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Biomedical subjects

P Monin

Publications and source records attributed to P Monin.

68 records · Page 4Linked to original sources

[The persistence of foetal circulation. Neonatal pulmonary arterial hypertension. Favourable action of tolazoline (author's transl)].

Alongside reversible secondary pulmonary arterial hypertension accompanying neonatal respiratory distress, there are primary PAH leading to the persistence of the foetal circulation. This is a true functional neonatal heart disease which may occur alone or be seen in association with another form of neonatal distress such as respiratory distress secondary to the inhalation of amniotic fluid. Any neonatal hypoxaemia irreductible by classical methods should suggest the possibility of persistent pulmonary arteriolar vasoconstriction and lead, in the absence of systemic hypotension, to the administration of vasodilators. These data remain in the preliminary stage and further studies, in particular pharmacological, of these drugs are necessary.

Heart Defects, Congenital↗

Pneumothorax.

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Humans↗

[Hypoplasia of the left side of the heart in two brothers].

Amongst the malformations which constitute the hypoplastic left heart syndrome, the coexistence of mitral and aortic valve atresia should be considered a separate entity. The analysis of cases reported in the literature does not reveal a male preponderance nor is the family picture characteristic of a genetic autosomal recessive disorder.

Child↗

Effect of seizures on brain phenobarbital concentration in newborn piglets.

Phenobarbital (PB) brain and blood concentrations were measured together with brain and blood pH in newborn piglets before and at the end of seizure activity induced by pentylenetetrazol or bicuculline. Seizures induced a significant elevation of arterial blood pressure and profound changes in the blood gases and in the acid-base balance, with a marked reduction in brain tissue pH. Despite an intense brain acidosis, however, and a significant rise in blood/brain [H+] gradient, phenobarbital brain concentrations were not reduced during seizures but, on the contrary, were increased in 7 of 11 piglets. These data suggest that contrary to the pH partition hypothesis, brain uptake of PB is concomitantly increased during seizures and brain acidosis.

Animals↗

Persistence of impaired autoregulation of cerebral blood flow in the postictal period in piglets.

Cerebral blood flow (CBF) autoregulation was evaluated in the postictal period in unanesthetized term newborn piglets with a mean age of 5.7 +/- 3 days. Seven animals (group 1) received 1 mg/kg bicuculline to induce brief generalized seizures, and six control animals (group II) received saline. Twenty to 90 min after the end of seizure activity in group I or saline injection in group II, CBF was measured by the radioactive labeled microspheres method at three levels of mean arterial blood pressure (MABP) obtained by controlled blood withdrawal within the normal range for autoregulation. In the postictal period, baseline CBF was higher in group I than in group II (85 +/- 21 vs. 48 +/- 7 ml/min/100 g, p less than 0.001). During hypotension, total CBF was positively correlated with variations of MABP in group I (r = 0.739, p less than 0.01) but not in group II. Regional CBF showed the same correlation with MABP. These data show that after seizures in piglets, the rise in CBF is associated with a persistent impairment of CBF autoregulation. These hemodynamic alterations may be relevant in the pathogenesis of hemorrhagic or ischemic brain lesions.

Animals↗

[Patent ductus arteriosus in premature newborns. Treatment with indomethacin (author's transl)].

The pharmacokinetic and pharmacodynamic effects of indomethacin were studied in 18 prematures with patent ductus arteriosus, treated either enterally (group I, n = 7), or intravenously (group II, n = 11). A definitive closure assessed by echocardiography was observed in 13 cases (72%), and it was only transient in 4 cases (21%). Assisted ventilation was discontinued between 1 and 6 days following therapy in 14 cases. In most cases, indomethacin induced a significant reduction of diuresis but the plasma creatinine level increased above 15 mg/l in 3 cases only. The elimination half life of indomethacin (t 1/2 beta), of 40.3 +/- 12.2 hours in group I and 33.9 +/- 11.7 hours in group II, is increased as compared with adults. The difference of the surface under the curve (AUC O leads to 24 h, ng.ml-1.h-1) between the infants who presented complete or transient closure, suggests a relationship between the biodisponibility of the drug and the effect on patent ductus arteriosus. Treatment with indomethacin is an interesting alternative to surgical ligation in prematures with patent ductus arteriosus. Because of its side effects, especially on the kidneys, it is recommended to use this treatment only in intensive care units. The intravenous route seems to be better than the enteral route.

Administration, Oral↗