Biomedical subjects
Publications and source records attributed to A Milhaud.
The measurement of transcutaneous PtcO2 in eight normal adults prove a comparable efficacy of 50 l.min-1 O2 through facial "small mask" (61.5 kPa; 463 mmHg) and 20 l.min-1 O2 through head tent (65.1 kPa; 490 mmHg). First procedure, inexpensive, is very simple to use.
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Authors who organised the 3e Réunion Inter-Régionale Nord d'Anesthésiologie sur le thème "Practice of Monitoring in Anesthesia and in critical care" proposed the creation of an incidents recorder for increasing patients' safety and medico-legal protection of Anesthesiologists.
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The authors used during 75 prolonged general anaesthesia in maxillo-facial surgery CT. 1341 (Alfatesine) administered pure at constant flow rate through a double lumen venous cannula and electric perfuser. Four series of patients were thus distinguished depending on their use or not of N2O as the only analgesic and of gallamine. We do not agree with the classical assertion that CT. 1341 has a cumulative effect on some EEG results. The technique is quite inocuous and the authors propose a technique using CT. 1341 at a dose of 0.1 ml/kg for induction of anaesthesia with, later, 1 mg/kg of gallamine. Under a mixture of oxygen and nitrous oxide at 60 p. 100, the maintenance dose advised in 6.17 microliters per kilo, per minute of CT. 1341.
During general anesthesia for bronchoscopy, hypoxemia is a major risk, especially in patients with a severe intrapulmonary shunt. With the technique of apnea in pure oxygen, after one hour denitrogentation, and with an intake of 50 liters of oxygen per minute through the bronchoscope, the PaO2 was greater than 400 mm of Hg, but hypercapnia and acidosis occurred. To compensate the latter, five minute sessions of apnea, alternating with two minutes of jet hyperventilation, nevertheless, have the disadvantage of producing a Ventrui phenomena at the proximal end of the bronchoscope, hence a fall in FiO2 which was dangerous in these high risk patients. The authors propose a method so that the Venturi phenomenon, which cannot be prevented, occurs in pure oxygen.
The Picardy regional S.A.M.U. implanted in Amiens, has participated in the implantation of antennae of the S.M.U.R. whereby aid can be given accident cases on the northern motorway. After a brief historical review of the creation of these antennae, and presentation of what exists in the sections of the northern motorway not in Picardy, the means of the regional S.A.M.U. are presented, and the way it which it functions, with regards to specific problems concerning medical aid on the motorway. The results of the S.M.U.R. activities are presented and discussed. The necessity for good coordination of medical aid, the fundamental role of the regional S.A.M.U., is particularly emphasized.
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The authors have made a critical study of the respective advantages and disadvantages of the various methods of access to the internal jugular vein. These have been classified under 3 headings: frontal access, lateral access and rear access. They outline their experience of the technique described by Boulanger and Delva in 1977. This method of access seems to be favoured on two scores, its simplicity and the absence of immediate serious complications. These encouraging results lead them to advocate this as the technique they would choose especially in urgent cases.
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