[Docetaxel-induced acute pulmonary capillary-leak syndrome mimicking cardiogenic oedema].
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Biomedical subjects
Publications and source records attributed to R Amathieu.
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Thyroid surgery is considered to be a risk factor for difficult airway management. We prospectively studied 324 consecutive patients undergoing thyroid surgery to investigate the incidence of difficult intubation as evaluated by the intubation difficulty scale as well as other specific predictive factors. The overall incidence of difficult intubation was 11.1% (95% CI: 7.6-14.5). Median intubation difficulty scale was 0 (25th-75th percentile: 0; 2.7). In three predefined groups (no echographic goiter, clinically palpable goiter, and impalpable goiter), difficult intubation occurred in 10% (95% CI: 4.8-17.4), 13% (95% CI: 6.5-18.4), and 11% (95% CI: 4.7-16.8) of patients, respectively, with no statistical difference among the groups. Specific predictive criteria (palpable goiter, endothoracic goiter, airway deformation, airway compression, or thyroid malignancy) were not associated with an increased rate of difficult intubation. Classical predictive criteria (mouth opening <35 mm, Mallampati III or IV, short neck, neck mobility <80 degrees , thyromental distance <65 mm, and a retrognathic mandible) were significantly reliable in the univariate analysis as risk factors for difficult intubation.
We report the case of a 68-year-old man with severe hypoxemic pneumopathy having cardiac output monitoring with the NICO system in prehospital medicine. This monitoring permitted the diagnosis of a compressive pneumothorax during the transfer to the intensive care unit. This ease of use technique based on partial carbon dioxide rebreathing, allows non-invasive, continuous and reliable cardiac output monitoring. We discuss the interest of this device in prehospital medicine.
We report the case of a post-traumatic pneumomyelogram in a 51-year-old woman. The pneumomyelogram associated with a skull base fracture was revealed by systematic total body scan. The discovery of a traumatic pneumomyelogram will be probably more frequently discovered with the largest use of modern helical CT-scan in traumatized patients. We discuss the etiologies and the implications for the anesthesiologist and the intensivist of this entity.