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Biomedical subjects

R Bernard

Publications and source records attributed to R Bernard.

At least 91 records · Page 5Linked to original sources
PubMed1984

Dobutamine effects on blood gases and hemodynamics in acute myocardial infarction with heart failure.

We studied the effects of dobutamine on blood gases, venous admixture and hemodynamics in ten patients suffering an acute myocardial infarction (AMI) with left heart failure. After one hour infusion of dobutamine (mean dose: 6.3 micrograms/kg X min) there was an increase in cardiac index (27%, P less than 0.005), and a decrease in pulmonary wedge pressure (13%, P less than 0.025) and right atrial pressure (25%, P less than 0.025). The increase in oxygen delivery (23%, P less than 0.005) and mixed venous oxygen tension (10%, P less than 0.01) were neither accompanied by significant change in low arterial oxygen tension nor in high venous admixture. We conclude that dobutamine improves hemodynamics and oxygen delivery in AMI without affecting existant intrapulmonary shunting.

Aged↗
PubMed1983

The effective plasma concentrations of sulmazol (AR-L 115 BS) on haemodynamics in chronic heart failure.

Sulmazol (AR-L 115 BS) is a new inotropic drug which has arterial and venous vasodilating properties. We used it in seven patients with severe refractory heart failure to determine the effective plasma concentration levels and the most effective bolus dose on haemodynamics. The haemodynamic monitoring included a Swan-Ganz catheter in the pulmonary artery and a radial catheter. Haemodynamic measurements and plasma concentration determinations were performed before sulmazol injection and at 5, 10 and 30 min after a bolus 0.25, 0.50, 0.75 mg/kg. We observed a gradual increase in cardiac index and decrease in pulmonary wedge pressure when plasma concentration levels rose but the beneficial effects were mainly observed for sulmazol plasma concentrations above 1 microgram/ml. A bolus injection of 0.75 mg/kg was effective in all cases: a significant increase of cardiac index (1.9 to 2.5 1 min-1 m-2; P less than 0.001) and a significant decrease in pulmonary wedge pressure (30 to 25 mm Hg; P less than 0.005) and right atrial pressure (13 to 10 mm Hg, P less than 0.01) were observed. In these patients sulmazol improved the severely deteriorated left ventricular function without affecting heart rate and blood pressure.

Aged↗
PubMed1983

Treatment of hypertension in acute stage of myocardial infarction. Haemodynamic effects of labetalol.

Labetalol was used to treat systemic hypertension (systolic blood pressure above 150 mmHg) in 11 patients with acute myocardial infarction; its haemodynamic effects and tolerance were studied. Increasing doses of labetalol were infused to lower systolic blood pressure to less than 130 mmHg; the optimal rate was then maintained for one hour (mean rate: 2.3 mg/min). Haemodynamic variables were measured before, during, and after labetalol infusion. Labetalol lowered blood pressure in all patients; this effect was related to a decrease both in total systemic resistance (17.7 to 14 IU) and in cardiac index (3.1 to 2.7 1/min per m2); the stroke index remained unchanged and the heart rate was reduced (94 to 81 beats/min). There was no significant change in the mean pulmonary wedge pressure; it was decreased, however, in the six patients with an initial pressure greater than 15 mmHg. The double product was greatly decreased (16 497 to 8598 mmHg x beats per min), which is favourable in acute myocardial infarction. We conclude that labetalol is a drug of choice to treat hypertension in acute myocardial infarction because it is very effective; its haemodynamic effects are likely to reduce myocardial oxygen requirements and suggest that labetalol administration does not worsen moderate left sided heart failure. The drug, however, may reduce the cardiac output.

Adolescent↗
PubMed1983

Hemodynamic and clinical response to three-day infusion of sulmazol (AR-L 115 BS) in severe congestive heart failure.

