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C Zerr

Publications and source records attributed to C Zerr.

26 records · Page 2Linked to original sources
PubMed1981

[Advantage of nicergoline after cardiac surgery in an adult (author's transl)].

Hemodynamic effects of nicergoline injected by intravenous route were studied in 43 patients early after open-heart operations. A serial witnesses has been compared with 5 other groups for which the posologies were increased. Catheterisms of radial artery and pulmonary artery allows the measuring of systolic arterial pressure (SP), right atrial pressure (RAP), pulmonary capillary wedge pressure (PCWP) and cardiac index (CI). The heart rate (HR) was noticed. The systemic vascular resistance (SVR), the stroke index (SI) and the left ventricular stroke work index (SWI) were calculated. The results were statistically analysed by the Student test. After injection of a bolus of 0,3 mg kg-1 by intravenous route, stable effects are obtained with a maintenance posology of 0,8 mg.kg-1.h-1. The SP diminishes by 20 p. cent (123 to 104 mm Hg; p less than 0,01). There is a loose of 16 p. cent from the RAP (9,5 to 8 mm Hg; p less than 0,05) and of 18 p. cent from the PCWP (16,5 to 13,5 mm Hg; NS). The HR decreases by 13 p. cent (97 to 81 syst. min.-1; p less than 0,05). The CI increases by 25 p. cent (2,2 to 2,75 1.min.-1m-2; p less than 0,01); the SI by 40 p. cent (35 to 35 ml beat-1m-2; p less than 0,01) and the SWI by 32 p. cent (27,5 to 36 g.m.m-2; p less than 0,05). We conclude from this investigation that nicergoline injected through intravenous route with an output of 0,8 mg.kg-1.h-1 mainly leads to afterload reduction. Thanks to its effect on the CI and on the HR as well as to its mild to moderate action, it is a clinical useful agent for primary or adjunctive therapy of postoperative low cardiac output.

Adult↗
PubMed1981

[Pulmonary artery catheterization. Advantages of internal jugular route. 75 cases (author's transl)].

The authors relate, after 75 cases, their experience of pulmonary artery catheterism carried out in case of cardiac surgery intervention. The Swan-Ganz catheter is exclusively introduced by the percutaneous internal jugular route and generally right (82 p. cent). During the progression of the catheter the radiologic control is not necessary. The complete failures are rare (2,5 p. cent) and the right pulmonary artery is mostly catheterised in every case. Complications are exceptional and often correspond to benign incidents like premature ventricular contractions which always disappear spontaneously, balloon ruptures (three cases) and the isolation of a non-pathogenic organism during the systemic bacteriologic examination without infections reactions. A serious infection complication has been found in one case and a pulmonary infarction is observed in another case. Compared with other venous route the advantages of this method lie in its very easy, simple, fast and trusty execution.

Adult↗
PubMedDate not supplied

[The management of mediastinal infection following cardiac surgery. Role of the reanimation and of hyperalimentation (author's transl)].

Apprehended complication of the cardiac surgery by median sternotomy, the mediastinitis leads very often to a high death rate, a long hospital-treatment, frequent and sometimes serious sequelae. Considering eleven cases, we are trying to show the interest brought by the choice of the immediate thorax-closing method, in so far as this technic is associated with a correct disinfection of the mediastin a good irrigation-drainage properly well-maintained and overseen, a reanimation technic the main purpose of which is to assure a sufficient caloric and nitrogenous supply.

Acute Disease↗
PubMedDate not supplied

[Antibiotic prophylaxis using a combination of pefloxacin and fosfomycin in heart surgery with CEC (extracorporeal circulation) in patients allergic to beta-lactams].

This study conducted for 15 months, was carried out in 34 patients with beta-lactam allergy scheduled for open heart surgery. In the study, pefloxacin was given orally an hour before the induction of anaesthesia and then as a short infusion following induction. When the bypass was stopped, pefloxacin (400 mg) and fosfomycin (60 mg.kg-1) were given in association by two separate slow intravenous infusions just before sternal closure and repeated in intensive care unit postoperatively. The antibiotic kinetics was observed in blood and cellular concentrations (atria, sternum and mediastinal part of pleura). The antibiotic level analysis showed a good diffusion during the surgical procedure, particularly during the bypass. The pefloxacin given orally was found to achieve satisfactory plasma levels of 5.4 to 6.9 mg.l-1 during sternotomy and always higher than 3 mg.l-1 during bypass. At the sternal closure, the residual plasma level was about 2.8 mg.l-1 before the reinfusion. The kinetic evaluation of fosfomycin has also shown same effective levels. Hence, the clinical potency of these antibiotics was confirmed as predicted by their excellent tissue diffusion. Thus, clinical evaluation was in favour of this antibiotic-association in most cases, except the two following ones. The first case had a lethal bronchiolar and lung reinfection with Pseudomonas aeruginosa and Candida albicans germs which appeared at the 6th postoperative day. The second patient is a case of antibiotic prophylaxis failure. He had developed an acute suppurating mediastinal infection at the seventh postoperative day with a methicillin resistant Staphylococcus aureus which had become pefloxacin fosfomycin resistant. However, the evolution was ultimately good after surgical disinfection of sternotomy and 30 days of drainage and irrigation with antiseptic solution associated with well adapted antibiotic treatment: vancomycin, pristinamycin and rifamycin. In fact, the choice of pefloxacin and fosfomycin for prophylaxis against staphylococcus in cardiac surgery is the right choice for patients having beta-lactam allergy. Their spectral activity and pharmacokinetics give us satisfactory results. But it is not the absolute solution as the bacteria responsible for nosocomial infection (hospital borne infection) may be found resistant to this association.

Adult↗