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  • 1
    ISSN: 1432-1238
    Keywords: Meningoencephalitis ; Penicillin-resistantStreptococcus pneumoniae ; Antibiotics in CSF ; Cefotaxime
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The case of a 68-year-old man suffering from pneumococcal meningoencephalitis is reported. Antibacterial susceptibility tests revealed a multiply resistant pneumococcal strain. High doses of cefotaxime were necessary to sterilize the cerebrospinal fluid despite the achievement of a satisfactory level of antibiotic in the cerebrospinal fluid with moderate dosage. In France, as well as in many countries, high doses of third-generation cephalosporins such as cefotaxime or ceftriaxone should be administered for the initial therapy of suspected pneumococcal meningitis.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1432-1238
    Keywords: Self-extubation ; Deliberate self-extubation ; Accidental self-extubation ; Oral intubation ; Nasal intubation ; Reintubation ; Agitation ; Sedation ; Respiratory distress
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objective To evaluate the incidence, associated factors and gravity of self-extubations. Design Prospective study about all patients intubated over an 8 month period. Setting A medical intensive care unit of a University Hospital. Patients Patients were divided into two groups: self-extubated and those that did not. The self-extubations were separated into deliberate acts by the patients and accidental. Results 24 of the 197 patients included presented a total of 27 extubations (12%). There were 21 deliberate incidents and 6 accidental. The only differences between the cases and the rest of the population were a higher mean age (67 vs 59 years) and a larger proportion of chronic respiratory failure (66% versus 35%). Reintubation was necessary in 20 cases (74%) within 30 min in 16 cases. The main indication for reintubation was acute respiratory distress (90%). Reintubation was associated with one death. Conclusion Self-extubation is a frequent and serious complication of mechanical ventilation. Deliberate self-extubation, the most frequent type of incident could possibly be reduced by better sedation of agitated patients and accidental self-extubation by better training of the nursing staff.
    Type of Medium: Electronic Resource
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