Search PubMed⌕ Search

Biomedical subjects

Y Blanloeil

Publications and source records attributed to Y Blanloeil.

At least 91 records · Page 5Linked to original sources
PubMed1985

[Acute renal failure after extracorporeal circulation with aortic counterpulsation in surgically treated patients].

In a series of 604 adults operated on for cardiac surgery with cardiopulmonary bypass (CPB), 21 (3.5%) underwent circulatory assistance by intra-aortic balloon pump (IABP); in 5 of them (24%), acute renal failure (ARF) was observed. ARF occurred in only 26 (4.4%) of the other patients who did not require IABP. Evolution of ARF and its factors were therefore investigated in those patients having received IABP. ARF was defined as serum blood urea nitrogen (BUN) greater than or equal to 16 mmol X 1(-1), urinary urea/BUN less than 10, creatinine clearance less than 40 ml X min-1 X 1.73 m-2. Some perioperative features were compared between patients with postoperative ARF and those without ARF. ARF occurred in the 5 patients with IABP during, or immediately after, weaning from IABP. ARF was more frequent in patients operated on for mechanical complications of myocardial infarction with a significant more severe haemodynamic status. They had significantly longer CPB and aortic clamping times. The prognosis depended on the cardiac failure and not on the ARF. In patients with mechanical complications of infarction, early IABP seemed to be the predominant preventive measure. Other therapeutic implications are suggested, particularly the use of dopamine (1 to 3 micrograms X kg-1 X min-1) because of its renal vasodilating action which can contribute to the maintenance of urinary flow.

Acute Kidney Injury↗
PubMed1985

[Plasma renin activity and prostaglandin E2 in hypotension induced by sodium nitroprusside].

Sodium nitroprusside (SNP) is a potent, effective and readily reversible vasodilating agent frequently used in anaesthesia for deliberate hypotension. Moderate hypotension induced by SNP activated catecholamine and vasopressin secretions, and the renin-angiotensin system, resulting in partial antagonism of the hypotensive response to SNP. Furthermore, this increase in renin release was involved in the hypertensive rebound after SNP withdrawal. This activation of vasoconstrictor systems led to pharmacological associations aimed at reducing the risk of cyanide poisoning. The physiological interrelationship between prostaglandins and renin secretion has now been well established but, as far as we know, no paper existed concerning prostaglandins during SNP-induced hypotension. In such hypotension (Pa: -30%), monitored by invasive and non invasive haemodynamic techniques (pulsed Doppler), the variations in plasma renin activity (PRA) and in venous and arterial plasma PGE2 concentrations (V PGE2 and A PGE2), determined by radioimmunoassay, were studied in anaesthetized dogs. Invasive haemodynamic data were similar to previous reports. Common carotid diameter increased (p less than 0.05), with a constant common carotid blood flow. PRA (p less than 0.05), V PGE2 (p less than 0.05) and A PGE2 (p less than 0.05) increased. PRA and V PGE2 were highly correlated before and after SNP. SNP resulted in hypotension with reflex sympathetic activation and dilatation of large arteries. Carotid blood flow autoregulation was maintained. Whilst pulmonary removal of PGE2 remained unchanged, an increase in A PGE2 may have been involved in the vasodilator mechanisms.

Animals↗
PubMed1985

[Viral hepatitis B. Risk for the anesthetist].

The risk of hepatitis B, previously reported in other countries, has never been investigated in French anaesthetic medical staff. The prevalence of hepatitis B viral markers has been calculated among the medical staff of the Department of Anaesthesiology, the hospital health care personnel, patients before surgical procedure and renal transplantation patients. The frequency in anaesthesiologists (18.75%; 12 out of 64) was significantly greater (p less than 0.05) than in health care personnel (10.5%; 91 out of 863). Prevalence increased with the length of practice in anaesthesiology. Prevalence of markers is 8.7% (27 out of 196) in patients undergoing surgery and 82% (27 out of 33) in patients operated on for renal transplantation in 1981. Frequency of carriers of the hepatitis B surface antigen is 0% in medical staff, 0.2% in health care personnel and 0.5% in patients before surgery. Among the health care staff, anaesthesiologists belong to a high risk population for hepatitis B. Prevention by administration of hepatitis B vaccine is recommended to protect the anaesthesiologist, his relatives and his patients.

