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Biomedical subjects

J du Cailar

Publications and source records attributed to J du Cailar.

At least 91 records · Page 5Linked to original sources
PubMed1977

[Admission and treatment of 592 patients over 70 years in an intensive care unit].

Using an IBM 3741 computer, the authors analysed 592 case records of patients aged over 70 years, admitted to hospital on an intensive care unit, age appears to be an important factor in determining the prognosis of numerous diseases without, however, being a criteria for rejection of admission of these patients to an intensive care unit. The fragility of these patients leads one to consider the following parameters: 1--the degree of resuscitation is assessed by quantification of the therapeutic means. As for other patients, survival varies inversely in relation to the important of the therapeutic means, but in the case of the elderly patient, there is a definite difference in the correlation mortality-therapeutic index towards aggravation, so one may determine a ceiling above which survival is not possible; 2--duration of the intensive care is very important. In most cases, the decisive point is situated on the 3rd or 4th day of care, at which time the decision to continue or stop treatment may be considered in the light of the patient's progress.

Aged↗
PubMed1977

[Routine comparison of trace element deficiencies during parenteral alimentation].

In 50 patients aged between 3 and 84 years treated in a multidisciplinary Intensive Care Unit and receiving parenteral alimentation, deficiency in certain trace elements or electrolytes (Cu++, Zn++, Mn++, Co++, PO-4, Mg++) was prevented or treated by the administration of a glucose solution (MB 147 G) enriched in trace elements. The aim of the present study was to demonstrate, on the basis of assay of serum levels of the trace elements involved, with the exception of Mn and Co, the effectiveness of treatment. Reference values were determined on the one hand in healthy individuals for normal figures and secondly on subjects included in the study, already on parenteral alimentation for several days, before treatment with MB 147 G, in order to demonstrate the existence of a deficiency (patient control values). In the case of PO--4, however, the patient control values concerned at one and the same time subjects in the study before treatment with MB 147 G and other patients receiving parenteral alimentation who were not part of the trial. MB 147 G solution was presented in units of 500 ml associated with glucose of varying concentrations (15 p. 100, 30 p. 100, 50 p. 100). The average daily amount administered, over a period of 236 days, was 3 unites per 24 hours, corresponding to an intake of copper of 3.78 mg, 3.90 mg of zinc, 0.20 mg of manganese, 0.24 mg of cobalt, 363 mg of magnesium, 240 mg of calcium and 15 mEz of phosphates. The results show that levels of copper, zinc, magnesium and phosphates were low during parenteral alimentation. The administration of MB 147 G resulted in a significant increase in these values, without there being any evidence of accumulation.

Adolescent↗
PubMed1977

[Functional sequelae of Mendelson's syndrome. Myth or reality?].

Twenty patients having previously had a Mendelson's syndrome were subjected to a respiratory functional test. A syndrome of diffuse interstitial pulmonary fibrosis (DIPF) was found only in 3 cases examined shortly after the pneumopathy. In one of these cases, another examination done later showed signs of regressing fibrosis. The authors concluded that if a functional syndrome of DIPF occurred immediately after a Mendelson's pneumopathy, it eventually disappeared in the long term in most cases.

Adolescent↗
PubMed1976

[Plasma level of the thiocyanate ion in sodium nitroprusside perfusion].

24 subjects were selected at random out of a group of 80 patients undergoing surgery under a hypotensive anaesthetic technique by means of nitroprusside perfusion; the variation of one of the metabolites, the thiocyanide ion, were assayed. Hypotension was of 30 to 380 minutes duration and mean dosage of 12,44 mg (1,99 mug/kg/min). SCN- assays were performed by means of an original technique, which is described in this publication, before any perfusion of nitroprusside, every 30 minutes during perfusion and 30 and 60 minutes after ending the perfusion. Results show that SCN- concentration is increasing during perfusion but not as much as compared with the toxic concentration. Major increase takes place 30 minutes after starting the perfusion (1,27 10(-4) M/l). Increase slows down then and remains on a plateau level until the end of the perfusion where it decreases. Those results allow to reject a toxicity risk related to an increase of SCN- during nitroprusside perfusion. However, the accidents reported after high dosage of NPS and probably related to cyanogenic ion accumulation combined with lactic acidosis as shown in this publication, led the authors to advise a dosage not over 10 mug/kg/min in a maximum of 2 hours time.

