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Biomedical subjects

M Rapin

Publications and source records attributed to M Rapin.

At least 55 records · Page 3Linked to original sources

Erythromycin pharmacokinetics in man.

This study shows that high serum concentrations are reached after either ethylsuccinate or lactobionate erythromycin administration. But the short elimination half-life implies repetitive administration to obtain efficacy, the ideal being represented by continuous infusion.

Administration, Oral↗

[Acute renal failure due to non traumatic rhabdomyolysis. 11 cases (author's transl)].

Previous nuclear disease was found twice: Mc Ardle disease, dermatomyositis. Causative factors were: strenous exercise, hyperthermia, intoxication, influenza. Myalgias and/or myoedema was recorded in ten cases, associated with an hypovolemia of variable severity in eight. Oligo-anuria was observed in eight cases. The acute renal failure (ARF) was characterized by an increase in the serum creatinin more important than the rise in the blood urea and, in some cases, severe metabolic disturbances: hyperkaliema (6 cases), hypocalcemia (5 cases), hyperphosphatemia (5 cases) and hyperuricemia (5 cases). Diagnosis was made by the increase in sera of the muscles enzymes, specially the CPK and the search for myoglobinuria, positive during the first seven days. A complete recovery of renal function was observed in the nine survivors with a transient and moderate hypercalcemia in three. Three patients had persistant neuro-muscular deficiencies. Non traumatic rhabdomyolysis is not a rare cause of ARF and should be considered when the etiology of ARF is uncertain.

Acute Kidney Injury↗

[The pharmacokinetics of nalidixic acid administered parenterally. Towards rational use in severe infections (author's transl)].

Nalidixic acid is effective toward Gram negative infections but its short half-life and potential neurological toxicity explain that its parenteral use is hazardous. Interindividual variations of its pharmacokinetic parameters explain also the absolute necessity of a careful drug monitoring adapted to each patient. The study of plasma kinetics of a single dose of nalidixic acid injected by intravenous route, shows these metabolic variations. With this results, the predicted plasma drug concentrations show that classical dosage regimens are adapted only to a little number of patients. Advantages and inadequacies of a single daily intravenous infusion of nalidixic acid are next analysed.

Bacterial Infections↗

[Acute respiratory failure: comparison of spontaneous ventilation with continuous positive airway pressure (CPAP) and mechanical ventilation with positive and expiratory pressure (CPPV) in 6 cases (author's transl)].

The hemodynamic and respiratory effects of spontaneous ventilation with continuous positive airway pressure (CPAP) and mechanical ventilation with positive and expiratory pressure (CPPV) were compared in six patients with acute respiratory failure. Arterial and mixed venous gases, cardiac output, oxygen delivery and consumption, airway and oesophageal pressures were measured, with each patient on intermittent positive pressure ventilation (IPPV), CPAP and CPPV with the same level of positive and expiratory pressure (PEEP = 20 cmH2O). CPAP was as efficient as CPPV for improving arterial oxygenation. Cardiac output was higher on CPAP than on CPPV due to a lower intra-thoracic pressure with spontaneous ventilation, thus oxygene transport was higher with this methode. However total oxygene consumption and PaCO2 were slightly increased with CPAP due to a higher breathing's work. So, CPAP is as efficient as CPPV at the same level of PEEP in improving intra-pulmonary shunt and PaO2, without adversely affecting cardiac output.

Heart Rate↗

[Cellular immunity skin testing and sepis in intensive care patients : relationship between results and mortality (author's transl)].

In 182 critically ill patients, after admission delayed hyersensitivity skin testing have been systematically performed with 3 antigens (tuberculin, candidin, varidase). Mortality in anergic patients was 55% while it dropped to 19% when at least one response was positive. A highly significant relationship was found between anergy and mortality (p less than 10(-5)) whether death was related to sepsis (p less than 10(-4)) or not (p less than 0.02). In patients with major sepsis, anergy was more frequent (38%) than in non septic patients (21%) (p less than 0.01). In 69 patients skin testing with phytohemagglutinin was performed. Seven out of 8 unresponsive patients were anergic and 5 died. The results suggest that in critically ill patients cellular immunity skin testing may early select high risk patients exposed to septic complication. In these patients several important measures should be promptly taken including superinfections prevention, adapted nutritional intake and septic focus eradication.

Adult↗