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Biomedical subjects

I Murat

Publications and source records attributed to I Murat.

At least 109 records · Page 6Linked to original sources
PubMed1987

Continuous epidural anaesthesia for major abdominal surgery in young children.

The benefits of epidural anaesthesia combined with general anaesthesia were studied in young children scheduled for major abdominal surgical procedure (pull-through for Hirschsprung's disease). Two groups of nine children were studied receiving, respectively, general anaesthesia or general anaesthesia plus epidural anaesthesia. In the group receiving both general and regional anaesthesia, a polyurethane 24 G catheter was inserted via a Tuohy needle 19 G into the lumbar epidural space after induction of anaesthesia and intubation and bupivacaine, 0.25%, was injected epidurally (mean initial volume 0.71 +/- 0.04 ml kg-1). No opiates were needed during operation on the children in this group. After epidural anaesthesia, heart rate decreased significantly but systolic blood pressure remained unchanged. During surgery mean values of both heart rate and systolic blood pressure were significantly lower in the regional analgesia group compared to the general anaesthesia group. The need for blood replacement was also significantly lower, whereas pre- and post-operative haematocrit values were not significantly different. Administration of fluid and electrolytes during operation was also similar in both groups. A combination of epidural and general anaesthesia avoids the use of opiates during surgery, provides excellent per- and post-operative analgesia, allows a rapid and safe recovery, and facilitates the nursing of young children.

Anesthesia, Conduction↗
PubMed1986

Respiratory effects of nitrous oxide during isoflurane anaesthesia in children.

Respiratory effects of nitrous oxide and isoflurane were studied in 13 children (mean age 45.6 +/- 19.3 months, mean weight 14.9 +/- 4.8 kg) during surgery under continuous extradural anaesthesia. Three different anaesthetic states were studied: isoflurane 0.5 MAC in oxygen (27 study periods), isoflurane 0.5 MAC with 50% nitrous oxide (32), isoflurane 1 MAC in oxygen (25). End-tidal carbon dioxide (PE' CO2) and isoflurane, respiratory indices (tidal volume, VT; minute ventilation, VE; mean inspiratory flow, VI; respiratory frequency f, effective inspiratory timing TI/Ttot were measured. The addition of nitrous oxide (comparison of respiratory variables obtained in 25 successive periods at (1) and (2)) produced a significant increase in PE' CO2' significant decreases in VT, VE and VI, a significant increase in f. The increase in alveolar concentration of isoflurane ((1) compared with (3) in 25 successive periods) was associated with a significant increase in PE' CO2' significant decreases in VT, VE, VI and a significant increase in f. The equipotent anaesthetic states (2) and (3) were compared in 21 successive periods. In children, the net result of substituting nitrous oxide for an equal MAC fraction of isoflurane was to produce a smaller decrease in VT responsible for a smaller decrease in VE without significant change in respiratory rate.

Anesthesia, Inhalation↗
PubMed1986

Ventilatory changes during nitrous oxide isoflurane anaesthesia in children.

The changes in ventilatory variables under nitrous oxide isoflurane anaesthesia were studied in 10 children (mean age 46 +/- 13.4 months, mean weight 16.2 +/- 2.1 kg). Measurements of flow and volume were performed by pneumotachography. PE'CO2 was measured by capnography. The following variables (VE, VT, TI/TTOT, VI, PE'CO2) were measured or calculated under three increasing inspired isoflurane concentrations (0.75%, 1.5%, 2.25%). At each level of anaesthesia, ventilatory changes during exposure to an inspired CO2 fraction of 2% were studied. The increase in the inspired concentration of isoflurane was associated with a decrease in alveolar ventilation. PE'CO2 increased significantly with increasing depth of anaesthesia. The respiratory rate was slightly increased under light nitrous oxide isoflurane anaesthesia, but no further changes were observed with increasing depth of anaesthesia, although the children were breathing a mixture of nitrous oxide and oxygen. The ventilatory response to a raised inspired CO2 is markedly decreased under light nitrous oxide isoflurane anaesthesia, and decreases significantly with increasing depth of anaesthesia. In response to a raised CO2, VE, VT and VI increase, but respiratory rate decreases or remains constant and TI/TTOT is unchanged.

Anesthesia↗
PubMed1985

Comparative efficacy of theophylline and caffeine in the treatment of idiopathic apnea in premature infants.

The purpose of our prospective randomized study was to compare the efficacy of theophylline ethylenediamine and caffeine sodium citrate in the treatment of idiopathic apnea in premature infants. Sixteen infants with three or more severe apneic attacks were studied. Twenty-four-hour cardiorespiratory recordings immediately before and after randomization and four days later showed similar significant decreases of the apnea frequency in both theophylline- (group 1, n = 8) and caffeine-treated infants (group 2, n = 8). No undesirable side effects were observed, except for tachycardia in one infant in group 1. We suggest reasons for preferring caffeine to theophylline in the control of idiopathic apnea in premature infants: caffeine is as efficient and easier to administer.

Apnea↗
PubMed1985

[Continuous peridural anesthesia in children less than 2 years old].

