Ritzenthaler T.,Service De Reanimation Neurologique |
Grousson S.,Service De Reanimation Neurologique |
Dailler F.,Service De Reanimation Neurologique
Journal of Clinical Apheresis | Year: 2016
Background: Therapeutic plasma exchanges are increasingly used, notably during myasthenia gravis crisis. Repeated exchanges may induce severe adverse events. Case: We reported a case of symptomatic hyperchloremic metabolic acidosis following a therapeutic plasma exchange. Analysis of 4% albumin substitution solution revealed a chloride concentration of 145 mmol/L, which could explain this acidosis. Discussion: Infusion of high volume of 4% albumin during plasma exchanges may produce hyerchloremic metabolic acidosis. Conclusion: Special attention should be paid when repeated plasma exchanges are performed. J. Clin. Apheresis 31:479–480, 2016. © 2015 Wiley Periodicals, Inc. © 2015 Wiley Periodicals, Inc.
Vandenberghe N.,Center Sclerose Laterale Amyotrophique Of Lyon |
Vallet A.-E.,University of Lyon |
Vallet A.-E.,French National Center for Scientific Research |
Petitjean T.,Service de Reanimation Medicale et dAssistance Respiratoire |
And 16 more authors.
Respiratory Care | Year: 2013
OBJECTIVE: To assess factors that predict good tolerance of noninvasive ventilation (NIV), in order to improve survival and quality of life in subjects with amyotrophic lateral sclerosis. METHODS: We conducted a prospective study in subjects with amyotrophic lateral sclerosis and requiring NIV. The primary end point was NIV tolerance at 1 month. Subjects, several of whom failed to complete the study, were classified as "tolerant" or "poorly tolerant," according to the number of hours of NIV use (more or less than 4 h per night, respectively). RESULTS: Eighty-one subjects, 73 of whom also attended the 1-month follow-up visit, participated over 34 months. NIV tolerance after the first day of utilization predicted tolerance at 1 month (77.6% and 75.3% of subjects, respectively). Multivariate analysis disclosed 3 factors predicting good NIV tolerance: absence of airway secretions accumulation prior to NIV onset (odds ratio 11.5); normal bulbar function at initiation of NIV (odds ratio 8.5); and older age (weakly significant, odds ratio 1.1). CONCLUSION: Our study reveals 3 factors that are predictive of good NIV tolerance, in particular the absence of airway secretion accumulation, which should prompt NIV initiation before its appearance. © 2013 Daedalus Enterprises.
Ritzenthaler T.,Service de reanimation neurologique |
Ritzenthaler T.,INSA Lyon |
Felix S.,Service de neurologie fonctionnelle et d'epileptologie |
Grousson S.,Service de reanimation neurologique |
And 2 more authors.
Reanimation | Year: 2015
In the intensive care unit, the neurological assessment of sedated patients, or patients with impaired consciousness, requires multimodal brain monitoring. There is no tool available that easily evaluates the risk of secondary insults. The main variables monitored are intracranial pressure, brain tissue oxygen, cerebral blood flow, brain metabolism, cerebral autoregulation, and electrophysiological parameters. Each tool has limitations that must be known in order to correctly interpret the data.We review herein each method in light of the recent guidelines. © 2015, Société de réanimation de langue française (SRLF) and Springer-Verlag France.
PubMed | Service de neurologie C, Service de neurologie fonctionnelle et depileptologie, INSA Lyon and Service de reanimation neurologique
Type: | Journal: Neurophysiologie clinique = Clinical neurophysiology | Year: 2016
Treatment of status epilepticus often requires highly sedative drugs with risk of side effects. Correct diagnosis is mandatory in order to prevent introduction of usefulness treatments. We report a case of suspected myoclonic status epilepticus. A thalamic lesion secondary to an osmotic demyelination syndrome was found to be the likely etiology of the myoclonus. Electrophysiological data (electroencephalography and electromyography) provided evidence for a subcortical origin of myoclonus and use of continuous EEG allowed monitoring of drug withdrawal.
PubMed | Service De Reanimation Neurologique
Type: Case Reports | Journal: Journal of clinical apheresis | Year: 2016
Therapeutic plasma exchanges are increasingly used, notably during myasthenia gravis crisis. Repeated exchanges may induce severe adverse events.We reported a case of symptomatic hyperchloremic metabolic acidosis following a therapeutic plasma exchange. Analysis of 4% albumin substitution solution revealed a chloride concentration of 145 mmol/L, which could explain this acidosis.Infusion of high volume of 4% albumin during plasma exchanges may produce hyerchloremic metabolic acidosis.Special attention should be paid when repeated plasma exchanges are performed. J. Clin. Apheresis 31:479-480, 2016. 2015 Wiley Periodicals, Inc.