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Biomedical subjects

F Nicolas

Publications and source records attributed to F Nicolas.

At least 73 records · Page 4Linked to original sources
PubMed1983

Influence of cardiac rhythm on the haemodynamic effects of fazadinium in patients with heart failure.

The haemodynamic effects of fazadinium were compared in two groups of elderly patients with class III functional heart failure about to undergo gastrointestinal surgery. Four patients were in sinus rhythm and four in atrial fibrillation. Following the assessment of baseline values fazadinium 1 mg kg-1 was injected i.v. and measurements obtained every 1 min for 15 min. In patients in sinus rhythm, fazadinium produced a decrease in total peripheral resistance, which was maximum at the 1st min (delta TPRI -738 +/- 88 dyn s cm-5 m2) and accompanied by a moderate decrease in arterial pressure (MAP -27 +/- 2.4 mm Hg) and cardiac index (delta CI -0.23 +/- 0.17 litre min-1 m-2) and a moderate increase in heart rate (delta HR +16 +/- 5.7 beat min-1). In patients in atrial fibrillation, a similar decrease in total peripheral resistance (delta TPRI -1160 +/- 174 dyn cm-5 m2) was accompanied by a significantly more pronounced tachycardia (delta HR +71 +/- 5.1 beat min-1) (P less than 0.001) and decreases in arterial pressure (delta MAP -51.7 +/- 5.9 mm Hg) (P less than 0.01) and stroke index (P less than 0.02).

Aged↗
PubMed1983

Echocardiography and left ventricular function on recovery from anaesthesia in patients with coronary artery disease.

Eight patients with coronary artery disease and eight age-matched patients without coronary artery disease undergoing noncardiac surgery were submitted to M-mode echocardiography and haemodynamic measurements. In the patients with coronary artery disease, but not in the controls, recovery from anaesthesia was associated with echocardiographic and haemodynamic changes suggestive of impaired cardiac pump function. This impairment seems to result from an imbalance between myocardial oxygen availability and demand in patients with coronary artery disease.

Acid-Base Imbalance↗
PubMed1983

[Collective acute poisoning by nitrous gases].

A collective nitrous fumes poisoning (five cases) is reported. Two patients (case 3 and case 4) were comatose, in severe respiratory distress. Shock and slate blue cyanosis were noted. Physical examination and chest X ray revealed acute pulmonary edema-Methemoglobin levels were 71,3% (case 3) and 58% (case 4). Despite treatment both of them died from severe hypoxia resulting in cardiorespiratory arrest. Post-mortem examination was performed upon these four men. On admission the last one (case 5) was conscious, and in good hemodynamic condition. Acute pulmonary edema and cyanosis were present. Methemoglobin level was 37,3%. This patient recovered appropriate therapy. For case 1 and 2 acute anoxia due to methemoglobinemia seems to be cause of death. For cases 3 and 4 death is due to hypoxemia associated with pulmonary edema.

Accidents, Occupational↗
PubMed1982

[Cell-mediated immunity studied by skin tests in patients receiving intensive care. Prognostic value of repeated tests. Study of some factors predisposing towards anergy (author's transl)].

Cell-mediated immunity was assessed by three skin tests (using tuberculin, candidin, and Varidase) in one-hundred patients in a medical intensive care unit. Anergy on admission was most often found after major blood loss and massive transfusion as well as in patients over sixty. For the 49 patients who were anergic on admission the mortality rate was 32%, against 12% for the 51 reactive subjects (p less than 0.01). Repetition of skin tests considerably improved their prognostic value. No deaths occurred among the 21 patients who were reactive on admission and throughout the course of their disease, or among the 16 patients who, after being anergic on admission, became reactive subsequently. Conversely, the survival rate was only 40% for the 22 patients who remained or became anergic. Our results confirm the value of skin tests for assessing cell-mediated immunity in patients receiving intensive care. Repeated tests allow early detection of high risk patients in whom fatal outcome, whether due to infection or not, is more frequent. Two factors which predispose to anergy are underlined: advanced age and massive transfusion after major blood loss.

Adult↗
PubMed1982

[Development of blood sugar and insulinemia in the first 12 postoperative hours. Effects of glucose and insulin intake].

Serum levels of glucose and insulin are studied during 12 hours in the early post-operative period after intra-abdominal surgery. Five groups of non diabetic patients are perfused with incremental doses of glucose, G. I: no glucose, G. II: 8,33 g . h-1 of glucose during 6 hours, G. III: 16,66 g . h-1 of glucose during 6 hours, G. IV: 16,66 g . h-1 of glucose with 20 mu insulin; G. V: 16,66 g . h-1 of glucose with 40 mu insulin. In all groups a significant rise in serum levels of glucose is observed (10,5-15,6 mmol . l-1). At the same time serum level of insulin remains unchanged except when insulin is infused. However exogenous insulin is unable to prevent the serum level of glucose to rise post-operatively.

