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Biomedical subjects

M C Laprevote-Heully

Publications and source records attributed to M C Laprevote-Heully.

At least 37 records · Page 2Linked to original sources
PubMed1980

[Influence of microaggregate transfusion filters on the rheological properties of blood].

Micro-aggregate transfusion filters have been suggested in order to prevent pulmonary complications in cases of shock after massive transfusions and cerebral complications after ECC. It is important to have prior knowledge of performance, in particular with regard to perfusion flow rate and the efficacy of filtration. Eight filters have been thoroughly studied: Bentley PF 127, Bentley PFF 100, Biotest, Fenwal 4C2417, Fenwal 4C 2423, Intersept, X Pall Ultipor SQ 40 S, Swank IL 40 S. For each of them, study included the following: perfusion flow rate, filtration pressure (Swank technique) of whole blood distal or proximal to the filter, viscosity and various haematological parameters (CBC, free haemoglobin, red cell ATP). Finally, the deposit retained by the filter must be studied morphologically by sweep electron microscopy. It would seem that good aggregate elimination power (decrease in filtration pressure of 75 to 95 per 100) often coincides with a poor flow rate and the need to rapidly change the filter. Efficacy is virtually the same for all filters with the exception of Pall filter where it seems to be less. The Bentley PF 100 and Fenwal 4C 2423 filters combine this efficacy with an adequate flow rate, resulting in easy use in practice. By contrast, the Pall filter with a very satisfactory flow rate is less effective than the other with regard to the retention of aggregates. Other parameters are only very slightly modified by filtration. The deposit collected on the filters consists of fibrinogen, deformed red cells (echniocytes), leucocytes and platelets.

Blood Transfusion↗
PubMed1980

[Modifications in hemorheological parameters following acute medical emergencies (author's transl)].

Various hemorheological parameters were studied in venous blood samples taken during the initial stages of acute medical emergencies in patients admitted to the Intensive Care Unit. These included more particularly: cerebrovascular accidents, recent acute arterial or venous thrombosis, pulmonary embolism, acute renal failure, pregnancy toxemia and emergencies occurring during pregnancy or in the puerperium, coagulation disorders, gas embolism... The examinations conducted were:--measurement of apparent--blood viscosity (eta a) and plasma viscosity--platelet aggregate fixation after fixing in formalin according to the method described by Wu and Hoak--blood filterability through filters with pores 5 microns in diameter. The principal modifications observed, often correlated were raised blood and plasma viscosity, reduction in the aggregation index, and diminution in filterability. It should be noted that the increase in viscosity, constant in all groups, is significant at low shearing speeds in the thrombosis cases, and that this significance is present in nearly all the pathological groups with high shearing speeds. Variations in the aggregation index are very dispersed and of low significance.

Blood Viscosity↗
PubMed1979

[Light and electron microscopic study of hepatic lesions in the course of hyperlactatemia in diabetic patients (author's transl)].

Histopathological study of the liver has been undertaken on twenty-one diabetics with hyperlactatemia exceeding 5 mEq/1 of whom seven were treated with phenformin, six with metformin and eight not biguanide-treated. Hyperlactatemia occurred during the course or during resolution of severe ketoacidosis or of hyperosmolar coma. Hepatic lesions were invariably present. By light microscopy, massive steatosis, steatonecrosis or necrosis of variable extent were observed. Ultrastructural study showed constant mitochondrial abnormalities. These results support the hypothesis of a major role for mitochondrial changes in hepatic cells in provoking pathological hyperlactatemia. In diabetic patients, these mitochondrial lesions could be induced either by an anoxic process resulting from a variety of metabolic insults or by some as yet undefined toxic action of biguanides or by the combination of both of these factors.

Adult↗
PubMed1979

[Compared study of micro-aggregates filters (output, filtration pressure and study of the deposit with scanning electron microscopy) (author's transl)].

Special filters for the elimination of cellular aggregates were conceived especially to prevent pulmonary complications in patients shocked particularly after massive transfusions as well as to prevent cerebral complications after extra-corporeal circulation. The performances and the conditions of use of these filters (perfusion output, change of the filter) were considered. Four filters were carefully studied: the Fenwal filter, the Swank filter, the Biotest filter and the intersep Johnson and Johnson filter. The following studies were carried out for each filter: the perfusion output (of three bottles filtered one after another with or without pressure); the filtration pressure (Swank technique) of the whole blood up-and-down filter; the viscosity and various hematologic parameters (NF, hemoglobin and gobular ATP); finally, the deposit was studied morphologically with scanning electron microscopy. It appeared that a good capacity of aggregates elimination (decrease of the filtration pressure of 95%) was often linked to a feeble output and the necessity of replacing the filter. The efficacy of the Fenwal filter, the Swank filter, the Biotest filter and the intersept filter was practically the same, but the Intersept filter provided the best output with an equal filtration capacity. The other parameters remained about the same. The deposits included fibrinogen, deformed red blood corpuscules (echinocytes), leucocytes and platelets.

Blood Transfusion↗
PubMed1978

[Acute renal failure and consumption coagulopathy in the puerperium].

Disseminated intravascular coagulation accompanied 18% of cases of acute renal failure during puerperal disorders. We studied in particular 31 cases of disseminated intravascular coagulation with renal failure due to obstetric disorders : 12 post-abortion infections, 3 retentions of a dead foetus, 5 infections, 6 cases of toxemia, 2 retroplacental hemorrhages, two hemorrhages during the third stage, one uremohemolytic syndrome. For diagnosis one relies on the clinical data (bleeding, purpura, shock, hemolysis, visceral involvement) and laboratory data, (coagulation should be supervised throughout the course). The renal lesions are either cortical necrosis, or interstitial nephritis. The analogies with experimental phenomena suggest a human equivalent of the Schwartzmann-Sanarelli syndrome.