Allied Health Personnel↗
PubMed1984

[Postoperative respiratory complications of myotonia dystrophica (Steinert's disease)].

Respiratory difficulties have long been recognized to be a major risk in patients with myotonia dystrophica, but postoperative pulmonary complications have only rarely been considered. Two cases of postoperative pulmonary complications which led to the patients's death stressed the severity and difficulty of treatment of these complications. A third case of postoperative respiratory failure revealed the underlying disease. These cases showed all the more the importance of preventing pulmonary complications. Pre-, per- and postoperative measures, chosen with respect to the severity of the myotonia and the seat of the surgical procedure, are suggested.

Adult↗
PubMed1984

Hemodynamic pattern in anaphylactic shock with cardiac arrest.

A 41-yr-old man developed anaphylactic or anaphylactoid shock 9 min after infusion of a modified fluid gelatin. The hemodynamic effects of shock from its onset were studied: fall in mean arterial pressure (MAP) and systemic vascular resistance index (SVRI), increase in cardiac index (CI) and stroke index (SI). When the infusion was stopped, a few min after the onset of shock, wedge pressure (WP) fell sharply and the patient experienced cardiac arrest without previous arrhythmia or other ECG anomaly, thus demonstrating the importance of maintaining the left ventricular filling pressure at a normal level in the course of anaphylactic shock.

Adult↗
PubMed1984

[Heart surgery with extracorporeal circulation in hemodialyzed patients with renal insufficiency].

The authors report 4 valvular replacements under cardiopulmonary bypass in chronic hemodialysis-dependent patients. The peri-operative management was the same in every case. The recent improvements of intensive care medicine amend this protocol. Considering the analysis of data from the literature and the results of our 4 valvular replacements these operations and coronary artery-bypass graft, can be scheduled with an acceptable risk in these patients. Because of the hemodynamic improvement secondary to the cardiac operation, which allows a better tolerance of hemodialysis, this surgery must not be delayed.

Adult↗
PubMed1984

[Prophylactic antibiotic therapy with cefamandole in total hip surgery replacement using Charnley's tent. A randomized study].

A randomized study of one-day prophylactic antibiotic therapy in total hip arthroplasty was performed in 93 procedures in 84 patients. All patients were operated by the same surgeons with use of a clean air system. They were divided into two groups: K- without antibiotic, and K+ with intravenous cefamandole, 1.5 g before incision followed by 1.5 g every four hours up to the 24th postoperative hour. Clinical follow up by the surgeons included four examinations within the first year. There was no significant difference in age, repartition of sexes or acquired physical defects between the two groups. Major deep infections requiring revision surgery occurred early in one case in K+ and early in four cases and late in one in K6. Nine patients had bilateral hip replacement. Only one infection was observed, in the only patient who did not receive cefamandole for either procedure. Physical disability had no influence on infection. Microbial organisms isolated from deep infection foci were not consistently identical with pathogens previously identified in wound drainage fluid. Staphylococcus aureus was responsible for 4 of 6 deep infections. One-day prophylactic antibiotic therapy by cefamandole decreases the incidence of deep infection at the surgical site in total hip arthroplasty with use of a clean air system.

Cefamandole↗
PubMed1984

[Incidence and prognosis of acute renal failure after cardiac surgery with extracorporeal circulation].

Acute renal failure occurred in 21 patients after 311 cardiac operations with cardiopulmonary bypass in adults (6,75%). It was non oliguric in 20 cases. It is related to per and postoperative hemodynamic depression. Patients operated for valvular replacement seemed most at risk if severe cardiac failure existed with or without preoperative renal dysfunction. Similarly those operated upon for mechanical complications of myocardial infarction were often affected. The prognosis depends on the degree of cardiac failure. Strict patient selection, myocardial protection during bypass and measures to increase low cardiac output are recommended. Intra-aortic balloon pump for patients with myocardial infarction and dopamine in the early postoperative period seem helpful.

Acute Kidney Injury↗
PubMed1983

[Peroperative circulatory arrest caused by a tumoral pulmonary embolism following hepatectomy for tumor. Apropos of a case].

