Introduction: Eclampsia is a common cause of maternal mortality in developing countries. The objective of this study is to evaluate the practice of anesthesia for eclampsia in tropical Africa. Patients and Methods: Re...Introduction: Eclampsia is a common cause of maternal mortality in developing countries. The objective of this study is to evaluate the practice of anesthesia for eclampsia in tropical Africa. Patients and Methods: Retrospective descriptive study on the parturients who benefited from eclampsia anesthesia in the operating theaters of the gynecology and obstetrics department, the University Hospital Center (CHU) of Bouake over a two-year period (January 2015 to December 2016). The parameters studied were: anesthetic risk assessment, anesthetic management, immediate anesthetic and post-anesthetic accidents and incidents. Results: Out of a total of 3831 emergency cesarean sections, 65 were for eclampsia, or 1.69% of obstetrical surgical activity. The mean age of the patients was 20.30 ± 3.34 years (range: 14 years and 39 years). Prenatal consultation was not performed in 70% of cases and 85% of patients were primiparous. Patients classified as ASA IIIU accounted for 75% of the population and in 62% of cases, the Glasgow score was between 9 and 12. Induction was achieved with thiopental in 98% of patients and vecuronium was the only muscle relaxant used. The most common fetal complications were hypotrophy (50%), prematurity (30%) and respiratory distress (40%). Postoperative anesthetic complications were agitation (70%) and wake delay (15%). Maternal mortality was 5% and the neonatal death rate was around 7.69%. The elements of poor maternal prognosis were the ASA IVU class (P = 0.015) and the Aldrete awakening score between 3 and 5 awakening (P = 0.001). Conclusion: Anesthesia for eclampsia at CHU of Bouake is difficult. It needs to be improved thanks to better equipment of the health structures.展开更多
Objective: To describe the practice of artificial ventilation (VA) in a resuscitation unit of a developing country with a view to its improvement. Patients and Methods: Prospective study for descriptive and analytical...Objective: To describe the practice of artificial ventilation (VA) in a resuscitation unit of a developing country with a view to its improvement. Patients and Methods: Prospective study for descriptive and analytical purposes, carried out in the intensive care unit of the University and Hospital Center of Treichville (Ivory Coast) from April 2009 to June 2010. All the patients having benefited from a artificial ventilation for a duration greater than 6 hours were included in this study. The studied parameters were: Socio-demographic (age, sex), diagnostic, therapeutic (indications, duration and complications of artificial ventilation), evolutionary. Results: Out of a total of 204 admissions during the study period, 81 patients received artificial ventilation, an incidence of artificial ventilation in the order of 39.7%. There were 49 men and 32 women. The ventilated patients had an average age of 43.9 years (range: 4 years and 85 years). Pathologies requiring artificial ventilation were neurological (46%) and traumatic (28%). Stroke was the leading medical condition (65%) while polytrauma was the major traumatic condition (65%). The most commonly used ventilatory modes were controlled volume ventilation (52.4%) and assisted ventilation (34.9%). The mean duration of artificial ventilation was 5.98 ± 3.73 days (range: 1 day and 21 days). The nosocomial pneumonia acquired under mechanical ventilation (PAVM) constituted 27% of the complications observed under artificial ventilation. The average length of ICU stay for all ventilated patients was 9.85 +/- 7.51 days (range: 1 day and 31 days). The lethality in our series was 80%. Patient age was the only prognostic factor associated with death (P = 0.003). Conclusion: The practice of artificial ventilation is still difficult in Ivory Coast and is at the origin of many complications such as nosocomial pneumonia acquired under mechanical ventilation which complicate the life threatening of the patients.展开更多
文摘Introduction: Eclampsia is a common cause of maternal mortality in developing countries. The objective of this study is to evaluate the practice of anesthesia for eclampsia in tropical Africa. Patients and Methods: Retrospective descriptive study on the parturients who benefited from eclampsia anesthesia in the operating theaters of the gynecology and obstetrics department, the University Hospital Center (CHU) of Bouake over a two-year period (January 2015 to December 2016). The parameters studied were: anesthetic risk assessment, anesthetic management, immediate anesthetic and post-anesthetic accidents and incidents. Results: Out of a total of 3831 emergency cesarean sections, 65 were for eclampsia, or 1.69% of obstetrical surgical activity. The mean age of the patients was 20.30 ± 3.34 years (range: 14 years and 39 years). Prenatal consultation was not performed in 70% of cases and 85% of patients were primiparous. Patients classified as ASA IIIU accounted for 75% of the population and in 62% of cases, the Glasgow score was between 9 and 12. Induction was achieved with thiopental in 98% of patients and vecuronium was the only muscle relaxant used. The most common fetal complications were hypotrophy (50%), prematurity (30%) and respiratory distress (40%). Postoperative anesthetic complications were agitation (70%) and wake delay (15%). Maternal mortality was 5% and the neonatal death rate was around 7.69%. The elements of poor maternal prognosis were the ASA IVU class (P = 0.015) and the Aldrete awakening score between 3 and 5 awakening (P = 0.001). Conclusion: Anesthesia for eclampsia at CHU of Bouake is difficult. It needs to be improved thanks to better equipment of the health structures.
文摘Objective: To describe the practice of artificial ventilation (VA) in a resuscitation unit of a developing country with a view to its improvement. Patients and Methods: Prospective study for descriptive and analytical purposes, carried out in the intensive care unit of the University and Hospital Center of Treichville (Ivory Coast) from April 2009 to June 2010. All the patients having benefited from a artificial ventilation for a duration greater than 6 hours were included in this study. The studied parameters were: Socio-demographic (age, sex), diagnostic, therapeutic (indications, duration and complications of artificial ventilation), evolutionary. Results: Out of a total of 204 admissions during the study period, 81 patients received artificial ventilation, an incidence of artificial ventilation in the order of 39.7%. There were 49 men and 32 women. The ventilated patients had an average age of 43.9 years (range: 4 years and 85 years). Pathologies requiring artificial ventilation were neurological (46%) and traumatic (28%). Stroke was the leading medical condition (65%) while polytrauma was the major traumatic condition (65%). The most commonly used ventilatory modes were controlled volume ventilation (52.4%) and assisted ventilation (34.9%). The mean duration of artificial ventilation was 5.98 ± 3.73 days (range: 1 day and 21 days). The nosocomial pneumonia acquired under mechanical ventilation (PAVM) constituted 27% of the complications observed under artificial ventilation. The average length of ICU stay for all ventilated patients was 9.85 +/- 7.51 days (range: 1 day and 31 days). The lethality in our series was 80%. Patient age was the only prognostic factor associated with death (P = 0.003). Conclusion: The practice of artificial ventilation is still difficult in Ivory Coast and is at the origin of many complications such as nosocomial pneumonia acquired under mechanical ventilation which complicate the life threatening of the patients.
