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Biomedical subjects

D Robert

Publications and source records attributed to D Robert.

At least 253 records · Page 14Linked to original sources
PubMed1983

[Comparison of high-frequency jet ventilation and conventional ventilation in the adult respiratory distress syndrome].

Sixteen adult patients with respiratory distress syndrome requiring mechanical respiratory assistance entered this study, the purpose of which was to obtain the same blood gas values under high frequency jet ventilation as under conventional ventilation. When high frequency jet ventilation without spontaneous breathing was compared to continuous positive pressure ventilation, peak airway pressure was the same, but mean airway pressure, positive end-expiratory pressure and pleural pressure were higher and cardiac index lower. When high frequency jet ventilation with spontaneous breathing was compared to intermittent mandatory ventilation, peak airway pressure was lower, mean airway pressure and positive end-expiratory pressure were higher, and pleural pressure and cardiac index were not different.

Adult↗
PubMed1983

Simultaneous variations of PaCO2 and PACO2 in assisted ventilation.

Thirty-two patients receiving artificial ventilation of the lungs were studied to determine if variations in PACO2 could be reflected in variation in PaCO2. Eleven patients had chronic obstructive lung disease, eight had suffered acute respiratory failure, and 13 had neurological disturbances but normal lungs. PaCO2 and PACO2 were measured concurrently as ventilatory patterns, haemodynamic state or inspired gas concentrations changed. Neither change in inspired oxygen concentration nor change in haemodynamic state had much effect PaCO2 or PACO2. Change in PaCO2 induced by ventilatory change and by change in inspired carbon dioxide concentration were well described by linear regression of PaCO2 on PaCO2. In patients with chronic lung disease, (PaCO2-PACO2) was the same at all values of PACO2 whereas, in the other patients the ratio PaCO2/PACO2 did not change.

Adult↗
PubMed1983

Static pressure-volume curves and effect of positive end-expiratory pressure on gas exchange in adult respiratory distress syndrome.

Fifteen patients with adult respiratory distress syndrome (ARDS) were studied: 11 in the early stage of ARDS (group 1); 4 in the late stage (group 2). The inspiratory and expiratory static pressure-volume (P-V) curves of the respiratory system were compared to the pulmonary shunt (Qsp/Qt) when PEEP was increased; cardiac output was kept constant. In group 1 patients, we found that a concavity on the P-V curves was associated with an abrupt decrease in Qsp/Qt when PEEP was increased; the concavity on the expiratory curve was correlated with the change in Qsp/Qt but not the concavity on the inspiratory curve. In group 2 patients, the P-V curves were found rectilinear and Qsp/Qt was not abruptly decreased when PEEP was increased. Expiratory P-V curve can be used to determine: first, whether a patient should be ventilated with PEEP; second, the PEEP level which can be set on the respirator. In group 1 patients, when PEEP was set to a value corresponding to the inflexion point, i.e., the point of departure from the exponential shape (mean value 14.6 +/- 2.8 cm H2O), Qsp/Qt compared to zero PEEP was abruptly decreased to 87.6 +/- 6%; further increase in PEEP had little advantage.

Adolescent↗
PubMed1983

[Permanent mechanical ventilation at home via a tracheotomy in chronic respiratory insufficiency].

This study describes our experience from 1960 onwards of 222 patients suffering from terminal chronic respiratory failure; we report our results of domiciliary mechanical ventilation for 11-17 hours per day using tracheotomy. The method was easy to use at home at a reasonable cost and was far less than in a medical environment. The results were excellent both for length of survival and quality of life for all cases where respiratory failure was due to chest wall problems (neurological, muscular or restrictive syndromes due to chest deformity). The majority of cases were sequelae of polio, myopathies, kyphoscoliosis or tuberculosis. The results were less good for patients with intrinsic pulmonary disease such as chronic airflow obstruction; for this the superiority of mechanical ventilation compared to long term oxygen therapy is not proven. The results were very poor for patients suffering from bronchial dilatation. However, a positive correlation between the efficacy of the method and the duration of a normal PaO2 during a 24 hour period seemed to exist, both during periods of mechanical ventilation and weaning from the machine.

Adolescent↗
PubMed1982

[Sensitivity of 1041 strains of bacteria obtained from an intensive care unit with regard to aminoglycosides].

