[The use of adrenaline for the treatment of anaphylaxis: the use by first-aid personnel is recommended].

Unlabelled: Anaphylaxis is the most serious form of the IgE-dependent food allergy, with lethal risk. The incidence is sharply rising.

Objective: Analysis of the actual management of anaphylaxis, searching for the appropriateness with the International Guidelines highlighting the absolute need of epinephrine, and further suggestions for the improvement of treatment.

[History of acute kidney injury, the early development of hemodialysis in France].

From the end of the 19th century to the 1950s, from mechanisms of disease and pathology to the first success of hemodialysis, the author depicts the history of acute kidney injury. These remarkable improvements of modern medicine led concurrently to the spread of hemodialysis for the replacement of end-stage renal disease.

[From the Revue médicale de l'Est to Les Annales médicales de Nancy one hundred years of medical press from Lorraine].

Les Annales Médicales de Nancy was a periodical review which published a lot of scientific, medical articles of which some deal with history of medicine. It listed among the oldest regional medical reviews since 1895 under many professors' leadership (Heydenreich, Hamant, Chalnot..

[First-aid in France. Current situation and future perspectives].

First-aid--treatment aimed at enabling a victim to survive pending the arrival of qualified medical support--is less well developed in France than in many other industrialized countries, especially among the general public. The current status of first-aid in France is paradoxical: schooling is free and obligatory, the ambulance service and emergency services are of the highest quality, but the general public are too often passive and unknowledgeable when faced with an emergency situation. This situation is due to several factors, including the complexity of first-aid training and regulations, the involvement of too many public bodies, the legal liability of the first-aider, and a lack of ongoing training.

Evolution of lactate/pyruvate and arterial ketone body ratios in the early course of catecholamine-treated septic shock.

Objectives: To measure arterial lactate/pyruvate (L/P) and arterial ketone body ratios as reflection of cytoplasmic and mitochondrial redox state at different stages of catecholamine-treated septic shock and compare them with normal and pathologic values obtained in patients in shock who have decreased oxygen transport (cardiogenic shock), and to assess the relationship between the time course of lactate, L/P ratio, and mortality in septic shock.

Design: Prospective, observational human study.

Setting: A university intensive care unit.

Comparison of systemic and regional effects of dobutamine and dopexamine in norepinephrine-treated septic shock.

Objectives: To compare the effects of dobutamine and dopexamine on systemic hemodynamics, lactate metabolism, renal function and the intramucosal-arterial PCO(2) gap in norepinephrine-treated septic shock.

Design: A prospective, interventional, randomized clinical trial.

Setting: Adult medical/surgical intensive care unit in a university hospital.

Gastric versus duodenal feeding and gastric tonometric measurements.

Objective: To compare the influence of gastric and postpyloric enteral feeding on the gastric tonometric PCO2 gap (tonometric PCO2 - PaCO2).

Design: A prospective, clinical trial.

Setting: Two intensive care units in a university hospital.

[Collective oxygen therapy and disaster medicine].

The distribution of oxygen to many victims can be necessary all along the medical help chain: operations of extraction, stand up, recovery, transport, life supporting care, surviving and transportation in mobile processing formations installed to proximity of the site, evacuations by road or by fly. Moreover, hospital in situation of crisis has an increased oxygen consumption (especially for ventilators). An estimable need calculation, a census of stocking and distribution ways have to allow to adapt resources to needs.

Reversal of late septic shock with supraphysiologic doses of hydrocortisone.

Objectives: Preliminary studies have suggested that low doses of corticosteroids might rapidly improve hemodynamics in late septic shock treated with catecholamines. We examined the effect of hydrocortisone on shock reversal, hemodynamics, and survival in this particular setting.

Design: Prospective, randomized, double-blind, placebo-controlled study.

[Complications of vascular surgery].

Vascular surgery, which in certain life-threatening situations is the only possible therapeutic option, has progressed considerably since its beginning in the 1950s. Because of the constant progression of vascular diseases, this surgery will present, in the forthcoming years, a major public health problem. Because of advances in medico-surgical management, evermore elderly and frail patients can be treated.

Dobutamine improves the adequacy of gastric mucosal perfusion in epinephrine-treated septic shock.

Objective: To assess the effects of dobutamine at a rate of 5 micrograms/kg/min on hemodynamics and gastric intramucosal acidosis in patients with hyperdynamic septic shock treated with epinephrine.

Design: A prospective, interventional, clinical trial.

Setting: An adult, 16-bed medical/surgical intensive care unit of a university hospital.

Comparison of norepinephrine and dobutamine to epinephrine for hemodynamics, lactate metabolism, and gastric tonometric variables in septic shock: a prospective, randomized study.

Objectives: To compare the effects of norepinephrine and dobutamine to epinephrine on hemodynamics, lactate metabolism, and gastric tonometric variables in hyperdynamic dopamine-resistant septic shock.

Design: A prospective, intervention, randomized clinical trial.

Setting: Adult medical/surgical intensive care unit in a university hospital.

Intracranial hypertension and adult respiratory distress syndrome: usefulness of tracheal gas insufflation.

The management of increased intracranial pressure (ICP) in patients with an associated acute lung injury is difficult. High levels of PaCO2 as tolerated for permissive hypercapnia are deleterious for cerebral circulation. In such circumstances, tracheal gas insufflation (TGI), which was recently proposed to reduce PaCO2, may be of benefit.

Hemodynamic and metabolic effects of rapid correction of hypophosphatemia in patients with septic shock.

Study Objective: To examine the hemodynamic and metabolic short-term effects of hypophosphatemia correction in patients with septic shock receiving catecholamine therapy.

Design: Prospective, single cohort study.

Setting: ICU, university hospital.

Therapeutic optimization including inhaled nitric oxide in adult respiratory distress syndrome in a polyvalent intensive care unit.

Objective: To investigate the effects of inhaled nitric oxide (NO) in adult respiratory distress syndrome (ARDS) associated with a therapeutic optimization strategy on oxygen parameters, barotrauma, and evolution in a medical and surgical intensive care unit.

Design: Prospective study.

Materials And Methods: Twenty consecutive patients with ARDS were studied (Murray score 3.