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Biomedical subjects

C Saint-Marc

Publications and source records attributed to C Saint-Marc.

27 records · Page 2Linked to original sources
PubMed1984

[Hypovolemic shock caused by an increase in capillary permeability after cesarean section].

A 24 year old woman was delivered by caesarean section after an uncomplicated full-term pregnancy. Non-specific prodromes appeared 48 h later, with development of a severe shock. After confirmation of hypovolaemia, attention was focused on the abnormal haematological findings (a sharp drop in serum proteins with a rise in haematocrit) which suggested major leakage of plasma. Treatment based on infusions of plasma and albumin failed, and the patient died in a state of anasarca and pulmonary oedema with normal wedge pressure. 18 similar cases have already been published, six of which were in obstetric or surgical patients. After analysing the prodromes and its onset, its pathophysiological mechanisms and treatment are discussed.

Adult↗
PubMed1984

[A pneumatic transfusion accelerator].

A new simple device using piped medical gases for the inflation of pressure cuffs used for rapid intravenous infusions is described. The pressure cuffs are maintained inflated with piped medical oxygen delivered by an adjustable pressure regulator. Operating advantages of this device were: 1) inflation time for the cuff and infusion time for fluids kept in collapsible PVC bags (whole blood, plasma, cellular concentrates or other fluids) were considerably shortened, not requiring any manual manipulation throughout the infusion; 2) when the bag is emptied, the large bore tubing used allowed rapid deflation of the cuffs; 3) the procedure was as safe as manual acceleration of transfusion, and simpler, requiring a simple three-way stopcock.

Air Pressure↗
PubMed1984

[Neuroleptanalgesia for chemical nucleolysis].

38 cases of chemionucleolysis, under neuroleptanalgesia by droperidol-Fentanyl with spontaneous respiration are reported. This technique was satisfactory and allowed the patient to cooperate.

Adult↗
PubMed1983

Rupture of the uterus during labor without apparent cause.

Spontaneous uterine rupture at term during labor of a non-scarred uterus under epidural anaesthesia is reported in a 17-yr-old primigravida. This exceptional event may lead to catastrophic maternal and fetal consequences. The authors discuss the prevention and diagnosis of this obstetrical complication.

Adolescent↗
PubMed1983

[Epidural anesthesia using the bupivacaine-fentanyl combination for cesarean section].

This prospective study was designed to evaluate the benefit of a bupivacaine-fentanyl mixture vs bupivacaine alone in epidural anaesthesia for caesarean section. In 10 women, 0.5% bupivacaine (1.18 ml per metamer) was injected in the epidural space. In 20 women, 0.5% bupivacaine (1.06 ml per metamer) was injected by the same route together with fentanyl (1.70 +/- 0.09 micrograms X kg-1). The bupivacaine-fentanyl group showed a significantly shortened onset of analgesia (p less than 0.001), as well as a significant reinforcement of this analgesia graduated from 0 to 4 (p less than 0.01 at 25 min, p less than 0.001 at 75 min and at the maximum of pain, for the two sets of scores). All the Apgar scores were maximal at 5 min. No clinical respiratory depression was observed in either the mothers or the neonates. Fetal and maternal blood concentrations were in favour of respiratory innocuousness of the method (peak fentanyl concentrations: in mothers 1.5 ng X ml-1, in neonates 0.8 ng X ml-1). Fentanyl never induced any significant haemodynamic variations. Pruritus and nausea respectively occurred in six and two patients respectively in the bupivacaine-fentanyl group. In conclusion, in caesarean section, the adjunction of fentanyl to bupivacaine significantly improved analgesia without any clinical respiratory depression both in the mother and the neonate.

Adult↗
PubMed1982

[Torsade de pointes. Apropos of 54 cases].

A retrospective study of 54 torsades de pointe cases in a cardiology department enabled us to specify the main characteristics of this serious arrythmia often observed in intensive care units: --the diagnostic criteria: more than the pattern of tachycardia attack, late ventricular premature beats and particularly QT prolongation are necessary for proper diagnosis. These two criteria allow us to differentiate between torsades de pointe and multiform ventricular tachycardia with similar morphology especially in acute myocardial ischaemia; --their clinical repercussion: the shortness of circulatory arrest related to the spontaneous end of the arrythmia explains that the torsades de pointe often result in short faintings. Nevertheless, they may degenerate into ventricular fibrillation (17 p. 100) which, in cases of recurrence, induced four deaths in this study; --there are many possible aetiologies often associated (30 p. 100) in the same patient. Their research must be exhaustive in each case. The chronic bradycardias especially the atrioventricular blocks of two or three degree whether continuous or not are often responsible (57 p. 100). Then, the metabolic disorders, essentially hypokalaemia and constant drug administration (antiarrythmic agents belonging to group I of Vaughan William's classification, some antianginal drugs, vasodilatator drugs) are often chief causative agents. Other aetiologies are rare. In 9 p. 100 of cases, no aetiological factor is found; --the best treatment is to suppress aetiological factors, to stop the administration of antiarrhythmic drugs; torsades de pointe must be controlled by increasing the heart rate; pace maker stimulation is the best way of making QT shorter and thus of synchronizing ventricular depolarization.

Adolescent↗