Sulmazol (AR-L 115 BS) is a new positively inotropic drug with arterial and venous vasodilating properties. We studied the effects of sulmazol (three-day infusion) on clinical tolerance, hemodynamics, and blood gas levels in ten patients with severe chronic heart failure. The hemodynamic monitoring included a Swan-Ganz catheter in the pulmonary artery and a radial catheter. Blood gas levels were determined on samples of arterial and mixed venous blood. After 24 hours of infusion, there was a significant increase in cardiac index (2 to 2.5 L/min/sq m; p less than 0.005) and a significant decrease in pulmonary wedge pressure (28 to 19 mm Hg; p less than 0.001) and in right atrial pressure (7 to 4 mm Hg; p less than 0.001) without significant changes in heart rate and systolic blood pressure. These beneficial effects lasted during the three days of infusion. Oxygen delivery was significantly increased (350 to 443 ml/min/sq m; p less than 0.005) without significant change in arterial oxygen tension. The side effects included nausea, vomiting, anorexia, and mild thrombocytopenia. We conclude that sulmazol is a potent drug which may improve severely deteriorated left and right ventricular function in patients with chronic refractory heart failure without affecting the heart rate and the systolic blood pressure.

Aged↗
PubMed1983

Relationship between plasma lipids, lipoproteins and other laboratory tests during the course of acute myocardial infarction.

A multivariate analysis was done for the observed variations of lipids, lipoproteins, glycoproteins, and other laboratory tests occurring after myocardial infarction. The origin of plasma triglyceride increase and VLDL-protein reduction is discussed in relation with modified enzyme activities (hormone-sensitive lipase, lipoprotein-lipase, LCAT). The relations between HDL and lipids, glucose, area are analyzed. Changes in VLDL are opposite in direction from the changes in HDL. Delayed significant increase in haptoglobin and alpha 1-antitrypsin exist with a tendency to an increase in C3 and IgM. Various associations link lipoprotein constituents to alpha 1-antitrypsin, IgM, witnesses of the development of an inflammatory process. Recent introduction of apoprotein determinations will bring new outlook on changes accompanying myocardial infarction.

Adult↗
PubMed1981

[Gluten enteropathy in children from south-eastern France (author's transl)].

Between 1969 and 1979, 123 cases of gluten-induced enteropathy were diagnosed in south-eastern France. The overall incidence of the disease was estimated at approximately one for 4 600 births. The mean age of the patients was 3.2 years. At the time of diagnosis, 71 children (57,7%) were less than 2 years old, and 52 children (42,3%) were above that age. There was a strong predominance of girls (60%) and North-Africans (48%). Children younger than 2 years presented with the usual malabsorption syndrome, whereas growth retardation, often isolated, was the main feature in older children. The relative increase observed since 1976 in the number of patients of the latter group despite a lower incidence of the disease was probably due to the withdrawal of infants' foods containing gluten. In 58 children followed up dietetic measures resulted in rapid clinical improvement, but healing of the mucosal lesions was much slower (19 months on average). In 28 patients who could be followed for longer periods, reintroducing gluten into the diet regularly led to histological relapse. These patients, however, had been selected for particular reasons. The true incidence of transient intolerance to gliadin is difficult to determine, since most subjects in perfect health refuse control biopsies.

Adolescent↗
PubMed1981

Haemodynamic reactions after intravenous injection of lorcainide hydrochloride in acute myocardial infarction.

Lorcainide hydrochloride given at the doses of 150 mg i.v. proved to be well tolerated at the acute stage of a myocardial infarction; the subjective signs were benign and never prevented us from completing the injection. The haemodynamic changes reflect some depressive effects on the myocardial function. Most of the observed changes are transient, and when significant from the statistical point of view, they remain very mild: the cardiac output decreased from 3.4 to 3.2 l/min per m2, the stroke index from 46 to 41 ml/m2, the pulmonary wedge pressure increases from 6.6 to 8.4 mm Hg (mean values). Lorcainide hydrochloride may thus be used as an antiarrhythmic drug in acute myocardial infarction.

Anti-Arrhythmia Agents↗
PubMed1980

Hemodynamic effects of parenteral and oral mexiletine.

Intravenous mexiletine (250 mg in 10 min) given to patients at the acute stage of a myocardial infarction was responsible of a mild decrease of the left ventricular function; two of our patients presented bradycardia with hypotension, immediately corrected by atropine (i.v.). Adverse hemodynamic effects are seldom reported after oral administration.

Administration, Oral↗