PubMed Health⌕ Search

Biomedical subjects

A Yazigi

Publications and source records attributed to A Yazigi.

At least 19 recordsLinked to original sources
PubMed2006

[Reliability and survival of arterial catheters: optimal dynamic response].

OBJECTIVES: Blood pressure is one of the most critical haemodynamic parameter in the intensive care unit (ICU). The measurement relies mainly on invasive methods (arterial lines) but also on noninvasive methods (Oscillometric and Manual). It is crucial to be instantaneous and accurate to adapt any decision making plan. The aim of this study is to evaluate the reliability of this measure given by an arterial catheter over time. This can determine the maintenance of catheter patency before clinical total occlusion. STUDY DESIGN: Observational prospective study. PATIENTS AND METHODS: Damping coefficient (xi) and natural frequency (Fn) of the arterial catheter system are studied in vivo each 12 hours by a fast flush test (FFT) in 61 patients. The measurements of the arterial blood pressure invasively (arterial catheter method) and non invasively (oscillometric method) are compared each 12 hours until the catheter is removed. RESULTS: All over the study period for each catheter (till 240 hours), the mean arterial blood pressure measurements given by either the catheter method or the oscillometric method were very concordant (coefficient > 0.7). Only 3.39% of the catheters had their physical characteristics (xi and Fn) in the optimal zone at T0; reaching 66.67% at T19. The maximal inserted time was highly correlated with a good operating catheter (R = 0.739; P < 10(-4)). CONCLUSION: The measure of the arterial blood pressure invasively can still be reliable for a long period of time (10 days), as long as the catheter is inserted, especially when the mean arterial pressure is considered. Each time the distance of the catheter insertion site moves away 1 cm from the radiocarpal joint or the groin, the risk of troubleshooting is doubled; on each blood sample from the catheter, this risk is reduced by 20%.

Adult↗
PubMed2006

Effect of vital capacity manoeuvres on arterial oxygenation in morbidly obese patients undergoing open bariatric surgery.

BACKGROUND: Arterial oxygenation may be compromised in morbidly obese patients undergoing bariatric surgery. The aim of this study was to evaluate the effect of a vital capacity manoeuvre (VCM), followed by ventilation with positive end-expiratory pressure (PEEP), on arterial oxygenation in morbidly obese patients undergoing open bariatric surgery. METHODS: Fifty-two morbidly obese patients (body mass index >40 kg m-2) undergoing open bariatric surgery were enrolled in this prospective and randomized study. Anaesthesia and surgical techniques were standardized. Patients were ventilated with a tidal volume of 10 mL kg-1 of ideal body weight, a mixture of oxygen and nitrous oxide (FiO2 = 40%) and respiratory rate was adjusted to maintain end-tidal carbon dioxide at a level of 30-35 mmHg. After abdominal opening, patients in Group 1 had a PEEP of 8 cm H2O applied and patients in Group 2 had a VCM followed by PEEP of 8 cm H2O. This manoeuvre was defined as lung inflation by a positive inspiratory pressure of 40 cm H2O maintained for 15 s. PEEP was maintained until extubation in the two groups. Haemodynamics, ventilatory and arterial oxygenation parameters were measured at the following times: T0 = before application of VCM and/or PEEP, T1 = 5 min after VCM and/or PEEP and T2 = before abdominal closure. RESULTS: Patients in the two groups were comparable regarding patient characteristics, surgical, haemodynamic and ventilatory parameters. In Group 1, arterial oxygen partial pressure (PaO2) and arterial haemoglobin oxygen saturation (SaO2) were significantly increased and alveolar-arterial oxygen pressure gradient (A-aDO2) decreased at T2 when compared with T0 and T1. In Group 2, PaO2 and SaO2 were significantly increased and A-aDO2 decreased at T1 and T2 when compared with T0. Arterial oxygenation parameters at T1 and T2 were significantly improved in Group 2 when compared with Group 1. CONCLUSION: The addition of VCM to PEEP improves intraoperative arterial oxygenation in morbidly obese patients undergoing open bariatric surgery.

Adult↗
PubMed2005

General anesthesia with remifentanil for Cesarean section in a patient with HELLP syndrome.

