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Biomedical subjects

L Quintin

Publications and source records attributed to L Quintin.

62 records · Page 4Linked to original sources
PubMed1984

[Modification of a continuous positive airway pressure in view of its use in postoperative resuscitation in cardiovascular and thoracic surgery].

This paper describes a modification of a CPAP "P.P" circuit. This modified circuit is used to wean from artificial ventilation: 1) Patients exhibiting an hypoxia when undergoing a T piece trial with high FiO2. 2) Patients presenting pulmonary pathology before the operation. 3) Patients with cardiogenic shock so long as controlled mandatory ventilation is not an absolute requirement. This modification of a CPAP "P.P" circuit may have general use in the post-operative care after cardiovascular and thoracic surgery.

Airway Resistance↗
PubMed1981

The effects of vascular catheterization upon heart rate and blood pressure before aorto-coronary bypass surgery.

Ten patients presenting for aorto-coronary bypass surgery were premedicated with their regular dose of propranolol and nitrates and diazepam 0.15 mg x kg-1 by mouth, morphine 0.15 mg x kg-1 and scopolamine 0.4 mg intramuscularly, 60 to 90 minutes before arrival in the operating room. Venous, arterial and pulmonary artery catheterizations were done under local anaesthesia. No significant changes were noted in systolic blood pressure and rate pressure product. Heart rate was decreased after internal jugular puncture and for the remainder of the study. PaCO2 increased and PaO2 decreased from values obtained the day before operation. Cardiovascular stability during vascular catheterization was achieved by emphasizing a detailed preoperative explanation, maintenance of beta-blockade up to the time of operation, substantial sedative premedication, and the liberal use of local anaesthesia.

Blood Pressure↗
PubMed1981

Swan-Ganz catheter contamination: a protective sleeve for repositioning.

Valuable haemodynamic data can be derived from a properly positioned Swan-Ganz catheter. Unfortunately, a significant number of these catheters will, for one reason or another, become malpositioned. Withdrawing a catheter from a permanently wedged position presents little difficulty. Repositioning may, however, necessitate its advancement, with the attendant risk of bacterial contamination. We have solved this problem by making a protective sleeve from readily available latex drain and tubing, which fits securely over the haemostatic valve of a No. 8F Cordis introducer. Iodine solution is injected into the sleeve to provide a sterile environment for the Swan-Ganz catheter, which can then be repositioned as required without the risk of bacterial contamination, as verified by bacteriological studies.

Cardiac Catheterization↗
PubMed1981

Oxygen-high dose fentanyl-droperidol anesthesia for aortocoronary bypass surgery.

Ten patients undergoing aortocoronary bupass surgery were studied during induction of anesthesia and during initial surgical stimulation. Each patient was anesthetized with fentanyl, 100 micrograms/kg, droperidol, 0.15 mg/kg, and pancuronium, 0.1 mg/kg, and ventilated with 100% oxygen. Preoperative medication consisted of propranolol, nitrate preparations, diazepam, 0.15 mg/kg orally, morphine, 0.15 mg/kg IM, and scopolamine, 0.4 mg IM. Intravenous, arterial, and Swan-Ganz catheters were inserted under local anesthesia after which control measurements of hemodynamic parameters and arterial blood gas tensions were taken. Observations were repeated after fentanyl, 50 micrograms/kg, after endotracheal intubation, after another dose of fentanyl, 50 micrograms/kg, after skin incision, and after sternotomy. The total dose of droperidol was given incrementally throughtout the fentanyl infusion. Normal saline was infused to maintain constant pulmonary capillary wedge pressure. Heart rate, left ventricular stroke work index, triple index, pulmonary capillary wedge pressure, and PaCO2 remained constant throughout the study. Systolic blood pressure decreased significantly after fentanyl, 50 micrograms/kg, and initial administration of droperidol, but thereafter remained unchanged. Stroke index increased significantly after fentanyl, 50 micrograms/kg, and remained elevated at all subsequent intervals. Cardiac index increased after fentanyl, 50 micrograms/kg and 100 micrograms/kg. Rate-pressure product was stable until the time of sternotomy after which it decreased significantly. In patients undergoing aortocoronary bypass surgery, 100% oxygen, fentanyl, 100 micrograms/kg, and droperidol, 0.15 mg/kg, produced stable hemodynamics during induction, intubation, and sternotomy. Maintenance of pulmonary capillary wedge pressure by volume infusion may have been contributed to this stability.

Anesthesia, Intravenous↗
PubMed1981

[Arterial hypotension induced by artificial cardiac pacing under general anaesthesia (author's transl)].

A case of haemodynamic decompensation is reported in a patient with a sick-sinus syndrome on a demand cardiac pacemaker, under-going surgery under general anaesthesia. While systemic arterial blood pressure showed adequate stability under the patient's own sinus drive, it consistently fell by 15 to 20 p. cent when artificial pacing was established. The possible mechanisms are discussed. The drop in arterial blood pressure with artificial pacing is probably due to the loss of the atrial contribution in maintaining adequate cardiac output. In the conscious patient, the resulting decrease in cardiac output is compensated by an increase in the peripheral resistance. Under general anaesthesia, this compensatory mechanism is lost, resulting in a drop in cardiac output and systemic arterial blood pressure. It needs to be emphasized therefore, that the patient who has a permanent pacemaker has significant under-lying cardiovascular disease and, that, continuous monitoring is indicated not only during surgery but also postoperatively until patient has stabilized.

Aged↗