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Biomedical subjects

D Morel

Publications and source records attributed to D Morel.

83 records · Page 5Linked to original sources
PubMed1981

[An automatic non-invasive method for the measurement of systolic, diastolic and mean blood pressure].

A new automatic apparatus for the measurement of arterial pressure by a non-invasive technique was compared with direct intra-arterial measurement in 20 adult patients in a surgical intensive care unit. The apparatus works on the basis of the principle of oscillometry. Blood pressure is determined with a microprocessor by analysis of the amplitude of the oscillations produced by a cuff which is inflated then deflated automatically. Thus mean arterial pressure corresponds to the maximum amplitude. Systolic and diastolic pressures are deduced by extrapolation to zero of the amplitudes on either side of the maximum reading. Mean arterial pressure (AP) proved to be very reliable within the limits studied: 8.0 - 14.7 kPa (60 - 110 mmHg) with a difference in mean direct AP and indirect AP of 0,09 +/- 0.9 kPa SD (0.71 +/- 7 mmHg) and a coefficient of linear correlation between the two methods of r = 0.82. This non-invasive technique determined systolic arterial pressure (sAP) in a less reliable fashion than AP when compared with the invasive technique, with a tendency to flatten the extreme values. The correlation coefficient here was 0.68. Finally, diastolic arterial pressure (dAP) showed a better degree of agreement through with a difference in mean indirect AP and mean direct AP of 1.0 +/- 0.8 kPa (7.6 +/- 6.0 mmHg). These results indicate a good degree of agreement for measurements of mean arterial pressure, clinically the most important, between the two methods used. Measurements of diastolic pressure and above all of diastolic pressure seemed to be less in agreement. This difference could be due to an error in determination of the automatic apparatus tested or to the peripheral site (radial artery) of the intra-arterial catheter used, itself falsifying the humeral arterial pressure.

Blood Pressure Determination↗
PubMed1981

[Comparative study of sequential analgesic anesthesia (SAA) with continuous-infusion analgesia by fentanyl].

A group of elderly (mean age: 75 years) patients undergoing a prothetic on the hip under analgesic anaesthesia using fentanyl by continuous infusion (7 micrograms.kg.h(-1)) was compared with a similar group receiving sequential analgesic anaesthesia using fentanyl (25 micrograms.kg as a bolus then 7 micrograms.kg(-1).2030mins(-1)). Comparison of the results obtained revealed a variation in mean cardiocirculatory parameters which was less marked in the group receiving fentanyl by infusion than in the group receiving it sequentially. The higher doses used in the sequential analgesia group led in the majority of cases to severe respiratory depression requiring its reversal by an antagonist or postoperative ventilatory assistance, whilst the use of fentanyl by infusion made it possible to reduce total doses of the drug and ensure adequate spontaneous respiration at the end of the operation.

Aged↗
PubMed1981

Comparative haemodynamic and respiratory effects of midazolam and flunitrazepam as induction agents in cardiac surgery.

30 cardiac surgical patients were investigated for comparing the respiratory and haemodynamic repercussions of induction of anaesthesia with either flunitrazepam or 8-chloro-6-(2-fluorophenyl)-1-methyl-4H-imidazo[1,5-a] [1,4]benzodiazepine (midazolam, Ro 21-3981, Dormicum). The patients were premedicated with morphine, 0.15 mg/kg i.m., and divided into two groups: one group receiving flunitrazepam 0.03 mg/kg, the other midazolam 0.15 mg/kg injected i.v. over a 15-s period. The induction time and the respiratory depression were similar in both groups. A similar decrease in systolic, diastolic and mean arterial pressures was noted, with maximum decrease of mean arterial pressure of 21% 5 min after injection of flunitrazepam, and of 19% after injection of midazolam. Midazolam produced a significant but transient pulse acceleration of 4% 1 min after the injection, while flunitrazepam produced a moderate decrease of the heart rate. These results indicate that in cardiac surgical patients midazolam produces a moderate respiratory and cardiovascular depression similar to flunitrazepam.

Adult↗
PubMed1980

[Laryngotracheal stenosis treated by the Rethi operation : anatomical and functional (respiratory and vocal) results (author's transl].

On the basis of 25 cases of laryngotracheal stenosis of mescellaneous etiology, the authors report their experience of Rethi's operation carried out in 14 cases, 8 patients having received medical and instrumental treatment, 1 undergoing surgery for resection and anastomosis according to Pearson's technique and 3 receiving symptomatic treatment by tracheotomy because of inoperable stenosis. The frequency of postop-operative complications of Rethi's operation was analysed (essentially infectious, but also as a result of obstruction of the calibration prosthesis which represents a definite vial risk). Functional results were also assessed, being relatively satisfactory from a respiratory functional standpoint, but less good from a phonetic standpoint. The authors then define their present therapeutic attidude which leans, in the case of pure sub-glottal and sub-glotto-tracheal stenosis, towards a direct approach with resection anatomosis according to Pearson's technique rather than calibration procedures which remain the treatment ofa choice for glotto-sub-glottal stenosis.

Adolescent↗
PubMedDate not supplied

[Nyctohemeral variations of cyclosporine administered orally in renal transplant patients].

The circadian intraindividual variations of cyclosporin blood concentrations were studied in nine renal transplant patients at steady state. The cyclosporin was administrated orally twice a day (9 a.m. and 21 p.m.). Blood concentrations were analysed by H.P.L.C. AUC = area under the drug concentration versus time curve, Cmax = maximum blood concentration, Cmin = minimum blood concentration, Tmax = Time to maximum concentration. Statistical analysis (t, Wilcoxon) shows: AUC, Cmax and Tmax are not significantly modified, Cmin (21) less than Cmin (9) (p less than 0.02). This phenomenon seems to be rather a cyclosporin metabolism variation than an absorption alteration.

Administration, Oral↗
PubMedDate not supplied

[Per- and postoperative buprenorphine analgesia: cardiocirculatory and respiratory effects].

In 25 non-premedicated patients, buprénorphine (5 micrograms/kg - 1) has been injected i.v. 30 mn before coelioscopic sterilization under general anaesthesia. Following the i.v. injection there no significant modification of the arterial systolic and diastolic blood pressure was observed but post-operative bradycardia. Tidal volume and minute/ventilation decreased whereas the respiratory rate remained stable. Arterial blood gaz analysis showed slightly hypoxaemia and a significant rise of PaCO2 with post-operative acidosis similar to that in the control group. Good postoperative analgesia was achieved but with profound sedation and a high incidence of nausea and vomiting.

Adult↗