Acute Kidney Injury↗
PubMed1978

[Heat stroke and disseminated intravascular coagulation. Apropos of 2 cases].

Two cases of fatal heat stroke, concerning a 20 year-old soldier and a 44 year-old psychiatric patient, treated with neuroleptics, are reported. The clinical picture, starting suddenly with coma and hyperthermia, was quite identical for both. Secondarily, while hyperthermia decreases and the conscience improved partially, an hemorrhagic syndrome similar to a consumption coagulopathy, acute renal insufficiency and acute hepatic failure appear. Death occurred after aggravated neurological disorders and respiratory distress. The anatomical lesions spread on all the viscera include tubular nephritis, and hepatic centro-lobular necrosis and an interstitial and alveolar oedema with hemorrhages and hyaline membranes in the lungs.

Acute Kidney Injury↗
PubMed1976

[Acute consumption coagulopathies. 120 cases].

Consumption coagulopathy is frequently observed in a resuscitation department. 120 cases of various etiologies are reviewed: complications of pregnancy (61 cases), infections (23 cases) or various stresses: acute hemolysis, shock, severe hepatic failure, intoxications, acidosis, heat-stroke... Consumption coagulopathy is intricated with the general stress which induces it, and with the visceral lesions induced by the stress and which can be aggravated by the consumption coagulopathy. The state of shock is observed in 76% of the cases, the haemorrhagic syndrome in 73%. Acute hemolysis and the clinical signs evocative of disseminated intravascular coagulation (cutaneous signs) are more rare. Following the initial manifestations, visceral complications may develop: renal, hepatic, respiratory, neurological, digestive. The evolution of the biology must be carefully studied. The diagnosis is made on both clinical and biological data. Etiological and pathophysiological treatment should be carried out. In our series, controlled and adapted heparin therapy was given systematically.

Disseminated Intravascular Coagulation↗
PubMed1976

[Consumption coagulopathies and severe postpartum hemorrhage].

15 patients were referred to the Intensive Care Unit immediately after delivery for severe post-partum haemorrhage. In 7 cases complications followed retroplacental haemotoma formation and in the other 8 cases they were due to secondary haemorrhages from the placental site and/or from tears of the cervix or vagina. It is a clinical picture that is associated with a state of shock, with continuing massive bleeding associated with failure of the blood to clot and which persists and becomes worse with the transfusion of stored blood and of the coagulation factors. In all these cases severe coagulation pathology due to consumption defects is revealed. We must point out that tears of the cervix and vagina which have been neglected and failure to compensate for the original blood loss are among the aetiological factors. Treatment with Heparin giving a dose of 1 to 3 mg per kg of body weight per 24 hours and controlled by a strict biological check together with symptomatic resuscitation from the state of shock and from the coagulation factors is successful (9 cases) if it is undertaken early on. A fatal outcome, whether it is due to a persistent state of shock (1 case) or to visceral complications of diffuse intravascular coagulation (C.I.V.D.) (5 cases) can be found where treatment is delayed and when insufficient blood is replaced and when antifibrinolytics are prescribed. A preventive therapeutic plan as well as a curative one can be drawn up for these cases of obstetrical drama.

Adult↗
PubMed1976

[Consumption coagulopathy and acidosis in the diabetic patient (author's transl)].

Four cases of intravascular coagulation associated with a state of acidosis in diabetics were observed in 57 patients with diabetic acidosis and 19 with lactic acidosis, in a series of 112 cases of consumption coagulopathy admitted to a department of medical resuscitation. In three cases the coagulopathy was found only on investigation; in one there were clinical and anatomic signs. The coagulopathy may be found either during the phase of recovery from ketoacidosis, or during the course of severe lactic acidosis, particularly during a recurrence of this form of acidosis. In spite of the unfavorable outcome in 3 of the 4 cases, the abnormal findings of coagulopathy reverted toward normal along with successful metabolic corrections. The factors responsible for consumption coagulopathy are acidosis, collapse, generalised systemic reactions and alterations of platelet function, of coagulation, of the balance between fibrin deposition and lysis and of lipid levels, all characteristic of diabetes. The clinical effects of this coagulopathy seldom become apparent but provide a possible explanation of some of the complications of diabetic ketoacidosis, particularly certain hemorrhagic or thrombotic events, as well as certain visceral complications, especially those affecting renal, pulmonary and cerebral areas.

Adolescent↗
PubMed1976

[Suicidal behavior and meterological conditions].

Six hundred and seventy five cases of attempted suicide observed in a resuscitation department were confronted with a certain number of biometeorological factors recorded daily: atmospheric pressure, air temperature, degree of insolation, precipitation, relative humidity, water vapour pressure, wind (speed and direction), hydrometeores, index of solar eruption, density of F2 layer. The confrontation is made for the two days before the intoxication and for the day when suicide is attempted. Parameters are then studied by statistical calculation (calculation of X2 and of the number of degrees of freedom). There does not seem to be any significant relationship, in spite of disconcerting series, between most meteorological factors and the number of attempted suicides observed. However, it is noted that no suicides were recorded during periods of solar eruption, and that there seems to be a marked correlation between suicide and winds, particularly according to their direction. Thus, winds charged with ionised particles seem to coincide with a high rate of self-destruction.

Atmospheric Pressure↗