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Biomedical subjects

F Beaufils

Publications and source records attributed to F Beaufils.

At least 73 records · Page 4Linked to original sources
PubMed1988

Hemodynamic patterns of meningococcal shock in children.

Meningococcal shock still is associated with high mortality. Along with antibiotics and control of metabolic derangements, standard therapy involves monitoring and maintaining numerous cardiorespiratory variables. From 1980 to 1985, 39 children with meningococcal shock were treated in our pediatric ICU. We obtained full hemodynamic monitoring in 18 (12 survivors, six nonsurvivors). Two hemodynamic patterns were observed: hypovolemia and cardiac failure. Early death was generally related to refractory hypovolemia, probably secondary to severe capillary leak. Survival usually occurred when noticeable cardiac failure was controlled with early use of catecholamines and judicious fluid management. Because cardiac failure only slowly recovered, a therapeutic approach that aims not at normal variables but, rather, at survival variables seems appropriate.

Blood Volume↗
PubMed1988

Optimization of oxygen transport in mechanically ventilated newborns using oximetry and pulsed Doppler-derived cardiac output.

In respiratory distress syndrome (RDS), PEEP improves arterial oxygenation but may impair cardiac output. The effects of PEEP on gas exchange and hemodynamics were studied in 12 mechanically ventilated newborns in the acute phase of RDS. Stepwise increase in PEEP resulted in both a) a progressive increase in PaO2 and transcutaneous oxyhemoglobin saturation, and b) a depression of pulsed Doppler-measured cardiac output that was statistically significant at 9 cm H2O PEEP. Thus, averaged systemic oxygen delivery (DO2) was maintained with improved arterial oxygenation up to 6 cm H2O PEEP. Further increase in PEEP induced a significant fall in DO2. No variation was observed in heart rate and mean arterial pressure. The combined use of oximetry and pulsed Doppler echocardiography enables noninvasive optimization of mechanical ventilation and PEEP during the clinical course.

Acute Disease↗
PubMed1988

[Agglutination of intravenous lipid emulsions by acute phase proteins of inflammation].

Agglutination of intravenous fat emulsions (IVFE) by sera of acutely ill children was studied in vitro in 23 patients. C-Reactive protein (CRP) has been showed to agglutinate with IVFE; after discarding CRP, serum of acutely ill patients still agglutinate with IVFE. The agglutination score in generalized sepsis is significantly highest than in localized sepsis. We studied agglutination during three periods: first days of treatment by antibiotics (period 1), between the fourth day and the end of treatment (period 2), and after the end of treatment (period 3). In period 2, when orosomucoid concentrations; nevertheless, the observation of an agglutination in periods 1 and 3 where the mean orosomucoid level is within normal range, strongly suggests that one or more others acute phase proteins are also involved in occurrence of agglutination.

Agglutination↗
PubMed1988

[Contribution of bactericidal rate in the initial treatment of severe staphylococcal infections in children].

Rapid bactericidal effect is essential for therapy of severe Staphylococcus aureus infections in children. The in vitro activity of clinically achievable levels of vancomycin and its combinations with gentamicin, amikacin and rifampin plus amikacin was studied with the time-kill curve method at 2.5, 4, 6, 24 and 48 hours against 20 strains of Staphylococcus aureus isolated from children with severe staphylococcal infection. Vancomycin alone exerted a bactericidal effect at 48 hours. However, with the combinations vancomycin plus gentamicin, vancomycin plus amikacin and vancomycin plus amikacin plus rifampin a bactericidal effect was respectively observed at 24, 6 and 4 hours. Most rapid killing was achieved with vancomycin plus rifampin plus amikacin. Thus this antibiotic combination seems the most appropriate for initial treatment of severe staphylococcal infections in children.

Anti-Bacterial Agents↗
PubMed1987

Evaluation of pediatric intensive care in Europe. A collaborative study by the European Club of Pediatric Intensive Care.

