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Biomedical subjects

J F Perrier

Publications and source records attributed to J F Perrier.

29 records · Page 2Linked to original sources
PubMed1994

[Development of antifactor VIII circulating anticoagulant after surgery of the biliary tract].

In a 25-year-old woman, admitted with a haemorrhagic syndrome following biliary surgery, an inhibitor of factor VIII was detected. As bleeding was major, she was re-operated on under perioperative administration of the anti-inhibitory coagulant complex Autoplex-T, associated with polyvalent i.v. immunoglobulins. The other therapeutic agents are also considered and their indications discussed, after a review of the circumstances of the diagnosis of this disease.

Adult↗
PubMed1994

[Can the quality of renal grafts be judged on basis of the organ donors?].

The aim of this study is to find brain dead organ donor parameters able to predict the functional value of a kidney graft after transplantation. It is a retrospective, multicenter study, set in the east of France (Besançon, Nancy, Reims, Strasbourg). All donors harvested over an 18 month period (n = 169), and kidney grafts transplanted in a recipient in the same region (n = 298) are studied. Recipients from another region receiving a kidney graft as well as kidney grafts transplanted in other regions are not studied. Parameters studied in the donor are: age, sex, etiology of brain death, vascular disease, hemodynamic stability, use of epinephrine, diuresis, creatinine level, graft preservation solution. Parameters studied in the recipient are: age, sex, first transplantation or not, cold ischemia duration, warm ischemia duration, early post-transplantation diuresis and creatinine level evolution, dialysis requirement, immunosuppression, creatinine level at 1, 6 and 12 month. During the early post transplantation period, 264 recipients recovered diuresis, and the creatinine level felt in 246 cases. 31 patients required dialysis. 12 months after transplantation, 128 patients had a normal graft function (creatinine level < 15 mg/l). No parameter in the donor was found able to predict kidney graft function after transplantation. In fact, it is the amount of several risk factors due to donor data, organ retrieval and preservation, and kidney transplantation which is responsible for the early graft function. This points out the importance of being very careful when there is already a risk factor due to old age or vascular disease.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1992

[Bacteriological relationship between organ donor and recipient. A survey apropos of 100 brain dead patients].

The aim of the study was to evaluate the relationship between germs found in samples systematically taken in the organ donors and germs found in the corresponding recipients in the 8 post-operative days. The 100 brain-dead patients received oxacillin (2g every 4 hours) when the bacteriological samples were taken. 41% of the donors were germ carriers. The germs were mainly located in the respiratory track (Staphylococcus aureus meti-S (34%) and Hemophilus (29%)). Among the 86 patients harvested, 40 donors were germ carriers and gave 132 organs, 46 donors were not germ carrier and gave 151 organs. The comparison between these two groups showed no difference. Assessment of infection occurring in organ recipient in the 8 post-operative days (germ, location, evolution) showed no difference, whether organs were removed from germ carrier donors or no. Comparison between the germs found in germ carrier donors and those found in recipients with sepsis showed a similitude in three cases (2.2%). In the other cases, there is no relationship between the germs found in the donors and post-operative sepsis in the recipient.

Brain Death↗
PubMed1991

[Value of hormonal treatment with triiodothyronine and cortisone in brain dead patients].