Adolescent↗
PubMed1976

[Endocrine effects of neuroleptics].

The neuroleptic drugs used in anesthetics belong to the group of phenothiazines or butyrophenones. The endocrine response to their intravenous administration is still ill-known and usually only concerns the association of anesthetics and neuroleptics. However, as far as the catecholamines are concerned, it is known that neuroleptic drugs do not prevent either their secretion nor their liberation but, depending on their dosage, they block the dopaminergic receptors and the alpha-receptors and induce disturbances in the metabolism of the mono-amines. The injection of neuroleptics associated with analgesics, raises the blood levels of catecholamines, does not induce a rise in ACTH and cortisol levels in the absence of stress, but does not totally prevent their rise in cases of aggression. As far as growth hormone is concerned, the effects are variable depending on the association studied. There is a rise with droperidol + pethidine or pentazocine, no change with chloroprotixene-dextromoramide. In both cases, the blood sugar rises. As far as STH, or growth hormone, free fatty acids and insulin are concerned, one may note a rise with associations containing droperidol even in the absence of any stress and stability with a mixture of chlorprotixene and dextromoramide. With none of these well known associations was there any variation either in levels of pituitary thyreo-stimulin, nor in thyroxine levels. Testosterone becomes reduced with the association of droperidol + analgesics but this effect does not seem to be specific to droperidol. These responses are frequently disturbed in case of additional stress.

Adrenocorticotropic Hormone↗
PubMed1976

[Hemodynamic effects of Etomidate].

Hemodynamic variations due to Etomidate administration were studies in 10 patients submitted to artificial ventilation. Etomidate was given at a 0.37 mg/kg B.W. dosage. Cardiac rate, mean arterial B.P., C.V.P., mean arteial pulmonary pressure, mean pulmonary capillary pressure and cardiac output were investigated. From values found, systolic output, systemic vascular resistance, and pulmonary arteriolar resistance were calculated. Results show that Etomidate has little effect on hemodynamics. There is only a 5 p. 100 increase in cardiac rate, a 16p. 100 decrease in cardiac output, 1 18 p. 100 decrease in systolic output and a 12p. 100 decrease in mean arterial B.P. Variations of mean capillary pressure, of systemic vascular resistance and of pulmonary arteriolar resistance are not significant.

Adult↗
PubMed1976

[Hemodynamic effects of high-dosage corticoids. Their justification in the treatment of shock].

In 61 patients in whom high doses of corticoids had been administered owing to various indications, the hemodynamic modifications caused by this injection were studied. The corticoids administered were : hydrocortisone hemisucccinate (150 mg/kg), methyl prednisolone sulfate (30 mg/kg), prednisone sodium m sulfobenzoate (50 mg/kg), prednisolone sodium m sulfobenzoate (35 mg/kg) and dexamethasone phosphate (2 mg and 6 mg/kg). The results study the modifications caused by each drug on heart rate, arterial blood pressure, cardiac output, systolic stroke volume and peripheral vascular resistance. The expression of the results is given as a percentage of the variation with statistical study. Methyl-prednisolone sulfobenzoate only leads to slightly marked hemodynamic effects : the four other compounds studied have definite hemodynamic effects, of variable intensity and duration. The most important variations are noted with dexametasone phosphate. From these results, the indications and results of the use of corticoids in states of shock are discussed.

Adrenal Cortex Hormones↗
PubMed1975

[Anesthesia in reoperations in abdominal surgery].