HELLP syndrome is a severe complication of pre-eclampsia characterised by hemolysis, elevated liver enzymes and a low platelet count. It is associated with an increased risk of adverse outcome for both the mother and the fetus. Patients with HELLP syndrome are also at greater risk of pulmonary edema, adult respiratory distress syndrome, abruptio placentae, intracerebral hemorrhage, eclamptic convulsions, disseminated intravascular coagulation, ruptured liver hematomas and acute renal failure. Perinatal mortality is equally high. Before delivery, aggressive obstetric management is directed toward stabilization of the affected organ systems, if possible, and interruption of the pregnancy in the early phase of the accelerated disease progression. Definitive therapy is delivery. Parturients HELLP syndrome often require general anesthesia for Cesarean section delivery. The anesthetic technique is critical for these patients with a high risk of uncontrollable hypertension, bleeding and multiple organ failure. Remifentanil is increasingly used as a very short analgesic agent providing cardiovascular stability in high-risk patients. We report the management of a patient presenting in labor with HELLP syndrome, and describe the successful use of remifentanil as part of the anesthetic technique for her subsequent Cesarean section.

Adult↗
PubMed2002

[Comparison of nicardipine and isradipine in hypertension following coronary artery bypass graft].

OBJECTIVE: Compare the efficacy of isradipine to that of nicardipine for the control of arterial hypertension following coronary artery bypass graft (CABG). STUDY DESIGN: Clinical prospective, randomised study. MATERIAL AND METHODS: 40 patients ASA II or III, mean age 66 +/- 8 years, scheduled for elective CABG were included. If the mean arterial pressure (MAP) was > or = 100 mmHg within the first six post operative hours, the patients were included and randomly attributed to either one of the 2 groups: Gr I (n = 20) received nicardipine, Gr II (n = 20) received isradipine in bolus then in continuous perfusion. HR, MAP, MPAP, CVP, PCWP, CI, SVRI, PVRI and SVI were recorded at: T0 before administration of drugs, T1 = 2 min after the first bolus. T2 when MAP reached 85 +/- 5 mmHg. T3, T4, T5, T6, T7 and T8 at 5, 10, 30, 60, 90 and 120 min after the continuous perfusion. T9 before stopping the perfusion. RESULTS: No significant changes in HR, CVP, PCWP, MPAP or PVRI at any time in both groups. Significant increase in CI at T2 in both groups. Reduction of MAP at T2 was more important (-27%) in Gr I compared to that in Gr II (-22%). This was mainly due to a significant decrease in SVRI. CONCLUSION: Isradipine is effective in the treatment of arterial hypertension following CABG. However there is not any significant beneficial effect of isradipine over nicardipine.

Aged↗
PubMed2002

[Bilateral ilioinguinal nerve block for ambulatory varicocele surgery].

OBJECTIVE: The aim of this study was to evaluate the effectiveness of bilateral ilioinguinal-iliohypogastric nerve blocks for pain relief following ambulatory bilateral varicocelectomy. STUDY DESIGN: Prospective and randomised. PATIENTS AND METHODS: Sixty adult men scheduled for bilateral varicocelectomy were included in this prospective study. All patients had a standardised general anesthesia. After surgical procedures, patients were randomized into two groups: patients in group I received a bilateral ilioinguinal nerve block with 15 ml x 2 of 0.25% bupivacaine; patients in group II received subcutaneously 1 mg kg-1 of tramadol. Visual analogue pain scores at rest and during mobilisation were recorded at 5 min and 1, 3, 5 postoperative hours. The side effects of analgesia and amounts of rescue analgesics were recorded. RESULTS: Pain scores at rest and during mobilisation, the incidence of postoperative nausea and vomiting and additional analgesics requirement were significantly reduced in group I. There was no complication. CONCLUSION: Ilioinguinal nerve block is effective in controlling pain after bilateral varicocelectomy in ambulatory surgery.

Adult↗
PubMed2002

Accuracy of radial arterial pressure measurement during surgery under controlled hypotension.

