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J F Dupuis

Publications and source records attributed to J F Dupuis.

11 recordsLinked to original sources
PubMed1994

Pharmacologic intervention can reestablish baseline hemodynamic parameters during laparoscopy.

BACKGROUND: Several studies in both animal models and human beings have shown that CO2 abdominal insufflation for laparoscopy can cause a variety of alterations in hemodynamic and pulmonary physiology. These physiologic changes could potentially have deleterious effects in patients with underlying cardiopulmonary disease. METHODS: We prospectively evaluated 15 patients with preexisting heart and/or lung disease to determine whether the use of invasive monitoring would allow early identification and treatment of these physiologic alterations and thus enable laparoscopy to be performed safely in this group of patients. RESULTS: CO2 abdominal insufflation caused statistically significant increases in systemic vascular resistance, mean arterial pressure, left ventricular stroke work index, and pulmonary capillary wedge pressure along with a concomitant decrease in cardiac index and oxygen delivery in these patients. The use of intravenous nitroglycerin resulted in a rapid return of the systemic vascular resistance, mean arterial pressure, pulmonary capillary wedge pressure, and cardiac index to baseline levels. No significant intraoperative or postoperative cardiac or pulmonary complications were noted. CONCLUSIONS: These results suggest that laparoscopy with CO2 pneumoperitoneum can be safely performed in high-risk patients if appropriate monitoring and pharmacologic interventions are used.

Aged↗
PubMed1994

Extracorporeal circulation as a blood conservation technique for extensive pelvic operations.

Difficult pelvic operations for malignancy or complex benign conditions can be associated with extensive blood loss. Religious beliefs that preclude transfusion and the known risks of homologous blood have prompted investigators to seek alternatives to transfusion. We used the Haemonetics-V50 Cell Separator (Haemonetics Corporation) to provide for extracorporeal circulation of the patient's own blood with associated normovolemic hemodilution as a means of conserving blood during operations. This technique was used in eight patients undergoing extensive pelvic operations. The procedure was accepted by Jehovah's Witnesses and was well tolerated by all patients. Estimated blood loss ranged from 75 to 2,000 milliliters. One instance of mild intraoperative disseminated intravascular coagulation was encountered. Two patients were given homologous transfusions. While clinical judgment is necessary to determine the safety of complicated operations, this technique is useful in expanding surgical options for some patients who object to blood transfusion.

Blood Loss, Surgical↗
PubMed1975

[Abdominal emergencies in the daily practice of a traumatology center].

This study analyses 57 cases of abdominal trauma occurring in patients with multiple injuries admitted to the accident unit in Garches, over a period of four years. After a few remarks concerning the use of a safety belt, the authors discuss in particular: -- 25 hepatic lesions; -- 20 splenic lesions. These lesions were operated on by the surgeons on the unit with the exception of 9 cases where a specialised surgeon was called in. In the vast majority of cases, we consider the patient should not be transferred to the other units but, if possible, all lesions should be treated simultaneously in one centre.

Abdominal Injuries↗
PubMedDate not supplied

[Infection in surgery].

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Adrenal Cortex Hormones↗