Continuous epidural anaesthesia was carried out in 23 children (age 13.9 +/- 6 months, weight 9.09 +/- 2.5 kg) scheduled for long surgical procedure (soft tissue release for club-foot, "pull-through" for Hirschsprung disease, various genito-urinary procedures). The lumbar epidural space was punctured under general anaesthesia with a 19 G Tuohy needle. A graduated 24 G polyurethane catheter was then inserted and fixed. The local anaesthetic used was bupivacaine 0.25% (0.71 +/- 0.02 ml X kg-1), with or without 1:200,000 adrenaline. Five and 10 min after injection of bupivacaine, heart rate was significantly decreased (p less than 0.05) when compared with pre-induction values, but systolic blood pressure did not change. No other haemodynamic changes occurred. Analgesia was sufficient in all but two cases at incision. Mean duration of surgical procedure was 143 +/- 9.2 min. The time of the first reinjection was significantly longer if bupivacaine with adrenaline was used (116 +/- 2.34 min), when compared with bupivacaine without adrenaline (68.9 +/- 3.92 min) (p less than 0.001). No systemic analgesic was needed during the surgical procedure and anaesthesia was maintained either with halothane (inspiratory fraction less than 0.5%) or enflurane (inspiratory fraction less than 0.8%). All children were extubated at the end of the surgical procedure. The catheter was maintained in 16 children for postoperative analgesia. The first postoperative injection was given 7.1 +/- 0.45 h later. The catheter remained in situ 26.7 +/- 4.1 h. No complication was observed. Thus, during surgery, the need for systemic analgesia was avoided and a rapid and safe postoperative recovery was obtained.(ABSTRACT TRUNCATED AT 250 WORDS)

Anesthesia, Epidural↗
PubMed1985

Ventilatory responses to carbon dioxide in children during nitrous oxide-halothane anaesthesia.

The ventilatory response to carbon dioxide was studied in 12 unpremedicated children, aged 20-68 months, weighing between 10 and 20 kg, under nitrous oxide-halothane anaesthesia. Tidal volume (VT) and end-tidal carbon dioxide tension (PE'CO2) were continuously measured by pneumotachograph and capnograph. Minute ventilation (VE), respiratory rate (f), mean inspiratory flow (Vl) and effective inspiratory cycle (Tl/Ttot) were calculated during anaesthesia at three different inspired halothane concentrations (0.5, 1 and 1.5%). The ventilatory response to carbon dioxide was determined by relating the increase in ventilation during exposure to 2% carbon dioxide to the change in end-tidal carbon dioxide concentration. When the inspired concentration of halothane increased, there were significant decreases in VE, VT, Vl, and a significant increase in PE' CO2. The slope of the carbon dioxide response under light nitrous oxide-halothane anaesthesia (0.5% halothane) was relatively flat (18.64 ml min-1 kg-1 mm Hg-1) when compared with the mean values published for anaesthetized adults, children or neonates. When the inspired concentration of halothane was increased, the slope decreased significantly (39% of initial value at 1% inspired halothane, 26% at 1.5%). The addition of carbon dioxide produced significant increases in VE, VT and Vl but no change in respiratory rate. No statistical difference was observed in the slope of carbon dioxide response between the initial and "control" periods which were measured at the same inspired halothane concentration (0.5%).

Anesthesia, Inhalation↗
PubMed1985

Changes in ventilatory patterns during halothane anaesthesia in children.

Changes in ventilatory variables (VE, VE, f, Tl/Ttot, VT/Tl, PE'CO2) were studied in 12 unpremedicated children, weighing between 10 and 20 kg, during halothane anaesthesia. At an inspired concentration of 0.5% halothane, respiratory rate increased, VT decreased, and VE did not change markedly. When the inspired halothane concentration increased further, there was a significant decrease in VE, mainly as a result of a marked decrease in VT. PE'CO2 increased significantly and inspiratory duty cycle decreased at high inspired halothane concentrations. On return to baseline (0.5% halothane), there was a significant decrease in inspiratory timing and a significant increase in PE'CO2. The relations between these changes and the effect of halothane on inspiratory muscles are discussed.

Anesthesia, Inhalation↗
PubMed1983

[High frequency ventilation during the surgical treatment of esophageal atresia].

The preliminary results of the use of high frequency positive pressure ventilation (HFPPV) in six newborn infants presenting a type III oesophageal atresia during the thoracic stage of surgical repair are reported. HFPPV allowed correct gas exchange during the surgical procedure. In the six cases, a significant decrease in PaCO2 (p less than 0.05) was observed, whereas the effects on PaO2 were variable. The technical problems, mechanism of gas transport during HFPPV and clinical interest of HFPPV in thoracic surgery are discussed.

Blood Gas Analysis↗
PubMed1983

[Surgical ligation of patent ductus arteriosus in the very-low-birth-weight premature infant].

