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Biomedical subjects

F d'Athis

Publications and source records attributed to F d'Athis.

50 records · Page 3Linked to original sources
PubMed1986

[Role of acute normovolemic hemodilution in treating retinal venous occlusions].

The supposed state of retinal venous occlusions by a thrombus has led to the use of diverse antithrombotic treatments (heparin, fibrinolytic agents). This theory being considered at the moment as controversial, haemorheological theories being more particularly favoured, other treatments are proposed in an attempt to better retinal microcirculation, and this by changing the blood viscosity parameters. The study reported here compared the effects on recovery of visual acuity of retinal venous occlusion patients of anticoagulant treatment alone, haemodilution alone, or both together. After initial ophthalmic assessment, twenty-five patients were randomly assigned to one of three groups: group I (n = 5; mean age 62 +/- 14 yr) received heparin for 21 days, followed by antivitamin K drugs for a further 30 days; group II (n = 10; mean age 54 +/- 16 yr) were acutely hemodiluted with 40,000 daltons molecular weight dextran, bringing the haematocrit to between 0.25 and 0.30; on day 2, the same anticoagulant treatment as in group I was associated; group III (n = 10; mean age 58 +/- 18 yr) were only hemodiluted. The hemodiluted state was maintained for 21 days. A biological assessment was carried out for the three groups on days 1, 2, 7, 14, 21 and 30 (haematocrit, fibrinogen level, platelet count, kaolin-cephalin time, heparin level). The evolution of visual acuity was assessed on days 7, 14, 21, 30, 60 and 90. Mean visual acuity was assessed on days 7, 14, 21, 30, 60 and 90. Mean visual acuity was virtually the same for the three groups on day 0.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1984

[Value of the lateral chest x-ray in the diagnosis of traumatic pleural effusions].

Forty patients were admitted to a hospital emergency department after closed chest injury. Chest X-rays, a-p and lateral, with low and high voltage, were performed in a supine position. The aim of the study was to show the interest of lateral films in the diagnosis of post-traumatic pneumo- and hemothoraces. A special technique, using a double-drawer plate holder, gave a good quality radiograph in emergency conditions without danger for patients with severe trauma. In 30 of the patients, chest radiographs confirmed pleural gas or blood collection. In ten of these, the diagnosis could only be made after radiographic examination. In nine other cases, radiographs showed an absence of hemo- or pneumothorax. Lateral views were very important in confirming a hemothorax and appreciating its volume, as well as in showing up partial pneumothoraces which could not be seen on a-p views. The interest of performing a lateral film in all the cases of chest injury is pointed out.

Adolescent↗
PubMed1984

[An improvement in the performance of emergency frontal- and lateral-view thoracic radiography].

A special technique giving good quality front and lateral chest roentgenograms in emergencies with no danger for the critically ill patient is described. The system consisted of a double-drawer plate-holder: one was passed at the back of the thorax, the other then being perpendicular to it. Placing the patient on an X-ray transparent stretcher made the technique easier. Several people were required to gently move the patient while the plate-holder was put in place.

Emergencies↗
PubMed1984

[An aid in the diagnosis of cardiac rhythm disorders in anesthesia and intensive care].

Exact diagnosis of tachycardia was sometimes difficult to do as P waves were not easy to see on ECG. A simple device is described, with which ample P waves were recorded in patients with a central venous catheter. This catheter was used as conductor of cardiac electrical activity. It proved simpler and less aggressive for the patient in comparison with other techniques (intracardiac and oesophageal recording).

Arrhythmias, Cardiac↗
PubMed1981

[Pharmacokinetics of local anesthetics].

This article first looks at the pharmacokinetics of local anesthetic agents injected intravenously, and then looks at the possible practical applications of this technique: the choice of a local anesthetic agent as a function of its toxic side effects, the use of lidocaïne in local and regional intravenous anesthesia, and the treatment of cardiac rhythm disorders. Finally the article envisages the pharmacokinetics of local anesthetic agents used in local-regional anesthesia. This depends on the following factors: the site of injection, the dosage, the speed of injection, the possible addition of adrenalin and the nature of the local anesthetic itself. On the basis of a personal study the authors underline the difficulty of being precise in the pharmacokinetics of local anesthetic agents injected by the peridural route continuously or discontinuously.

Anesthesia, Conduction↗
PubMed1977

[Atypical pulmonary embolism associated with inter-auricular communication].

A case of massive pulmonary embolism at a patient with undetected atrial defect is reported. The authors discuss the difficulties of establishing a proper diagnosis when the right heart pressure is not raised and when a large emboliser is well tolerated. Angiography confirmed the diagnosis and the patient was successfully treated with embolectomy followed by ligation of the inferior vena cava.

Heart Septal Defects, Atrial↗
PubMedDate not supplied

[Risks associated with the use of local anesthetics].