Fifty one patients from different surgical units, hence anesthetized by different anaesthesists, underwent reinterventions in abdominal surgery. The indications for the first intervention essentially involved the supra-mesocolic region of the abdomen (62 out of 100 cases). The operative risk during the first intervention was on the average 18 pour cent. The protocol of the first anaesthesia which was known in 42 cases, was of the narco-ataralgestic type. The date of the return to the operation table varied from 1 to 60 days. The state of the patients was in general catastrophic (organic renal failure, acute respiratory failure). Here again the anaesthesia was of the narco-ataralgesic type but the choice of drugs varied depending on the patients' state. However non significant difference was noted in the average hourly drug consumption between the two interventions. Apart from one circulatory arrest during induction, in one patient with hemorrhagic shock, no death was attributable to the anesthetic technique. The authors, using these findings, attempt to pick out a practical line of behaviour.

Abdomen↗
PubMed1975

[Use of dopamine in acute cardiovascular distress. Its place in comparison to isoproterenol].

Nineteen patients presenting cardiovascular distress were treated with dopamine. For seventeen of these, the accident occurred immediately after cardiac surgery. Dosages varied from 1 to 15 mug/kg/min and the duration of treatment from 10 minutes to three days. The efficacy of the treatment was judged according to the clinical and hemodynamic improvement of the cardio-circulatory function and the increase in urinary output. There were 15 favourable results. The positive effects of the dopamine seem to be limited in certain patients by the appearance of a cyanosis testifying to a rise in vascular resistances which increases the left auricular pressure and limits the inotropic effect. In these cases, isoproterenol or a combination of both isoproterenol and dopamine gives better results.

Adolescent↗
PubMed1975

[Constant outflow anesthesia with the combination of alfatesine and fentanyl].

In a previous work, the authors showed the value of administering Alfatesine, in interventions of long duration, at a constant rate by using an automatic syringe, and by combining it with destromoramide. In this new work the authors present an analagous study carried out in 47 subjects, in which dextromoramide was replaced by fentanyl. The automatic syringe used was the Braun Perfusor IV equipped with a 50 ml syringe containing 0.3 ml. of CT 13.41 and 0.006 mg. of fentanyl per ml. Induction was achieved at graduation 10, 14 ml of the mixture having been injected in approximately 60 seconds. Maintenance of anesthesia was ensured at graduation 6 corresponding to an hourly administration of 27 to 30 ml of the mixture (9 ml of CT 13.41 and 0.18 mg of fentanyl). The patients were adults of average weight 64 kg., who had undergone sometimes major orthopedic surgery, of an average duration of 161 mn. The results are looked at from the angle of quality of the anesthesia and of the awakening and of the side effects. They confirm the non-accumulation under these conditions of use and these doses of CT 13.41 used and reveals an analagous behaviour of fentanyl. Reserves are however made owing to the mode of elimination of fentanyl, on the use of such a technique in anuric patients or in renal insufficiency.

Adolescent↗
PubMed1974

[EB 51 (Trivemil), a complete nutriment for parenteral alimentation].

EB 51 (Trivemil) is an original fat emulsion containing L. aminoacids and glucids in its liquid phase in the following proportions: amino acids: 60 gl/l corresponding to 8,77 g of nitrogen or 250 calories, sorbitol: 100 g/l or 400 calories wheatgerm oil: 38 g/l or 350 calories. This preparation supplies 1000 per liter. Its objective is to furnish simultaneously the amino acids as well as the energy necessary for their anabolism. EB 51 was administered in 43 patients during several days at a dosage of 1000 or 1500 ml. The tolerance of the product was excellent. Its usefulness was appreciated by nitrogen balance studies as well lipid blood tests. The clearing of the plasma in practically all the cases was very good and the nitrogen saved was almost equivalent to the amount furnished. The indications, dosage and contreindications of EB 51 are detailed.

Age Factors↗