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Biomedical subjects

G Offenstadt

Publications and source records attributed to G Offenstadt.

At least 91 records · Page 5Linked to original sources
PubMed1989

Pharmacokinetics of intravenous salbutamol in renal insufficiency and its biological effects.

Salbutamol was administered intravenously to 5 patients with renal function impairment for estimation its pharmacokinetic parameters. The mean terminal half-life was 256 min, similar to previously reported values in healthy adults. The mean clearance (167 ml/min) and the mean volume of distribution (551) were decreased. These parameters were not correlated with the creatinine clearance. A slight but significant decrease was observed in the plasma potassium level up to 125 min after the salbutamol infusion. The heart rate was significantly increased, and the increase in 3 patients was correlated with the salbutamol concentration. The biological effects of the drug were less marked than expected.

Acute Kidney Injury↗
PubMed1987

Polycythemia in chronic obstructive pulmonary disease. A study of serum and urine erythropoietin and medullary erythroid progenitors.

In order to investigate the mechanism of polycythemia in chronic obstructive pulmonary disease (COPD), serum and urinary levels of erythropoietin and medullary erythroid progenitors were studied in 21 patients; nine were nonpolycythemic (hematocrit, 39 +/- 4 percent; red blood cell [RBC] mass, 28 +/- 5 ml/kg; forced expiratory volume in one second [FEV1], 0.6 +/- 0.1 L), and 12 patients were polycythemic (hematocrit, 52 +/- 7 percent; RBC mass, 46 +/- 7 ml/kg; FEV1, 0.9 +/- 0.3 L). Hypoxia was severe in both groups, with mean arterial oxygen pressure of 47 mm Hg. The following parameters of tissue oxygenation were not significantly different between the two groups: arterial and mixed-venous oxygen saturations; cardiac output; oxygen utilization coefficient; 2, 3-diphosphoglycerate, and carboxyhemoglobin level. The level of erythropoietin was measured by bioassay in vitro. The level was increased in the serum of 85 percent (18) and in the urine of 38 percent (8) of the patients. There was no significant difference between the nonpolycythemic and polycythemic groups. Without exogenous erythropoietin, none of the subjects showed spontaneous colonies of erythroid progenitors. The addition of one unit of erythropoietin induced a similar normal proliferation of erythroid progenitors in both groups. The absence of adaptative polycythemia in the nonpolycythemic group with severe hypoxia was seemingly related neither to a quantitative deficit of erythropoietin nor to a lack of sensitivity of erythroid progenitors to its action.

Aged↗
PubMed1987

Hemodynamic tolerance and plasma volume variations during plasma exchange. Replacement fluid: albumin alone or albumin plus gelatin?

Little is known about mechanisms of systemic hypotension frequently reported during plasma exchange (PE). Type of substitution fluids may interfere with hemodynamic tolerance. In a prospective study, right heart catheterization was performed during 18 PE by filtration with isovolumic substitution. Blood volume was measured with 51Cr tagged erythrocytes and plasma volume (PV) calculated from hematocrit. Substitution fluids were either albumin (A; n = 9) or A + gelatin (A + G; n = 9). In both groups, PE induces significant (p less than 0.01) decreases of mean arterial pressure: group A: - 21 +/- 14%; group A + G: - 23 +/- 15%; of pulmonary wedge pressure: group A: - 41 +/- 33%; group A + G: - 36 +/- 22%; of cardiac index: group A: - 38 +/- 18%; group A + G: - 25 +/- 15%. Plasma volume also decreases after PE: group A: - 13.5 +/- 4%; group A + G: - 18.5 +/- 4%. None of the variations are significantly different between the two groups. So we think that substitution with albumin alone has no advantage for hemodynamic tolerance.

Albumins↗
PubMed1986

[Pulmonary arterial hypertension and chronic obstructive bronchopneumopathy].

Sooner or later, chronic obstructive lung disease becomes complicated with pulmonary arterial hypertension, largely responsible for chronic cor pulmonale. Its principal cause is an increase in pulmonary resistance due to chronic hypoxia. There is no non-invasive method that can be used to measure pulmonary arterial pressure (PAP) with accuracy. In the course of chronic obstructive lung disease PAP increases slowly, by about 0.5 to 0.6 mmHg per year. As mortality factor, it is the second major variable after FEV1. The usefulness of specific vasodilators has not yet been demonstrated.

Animals↗
PubMed1986

[Polycythemia in patients with chronic respiratory insufficiency].