Brain death leads to substantial falls in the plasma levels of cortisol and tri-iodothyronine (T3). These alterations may be responsible for physiological instability in these patients, and impairment in donor organ function. A double-blind study was therefore designed to assess the possible improvement in metabolism and haemodynamic stability in brain-dead organ donors treated with T3 and cortisone. Forty adult brain-dead patients were randomly assigned to two groups, the patients of the treated group were given every hour, or half hour, 2 or 4 micrograms T3 and 100 mg hydrocortisone intravenously, and those of the placebo group normal saline. Both groups of patients received conventional management for brain-dead donors. The main assessment criterion was the haemodynamic course, appreciated by the Pasys, the CVP and the needs in dobutamine; the secondary criterion was the start, or worsening, of a metabolic acidosis, as judged by the pH, the level of arterial bicarbonate, and the needs in sodium bicarbonate. The two groups were comparable for age, sex, aetiology of brain death, the delay between brain death and the start of the experimental protocol, and the duration of this protocol. There were differences between the two groups, which were not statistically significant: improvement in haemodynamic profile (hormone group 9/20 versus placebo group 10/20); worsening in haemodynamic profile (2/20 vs 4/20); increased requirements in dobutamine (2/20 vs 4/20); decreased requirements in inotropic support (15/20 vs 13/20); mean dose of dobutamine (3.1 +/- 4.2 micrograms.kg-1 vs 2.5 +/- 3.8 micrograms.kg-1); metabolic acidosis (5/20 vs 5/20); mean bicarbonate dose (30.0 +/- 67.7 mmol vs 45.0 +/- 74.2 mmol); donors harvested (20/20 vs 18/20).(ABSTRACT TRUNCATED AT 250 WORDS)

Acidosis↗
PubMed1988

[Measurement of cardiac output by thoracic electrical bioimpedance or thermodilution].

The present study was designed to assess a new non invasive method for measuring cardiac output. The thoracic electrical bioimpedance method was compared with the reference one, thermodilution. The measurements were made simultaneously with NCCOM3 (bioimpedance) using the freeze data mode, and with a Swan-Ganz catheter and a haemodynamic computer (thermodilution). The study involved 11 spontaneously breathing patients in a steady haemodynamic state. Ten measurements were carried out with both methods for each patient. Statistical analysis of the 110 paired values was carried out by computer. The various statistical tests applied confirmed that there was a highly significant correlation between values for cardiac output obtained by each of these two methods (r = 0.818; p less than 0.005); they also showed a significantly more important dispersion of the measures for each patient with thermodilution. The mean value of the thermodilution "standard deviation" (0.64 l.min-1) was significantly more important (p less than 0.005) than the one with NCCOM3 (0.24 l.min-1). Thoracic electrical bioimpedance appeared a safe method for measuring cardiac output, providing the limits of the method are kept. The objective is not to replace the Swan-Ganz catheter, but to propose an alternative method for measuring cardiac output. This method is very interesting in many circumstances, particularly for intensive care patients: it is a non invasive technique, continual measurement is not time-limited, and its use is very easy.

Adult↗
PubMed1988

[Biological effects of golytely in children].

Golytely solution is now commonly used in preoperative bowel preparation or in colonoscopy and barium enema in adults. Studies have demonstrated its effectiveness and good acceptance in regards to clinical as well as biological point of view. In children, it has been used more recently, but since 1984 several teams agree to find the method excellent. Our study aimed to confirm there was no electrolytic movement caused by golytely and that using it without reserve in children was possible, even in the very young ones. Children are generally very sensible to those movements and mainly as they have a general anaesthesia in the hours following the golytely administration for investigation or surgery. Up to now, 54 children from 4 months to 18 years aged have been studied. Besides the good quality of the preparation noted by the operator and the good clinical tolerance, no significant change of the sodium, potassium, chloride, creatinine and proteins has been noticed. Only urea has decreased very lightly but not out of norms. These results confirm that golytely is safe and effective in preparing the bowel in children.

Adolescent↗
PubMed1986

[Hemorrhagic delivery in a full-term abdominal pregnancy with a live infant].

This is a new case report of a primary abdominal pregnancy with a full-term live baby in a 26 yr old women. The diagnosis was only made at laparotomy. The premature placental separation was followed by massive haemorrhage. Over a period of five days, the patient required a transfusion of 139 blood units and nine surgical explorations before control of the bleeding site could be obtained. Control of the haemorrhage could only be obtained with massive transfusions of fresh platelets and biological monitoring of coagulation by specialized laboratories. This case confirmed the diagnostic difficulties and the need to leave the placenta in situ until control of bleeding sites can be obtained.

Adult↗