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Biomedical subjects

F Seigneur

Publications and source records attributed to F Seigneur.

15 recordsLinked to original sources
PubMed1998

Accelerated obstructive pulmonary disease in HIV infected patients with bronchiectasis.

Human immunodeficiency virus (HIV) infection has been associated with a wide spectrum of pulmonary disease. We report three HIV-seropositive patients with rapidly worsening airway obstruction associated with bronchiectasis. All subjects (age range 33-39 yrs) were cigarette smokers. Two had previously used intravenous drugs. The CD4 lymphocyte count ranged 40-250 cells x mm(-3). All individuals had complained of increasing dyspnoea for 3-6 months. Within 1 yr, they all developed severe airway obstruction with a decrease in both forced expiratory volume in one second (FEV1) and ratio of FEV1 to forced vital capacity (FEV1/FVC) to less than 60% of predicted value, and a decrease in mean forced expiratory flow at 25-75% of the forced vital capacity (FEF25-75) to less than 35% of predicted value. Computed tomography of the chest disclosed bilateral dilated and thickened bronchi. No classical causes of genetic or acquired bronchiectasis were identified in our patients. Recurrent bacterial bronchitis occurred in the follow-up period of the three patients. In conclusion, unusually rapid airway obstruction associated with bronchiectasis should be added to the wide spectrum of respiratory complications of human immunodeficiency virus infection.

Adult↗
PubMed1994

[Evaluation of the right ventricular function for lung transplantation. Value of the electron beam scanner].

Several invasive or not invasive technics were used to evaluate right ventricular insufficiency associated to severe chronic pulmonary insufficiency. But none of them were very accurate and now the use of EBT appears as a real improvement. We performed a prospective study with 50 patients waiting for a lung transplantation and we compared the values of right ventricular function obtained by EBT to those obtained by nuclear medicine and catheterism. Accuracy of EBT for left ventricule evaluation has already been proved. Stroke volumes calculated by EBT in right and left ventricules are similar and this constitutes a good validation of the method for right ventricule evaluation. Correlations with hemodynamic measurements are poor and nuclear medicine technics underestimate the ejection fraction. So, EBT is recommended for right ventricular study before and after lung transplantation.

Adult↗
PubMed1988

[Relation of the fall in PO2 in ventilation of the lower lung in pulmonary surgery and the preoperative distribution of respiratory function].

Hypoxaemia during one-lung ventilation is influenced by the anatomic distribution of lung perfusion and hypoxic vasoconstriction. This study aimed to assess whether preoperative selective bronchospirometry could predict the degree of peroperative hypoxaemia. Twelve patients scheduled for pneumonectomy, lobectomy, wedge resection or decortication were included in the study. Preoperative data included the usual spirometric parameters, oxygen consumption, minute ventilation of each lung and arterial blood gases. A Carlens or Robertshaw tube was inserted in each case; the patients were ventilated with 100% oxygen and halothane was used for anaesthesia. Blood gases were measured during surgery before and after upper lung exclusion. When both lungs were ventilated, mean PaO2 was 390.5 +/- 92.4 mmHg; during one-lung ventilation, it fell to 210.8 +/- 109.2 mmHg. Routine spirometry could not predict the magnitude of fall in PaO2; however, it was correlated with the bronchospirometric oxygen consumption of each lung (r = 0.83; p less than 0.01). The anatomical distribution of lung perfusion seemed to be the predominant factor influencing the decrease in PaO2 during one-lung ventilation.

Aged↗
PubMed1986

What changes can be expected during high frequency jet ventilation when the rate of ventilation, the I:E ratio and the driving pressure are modified? A laboratory study.

Changes in minute ventilation, tracheal airway pressure and lung volume have been measured using a jet ventilator (VS 600) during different rates of ventilation, I:E ratios and driving pressures. A lung model with a slightly increased compliance and an increased airway resistance was used. Five rates of ventilation (from 60 to 230 b.p.m.), three I:E ratios (0.25, 0.43, 0.67) and three driving pressures (200, 300 and 400 kPa) were studied. The increases in the rate of ventilation did not modify minute ventilation significantly, decreased peak airway pressure only slightly and increased end-expiratory pressure and lung volume. The increases in I:E ratio produced increases in minute ventilation, peak airway pressure, end-expiratory pressure and lung volume. The increases in driving pressure induced changes similar to those produced by the alterations in I:E ratio.

Airway Resistance↗
PubMed1985

Jet ventilation using low or high frequencies, during bronchoscopy.

Jet ventilation, through a bronchoscope, was evaluated using a lung model (normal compliance and increased airway resistance). Three I/E ratios (0.25, 0.43, 0.67) and seven rates of ventilation (from 20 to 230 cycles per min (c min-1) were studied with the bronchoscope either unoccluded or partially occluded by a telescope. Increases in I/E ratio induced increases in minute ventilation, peak airway pressure, end-expiratory pressure and lung volume. Increase in the rate of ventilation decreased peak airway pressure, increased end-expiratory pressure and lung volume; minute ventilation increased in parallel with the increase in the rate of ventilation or remained constant when a high I/E ratio was used. The introduction of the telescope reduced minute ventilation, as a result of a decrease in the amount of air entrained, and increased end-expiratory pressure and lung volume. The risk of barotrauma as a result of high peak pressure is reduced during high frequency jet ventilation, but the increase in lung volume, particularly when the telescope is introduced, may be of clinical importance.

