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Biomedical subjects

A Tenaillon

Publications and source records attributed to A Tenaillon.

At least 19 recordsLinked to original sources
PubMed1992

[From asthmatic crisis to severe acute asthma].

Life-threatening acute attacks constitute the major complication of asthma. These attacks develop progressively or abruptly, within minutes. They are responsible for a mortality rate which in France has been estimated at 3 in 100,000 inhabitants. Most of the deaths occur before any medical assistance is given. Such deaths in serious attacks are caused by bronchial obstruction and not by possible cardiovascular complications. Since inflammation of the bronchi is now thought to be the primum movens of these near-fatal to fatal attacks, nothing but an early and prolonged anti-inflammatory treatment can prevent them. Because no precise profile of subjects at risk can be drawn, it is necessary to supervise with the utmost attention all patients who suffer from attacks of acute asthma which, unless proven otherwise, should be regarded as potentially serious: signs of severity must be systematically looked for, and strict therapeutic and monitoring measures must be taken.

Acute Disease↗
PubMed1992

Evaluation of risk factors for laryngeal edema after tracheal extubation in adults and its prevention by dexamethasone. A placebo-controlled, double-blind, multicenter study.

Because laryngeal edema (LE) after tracheal extubation is likely to result from an exudative response, corticosteroids often are given routinely as a preventive treatment. No adequate controlled study supports this strategy, however. A prospective, randomized, placebo-controlled, double-blind, multicenter trial that included 700 consecutive patients requiring tracheal intubation and mechanical ventilation was conducted to determine risk factors for LE occurrence after tracheal extubation in adults and to evaluate the efficacy of corticosteroids in its prevention. One hour before extubation, patients were given either an intravenous bolus of 8 mg dexamethasone or a placebo. Patients were divided into two groups: 1) those in whom short-duration intubation (SDI, less than 36 h) was administered; and 2) those in whom long-duration intubation (LDI, more than 36 h) was administered. Minor LE was diagnosed when either stridor or laryngeal dyspnea, or both, occurred; major LE was diagnosed when reintubation due to LE was required, with LE evidenced during direct laryngoscopy. The overall incidence of LE was 4.2% and varied among the six participating centers from 2.3 to 6.9% (not significant). In only seven patients (1%), all with LDI, was tracheal reintubation required for LE. Laryngeal edema occurred more frequently after LDI than after SDI (7.2 vs. 0.9%; P less than 0.001). It also was more frequent in female than in male patients (20/284 vs. 8/379; P less than 0.05), irrespective of intubation duration and treatment. There was no association between LE and either difficulty/route of intubation or admission diagnosis.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1990

[Humidification and aspiration of the respiratory tract in patients with mechanical ventilation].

Mechanical ventilation through endotracheal prosthesis, suppresses the nose functions and stops elimination of secretions. It is mandatory to heat artificially, humidify insufflated gas and to suction tracheobronchial secretions. Heating humidifiers are very efficient for the first purpose but heat and moisture exchangers, a little less efficient, seem to be a good alternative as they are easiest to use and offer a good bacterial protection. Tracheobronchial suctioning has to be carried out at least each four hours and at the best as soon as adventitious sound are heard in the chest. Suction catheters have to be atraumatic; vacuum has to be between -200 to -400 cm H2O; catheter have not to be pushed further than the carina; suction hypoxemia can be reduced by shortening suction maneuver, by using suction catheter with little diameter, by conducting the suction on mechanical ventilation.

Arrhythmias, Cardiac↗
PubMed1979

[Optimal expiratory positive pressure during artificial ventilation. Application in the treatment of respiratory distress syndrome in the adult (author's transl)].

In a group of 14 patients (7 males and 7 females) ventilated artificially for acute respiratory distress syndrome, the authors defined a level of optimal expiratory positive pressure giving an FiO2 = 1, an arterial pO2 greater than or equal to 400 mmhg and/or an intrapulmonary shunt less than or equal to 15%. Improvement in arterial pO2 under such conditions would appear to be related to maximum alveolar recrutment. This optimal level of expiratory positive pressure would appear to be independent of values of total static pulmonary compliance. The long term use of this technique would seem to be encouraging.

Adult↗
PubMed1979

PEEP and paCO2.

Explore the source record for details and available documents.

Carbon Dioxide↗
PubMed1977

[Effect of artificial ventilation on pulmonary capillary pressure in acute respiratory insufficiency].

To determine the influence of intermittent positive pressure breathing (IPPB), the level of pulmonary capillary wedge pressure (PCWP) was compared during IPPB and after a short period off the respirator in 68 occasions on 42 patients with an acute respiratory failure (ARF) of various etiologies. During IPPB, the average PCWP was in the normal range in patients with toxic or neurologic comas and in cases of increased pulmonary capillary permeability edema (IPCPE), PCWP slightly increased within chronic obstructive pulmonary disease (COPD) complicated with ARF and in hemodynamic acute pulmonary edema (HAPE). During the weaning stage, PCWP decreased in the groups of coma, COPD, and IPCPE, but increased in HAPE. The weaning test demonstrates that IPPB influenced PCWP in all patients. Therefore, PCWP cannot be assumed to represent the left ventricle filling pressure. The weaning test allows differentiation of IPCPE from HAPE. In the event of over-infusion or hypovolemia, PCWP measured under IPPB can lead to misinterpretation if not followed up by a second measurement off the respirator.

Acute Disease↗