BACKGROUND: Radial arterial pressure underestimates the pressure in the aorta in several clinical situations. A central-to-radial pressure gradient was attributed to intense vasodilation. The aim of this study was to evaluate the accuracy of radial pressure monitoring during controlled hypotension achieved with profound arterial vasodilation. METHODS: Ten patients with ASA physical status I and II undergoing maxillofacial surgery under general anesthesia were enrolled in this prospective study. Radial and femoral arteries were cannulated and connected to a pressure monitoring system. Controlled hypotension was achieved with an infusion of nicardipine titrated to maintain MAP between 50 and 60 mmHg. Simultaneous radial and femoral systolic, mean and diastolic arterial pressures were recorded before, during and after controlled hypotension. Results were expressed as mean +/- SD. Concomitant radial and femoral pressures were compared by a paired Student's test, P < 0.05 being significant. RESULTS: In all, 150 sets of arterial pressures measurement were obtained. There were no statistically significant differences between radial and femoral arterial pressures measured before, during or after controlled hypotension. CONCLUSION: Radial arterial pressure is an accurate measure of central arterial pressure during controlled hypotension achieved with arterial vasodilation.

Adult↗
PubMed2002

Bone mineral density in beta - thalassemic Lebanese children.

Osteoporosis has been described extensively in adult thalassemics. Fewer studies have been reported in thalassemic children. In this article, we measured the bone mineral density (BMD) of Lebanese beta-thalassemic children before institution of a balanced transfusion-chelation regimen, in comparison with that of healthy controls, and studied its correlation with various demographic and biological parameters. Both groups, controls and thalassemics were comparable with respect to age, sex, socioeconomic and regional distribution. On the other hand, thalassemics had a significantly lower height age (p<0.001), lower bone age (p=0.001), lower sexual maturation (p=0.004), lower absolute BMD values and larger negative BMD-Z scores (p<0.001). Within the thalassemic group, BMD correlated significantly with luteinizing hormone (LH) and follicle stimulating hormone (FSH), estradiol and testosterone values, as well as with the pretransfusion hematocrit, but not with other endocrine or bone metabolism parameters. We conclude that Lebanese beta-thalassemic children have a significantly lower BMD than their healthy counterparts due, in part, to their slower physical development. A major contributor seems to be the low-transfusion regimen followed by these patients, as well as the endocrine dysfunction which was detected in about 25% of them.

Journal Article↗
PubMed1998

Colchicine for recurrent pericarditis in children.

The incidence of recurrence of acute pericarditis in children varies from 15% to 30% and is accompanied by a high morbidity. Various treatment modalities have been used with variable success rates and side effects. La Serna et al. (Lancet 1987; 26: 1517) were the first to treat adults with recurrent pericarditis with colchicine, and were followed by other authors. To our knowledge no studies in children have been reported. In this paper, we present three children who suffered from viral or idiopathic recurrent pericarditis, despite multiple courses of non-steroidal anti-inflammatory drugs (NSAIDs) and/or corticosteroids. They responded remarkably well to colchicine, which was administered for 6 months with no adverse reactions. They continue to do well 18, 11 and 12 months after cessation of treatment, respectively.

Adolescent↗
PubMed1998

Prognostic importance of automated ST-segment monitoring after coronary artery bypass graft surgery.

BACKGROUND: Automated ST-segment monitors are widely used in cardiac surgery units. The purpose of this study was to determine if cardiac morbidity and mortality, after CABG surgery, are predicted by ECG ST-segment changes on automated monitors. METHOD: One hundred patients, who underwent CABG, were included in this prospective study. ST-segment deviations were recorded by an automated ST monitor, in the ICU, for 24 h after surgery. A reversible ST depression of more than 0.1 mV or a ST elevation of more than 0.2 mV and for at least 1 min were considered as significant episodes. Adverse cardiac outcomes were defined as: myocardial infarction (MI), severe left ventricular failure, ventricular fibrillation (VF) and cardiac-related death. RESULTS: Sixty patients (group 1) presented significant episodes of ST deviation (6+/-5 episodes per patient). Forty patients (group 2) were free from ST changes. Eight patients from group 1 had postoperative adverse cardiac outcomes: 5 MI, 2 VF and 1 cardiac-related death. Patients from group 2 were all free from adverse cardiac outcomes. Automated ST-segment analysis during the first 24 h had a positive predictive value of 13% and a negative predictive value of 100%. CONCLUSION: Automated ST analysis is a non-invasive, sensitive and very easy-to-use monitoring system to screen patients who may develop myocardial ischemia and cardiac complications after CABG surgery.

Automation↗