Tissue hypoxia is the main stimulus of erythropoietin production. Erythropoietin stimulates erythropoiesis by acting on medullary stem cells. Unlike healthy subjects adjusting to high altitude, patients with chronic respiratory failure do not always develop polycythaemia. In those who do, the physiopathology of polycythaemia remains unknown. It seems to be due to insufficient action more than to insufficient production of erythropoietin. Most authors agree that polycythaemia is harmful when the haematocrit exceeds 60%. The most commonly used corrective method nowadays is phlebotomy. Blood withdrawal is effective on clinical symptoms and on pulmonary arterial hypertension, but not on blood gases and ventilatory parameters at rest or during exercise.

Adaptation, Physiological↗
PubMed1985

Temocillin treatment of serious infections due to gram-negative bacilli in an intensive care unit.

In a group of 27 severely ill patients in an intensive care unit, 40 infections caused by Gram-negative bacilli were treated with temocillin 2g twice daily by the direct intravenous route. The patients (17 men and 10 women) were aged from 35 to 93 years (mean 65.7 years) and 22 had severe underlying diseases. In addition, 10 of the patients were admitted to the intensive care unit following surgery; 6 had acute renal insufficiency, 5 had acute respiratory insufficiency, and 12 were suffering from infectious shock. The infections included septicaemia (19), urinary tract infection (10), respiratory tract infection (4) and biliary tract infection (4). The most frequent bacterial isolate was Escherichia coli (14), followed by Enterobacter cloacae (5), Proteus spp. (5) and Klebsiella pneumoniae (4). The initial pathogens were eliminated in 34/40 infections (85%) and the corresponding clinical cure rate was 60%, with a further 27.5% of patients being improved. In the septicaemic patients, 17/19 pathogens were eradicated from the blood, while clinically, 12 patients were cured and 5 were improved. Eight of the 10 urinary tract pathogens were eliminated, with 6 patients being clinically cured and a further 3 being improved. All of the initial pathogens in both biliary tract and respiratory tract infections were eradicated, accompanied by clinical success in 3 and 2 patients, respectively; the remaining patients were improved. Superinfection with streptococcus group D, Pseudomonas aeruginosa and Staphylococcus aureus was seen in 3 patients. The emergence of resistance to temocillin occurred in an isolate of E. coli, and also possibly in an isolate of K. pneumoniae. No adverse reactions nor abnormal laboratory values related to temocillin administration were observed and, although 7 patients died, none of the deaths were attributable to uncontrolled Gram-negative infection.

Adult↗
PubMed1985

[Spontaneous pneumothorax: drainage by catheter or chest tube?].

One hundred and fourteen spontaneous pneumothorax, idiopathic or with chest disease, were retrospectively analysed in order to compare the efficacy of suction drainage by small lumen IV catheter and by chest tube. Age, importance and tolerance of spontaneous pneumothorax were similar in both groups. Frequency of recidive and failure as well as duration of drainage were also not different. So we advocate the use of suction drainage by small lumen IV catheter. The efficacy is the same than with chest tube. But the technic is more simple and less traumatic.

Adult↗
PubMed1983

[Contribution of the determination of soluble antigens to the diagnosis of Streptococcus pneumoniae pneumopathies].

We studied the diagnostic value of the detection of soluble pneumococcal antigens by counter-immunoelectrophoresis (ES) in patients with pneumonia. Pneumococcal antigens were detected in blood, urine and pleural fluid. 59 patients were distributed into 3 groups: (Group 1) - 19 patients with a non-pneumococcal, but bacteriologically-proven pneumonia, (Group 2)-32 patients with a bacteriologically confirmed pneumococcal pneumonia, (Group 3)-8 patients with a non-bacteriologically proven pneumonia, but with pneumococcal antigens. No Group 1 patients had pneumococcal antigens. In Group 2 pneumococcal antigens were present in 15 cases. The sensitivity of ES in the detection of soluble pneumococcal antigens (APS) in the blood, urine and pleural fluid during pneumococcal pneumonias was 57.5%. There was a diagnostic benefit when compared to bacteriological analysis alone of 20%. We believe that ES is a useful complementary examination to classical bacteriology.

Adult↗
PubMed1983

[Lung diseases complicating acute poisoning with psychotropic drugs].

474 patients admitted in ICU between 1976 and 1981 were retrospectively analysed. Pneumonia (P) was assessed by condensation on chest X ray. P developed in 14,3%. 24 hours after admission 77,6% of P had appeared. Initial location was unilateral in 79,4% with predilection to the inferior half of the right lung. Fever was almost constant (89,5%). Promoting factors were observed: delay between ingestion and admission, vomiting and tracheobronchial embarrassment, coma depth. Recovery was simple in 83,3%. Among the 14 deads, 6 died because only of p, in 4 other P was aggravating. Duration in ICU was much longer when P was present (9 +/- 8,1 days) than when P was absent (2,5 +/- 2,1) p less than 0,001.

Adult↗