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N Delorme

Publications and source records attributed to N Delorme.

At least 37 records · Page 2Linked to original sources
PubMed1987

[Is the theoretical blood volume the optimum for chronic respiratory insufficiency? Hemodynamic study of chronic bronchitis patients as a function of the hematocrit].

We have studied oxygen transport and haemodynamics in 19 clinically stable chronic bronchitis split into two groups with comparable blood gases but different haematocrits (Group I = 33%, Group II = 51.5%). The aim of the study was to assess the suitability of bringing the blood volume down to the predicted normal value by repeated venesection. The respiratory function was moderately altered in these patients. The pulmonary and systemic vascular resistance were significantly more elevated in Group II. The arterial oxygen transport was comparable in the two groups. On the other hand for Group I the systolic work of the right ventricle was greater on account of the increased cardiac output. We have not observed any difference in blood volume between the two groups of patients. These results suggest that a return to the predicted blood volume is not recommended without some doubts in chronic bronchitis with polycythaemia.

Blood Pressure↗
PubMed1986

[Shoshin beriberi with hyponatremia in a beer drinker].

Shoshin beriberi - a fulminant form of cardiovascular beriberi - and severe hyponatraemia were observed concomitantly in a heavy beer drinker. Hyponatraemia due to water overload and not to sodium deficiency is not a feature of the true beer drinker syndrome. Cardiogenic shock with major lactic acidosis developed. This case confirms the remarkable effectiveness of thiamine and the ineffectiveness of cardiotonic and vasoconstrictive drugs in such cases.

Adult↗
PubMed1986

[Acute respiratory distress syndrome in adults in colchicine poisoning].

Two cases of adult respiratory distress syndrome were treated in a series of 26 patients suffering from colchicine overdose. The syndrome appeared between the 24th and 72nd hours. It was characterized by the presence of interstitial as well as alveolar oedema seen on chest roentgenograms. Haemodynamic investigation showed a hyperkinetic state with moderate precapillary pulmonary arterial hypertension. In addition, multivisceral phenomena were observed in all cases. Post-mortem examination revealed interstitial and alveolar pulmonary oedema with haemorrhagic or macrophagic alveolitis often accompanied by hyaline membrane. The physiopathology of ARDS occurring in colchicine poisoning appeared to involve such different factors as infection, the presence of a state of shock and disseminated intravascular coagulopathy. The direct toxic action of colchicine on pneumocyte microtubules and the inhibition of surfactant production were a probable cause. The responsibility of colchicine in leukocyte aggregation remains to be determined.

Adult↗
PubMed1986

[Respiratory encephalopathy].

Encephalopathy is a common and sometimes a presenting feature of decompensated chronic respiratory failure. There is a wide number of clinical and paraclinical signs of this condition and four grades of severity without a close correlation with blood gas changes. This condition is the consequence of complex metabolic and circulatory disturbances resulting from the blood gas abnormalities. The prognosis is good when the respiratory failure is quickly and correctly treated.

Acute Disease↗
PubMed1984

[Acute edema of the lung in eclampsia].

In 6 cases of eclampsia in the course of pre and post-partum, we could observe neurological disorders associated with acute pulmonary oedema with acute respiratory distress occurring 5 to 72 hours after the first convulsive crisis. Hemodynamic check-up provided various results: 3 cases corresponded to A.P.O resulting from a lesion, with normal capillary pressure. In 3 other cases, there was hemodynamic oedema (overloading with high flow and hypervolemia in one case, myocardial incompetence with hypovolemia in an other case revealed by test filling in a third case). There were clinical signs of left ventricular failure in 4 case. Post-mortem investigations (5 cases) revealed unimportant ultrastructural alterations of myocardium only in 2 cases. Pulmonary histopathological investigations (5 cases) were the investigations carried out in case of oedema resulting from lesions with interstitial and alveolar oedema, hyaline membranes, alteration of pneumocytes, and intra-capillary thrombi. Mendelson's syndrome which was always discussed could be eliminated. The syndrome of respiratory distress was certainly connected with more or less generalized microcirculatory disorders (microembolism with hyperpermeability) connected with hemostasis disorders and cerebral manifestations.

Acute Disease↗
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↗
PubMedDate not supplied

[Severe complications related to metabisulfites].

Metabisulfite intolerance is encountered in 8 p. 100 of cases of extrinsic asthma and in 20 p. 100 of cases of the "aspirin triad" with nasosinusal polyposis, asthma and aspirin sensitivity. The possibility that anaphylactoid shock or acute severe asthma leading to status asthmaticus, might be related to sulfite sensitivity must be well known. Two case reports are set out. The first observation is that of a 35-year-old woman suffering from intrinsic asthma with alcohol intolerance, who developed status asthmaticus a few minutes after intravenous administration of Doxycycline associated with a metabisulfite preservative. The other 33-year-old patient presented with an acute bronchospasm in the course of a fiberoscopy using Lidocaine associated by mishap with epinephrine, as local anesthetic. The authors point to the miscellaneous drugs containing sulfites, that are employed in asthmatics by different routes, i.e. parenteral, oral, inhalational and other local treatments. Heavy metabisulfite intake may also arise from daily alcohol consumption. Sulfite intolerance could contribute to the persistence of chronic inflammatory processes in bronchial asthma and therefore should be systematically investigated.

Adult↗
PubMedDate not supplied

[Effect of artificial ventilation with an end-expiratory plateau on gas exchange amd hemodynamics in chronic respiratory failure].

Previous studies of pulmonary models and with animals have shown that in obstructive disease of the airways, ventilation with an end-expiratory plateau improves ventilation distribution. Paradoxically, there has been no data published on patients with obstructive disease. For this reason, we examined the effects of mechanical ventilation with an end-expiratory plateau on gas exchange and haemodynamics in 12 patients presenting acute exacerbations of chronic respiratory failure. Following a period of conventional controlled ventilation, two plateaux of 0.3 and 0.5 s respectively are successively introduced while the I/E ratio (1/2.5) and then inspiratory flow (respiratory frequency and end-tidal volume remaining the same) are kept constant. PaCO2 decreases by approximately 10% with the addition of each plateau. In spite of a moderate increase in mean airway pressure (+8%), greatest improvement in gas exchange is observed with the longer plateau (0.5 s), maintaining expiration time (I/E constant) : a decrease in PaCO2 and in VD/VT (approximately - 14%), an increase in PaO2 (+7%) and a decrease of venous admixture (shunt + shunt effect : - 18.5%). The plateau tends to reduce ventilation/perfusion mismatch, whereas maintaining prolonged expiration assures "emptying" of slow alveoli. However, no matter which plateau is used, cardiac output decreases by more than 10% in six patients, probably due to a drop in systemic venous return. PaCO2 increase is too slight to hinder a decrease in arterial oxygen transport. The variability of these results accounts for patient diversity and restricts the indication of end-expiratory plateau to patients with severe ventilatory distribution disturbances who can benefit from close cardiorespiratory monitoring.

Aged↗