There are no reports analyzing the results of pediatric intensive care in Europe. We evaluated quantitatively the severity of illness and the amount of care required for 714 consecutively admitted patients. We used simultaneously the Clinical Classification System (CCS) the Acute Physiology Score (APS) and the Therapeutic Intervention Scoring System (TISS). Overall mortality at 1 month was 15%. The mortality rate was higher for CCS Class IV patients (32.3%) than for CCS III (4.5%) and CCS II (3.2%). The difference was significant between CCS IV and CCS III and II respectively (p less than 0.001) but no difference was observed between CCS III and CCS II. The patients were also classified among 7 major organ system failures: cardio vascular, respiratory, neurologic, gastro intestinal, renal, metabolic, hematologic. Three of them were primarily involved: respiratory (44.9%) cardio-vascular (20.7%), neurologic (18.8%). Among these 3 groups the highest mortality was observed in cardio-vascular patients (p less than 0.01 v.s. respiratory, p less than 0.05 v.s. neurologic). The death rate was 22% among the 264 neonates, 9.7% among the 247 infants (p less than 0.01) and 12.6% among the 198 children. APS and TISS scores increased significantly with the CCS classes.(ABSTRACT TRUNCATED AT 250 WORDS)

Child↗
PubMed1986

[Value of bactericidal curves in the optimal selection of a beta-lactam-aminoglycoside combination on Pseudomonas aeruginosa. In vitro study of 40 strains of Pseudomonas aeruginosa isolated in pediatric intensive care units].

Antimicrobial sensitivity and time-kill curves were determined for ticarcillin, azlocillin, piperacillin, cefsulodin, ceftazidime, gentamicin, tobramycin and amikacin alone or in combination against 40 strains of Pseudomonas aeruginosa isolated from blood cultures and tracheal aspirates in pediatric intensive care units. The antibiotics were used in concentrations obtainable with the usual therapeutic dosage. No bactericidal effect was observed with each of the beta-lactam antibiotics tested alone. For ticarcillin-sensitive strains the most rapid bacterial inoculum size decrease was observed at 2.5 h with the piperacillin-amikacin combination, and a bactericidal effect was obtained within 4.5 h when amikacin was combined with ticarcillin, azlocillin, piperacillin, ceftazidime or cefsulodin. For ticarcillin-resistant strains a bactericidal effect was obtained within 4.5 h when amikacin was combined with piperacillin, azlocillin, ceftazidime or cefsulodin.

Amikacin↗
PubMed1986

[Choice of a rapidly bactericidal beta-lactamin-aminoglycoside combination in the treatment of Pseudomonas aeruginosa infections at a child intensive care unit].

Morbidity and mortality among children with Pseudomonas aeruginosa infection in Pediatric Intensive Care Unit remains high. Delays in bacterial killing may be responsible for the poor outcome. Antimicrobial sensitivity and timed-killing assays were determined for ticarcillin, azlocillin, piperacillin, cefsulodin, ceftazidime, gentamicin, tobramycin and amikacin alone and in combination against 40 strains of Pseudomonas aeruginosa isolated from blood cultures and tracheal aspirate. Antibiotic concentrations used were at clinically achievable level. None bactericidal effect was observed with each beta-lactamin alone. However with the combinations azlocillin or piperacillin or cefsulodin or ceftazidime plus amikacin a bactericidal effect was observed at 4.5 hours.

Aminoglycosides↗
PubMed1985

Urokinase treatment of pulmonary artery thrombosis complicating the pediatric nephrotic syndrome.

Two pediatric patients with severe pulmonary thrombosis complicating a lipoid nephrosis were treated with urokinase administered either as a continuous infusion or in massive bolus doses. Both patients recovered but one died suddenly 2 yr later after recurrence of the nephrotic syndrome and probably new massive pulmonary thrombosis. These patients had severe abnormalities of hemostasis and fibrinolysis, which favored thrombosis and complicated fibrinolytic treatment.

Child↗
PubMed1984

[Neonatal syphilis despite erythromycin treatment of the mother].

A one-month old infant whose mother had been treated with erythromycin during pregnancy exhibited signs of severe congenital syphilis with collapse requiring admission to an intensive care unit. Erythromycin has low placental transfer and other treatments would have probably been more adequate. Some authors advocate the use of the latest tetracyclines and doxycycline could also be administered. The WHO's recommendations that all children born of mothers who were not treated with penicillin should receive this antibiotic after birth is still valid.

Erythromycin↗