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Biomedical subjects

J M Hurpe

Publications and source records attributed to J M Hurpe.

11 recordsLinked to original sources
PubMed2001

[Programmed left ventricular stimulation in non-sustained ventricular arrhythmias].

The presence of nonsustained ventricular arrhythmia (NSVA) is an independent factor of sudden rhythmic death. The primary objective of our study was to evaluate the correlation between inducibility during programmed ventricular stimulation (PVS) and the presence of ventricular late potentials, the ejection fraction, the grade of arrhythmia, and the underlying cardiopathy. The secondary objective was to evaluate the interest of PVS in patients with NSVA. Ninety eight patients with NSVA have been tested by PVS and 14 were inducible. During the mean follow up of 24 months, 8 patients died, 3 of them suddenly. A significative statistical correlation was found between ventricular late potentials and inducibility (negative predictive value = 91%; p = 0.03). No correlation was found between the ejection fraction, the grade of arrhythmia, the cardiopathy and inducibility. In patients with ischaemic cardiopathy, PVS has allowed to identify a subgroup of patients with high risk of sudden death. In this subgroup, serial PVS for drug testing has contributed to choose the therapeutic regimen supposed to be more effective for prevention of fatal arrhythmia. Multiple factors explain sudden death, even though the initial treatment has been chosen by electrophysiologic studies. For non inducible patients, empiric treatment is not proven to be reliable, and the best therapeutic regimen is still unidentified, especially in the subgroup of patients with low ejection fraction. In this subgroup, the implantable cardioverter defibrillator vives better protection against sudden rhythmic death.

Adolescent↗
PubMed1992

An uncommon electrocardiographic change in subarachnoid hemorrhage: increase in the Sokolow's Index.

In this paper we are reporting a case of electrical left ventricular hypertrophy with increased Sokolow's index following subarachnoid hemorrhage. Two-dimensional echocardiography ruled out anatomical left ventricular hypertrophy, and the Sokolow's index eventually reverted to normal. This electrocardiographic abnormality has rarely been associated with subarachnoid hemorrhage and does not appear to be related to the neurologic grade of the patient because he presented with headaches only and was conscious throughout (Hunt and Hess grade I). The possibility that such electrocardiographic changes should reflect anatomical changes in the heart should always be ruled out by proper investigations (i.e., echocardiography and coronarography), as the presence of cardiac disorders would greatly influence medical and surgical management. In terms of electrocardiography, this observation suggests that the Sokolow's index is a poor indicator of left ventricular hypertrophy, and tends to reflect a more comprehensive catecholaminergic process.

Journal Article↗
PubMed1991

Malignant ventricular tachycardia during propafenone treatment in a child with junctional automatic tachycardia: effectiveness of intravenous molar sodium lactate.

Propafenone may aggravate the preexisting arrhythmia or induce another one. Usually, such proarrhythmic effects occur in patients with spontaneous ventricular arrhythmias and/or coronary heart disease with poor left ventricular function. We report the case of a 5-year-old girl with junctional automatic tachycardia and no structural heart disease, in whom malignant ventricular tachycardia occurring during propafenone treatment could be terminated by molar sodium lactate (MSL) infusion. The serum propafenone level obtained before MSL infusion was within the therapeutic range. Two hypothesis could explain the beneficial effects of MSL in our patient: (1) alkalinization facilitates the cell membrane hyperpolarization and thus can decrease the voltage-dependent effect of Class Ic drugs, (2) alkalinization could displace propafenone from its tissue receptor sites by an increase in the nonionized fraction.

Atrioventricular Node↗
PubMed1990

[Differed autotransfusion in orthognathic surgery. Impact on the economics of blood products. Our experience of 40 cases].

Delayed autotransfusion has been recommended for orthognathic surgery. The authors review and discuss the advantages of this technique. Emphasis is placed on the preventive aspect as it relates to transfusion-associated viral contamination, as well as on the positive implications on health expenditures in the long run. This technique requires excellent intercollaboration on the part of the blood transfusion centers and should definitely be recommended in certain cases of planned surgery. Furthermore, combined with hemodilution methods, it constitutes a very effective means of struggle against edema.

Adolescent↗
PubMed1987

[Contribution of autologous blood transfusion in cardiac surgery in the adult].

The use of autologous blood transfusion in cardiac surgery is still controversial. This study was prospectively designed to evaluate the haemodynamic and haematological benefits of this method, with special attention to its impact on reducing bank blood requirements. Between November 1983 and October 1984, 160 patients underwent cardiac surgery with extracorporeal circulation and were randomly assigned to two groups: group I (81 patients) was the control group and group II (79 patients) received autologous transfusion following extracorporeal circulation. Blood was withdrawn immediately after the induction of anaesthesia via a jugular catheter and stored in CPD solution at room temperature. The volume of blood removed was replaced with gelatin solutions; after bypass, blood was returned to the patient. There was no difference in systolic, diastolic or mean blood pressures between the two groups. Right atrial pressure and heart rate were not statistically different in both groups. Myocardial perfusion and myocardial oxygen consumption remained unchanged in group II compared with group I. Complete haematological evaluation was carried out before and during bypass, and thereafter daily for the first twelve days of the postoperative period. There was no significative difference between the two groups in platelet counts, fibrinogen levels, prothrombin and partial thromboplastin times. During extracorporeal circulation, mean haematocrit was 22.9 +/- 0.4% in group II and 25.3 +/- 0.5% in group I (p less than 10(-3)). The mean haematocrit time course was similar in both groups during the postoperative period and returned to preoperative value at discharge.(ABSTRACT TRUNCATED AT 250 WORDS)

Anesthesia, General↗