Despite widespread use, accidents following the injection of a local anaesthetic are exceptional. Some peripheral nerve lesions have been described, in keeping with mechanical distension because of accidental intravenous injection, rather than because of the anaesthetizing product itself. Generally speaking, two aetiologies are to be underlined: allergy and toxicity. Allergy is exceptional with anaesthetics of the amine type, the only commercialized kind in this country. Some cases of cutaneous allergy and bronchospasm have been reported. The accident more to be feared is toxicity, which emerges in neurological symptoms (convulsions) then cardiac symptoms (rhythm disturbance, even cardiac arrest). These accidents are associated with the sudden presence of a high concentration of local anaesthetic in the blood, resulting from accidental intravenous injection, or, more rarely, excessive resorption of a strong dosage injected into a highly vascularized area. The stronger the anaesthetic, the more this type of accident is to be feared. These accidents can be avoided by means of the observation of a rigorous technique, careful checking of the patient after the injection, and readiness to start immediate and effective reanimation at the very onset of toxication symptoms.

Anesthetics, Local↗
PubMedDate not supplied

Cardiac electrophysiological effects of bupivacaine in the anesthetized dog: relation with plasma concentration.

The effects of increasing plasma levels of bupivacaine on sinus node, atrial tissue, atrio-ventricular node, His-Purkinje system and ventricular tissue were evaluated in 16 thiopental-anesthetized dogs. A bolus of bupivacaine administered over 3 min was followed by an infusion over 60 min. Three dosages were administered: 1 mg/kg followed by 0.5 mg/kg/hr in 4 dogs, 2 mg/kg followed by 1 mg/kg/hr in 6 dogs and 4 mg/kg followed by 2 mg/kg/hr in 6 dogs. Electrophysiological parameters of sino-atrial node, atria, atrioventricular node, His-Purkinje system and ventricle and mean aortic pressure were recorded before the administration of bupivacaine (control) and 5, 15, 30, 45 and 60 min after the initial bolus. Blood samples were taken at the same time. On the basis of plasma bupivacaine concentrations, the dogs were divided in 6 groups: group 0 (control), group I (less than 1 microgram/ml), group III (1.5 to 2 micrograms/ml), group IV (2 to 3 micrograms/ml) and group V (greater than 3 micrograms/ml). At plasma concentrations less than 1.5 micrograms/ml bupivacaine prolonged conduction times over the His-Purkinje system and ventricle. At plasma levels greater than 1.5 microgram/ml it depressed also the sinus node and the atrioventricular node functions. No statistically significant difference was found between the control group and the other groups for mean aortic pressure, pH, PaCO2, PaO2 and kalemia. In conclusion, it is suggested that bupivacaine behaves as a class I antiarrhythmic drug at the lower plasma concentrations and as a class I and class IV antiarrhythmic drug at higher plasma concentrations.

Anesthesia↗
PubMedDate not supplied

Hemodynamic effects of 0.375% versus 0.25% bupivacaine during cervical epidural anesthesia for hand surgery.

BACKGROUND AND OBJECTIVES: Cervical epidural anesthesia with 0.375% or 0.25% bupivacaine plus fentanyl is a reliable technique for surgical restoration of digital motion-after tourniquet release and rehabilitation. The study was designed to assess the hemodynamic effects of this technique in 11 ASA 1 patients. METHODS: The epidural catheter was introduced at the C7-T1 interspace on the day of operation. The volume of 0.375% bupivacaine necessary to block the brachial dermatomes was determined. The day after (day 1), every patient received epidurally the determined volume of 0.375% bupivacaine plus 1 microgram/kg fentanyl (group A). On day 2 the same volume of 0.25% bupivacaine plus 1 microgram/kg fentanyl (group B) was injected. For each patient one or several pairs of injection (A + B) were performed in relation with duration of rehabilitation. Cardiac index, stroke volume index, end diastolic index, ejection fraction, and systemic vascular resistance were studied by thoracic electrical bioimpedance. These parameters, mean arterial pressure and heart rate were recorded before and after injection. Sensory level was assessed by loss of cold sensation. RESULTS: Nineteen paired injections were performed. Mean volume of bupivacaine was 7.1 +/- 2 mL. The caudad sensory level was lower in group A: T7 (T3-L1) versus T6 (T2-T11) in group B. Hemodynamic variables were not different between the 2 groups. Mean arterial pressure cardiac index, heart rate, stroke volume index, and ejection fracture decreased slightly as end diastolic index remained unchanged and systemic vascular resistance increased slightly. No correlation was found between hemodynamic changes and spread of analgesia. CONCLUSIONS: Hemodynamic effects, in ASA 1 patients, are moderate and not dependent on the studied concentration of bupivacaine, indicating that a similar degree of sympathetic block is achieved with 0.375% and 0.25% bupivacaine.

Adult↗