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Biomedical subjects

M F Jorda

Publications and source records attributed to M F Jorda.

At least 19 recordsLinked to original sources
PubMed1991

[Use of propofol in 1350 anesthetized patients for electroconvulsive therapy].

Propofol was used for 1,350 sessions of electro-convulsive therapy (ECT). After 0.5 mg of intravenous atropine, patients received 1 to 1.5 mg.kg-1 bolus of propofol over a period of 20 seconds or less. This was convenient for loss of the eye-lash reflex. A bolus of 15 to 20 mg suxamethonium was given, in non allergic patients, to prevent trauma from the seizure. The patient was hyperventilated with pure oxygen through a facial mask. The electric shock was delivered bitemporally after a dental protection had been inserted. For each patient, the following data were noted: sex, use of tricyclic antidepressant drugs, atopy, amount of administered propofol and the effective intensity of the electric shock. The 99 patients were given 16.27 +/- 14 ECT sessions. Among them 26 took antidepressant drugs and 34 were atopic. There was no difference, except for weight, between the 25 men and 74 women. The mean dose of propofol was 1.37 +/- 0.3 mg.kg-1. The dose decreased with increasing age. There was no statistical relationship between the amount of propofol and intensity of the electric shock required to set off a seizure. The use of antidepressant drugs, and atopy did not influence the required amount of propofol. Speed of injection seemed to be the determining factor for narcosis with low doses of propofol. Hyperoxia and hypocapnia induced by hyperventilating with pure oxygen seemed to facilitate occurrence and duration of seizures. Although propofol has been said to reduce the length of seizures, there is controversy concerning the ECT efficacy criteria.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1990

[Study of cerebral energy metabolism and development of postanoxia coma].

An open prospective study of brain energy metabolism was carried out in 20 consecutive cases of coma occurring after cardiopulmonary arrest (CPA) of various causes. Mean age was 54 years and mean duration of CPA 2.75 min, with a mean of 11 min for resuscitation. Brain energy metabolism was compared with clinical course, electroencephalogram (EEG), and neurological outcome. All the patients were given the usual intensive care: intermittent positive pressure ventilation, haemodynamic control, sedation with benzodiazepines, neuromuscular paralysis, anticonvulsants, mannitol. A clinical examination and an EEG were carried out daily, 4 h after all drugs which might interfere with these investigations or brain energy metabolism had been stopped (except for anticonvulsants). Successive measurements of the cerebral arteriovenous oxygen (C (a - v) O2) and glucose (C (a - v)gluc) contents were made. The oxygen glucose index (OGI) was calculated according to Cohen's formula. The first set of measurements were carried out within the first 30 h after CPA. The last measurements were made a few hours before death or recovery, or stabilization of the coma. Patients were assigned to 2 groups according to their neurological outcome: group R (n = 8), patients who recovered consciousness; group D (n = 12), patients who developed brain death or a vegetative state - Safar's cerebral performance category 4. During the first 30 h, there was no relationship between clinical course, EEG and cerebral outcome. Half of the patients died or recovered within 72 h.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1984

[Mediastinitis caused by odontogenic anaerobic bacteria].

Anaerobic odontogenic mediastinitis appeared to be on the increase. The case described had a favourable outcome. The aetiology and pathology of this disease, the dreadful prognosis of which was a mortality rate of 50%, were discussed. The aggravating factors appeared to be general, these patients presenting a particular predisposition, due to steroids and malnutrition, and anatomical, as the cellulitis spread along cervical fascial planes. The treatment always required was mediastinal surgical drainage by a transcervical approach or by thoracotomy, the association of three antibiotics (a penicillin with an imidazole, an aminoglycoside or a macrolide) and a high energy and nitrogen intake.

Adult↗
PubMed1981

[Massive blood transfusion in 50 seriously injured patients. Occurrence of pulmonary oedema (author's transl)].

This retrospective study shows correlations between the occurrence of pulmonary and massive blood transfusion in 50 seriously injured patients. They received massive transfusions on an average of 13 titers (minimum 51, maximum 30 l) including from 0 to 7,51 of macromolecular solutions (average 2,43 1). These seriously injured patients were divided into 4 groups: --20 thoracic injured patients with associated abdominal lesions, --15 thoracic injured patients without any abdominal lesions, --4 peripheral traumatism with abdominal lesions, --11 polytraumatic patients (considering only lesions of the limbs). There is a significant difference between seriously injured patients with associated abdominal lesions who were transfused and the other groups studied. Sixteen patients experienced pulmonary edema the diagnosis of which was reinforced on grounds of clinical, biological and radiological evidences. Significant difference (p:minor 0,05) were noted as regard the incidence of pulmonary edema when comparing the volume of fluids administrated to the different groups. New out of 16 patients died, mainly because of refractory hypoxia. When more than 25 liters of fluids are transfused, the prognosis is poor. Though pulmonary edema may be brought about by transfusion, other etiologic possibilities are to be investigated.

Abdominal Injuries↗