Three recent cases of surgical closure of ductus arteriosus in very low birth weight infants (less than 1 000 g) are reported. The indications of both surgical and pharmacological closure in very low birth weight premature infants are discussed. The necessity of an early closure of a patent ductus arteriosus is now admitted in the very premature infant, but the use of indomethacin in the first days of life is often impossible because of its side-effects. The use of adapted non-invasive monitoring devices during surgery allows a better control of anaesthesia.

Anesthesia, General↗
PubMed1983

[Pulmonary edema following generalized peritonitis in a 4-year-old child].

Following a recent case of adult-type respiratory distress syndrome in a four-year old child, the rare occurrence of this pathology in visceral paediatric surgery is recalled. The few published cases do not allow a comparison of the mortality in paediatric and adult patients. The treatment is discussed, as well as the results of pulmonary function tests performed some time after the acute pulmonary episode.

Child, Preschool↗
PubMed1983

Necrotizing enterocolitis in full-term newborns.

During a 17-month period, 19 full-term newborn infants were hospitalized for necrotizing enterocolitis (NEC). 10 of these infants had no apparent risk factors. Only 7 suffered acute fetal distress. 16 of the 19 infants were born in the same hospital. Toxicological and bacteriological investigations of possible cause revealed no specific agent. Virological analysis of 8 stool samples revealed the presence of corona virus in 5 of the 8.

Bacteroides↗
PubMed1983

[Controlled trial of intravenous lyophilized indomethacin in the treatment of persistent ductus arteriosus in premature infants].

As a result of randomized assignment, 24 premature infants with symptomatic patent ductus arteriosus (PDA) were either treated by 0,2 mg I.V. indomethacin just after diagnosis (12) or left untreated for 48 hours (12). Clinical, radiological, and biological data before trial were remarkably similar. In the 12 "treated" infants, the DA closed within 4 to 26 hours of the first dose in 8 cases. In all 12 "non-treated" infants, PDA persisted for at least 48 h, then 10 infants were treated ad libitum by I.V. (5) or oral (5) indomethacin. Three deaths (late) did not appear to be associated with either PDA or treatment. Two surgical closures were required (1 in each group). Four spontaneous closures occurred after more or less delay: 2 in the 2 never treated infants, and 2 after a double failure of I.V. or oral indomethacin. Treatment (even when unsuccessful) was usually followed by some water retention and blood dilution, sometimes of striking magnitude but always transient. To date, I.V. indomethacin can be given earlier than orally and offers slightly better chances for closure of PDA, thereby reducing the needs for surgical closure which should be reserved for badly tolerated failures of pharmacologic closure.

Clinical Trials as Topic↗
PubMed1983

[Critical approach to technics for the disinfection of respirators with formaldehyde].

Method of artificial respirators desinfection by Formaldehyde is studied. Formaldehyde and ammoniac quantitative analysis are performed. Air samples are taken by dry process and by wet process. Two concentrations are in ceiling values for exposure of workers and exceed irritant concentrations during chronic exposition. Particular attention should be paid to perform measurement: air samples must be taken by wet process as artificial ventilation circumstances: indeed in this case air is humidified; potential toxicity is unappreciated in this use. Complementary studies are required.

Air Pollutants↗
PubMed1983

[Location of the left recurrent laryngeal nerve during high frequency ventilation in surgery for esophageal atresia].

The authors are describing a surgical technique to recognize the left recurrent laryngeal nerve during the oesophage atresia surgery. This technique uses for anatomical marks the superior line of the great azygos vein an the oeso-tracheal lateral junction. The dissection is very delicate, and the hight frequency ventilation during anesthesia gives a precious comfort to the surgeon.

Esophageal Atresia↗
PubMed1982

[Very low birth weight neonates. Results of management. Future prospects].

70 neonates with birth weights (BW) less than 1 250 g were treated at the intensive care unit for neonates (USINN), hôpital Port-Royal, from April 1st 1976 to July 31st 1977. 16 of them had intra-uterine growth retardation. In 20, BW cas under 1 000 g. Assisted ventilation was necessary in 54 (77%). 43 children (61%) survived, those who were born in the same hospital did so more often (88%) than those who came from other hospitals (53%) (p less than 0.01). These results show the needs and risks of the management of very low birth weight neonates: preventing hypothermia, assisted ventilation of long duration and risk of persisting ductus arteriosus, prolonged parenteral nutrition, risk of intracranial hemorrhage more especially as respiratory distress is more severe. In survivors, the high rate of respiratory sequellae (around 30%) suggests that the duration and intensity of assisted ventilation should be reduced as much as possible.

Follow-Up Studies↗
PubMed1982

[Arterial pressure in newborn infants during the first 72 hours of life].

Arterial pressure (AP) (systolic, mean and diastolic) was recorded during the first 72 hours of life in 93 neonates, 27 to 42 weeks of gestational age and weighing 800 to 4,600 g, i.e. in stable hemodynamic and respiratory conditions. 4,464 measurements were performed. Results show that the 3 AP parameters increase with gestational age and birth weight and that AP increases with age after birth in full term as well as premature children. The physiologic variability of AP in full term and premature children accounts for the difficulty of establishing standards and for the need of a permanent recording of this parameter.

Age Factors↗