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C Defouilloy

Publications and source records attributed to C Defouilloy.

28 records · Page 2Linked to original sources
PubMed1989

[Incidence of nosocomial infections in patients with chronic respiratory insufficiency admitted to a respiratory intensive care unit].

The incidence of nosocomial infections is studied retrospectively, among 174 patients with a chronic respiratory disease, in a ICU during one year (1987). The medium-age is 65 years (range: 19-87 years); the sex-ratio is 125/50 (men/women); 88 (50%) are ventilated; 48 (27%) meet with a nosocomial infection during their stay in the unit. This superinfection involve 61% of the deaths. The lung involved in 67% of the cases, a septicemia from a venous catheter is found in 18% and an infection of the urinary tract in 15%. The nosocomial pneumonias are always the outcome of the ventilation. The Gram-negative bacilli are the most frequent, particularly Pseudomonas aeruginosa (44%). The initial gravity promote the superinfection (SAPSE with superinfection: 16.63 +/- 5.67/without 11.43 +/- 4.59 p less than 0.001). The superinfection involve a prolongation of the ventilatory time (with 27.52 +/- 31.14 days/without 7.27 +/- 7.05 days p less than 0.001). The gravity and the frequency (28%) of the nosocomial infections set the problem of the antibioprophylaxis.

Adult↗
PubMed1988

[Chronic respiratory diseases and their decompensation during pregnancy (asthma excluded)].

There are relatively few observations on the influence of pregnancy in chronic respiratory illness, excluding asthma and interstitial pneumonia. Chronic airflow obstruction only presents at a relatively advanced age, past the menopause. Chronic respiratory failure due to restrictive lung disorders appears well tolerated as long as the vital capacity is greater than one litre. Mucoviscidosis has been the object of more detailed studies since the management of this disorder now raises hopes of survival compatible with pregnancy.

Bronchiectasis↗
PubMed1987

Effects of indomethacin on pulmonary hemodynamics and gas exchange in patients with pulmonary artery hypertension, interference with hydralazine.

To assess the ability of indomethacin (Indo) to influence pulmonary vascular tone in patients with chronic lung disease, we studied the hemodynamic and gas exchange alterations induced by a 50-mg indomethacin infusion in 10 patients suffering from varying degrees of pulmonary artery hypertension and hypoxemia. The most pronounced effects were observed 3 h after Indo administration. Mean systemic arterial pressure (Psa) increased from 76 +/- 4 to 86 +/- 4 mm Hg (p less than 0.01), whereas mean pulmonary arterial pressure (Ppa) was unchanged. The cardiac index (CI) decreased from 3.1 +/- 0.2 to 2.8 +/- 0.2 L/min/m2 (p less than 0.02) because of the reduced heart rate, which decreased from 86 +/- 5 to 80 +/- 4 beats/min (p less than 0.05). Systemic and pulmonary vascular resistance indexes increased, respectively, from 22 +/- 2 to 27.5 +/- 2 U/m2 (p less than 0.001) and from 11.9 +/- 2 to 13.4 +/- 2 U/m2 (p less than 0.05). We measured an increase in PaO2, from 49.5 +/- 4 to 57.5 +/- 4 mm Hg (p less than 0.001) simultaneously with a reduced venous admixture, from 39.5 +/- 4 to 30.5 +/- 3% (p less than 0.001). The calculated PO2 uptake was unchanged, but mixed venous O2 tension increased from 30.5 to 33.5 mm Hg (p less than 0.01). Because Indo may interfere with the hypotensive effect of hydralazine and because hydralazine has been proposed in the treatment of patients with pulmonary hypertension, 7 of these patients also received 0.35 mg/kg hydralazine and Indo plus hydralazine (Indo + H) injected simultaneously.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1987

Hemodynamic effects of urapidil in patients with pulmonary hypertension. A comparative study with hydralazine.

Vasodilator therapy for pulmonary hypertension ideally should cause a proportionately greater reduction of resistance in the pulmonary vascular bed than in the systemic circulation. This should limit the occurrence of systemic hypotension, which can complicate the use of most vasodilator drugs. Urapidil is a new vasodilator that acts by postsynaptic alpha 1-blockade while inhibiting the aortic pressure baroreceptor reflex and reducing central sympathetic tone. We investigated and compared the short-term effects of Urapidil and hydralazine in 10 patients suffering varying degrees of pulmonary hypertension. Each patient received either 0.35 mg/kg hydralazine or 0.75 mg/kg Urapidil intravenously on 2 sequential days in a randomized order. The main effect of Urapidil was to decrease the mean pulmonary artery pressure in all 10 patients from 44 +/- 4 to 37 +/- 3.5 mm Hg (p less than 0.001). After Urapidil infusion, the mean decrease of resistance in the pulmonary vascular bed (32%) exceeded that in the systemic circulation (25%). In contrast, pulmonary artery pressure remained unchanged with hydralazine, and predominant systemic vasodilation occurred: systemic vascular resistance decreased by 45%, whereas pulmonary vascular resistance decreased by 25%. Hydralazine markedly increased the cardiac index and induced tachycardia. Urapidil maintained the heart rate nearly constant and only slightly increased the cardiac index, thereby fostering the diastolic emptying of the pulmonary circulation. No significant change in arterial oxygenation occurred with either drug, although arterial oxygen partial pressure tended to increase with hydralazine. Urapidil may be a promising drug in the treatment of patients with pulmonary hypertension.

Aged↗
PubMed1987

[Use of intrapleural doxycycline via lavage-drainage in recurrent effusions of neoplastic origin].

27 patients (17 F, 10 M) with a mean age of 65 +/- 11 years and suffering from recurrent pleural effusions were treated with locally administered Doxycycline by lavage-drainage to achieve pleural symphysis (17 adeno-carcinomas, 3 large cell carcinomas; 3 epidermoid cancers; 3 non-Hodgkin's lymphoma; 1 small cell carcinoma). The solution used was a dilution of 50 ml doxycycline in 250 cc of isotonic saline. 22 of the 27 patients could be evaluated long term, 5 were lost to follow up, of whom two had recurred straight away despite local treatment. An immediate response was obtained in 23 out of the 28 patients (85%). Later the absence of recurrence was seen in 90% of the patients evaluated. The incidence of antimitotic therapy did not seem to be the determining factor in the 7 patients who received this in parallel. The duration of drainage was 11 +/- 6 days, the local treatment was well tolerated in the majority of cases. The use of the technique of lavage-drainage of doxycycline could be an alternative in those patients with a malignant pleural effusion whose general condition contra-indicates a symphysis under pleuroscopy.

Aged↗
PubMed1984

[Effect of oxygen therapy on chronic pulmonary artery hypertension].

The haemodynamic definition of chronic cor pulmonale is precapillary pulmonary artery hypertension (P.A.H.T.), which determines the long term prognosis of chronic respiratory failure (C.R.F.) due to chronic obstructive airways disease (C.O.A.D.). The essential element of the various causes for an increase in pulmonary arterial pressure (PAP) is an increase in pulmonary arterial resistance secondary to alveolar hypoxia. At the present time, only long term oxygen therapy at home seems capable of limiting the progression of P.A.H.T., with a favourable influence on survival as demonstrated by two recent Anglo-Saxon multicenter surveys. The value of new drugs which have been proposed as a complement to or even a replacement for oxygen therapy, such as Almitrine dimesylate and Nifedipine, is currently being evaluated.

Female↗