Skin blood flow measured by thermal clearance method in anesthesia.
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Biomedical subjects
Publications and source records attributed to V Banssillon.
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Spinal anaesthesia was performed in 9 patients with multiple sclerosis for 14 surgical procedures: urological surgery 13 times and plastic surgery once. No complication was observed. except for a transient exacerbation in one case. Spinal anaesthesia appeared to be an innocuous procedure in multiple sclerosis as no neurotoxicity was observed. Exacerbation of multiple sclerosis was similar to that seen with general anaesthesia. Moreover, spinal anaesthesia improved the operating conditions by relieving bladder spasticity; it was also often asked for by patients who feared the loss of consciousness of general anaesthesia.
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A fiberoptic bronchoscopy was performed in 44 out of 1160 burnt patients. The indications for this investigation were dictated by the kind of accident suffered by the patient: explosion or fire; in 16 patients, the face was spared. The clinical, radiological and biological signs could be absent on arrival, and occur later. Four different aspects were seen: very characteristic, although not entirely specific, was the pale white mucosa following blast injury. The degree of obstruction by soot varied, and could be fatal. The aspect of mucosal burn was due to the inhaling of hot gases or burning particles leading to the formation of blisters or crusts on the mucosa. Finally, a non-specific mucosal congestion was seen alone or with either of the preceding forms. The therapeutic interest of this technique was limited to the inhalation of soot and ash, broncho-aspiration not always being easy. The prognostic value was very restricted as it was not possible to investigate the distal ramifications of the bronchial tree. Further studies are necessary to define some more mucosal aspects, as well as the clinical and paraclinical correlations.
The mechanism of microbial colonization and sepsis is disputed. For many authors, catheter contamination results from poor aseptic technic during insertion or removal or from the descent of organisms along the catheter from the skin puncture site; we think with Michel that endogenous colonization of the thrombus at the tip of the catheter must be considered: a statistical correlation between infected foci remote from the catheter allows this hypothesis; tracheostomy may be considered as well as a percutaneous contaminant as a deep infected focus. The correlation between non specific immunity and contamination is another finding which allows the ability of endogenous colonization.
We found in the literature 119 cases of pheochromocytoma manifested during pregnancy and observed 2 personal cases. Pheochromocytoma and pregnancy show reciprocal influences. Unsuspected diagnosis is frequent and followed by a high maternal mortality. The tumor was surgically removed in 42 cases. There are two different attitudes: when diagnosed in early pregnancy, the tumor can be excised without delay although the foetal risk is high; when the diagnosis is made in the last trimester, foetal maturity has to be awaited to perform a combined caesarean section and excision of the tumor.
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This study was carried out on 17 burned patients. Metabolic heat production, rectal and skin temperatures, and heat exchanges by R+C were measured. It was found that R+C heat loss takes into account 60 to 80% of the increased metabolic heat production. Two methods were used to measure R+C heat loss: calculation by indirect calorimetry and direct measurements by using heat flow discs. The direct relationship which exists between the results of these two methods showed the reliability of the use of heat flow discs for measuring R+C heat loss. This fast-responding techniques may allow the elaboration of a thermal setting system which could modulate ambient air temperature, thus limiting exagerated heat loss due to the skin lesions.
Arterial blood pressure is nowadays easily and reliably measured with ultrasonic equipment. It correlates well with blood volume, and may therefore be used to guide fluid infusion in burned patients. Monitoring of blood pressure, instead of application of old-fashioned recipes, helps to avoid dangerous situations of hypovolemia or overload.
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