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J P Bousser

Publications and source records attributed to J P Bousser.

7 recordsLinked to original sources

[Severe hyperkalemia in cardiac patients].

Hyperkalaemia with severe myocardial consequence may complicate the treatment of heart failure. In five patients who developed kalaemia ranging from 6.5. to 8.6. mEq/l, the ECG showed altered auriculogram and/or widened QRS, the latter change being associated with ST segment elevation and very large T wave in one case. Such hyperkalaemia cannot be termed iatrogenic, although it is promoted by diuretic-induced hyponatraemia and dehydration. The essential part is played by an aggravation of the haemodynamic status, responsible for acute renal insufficiency with oligoanuria, and by the attendant metabolic acidosis. The correction of this metabolic acidosis promotes diuresis, causing potassium depletion and the rapid regression of electrocardiographic abnormalities. Parenteral alkalinization with sodium bicarbonate, associated with furosemid to prevent sodium overload, instituted in emergency, is the only way to prevent asystole or ventricular fibrillation when kalaemia exceeds 8 mEq/l.

Acidosis↗

[Acid-base disorders in status asthmaticus (author's transl)].

In 85 patinets withstatus asthmaticus, the authors have studied the acid-base balance, the blood gas tensions and various humoral parameters. The values were classified into two groups according to the PaCO2 level: below or equal to 44 torr (Group I), higher than 44 torr (Group II). In the 58 cases of Group II, there was a very close positive correlation between PaCO2 and H + ions, practically the same as that established by BRACKETT et al. [3] in experimental acute hypercapnia in man. On the contrary, the correlation derived from cases of status asthmaticus in the literature showed, in some cases, a metabolic component in acidosis. In the present work, the mean value of lactates was close to normal; there was a slow increase in protein content and hematocrit, in the two groups. The prognosis of the status asthmaticus depends on the degrees of hypercapnia: when it reaches 70 torr, mechanical ventilation is urgently needed and is the main part of the treatment; the use of additional drugs remains a matter of specific case.

Acid-Base Imbalance↗