Biomedical subjects

F Servin

Publications and source records attributed to F Servin.

39 records · Page 3Linked to original sources

PubMed1987

Pharmacokinetics of midazolam used as an intravenous induction agent for patients over 80 years of age.

The pharmacokinetic profile of 0.2 mg kg-1 midazolam given i.v., for induction of anaesthesia, was compared in young subjects and in those who were over 80 years of age. Thirty-five patients were allocated into four groups according to their sex and age. Plasma samples were drawn before midazolam injection and at regular intervals over 24 h following injection. Plasma midazolam concentrations were measured by electron capture gas-liquid chromatography. Equilibrium dialysis was used to assess the plasma protein binding of midazolam. Distribution volume (Vdss) was significantly increased in elderly subjects when compared to young subjects of the same sex (young vs. elderly males, Vdss = 1.22 +/- 0.31 l kg-1 and 2.47 +/- 0.98 l kg-1 respectively; and young vs. elderly females, Vdss = 0.91 +/- 0.29 l kg-1 and 1.70 +/- 0.78 l kg-1 respectively). Total body clearance was significantly reduced in elderly males compared with young males (5.60 +/- 1.77 ml min-1 kg-1 vs. 8.10 +/- 3.58 ml min-1 kg-1). No significant difference in clearance was found between young and elderly females (6.08 +/- 2.04 ml min-1 kg-1 vs. 9.14 +/- 3.36 ml min-1 kg-1). As a consequence, elimination half-life (T1/2E) was significantly prolonged in elderly compared to young males (8.52 +/- 5.4 h vs. 2.77 +/- 0.80 h). In contrast, T1/2E was unchanged in elderly compared to young females (2.99 +/- 0.86 h vs. 2.86 +/- 1.04 h). Midazolam plasma protein binding was not influenced by age and sex.

Adult↗

PubMed1986

[Massive digestive hemorrhage caused by aorto-esophageal fistula].

A very rare diagnosis before a terminal hemorrhagic accident, aorto-esophageal fistula (FAO) is almost always fatal. Three cases of this exceptional lesion are reported. The first patient died within a few minutes of admission from a cataclysmic hematemesis. This 52 year old man had a recurring adenocarcinoma of the cardia that had been treated by laser. A "premonitory hematemesis" of bright red blood had occurred eight hours before admission. In the two other cases the problem arose with an "open abdomen" in exsanguinated patients operated upon as emergencies for massive hematemesis. In both cases, an intra-esophageal balloon catheter and controlled hypotension allowed performance of a left thoracotomy and aortic clamping. One patient had a cancer of middle third of esophagus that had perforated into the descending aorta. A resection-graft of the aortic isthmus and a retrosternal gastric esophagoplasty was successfully carried out at the time of exploration. The other patient had an FAO in the aortic isthmus region probably due to a foreign body. Operation involved an esophagectomy with cervical esophagotomy and gastrotomy combined with a resection-graft of aortic isthmus using a Dacron prosthesis. This patient died on the 21st postoperative day from rupture of the brachiocephalic trunk over a tracheotomy tube. In both of these patients a "premonitory hematemesis" with dysphagia had preceded the severe hemorrhagic accident. Successful treatment is rarely obtained with such lesions, since difficulties in ensuring rapid hemostasis in exsanguinated patients operated upon usually without diagnosis and for massive hemorrhage only, are associated with the risks of aortic repair surgery in a hemorrhagic field and with a mediastinum infected from the esophageal wound.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed1985

[Enflurane and extracorporeal circulation. Peripheral vascular effects and consequences of hypothermia on its biotransformation].

The effects of enflurane on systemic vascular resistance and venous capacitance, and its biotransformation during hypothermia, were studied in patients undergoing cardiovascular surgery with enflurane anaesthesia. When administered during cardiopulmonary bypass (CPB), cardiac regulatory mechanisms being therefore excluded, enflurane induced an arteriolar vasodilation related to the concentration inhaled. An inspired concentration of 2.5% in hypothermia (28 degrees C) produced a drop in systemic vascular resistance of 30% from control level. In the same conditions, venous capacitance was not altered. The rise in the blood gas solubility coefficient during hypothermia was only partly balanced by haemodilution. Therefore, inspired enflurane concentration should be higher during hypothermic CPB than during normothermic anaesthesia to obtain the same effects. For the same amount of enflurane inhaled, the fraction of enflurane metabolized was higher in hypothermia than in normothermia, but the inorganic fluoride plasma concentration at its highest never reached the level of 50 mumol X 1(-1) regarded as the nephrotoxic threshold.

Adult↗