Antibiotic treatment of infections due to opportunistic organisms often involves an aminoglycoside/bêta lactamine combination. In order to help in the selection of the aminoglycoside used, a statistical study was made of 1041 strains of organisms obtained from an intensive care unit to 4 aminoglycosides: gentamicin, amikacin, tobramycin and dibekacin. These included Gram negative bacilli (enterobacteria, pseudomonas, acinetobacter) and staphylococci. The study showed amikacin to be the most suitable aminoglycoside for prescription in an infection threatening the vital prognosis in the short term and where the organism has not been identified. In non-threatening infections when the organism has not been identified, gentamicin, tobramycin or dibekacin should be used in preference to amikacin. For any type of infection, once the organism has been identified, amikacin should only be used if it is the only effective agent. When the organism is equally sensitive to gentamicin, tobramycin and dibekacin the choice of drug should take into account the known potential toxicities of each drug.

Amikacin↗
PubMed1982

[Dibekacin in the treatment of septicemia].

During an open multicentric trial (17 centers), we have treated 62 septicemia by dibekacin, alone or associated with other antibacterial drugs. Taking into account the degree of severity of these patients, the results are considered satisfactory in 47 patients. 15 failures were noted (including 9 deaths). General and local tolerance were good, in spite of the duration of treatment.

Adult↗
PubMed1982

[Dibekacin in bronchopulmonary infectious pathology].

Thirty six patients in an intensive care unit with a bacterial bronchopulmonary infection were treated with intraparenteral dibekacin at a dose of 3 mg/kg/day. Mean age of the patients was 55 years and the mean duration of treatment 14 days. Biological material was obtained by fibro-aspiration or pleural tap. One or more organisms were identified in 36 cases. These were essentially staphylococci and Gram negative bacilli sensitive to dibekacin. Results showed a favourable course in 26 cases and a clinical improvement in 10. Clinical and biological tolerance was good. No clinical manifestations of cochleo-vestibular toxicity were seen.

Adult↗
PubMed1982

[Prediction of aminoglycoside nephrotoxicity].

Mechanism of aminoglycoside nephrotoxicity is yet unclear. Reduction of 20 p. cent of glomerular filtration initial value is observed in 10 p. cent of cases. Aminoglycoside nephrotoxicity appears to be related to high doses, to duration of treatment and also to individual factors such as age and preexisting renal impairment. No mean of predicting aminoglycoside nephrotoxicity without any error is available. Meanwhile, accurate measurement of glomerular filtration and of beta 2-microglobulin urinary elimination seems clinically more usefull for detection of impaired renal function than uneasy measurement of urinary enzyme excretion and than monitoring the aminoglycosides serum concentrations.

Aminoglycosides↗
PubMed1982

Study of the mode of action of ribosomal vaccines from Klebsiella and Streptococcus pneumoniae and their ribonucleic and protein fractions using passive immunization.

The vaccinating potency of ribosomal fractions of Klebsiella pneumoniae and Streptococcus pneumoniae as well as their ribosomal RNA and protein fractions has been studied with respect to their ability to induce cellular or humoral immunity. Experiments with transfer of serum or spleen cells from vaccinated animals have shown that anti-Klebsiella immunity is essentially cellular, while streptococcal immunity is exclusively humoral. Results have been discussed as a function of differential results for the various fractions under study.

Animals↗
PubMed1982

An attempt to localize the vaccinating power of Klebsiella pneumoniae ribosomal preparations using saccharose-gradient ultracentrifugation.

The study of the vaccinating power of ribosomal vaccines against Klebsiella pneumoniae led us to define the chemical nature which supports this protective activity. We tried to separate this support and the ribosomes by sucrose gradient ultracentrifugation. We isolated high protective membrane vesicles by this technique applied to salt-washed ribosomal preparations. When the ribosomal preparations were exposed to SDS, the protective activity was conserved all along the gradient, with no correlation with the ribosome concentration. The addition of bovine serum albumin to the ribosomal preparation focused the protective activity on the ribosomal peak. No correlation was observed between the response to capsular polysaccharide and the vaccinating power of the fractions.

Ammonium Chloride↗
PubMed1982

[Prevision of aminoglycoside nephrotoxicity (author's transl)].

Mechanism of aminoglycoside nephrotoxicity is yet unclear. Reduction of 20 p. cent of glomerular filtration initial value is observed in 10 p. cent of cases. Aminoglycoside nephrotoxicity appears to be related to high doses, to duration of treatment and also to individual factors such as age and preexisting renal impairment. No mean of predicting aminoglycoside nephrotoxicity without any error is available. Meanwhile, accurate measurement of glomerular filtration and of beta 2-microglobulin urinary elimination seems clinically more useful for detection of impaired renal function than uneasy measurement of urinary enzyme excretion and than monitoring the aminoglycosides serum concentrations.

Aminoglycosides↗