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Biomedical subjects

E Weitzenblum

Publications and source records attributed to E Weitzenblum.

204 records · Page 12Linked to original sources
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[Regional pulmonary function in hemidiaphragmatic paralysis (author's transl)].

Gaseous exchange and regional pulmonary function (using 133Xe) were studied in 10 subjects with hemidiaphragmatic paralysis; the paralysis was presumably idiopathic in nine subjects. Global and regional investigations were performed on the same morning, the subjects being studied in the sitting position. Six subjects were obese; nevertheless overweight was moderate except in one case. Lung volumes were moderately decreased (vital capacity ranged from 69 to 100 percent of the predicted value). PaO2 was normal or nearly normal: mean = 75.8 +/- 7.5 torr in the sitting position. PaO2 did not vary significantly in the supine, nor in the lateral recumbent position. AaDO2, breathing air or during hyperoxia, was slightly increased. Qs/Qt was markedly increased in only three cases. Regional lung function data suggest that the paralysed side still plays an appreciable part in pulmonary volume (43.5 +/- 6.3 percent), ventilation (39.1 +/- 8.2 percent) and perfusion (40.4 +/- 9.3 percent). Impairment of the paralysed side was mainly localized in the lower zone; in the middle zone only ventilation was significantly reduced. Results of regional ventilation and perfusion, expressed as absolute values, suggest a redistribution of ventilation and perfusion from the base towards the apex, not only for the paralysed side but also for the opposite side. This adjustment is probably due to the hemidiaphragmatic paralysis but the possible role of obesity (present in six cases) must be kept in mind. Possible therapeutic deductions are discussed.

Aged↗
PubMedDate not supplied

[Pulmonary hemodynamic effects of intravenous almitrine in patients with chronic bronchitis and respiratory insufficiency].

The effects on ventilation, gas exchange and pulmonary haemodynamics of 1 h infusion of 0.5 mg X kg-1 almitrine (Vectarion) were studied in 14 patients with chronic bronchitis, with clear hypoxemia (PaO2 less than 65 mmHg) and hypercapnia (PaCO2 greater than or equal to 45 mmHg). The separate effects of the almitrine solvent and/or the solution were studied in six similar chronic bronchitics. In this latter group, blood gases and haemodynamic values were not significantly altered. In subjects treated with almitrine, PaO2 raised from 51.9 +/- 6.6 (control: T0) to 61.9 +/- 9.9 mmHg at the 60th min (t60) of infusion (p less than 0.001); PaCO2 decreased from 52.8 +/- 6.3 (t0) to 45.7 +/- 5.2 mmHg at t60 (p less than 0.001). The effects on blood gases were still marked 10 min after infusion (t70). The significant increase in PaO2 was faster (10th min) than that of PaCO2 (20th min). The mean pulmonary artery pressure (Ppa) rose appreciably, from 27.8 +/- 11.3 at t0 to 35.5 +/- 12.5 mmHg at t60 (p less than 0.001). This rise was significant from the 10th min (p less than 0.005) and was related to that of pulmonary vascular resistance since on average cardiac output and pulmonary wedge pressure did not change. Ppa came back to its initial value at t70. Thus pulmonary vasoactive effects were at the same time early and transitory. They seemed due to an arterial vasoconstriction (role of chemoreceptors?), which could also explain the perfusion redistribution to the best ventilated areas and the improvement of VA/Q inequalities.

Adult↗
PubMedDate not supplied

Echocardiographic aspects of pulmonary arterial hypertension in chronic lung disease.

An echocardiographic M-mode study has been performed on 58 patients with pulmonary arterial hypertension at rest or on exercise, with chronic lung disease, either obstructive (41 cases of COLD) or restrictive (17 cases of interstitial lung disease, ILD) in nature. The average Ppa was practically the same (i.e. 27.3 +/- 11.7 mmHg and 26.0 +/- 8.0 mmHg respectively) in the two groups of patients, even though the COLD patients were older than the ILD patients (58.7 +/- 9.3 vs 38 +/- 11 years). The echo detection of the pulmonary valve was successful in only 35% of COLD patients and in 86% of ILD patients (p less than 0.01). A multiple regression analysis disclosed a rather weak, but nevertheless statistically significant, correlation (p less than 0.01) between 1) Ppa and the ratio of right ventricular to left ventricular end-diastolic volume, and 2) between right ventricular end-diastolic pressure and septal systolic displacement. The standard error of estimated versus actual Ppa taking into account the ventricular and septal echo variables was as high as +/- 7.63 mmHg, thus preventing a reliable prediction of Ppa in individual cases. An echocardiographic pattern of pansystolic mitral valve prolapse was observed in 29% of ILD patients, but never in cases with COLD.

Cardiac Output↗