The authors report a case of pulmonary tumor embolism during a hepatectomy for hepatoma, leading to a fatal cardiac arrest. This cause of cardiac arrest during operation has never been reported in the literature, but systematic autopsies of patients dying from liver cancer, especially primary or metastatic tumors, shows that the incidence of these embolisms is frequently underestimated. Any anomaly of the hepatic vein appearing in the X-rays implies a danger of intra- or post-operative embolism. Allowance must therefore be made for this in the surgical technique, which should include complete or partial cross-clamping of the vena cava.

Carcinoma, Hepatocellular↗
PubMed1983

[Acute respiratory distress syndrome after accidental inhalation of a hydrosoluble contrast medium].

Acute respiratory distress syndrome after accidental aspiration of hydrosoluble contrast medium is reported. In spite of pulmonary superinfection, the outcome was favorable after mechanical ventilation with permanent positive pressure. This case confirms previous reports and invites to extreme caution when such agents are used in patients with swallowing disorders and preexisting pulmonary disease.

Diatrizoate↗
PubMed1983

Intraoperative pulmonary tumor embolism after hepatectomy for liver carcinoma.

Intraoperative pulmonary tumor embolism occurred during right hepatectomy for primary hepatic carcinoma. The tumor embolus produced abrupt arterial hypotension, tachycardia, an increased central venous pressure, intense cyanosis, followed by cardiac arrest. Pulmonary tumor embolism resulting from hepatic tumors is rare and has not been reported to have occurred intraoperatively. When tumor thrombosis has been detected or suspected, hepatic vascular exclusion should be considered for the prevention of intraoperative embolism.

Carcinoma, Hepatocellular↗
PubMed1983

[Hemodynamic effects of flunitrazepam in cardiac patients during anesthetic induction].

The hemodynamic effects of flunitrazepam were studied in eight coronary patients (group I) and in six patients with compensated cardiac failure (group II) during the induction of anesthesia with droperidol 5 mg and fentanyl 4 micrograms . kg-1. A right sided cardiac catheterization was performed to measure cardiac output by thermodilution. In coronary patients, the hemodynamic parameters were only slightly modified (NS). Cardiac output (-12.7%) and oxygen consumption (-20.4%) decreased; Pvo2 increased from 6.4 +/- 0.1 to 7.3 +/- 0.3 kPa. In patients with cardiac failure, significant cardiovascular changes were not observed. Arterial pressure (-13%), cardiac output (-2.6%), oxygen consumption (-6%) and systemic vascular resistance (-13.4%) decreased; Pvo2 increased from 6.4 +/- 0.5 to 6.8 +/- 0.7 kPa. In both groups, heart rate and pulmonary capillary wedge pressure were unchanged. There was only a significant difference (p less than 0.05) between the decrease in systemic resistance in group II and in the absence of change in systemic resistance in group I. Decrease in oxygen consumption be decrease in oxygen demand could explain the slight decrease in cardiac output. Flunitrazepam was a good hypnotic for the induction of anesthesia in normovolaemic coronary patients and in patients with compensated cardiac failure.

Acid-Base Equilibrium↗
PubMed1982

[Comparison of the hemodynamic effects of fazadinium, pancuronium and alcuronium in coronary insufficiency (30 cases)].

Cardiovascular effects of neuromuscular blocking agents mainly guide the choice of these relaxants in patients with cardiovascular disease. The purpose of this study was to compare the hemodynamic effects of fazadinium (1 mg . kg-1), pancuronium (0,08 mg . kg-1) and alcuronium (0,2 mg . kg-1) in 30 coronary patients without beta-blocking therapy. No hemodynamic changes were observed after pancuronium. Fazadinium induced at the fifth minute a mean five p. 100 decrease in mean arterial pressure, cardiac index, stroke volume and systemic vascular resistance. At the fifth minute with alcuronium, mean arterial pressure decreased (22 p. 100) (p less than 0.01) with a decrease in cardiac index (12 p. 100), stroke volume (8 p. 100) and systemic vascular resistance (10 p. 100). This study shows that pancuronium and fazadinium are well tolerated. Alcuronium induces at the fifth minute a significant decrease in arterial pressure. This effect does not seem to be deleterious in normovolemic patient with coronary artery disease without beta-blocking therapy.

Aged↗