Adult↗
PubMed1982

[Fluid loading in the surgical care of pheochromocytoma. Hemodynamic study].

Collapse following removal of pheochromocytoma can be usually prevented by fluid loading. Fluid infusion is administered at the early beginning of the surgical procedure and is accelerated just after removal. Some authors prefer to start the fluid infusion in the preoperative period. In every cases preload measurements are of primary importance for a safely fluid administration. Problems of fluid loading in course of pheochromocytoma surgery are studied in six patients. Hemodynamic data are collected during pre, per and postoperative periods. Pre and post operative rapid fluid loading was performed in three patients in order to obtain a left ventricular function curve. Before any fluid treatment, two groups of patients are distinguished: 1) five hypovolemic patients who are about to receive 1 000 +/- 300 ml to normalize pulmonary wedge pressure, 2) one patient with high pulmonary wedge pressure and with alterated myocardial performance observed during rapid fluid loading. Combined use of sodium nitroprusside and fluid loading allowed to control hypertensive accesses and preload elevations and to prevent collapse following tumor removal. Hypovolemia and myocardial lesions are not necessarily present in all cases of pheochromocytoma. The routine use of a pulmonary artery catheter is warranted to improve cardiac pump function by combined fluid and vasodilator management.

Adrenal Gland Neoplasms↗
PubMed1981

[Sodium nitroprusside in ischaemic complications of acute ergot poisoning (author's transl)].

Various treatments have been tried against ischaemic complications of acute ergot poisoning, but no definite therapeutic approach based on a sufficient number of cases has yet been proposed. The mechanism of vascular spasm, the action of sodium nitroprusside and the good results obtained in 7 cases reported in the literature and in 2 personal cases have prompted the authors to suggest the use of this drug as first-choice treatment in these patients.

Acute Disease↗
PubMed1981

Comparison of effects of balanced anaesthesia and neuroleptanalgesia on postoperative cardiovascular function in patients with coronary artery disease.

Patients with chronic ischaemic heart disease and a history of myocardial infarction or who present with exertional or spontaneous angina suffer a decrease in left ventricular pump function during recovery from anaesthesia and in the period immediately after operation. This decrease is reflected in an increase in pulmonary capillary wedge pressure and in a decrease in stroke volume and cardiac output. Two groups of 10 such patients, clinically and haemodynamically comparable in the preoperative period, were studied: 10 patients received balanced anaesthesia, and 10 neuroleptanalgesia. The disturbance in left ventricular function was less pronounced with neuroleptanalgesia. A significant difference was noted between the groups with regard to pulmonary capillary wedge pressure during recovery from anaesthesia (balanced anaesthesia 15.8 +/- 4.4 mm Hg; neuroleptanalgesia 10.7 +/- 4.4 mm Hg; P less than 0.02). There was a relationship between type of anaesthesia and pulmonary capillary wedge pressure variations (P less than 0.01).

Abdomen↗
PubMed1981

[Gas gangrene of dental origin. Report on four cases (author's transl)].

Four patients developed diffuse cervicofacial cellulitis following an acute circumscribed infection of dental origin. Necrosis of skin, subcutaneous and muscle layers was associated with a severe generalised toxic infective syndrome, producing a clinical picture and following a course identical with that observed in gas gangrene of the limbs. Anaerobic germs, normally present in the buccodental region, were at the origin of the affection in all four cases, chronic dental lesions providing favourable anaerobic conditions for an increase in their virulence. Three factors appear to be of importance for the development of gas gangrene from dental abscesses: insufficient or lack of suitable surgical treatment, the use of antibiotics not active against anaerobic germs, treatment with corticoids or anti-inflammatory drugs. Once gas gangrene has developed, possible intramediastinal spread should be investigated. Treatment is essentially surgical (with excision of necrotic tissue and wide drainage), plus penicillin therapy and hyperbaric oxygen. The prophylaxis of these gas gangrene lesions is discussed.

Adult↗
PubMed1981

[Anaphylactoid shocks induced by infusion of a modified gelatin. Six cases (author's transl)].

One of these shocks occurred in course of a rapid infusion in a patient in whom catheters were previously inserted. So, an hemodynamic study was possible. This study shows a peripheral vasodilatation leading to a decrease of preload and cardiac output, and finally to a systemic hypotension which generally raises the alarm. These cases are the first anaphylactoid shocks reported after an infusion of modified gelatin. They demonstrate the general risk of anaphylactoid shock with all types of colloids.

Adult↗