ABSTRACT
We reported a case of acute restless arms syndrome occurring after colorectal surgery under general anaesthesia. This case was also compared with other cases of restless legs/arms syndromes occurring in a perioperative context through a literature review. As the restless legs syndrome, the restless arms syndrome can be exacerbated by perioperative procedures and improved with pramipexole from the first day of treatment. This case reinforces the idea that the restless arms syndrome seems to be subsumed along with the restless legs syndrome, and is a further argument to use the diagnosis term "restless limb syndrome" for the restlessness of any limb with clinical features similar to the restless legs syndrome.
Subject(s)
Arm , Benzothiazoles/therapeutic use , Dopamine Agonists/therapeutic use , Neuromuscular Diseases/drug therapy , Neuromuscular Diseases/etiology , Postoperative Complications/drug therapy , Anesthesia, General , Colorectal Neoplasms/surgery , Humans , Male , Middle Aged , Pramipexole , Restless Legs SyndromeABSTRACT
We report the case of a young woman who suffered from a severe traffic accident with major thoracic trauma consisting of hemopneumothorax and flail chest. At day 5 of mechanical ventilation, a surgical reduction and fixation of the fractured ribs were performed; the patient was liberated from mechanical ventilation the next day and discharged from the intensive care unit two days later. The success of this local first case incites us to further a similar approach in such challenging trauma cases.
Nous rapportons le cas d'une jeune patiente victime d'un accident grave de la circulation avec un traumatisme thoracique sévère ayant entraîné un hémopneumothorax et un volet thoracique. Au 5ème jour de ventilation invasive, une réduction et une fixation chirurgicales du volet thoracique furent réalisées. La patiente fut sevrée de la ventilation invasive le lendemain et transférée en salle de soins banalisés deux jours plus tard. Le succès de cette première thérapeutique nous incite à la proposer à l'avenir dans des situations similaires.
Subject(s)
Flail Chest/surgery , Rib Fractures/surgery , Adult , Female , Flail Chest/therapy , Humans , Intensive Care Units , Respiration, Artificial , Rib Fractures/therapy , Thoracic Injuries/surgery , Thoracic Injuries/therapy , Treatment OutcomeABSTRACT
A blunt cerebrovascular injury (BCVI) can cause severe cerebral ischemic sequelae. The diagnosis is tricky and often entails a latency period. Adequate treatment at this time will dramatically reduce mortality and morbidity. The Denver protocol guides the selection of the patients to be screened. Current treatment is based on heparin, anticoagulant antiplatelet drugs, interventional radiology and surgery. The treatment is based on a dynamic strategy.
Les lésions artérielles des vaisseaux du cou et de l'encéphale par traumatisme fermé peuvent provoquer de graves séquelles ischémiques cérébrales. Leur diagnostic est délicat et requiert très souvent une période de latence. Une thérapeutique adéquate à ce moment peut considérablement réduire la mortalité et la morbidité. Le protocole de Denver vise à déterminer quel patient doit être dépisté. Le traitement actuel fait appel à l'héparine, aux antiagrégants, à la radiologie interventionnelle et à la chirurgie. La stratégie thérapeutique est dynamique.
Subject(s)
Cerebrovascular Trauma/therapy , Wounds, Nonpenetrating/therapy , Anticoagulants/therapeutic use , Heparin/therapeutic use , Humans , Retrospective Studies , Tomography, X-Ray ComputedABSTRACT
Evidence supporting the implementation of a Massive Transfusion Protocol (MTP) and its effect on patients' outcome is still limited. However, we implemented in June 2013 a local MTP for trauma and nontrauma massively bleeding patients. Twenty months later, we propose here a short presentation of our MTP population and a critical analysis of the actual data supporting MTP implementation.
