[A survey on premedication prior to intubation in very preterm infants (28-32WG) with respiratory distress syndrome in French neonatal intensive care units]. / Enquête nationale sur la sédation-analgésie pour intubation des grands prématurés atteints de détresse respiratoire en dehors de l'arrêt cardiorespiratoire et de la salle de naissance.

INTRODUCTION/OBJECTIVES: Tracheal intubation is a painful procedure for which the routine use of analgesia is recommended. However, the use of premedication for intubation is not yet generalized and there is great diversity in the drugs used. The main objective of this study was to describe the frequency of premedication use in preterm neonates aged between 28 and 32weeks of gestation, intubated for respiratory distress syndrome. Secondary objectives were to describe the existence of a written protocol, its influence on the frequency of premedication and the drugs used. MATERIALS AND METHODS: Declarative survey on Google.docs forms addressed to physicians and residents working in neonatal intensive care units in France. RESULTS: One hundred thirty respondents from 64 units completed this survey between 1 June and 31 July 2014. Fifty-seven percent of respondents declared always using a premedication, and 64 % of participants had a written protocol in their units. Persons working in a unit with a written protocol more frequently reported using premedication (P=0.04). The drugs used were various (mostly a hypnotic/morphine combination) and their dosages scattered. DISCUSSION: The results found by this survey confirm data from the literature and the situation seems to have stagnated over the last few years. A written protocol might encourage premedication use. CONCLUSION: Improvements in practices and increased knowledge are required to generalize the sedation/analgesia practices for tracheal intubation in neonatal intensive care units in France.

[Atypical presentation of hepatosplenic cat scratch disease in a 3-year-old child]. / Forme hépato-splénique de la maladie des griffes du chat chez un enfant de 3ans.

Cat scratch disease is caused by a facultative intracellular Gram-negative bacteria, Bartonella henselae. This disease is transmitted by cat scratches or bites. The typical form is a large and rough adenopathy, with no general signs. In a few cases, the symptoms are aspecific and various, which makes the diagnosis difficult. A 3-year-old child presented a prolonged fever with an aspecific skin eruption and hepatosplenic lesions seen 1 month after the beginning of the disease, which led to the diagnosis of hepatosplenic cat scratch disease. An adapted antibiotic therapy completely cured the disease.