyte migration P. L.