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F Beaufils

Publications and source records attributed to F Beaufils.

144 records · Page 8Linked to original sources
PubMedDate not supplied

Effect of amnioinfusion on the outcome of prenatally diagnosed gastroschisis.

OBJECTIVE: Following recent data showing that an inflammatory response exists in the amniotic fluid of gastroschisis-affected fetuses, we hypothesized that amniotic fluid exchange or amnioinfusion would improve the prognosis of prenatally diagnosed gastroschisis. METHODS: We compared the outcome of prenatally amnioinfused fetuses with gastroschisis to non-amnioinfused fetuses with gastroschisis. 10 patients undergoing this procedure were matched with 10 patients of our previous study. Comparisons were done on data including surgical procedure, follow-up in the NICU and the gastro-pediatric unit. RESULTS: Our results show that gastroschisis-affected fetuses undergoing amnioinfusion had a lower duration of curarization after surgery (2.2 +/- 1.9 vs. 6.8 +/- 6.9 days, p = 0.019), a shorter delay before full oral feeding (49.7 +/- 21.5 vs. 72.3 +/- 56.6 days, NS), and a shorter overall length of hospitalization (59.5 +/- 19.7 vs. 88.5 +/- 73.6 days, NS). We confirmed our previous data showing that amniotic fluid displays a chronic inflammation profile. CONCLUSION: Our data suggest that amnioinfusion could improve the outcome of gastroschisis affected fetuses. The hypothesis by which this improvement could be due to a reduction of an inflammatory response remains to be proved.

Adult↗
PubMedDate not supplied

[Prognosis factors in severe bronchopulmonary dysplasia. A retrospective study of 65 premature infants with bronchopulmonary dysplasia].

The annual incidence of bronchopulmonary dysplasia (BPD) is presently 1.3 case p. 1,000 alive births. The most severe forms of BPD are characterized by a prolonged oxygen-dependence and a spontaneous evolution marked by numerous complications which could be life-threatening. We studied retrospectively 65 premature infants with BPD who underwent ventilation for one month or more during the first weeks of life. Comparison between survivors and children deceased during the first year of life allowed for discerning 5 prognostic criteria: the nature and severity of initial respiratory disease, the respiratory improvement during the first trimester, the results of hematosis by age 3 months, the ability of maintaining and increasing the respiratory improvement while reducing the therapeutic management, the weight and head circumference gains. The respective parts and conditions of oxygen therapy and prolonged mechanical ventilation in severe cases of BPD are discussed.

Age Factors↗
PubMedDate not supplied

[Breast feeding and hypernatremic dehydration. 3 case studies].

Despite the well-recognized advantages of breast-feeding, a rare but life-threatening complication may occur with failure to thrive resulting in severe malnourishment or hypernatremic dehydration. We report 3 more cases. Two of them with severe hypernatremic dehydration and cachexia were treated using peritoneal dialysis rather than intravenous fluids in order to rapidly correct the severe metabolic acidosis but slowly the serum osmolarity. Although insufficient breast-milk volume appears to prevail over positive sodium balance in the pathway to hypernatremic dehydration, high sodium concentrations were found in breast milk as previously reported. However, the discovery of a low lactose content inversely related to that of sodium in breast-milk, suggests more complex disturbances in lactation and may draw up new hypothesis in the pathogenesis of this challenging syndrome.

Breast Feeding↗
PubMedDate not supplied

[Total abnormal pulmonary venous return. Preoperative stabilization by extracorporeal veno-venous circulation].

BACKGROUND: Total anomalous pulmonary venous return (TAPVR) is a rare congenital cardiac disease. When this includes pulmonary artery hypertension, the infant is severely ill. Survival beyond infancy is rare without surgical correction. CASE REPORT: A girl in whom hydramnios and a short femur were discovered by ultrasonography at the 25th week of gestation was admitted to the intensive care unit a few hours after birth because of respiratory distress. Blood PaO2 was 37 mmHg, PaCO2, 36 mmHg, and pH 7.25. She had tachycardia (190/min) and circulatory insufficiency. Echocardiography showed right ventricular overload, a right-to-left shunt through a patent ductus arteriosus and foramen ovale and tricuspid insufficiency. This refractory hypoxemia was not corrected by conventional respiratory support, high-frequency oscillation plus dobutamine and dopamine followed by noradrenaline infusion. Because of further deterioration, the baby was given extracorporeal lung support; this rapidly improved the respiratory and hemodynamic conditions. Persistent pulmonary artery hypertension led to a second investigation that showed TAPVR She underwent emergency surgery. CONCLUSION: Extracorporeal lung support can stabilize a precarious state in a case of severe congenital cardiac disease, so allowing surgical treatment under satisfactory conditions.

Emergencies↗