Bronchoscopy↗
PubMed1983

High frequency jet ventilation v. manual jet ventilation during bronchoscopy in patients with tracheo-bronchial stenosis.

Six patients with airway stenosis were submitted to bronchoscopy under general anaesthesia. Each was ventilated with a gas mixture of 50% oxygen and nitrogen using successively manual jet insufflation (JV) using the Sanders technique at 20 b.p.m., and high frequency jet ventilation (HFJV) at rates of 150, 300 and 500 b.p.m. The effects on alveolar ventilation were assessed by blood-gas analysis and the transcutaneous monitoring of carbon dioxide tension. It is concluded that HFJV achieves satisfactory operating conditions, and provides adequate gas exchanges up to a rate of 300 b.p.m. At the faster rate some degree of hypoxaemia and hypercarbia were noted. The correlation between PaCO2 and transcutaneous carbon dioxide tension was satisfactory.

Anesthesia, General↗
PubMed1983

Manual jet ventilation v. high frequency jet ventilation during laser resection of tracheo-bronchial stenosis.

Manual jet ventilation (20 b.p.m.) and high frequency jet ventilation (300 b.p.m.) were compared during laser resection of tracheo-bronchial stenosis under general anaesthesia. Both methods provided similar blood-gas tensions at the 10th min of surgery in patients with tracheal stenosis. In patients with bronchial stenosis high frequency jet ventilation resulted in modest hypercarbia and manual jet ventilation appeared to be the preferred method in these particular patients.

Anesthesia, General↗
PubMed1982

[Diaphragmatic eventration in adults. Apropos of 20 cases].

Twenty adults with a mean age of 49 were operated on between 1972 and 1980 for eventration of the diaphragm. The etiology was probably traumatic in 11 cases; it was congenital in 2 and degenerative in 7. The functional signs were usually respiratory (55%) or digestive (10%). In all cases, the diagnosis was based on standard fluoroscopy showing superelevation of the hemidiaphragm, which was visualized fluoroscopically as immobile while a pneumoperitoneum showed a absense of any tear. Spirography confirmed a restrictive deficit which was sited broncho-spirometrically on the eventration side. Surgical repair was achieved in most cases by thoracotomy (19 cases) and consisted in plication (17 cases) or incision followed by suturing of the overlapping edges of the muscle (3 cases). Postoperative complications included the death of the patient with multiple trauma, on the eight postoperative day, as a result of the cerebrovascular accident, and in another case rutpure of the repair on the second day, requiring a second operation. Apart from one patient who died as a result of a fatal accident two years postoperatively, all the surgically treated cases are alive, and, with one exception, symptom free. After an average follow up period of 2 years and 2 months, the control respiratory function tests show a 21% improvement in vital capacity and a 20% increase in FEV1. On the basis of these results, the authors conclude that this functional surgery is justified in the case of patients presenting with typical clinical symptoms, and worth considering in cases where respiratory function tests show a restrictive deficit, but also in patients who do not complain of breathlessness.

Adult↗
PubMed1978

[Pulmonary emphysema and hepatic involvement by alpha-1 antitrypsin deficiency in two adults with a PiZ phenotype (author's transl)].

Two unreleated adult males were found to be suffering from an association of pan-lobular severe emphysema and hepatomegally of unknown origin which led to the discovery of a marked deficit in alpha-1 antitrypsin (A1-AT) in relation to a PiZ phenotype. Liver biopsy revealed cirrhosis with portal fibrosis in one case and in both cases fatty infiltration with the accumulation of a glycoprotein antigenically identical to A1-AT. Electron microscopy showed this protein to be situated within the dilated lumina of the endoplasmic reticulum of the hepatocytes. A1-AT deficiency is usually associated with pulmonary involvement only in the adult and liver involvement only in the child. The association of the two remains rare--hence the interest of the two cases reported.

Adult↗
PubMedDate not supplied

Air entrainment during high-frequency jet-ventilation. Simulation of a bronchoscopy with a lung model.

Air entrainment contribution to jet-ventilation during bronchoscopy was evaluated as a lung model (increasing compliance and airway resistance). Ventilation was provided through a 10 mm internal diameter tube using either jet alone without air entrainment, or injection with air entrainment (coaxial and lateral injectors). Three I/E ratios (0.25, 0.43 and 0.67) and nine rates of ventilation, ranging from 20 to 300 c X min-1, were assessed. The driving pressure of the injected air was 350 +/- 10 kPa. Air entrainment is an important part of total ventilation (63.7 +/- 5.5%). The magnitude of air entrainment depends upon the levels of peak and end expiratory airway pressures. Increase in lung volume varies linearly with the end expiratory pressure. Air entrainment contributes to keep the tidal volume above the model dead-space. CO2 elimination is related to the magnitude of ventilated volumes. The amount of entrained air interferes with the FIO2 of delivered gases. During bronchoscopy, lateral injection should be preferred because of smaller airway pressures (- 31.2 +/- 0.6%) and lung volumes, while tidal volumes remain adequate.

Airway Resistance↗