Search PubMed⌕ Search

Biomedical subjects

C Bismuth

Publications and source records attributed to C Bismuth.

At least 109 records · Page 6Linked to original sources
PubMed1980

Biological evaluation of hemoperfusion in acute poisoning.

The efficiency of Hemoperfusion in acute poisoning cannot be clinically estimated, because: a) concomitant intestinal absorption, hepatic metabolism and urinary excretion must be taken into account. b) with supportive treatment alone, spontaneous recovery usually occurs in 98% of the intoxications in Intensive Care Units. The efficiency of hemoperfusion can only be estimated biologically. Measuring the blood level at the beginning and the end of hemoperfusion as well as measuring the clearances of the drug is misleading. A better method is to measure the amount of extracted drug, either indirectly by calculation (form hourly differences of arterio-venous measures of drug concentration multiplied by the blood flow) or directly by elution of the cartridge. In a practical way, if the blood level of drug is readily available after the patient is hospitalized, the optimum efficiency of hemoperfusion can be estimated beforehand, so that the decision to carry out the hemoperfusion can be maintained, postponed or abandoned. For the most part, the experience of toxicologists has shown hemoperfusion to be ineffective for drugs with weak extra-cellular distribution (such as Digitoxin, Tricyclic drugs, Heavy Metals, Colchicine). Its effectiveness for certain drugs, with poor in vitro dialysance (such as Paracetamol) or with small percentage of intestinal absorption (such as Paraquat) is still debatable. In the case of intoxications by hypnotic drugs, one hemoperfusion allows an average of 4 - 12% of the ingested medium and short barbiturates, 7 - 17% of the ingested Meprobamate. Whether these results can be judged satisfactory, life-saving or insignificant is largely a matter of personal standards.

Barbiturates↗
PubMed1979

[Haemoperfusion on coated activited charcoal. Experience in French anti-poison centres based upon 60 cases (author's transl)].

Sixty three sessions of haemoperfusion on coated activated charcoal were carried out in 60 cases of poisoning. The indications concerned 2 clinical situations: - massive poisoning with coma (by hypnotics or chlorine-containing solvents) with high extracellular concentrations of the toxic agent, with the aim of reducing the duration of the coma; - intoxications with a high mortality rate, such as those due to paraquat, colchicine, digitoxine, tricyclic antidepressants, and heavy metals, even when plasma levels were low in relation to the dose ingested. Such discordance may be related not only to predominantly intracellular fixation, but also to low intestinal absorption. The effectiveness of haemoperfusion was estimated in terms of the amount of toxic substance extracted, measured either indirectly by repeated calculation of the arteriovenous difference multiplied by the flow rate through the column, or directly by elution of the column. This method for the removal of toxic substances would not appear to be life-saving, is too costly for the extraction obtained and is not free from specific complications. Thrombocytopaenia remains an epiphenomenon, but the frequency of infection is significantly higher than with haemodialysis. An effective and safe method for the vascular extraction of poisons, particularly one favourising removal of toxic substances from intracellular localisation, remains to be found.

Antidepressive Agents, Tricyclic↗
PubMed1979

[Acute tubular necrosis in acute alcoholic hepatitis with cardiac beriberi (author's transl)].

In one case of fulminant hepatic failure by acute alcoholic hepatitis, renal failure seemed to be related to active renal vasoconstriction by systemic endotoxemia due to impaired hepatic clearance of toxins, associated with or complicated by a located intravascular coagulation with acute tubular necrosis. The associated thiamin deficiency may have accentuated this renal vasoconstriction.

Acute Disease↗
PubMed1977

[Medullary aplasia after acute colchicine poisoning. 20 cases].

Out of 84 patients with colchicine poisoning hospitalised between 1966 and 1976, 11 died during the first 72 hours. Amongst the 73 survivors, 20 showed signs of marrow aplasia between the 3rd and 6th days, lasting on average 4 days. The average amount of colchicine ingested by these patients was 0.5 to 0.8mg/5g. Marrow aplasia was associated with: -- infectious episodes in all cases, -- haemorrhage in 50%, -- dilution hyponatraemia in 25% (but in 50 % of patients if those in renal failure are excluded), -- regressive polyneuropathy in 10 % of cases, -- secondary alopoecia in all cases, -- weight loss of more than 10 % of initial weight in 60 %. Two patients died as a result of septicaemia. This mortality rate of 10 per cent despite the brief duration of the aplasia and the absence of underlying haematological disease would appear to be related to the susceptibility of these poisoned patients to endogenous secondary infections, essentially intestinal in origin.

Adolescent↗