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Biomedical subjects

J L Canivet

Publications and source records attributed to J L Canivet.

At least 19 recordsLinked to original sources
PubMed2006

The use of pre-operative intrathecal morphine for analgesia following coronary artery bypass surgery.

With the emergence of rapid extubation protocols following cardiac surgery, providing adequate analgesia in the early postoperative period is important. This prospective randomised double-blind study investigated the benefits of pre-operative intrathecal administration of low dose morphine in patients undergoing coronary artery bypass graft surgery. Postoperative analgesia, pulmonary function, stress response and postoperative recovery profile were assessed. Thirty patients were allocated into two groups, receiving either 500 mug of morphine intrathecally prior to anaesthesia and intravenous patient-controlled analgesia with morphine postoperatively following tracheal extubation, or only postoperative intravenous patient-controlled analgesia. In the intrathecal group, the total consumption of intravenous morphine following surgery was significantly reduced by 40% and patients reported lower pain scores at rest, during the first 24 h following extubation. Peak expiratory flow rate was greater and postoperative catecholamine release was significantly lower. Patients in the control group had a higher incidence of reduced respiratory rate following extubation.

Aged↗
PubMed2006

[Surgical left ventricular remodelling via endoventriculoplasty: clinical observation].

A case of dilated ischemic cardiomyopathy, with severely impaired left ventricular systolic function, treated by endoventriculoplasty and CABG, is reported. The authors discuss the modern concepts regarding the surgical treatment of large anterior asynergic scars following occlusion of the LAD. Since there are more similarities between akinesia and dyskinesia than previously thought, the endoventriculoplasty of DOR may constitute a new way to surgically remodel the left ventricle in dilated cardiomyopathies with large anterior akinesia. This surgery significantly improves the ventricular function and the overall patients' prognosis at short and mid term follow up.

Cardiomyopathy, Dilated↗
PubMed2006

[Aspergillus pericarditis with cardiac tamponade and haemophagocytic syndrome: a non-classical case of immunodeficiency].

We report the case of a 31-year-old woman who died in a context of haemophagocytic syndrome with multiple opportunist infections:viral, mycobacterial and fungal. To our knowledge, this is the tenth case of invasive aspergillosis manifested by an aspergillus pericarditis with cardiac tamponade. Search for HIV infection, neoplasia, haematological malignancies was negative. In addition, the patient carried on a nonviral, non-ethylic cirrhosis, the etiology of which remained unknow. We will particularly develop the aspergillus pericarditis with cardiac tamponade and the haemophagocytic syndrome.

Adult↗
PubMed2005

Effect of hydroxyethylstarch on renal function in cardiac surgery: a large scale retrospective study.

BACKGROUND: Recent reports indicated negative effects of hydroxyethylstarch (HES) on renal function. The goal of this large scale retrospective study was to detect whether there was an association between postoperative deterioration of renal function and the use of HES 200 kD, 0.5 DS in the cardiac surgery setting. METHODS: Retrospective analysis of daily collected data in 3124 patients who underwent coronary artery bypass and/or valvular surgery. Three groups were compared according to differences in fluid therapy: --GEL: gelatin was used as priming fluid of extracorporeal circulation (ECC) and for postoperative filling (n = 1276). --MIX: HES was used as priming fluid of ECC an gelatin was used for postoperative filling (n = 1008). --HES: HES was used as priming fluid of ECC and for postoperative filling (n = 840). MAIN RESULTS: There were no significant differences in postoperative serum creatinine concentrations between the 3 groups: GEL: 12,2 +/- 0,5 mg/l; MIX: 12,3 +/- 0.5 mg/l; HES: 12,3 +/- 0.6 mg/l. The need for postoperative extrarenal epuration was not significantly different between the 3 periods: GEL: 2,9%; MIX: 3,1%; HES: 3,8%. CONCLUSION: The use of HES 200 kD, 0.5 DS in cardiac surgery does not seem to be associated with a clinically significant deterioration of postoperative renal function.

Acute Kidney Injury↗
PubMed2005

["Fulminant" endocarditis due to Staphyloccocus aureus].

We report two cases of "fulminant" endocarditis due to Staphyloccoccus aureus. In both cases, the echocardiographic and bacteriologic diagnosis was esthablished in a clinical picture of severe sepsis and thrombocytopenia evolving after a fever of less than 3 days duration.

Adult↗
PubMed2004

Cardiac tamponade and pulmonary compression due to volvulus of oesophageal coloplasty.

We describe an unusual case of cardiac tamponade and pulmonary compression due to acute volvulus of colon interposition occuring late after oesophagectomy. Clinical signs were suggestive of cardiac tamponade but there was no evidence of pericardial effusion by transthoracic echocardiography. Thoracic-CT provided the diagnostic clue in revealing the extrapericardial nature (a major dilatation of the colonic transplant) of the tamponade. This diagnosis should be considered in case of acute cardiopulmonary distress occuring early or late after oesophagectomy.

Cardiac Tamponade↗
PubMed2004

[The image of the month. Portal venous gas].

Portal venous gas is a rare radiological symptom related to several possible causes. Its severity is only correlated with the severity of the primary disease. We report the case of a portal pneumatose. The diagnosis was made by ultrasound and CT scan.

Embolism, Air↗
PubMed2003

Barotrauma-induced tension pneumoperitoneum.

We report the case of a massive tension-pneumoperitoneum developing immediately after starting mechanical ventilation (barotrauma). Careful analysis of CT-data provided meaningful informations in assessing the non surgical pulmonary source of pneumo peritoneum.

Barotrauma↗
PubMed2003

[Pitfalls in tamponade: main error causes in the clinical and echocardiographic diagnosis].

The diagnosis of tamponade is confirmed by Doppler echocardiography. Early examination by this means is capital which implies easy access to this facility whenever the clinician suspects this condition. The diagnostic value of classical clinical and Doppler echocardiographic signs requires a model of circumferential pericardial effusion exerting compressive effects in the context of spontaneous ventilation. The underlying pathologies, assisted, ventilation, localised pericardial effusions, are responsible for over- or under-diagnostic errors.

Acute Disease↗
PubMed2002

[Homograft mitral valve replacement].

The total homograft replacement of the left AV valve and subvalvular apparatus constitutes a delicate operation, which may prove beneficial in young patients with extensive bacterial endocarditis. The case of a staphylococcal endocarditis in a young drug addicted patient, operated three years previously of mitral valve repair for the same pathology, is presented. In addition to the complete excision of infected tissues and valvular substitution with biological material, this technique has the advantage of avoiding long term anticoagulation. The history, technical key points, and current indications of mitral homograft in the surgery of the left atrio-ventricular valves are reviewed.

Adult↗
PubMed2001

[Severity scoring systems in the the ICU. Description, utilization, and potential].

Severity scoring systems are of great interest for the intensive care physicians. They provide major objective information regarding their patients and their medical practice. Scoring systems have been regularly improved over the two last decades. The different existing systems present advantages and disadvantages which influence their use in the intensive care. These scoring systems offer a wide range of analysis, however they are often underused. In this paper we suggest recommendations that could help to maximise the information provided by these systems.

Humans↗