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Biomedical subjects

N Louvier

Publications and source records attributed to N Louvier.

11 recordsLinked to original sources
PubMed2003

[Allergy investigations after two cases of adverse reactions to a neuromuscular blocking agent and management for subsequent general anaesthesia].

We report two cases of severe anaphylactic reactions to rocuronium. Diagnosis was confirmed by skin tests and specific IgE assay. Cross-reactivity to all neuromuscular blocking agents was investigated by intradermal tests and leucocyte histamine release test. Intradermal tests and leukocyte histamine release were negative for cisatracurium. The two patients had undergone a subsequent general anaesthesia using cisatracurium and did not present any adverse reaction.

Aged↗
PubMed1999

[Latex allergy: diagnostic pitfalls].

A 44-year-old woman, native of Martinique, with a history of multiple allergies and severe asthma, sustained an unexplained cardiovascular collapse during surgery under general anaesthesia. The patient recovered normally. Postoperatively, neither additional explorations were undertaken nor informations given to the patient. Later on she had to undergo cholecystectomy. Data obtained from preanaesthetic assessment (history, analysis of medical files) were in favour of a past intraoperative allergic accident. Allergological tests confirmed a latex allergy. This case substantiates the importance of a careful preanaesthetic consideration of patient's history and the value of a systematic allergologic exploration after an unexplained intraoperative event compatible with an anaphylactoid reaction. All such events should be clearly explained and a written document handed to the patient.

Adult↗
PubMed1999

[Adsorption of carbon dioxide gas].

OBJECTIVES: To analyse the various methods for carbon dioxide absorption in anaesthesia, the available absorbents and their modes of use. DATA SOURCES: We searched the Medline and Internet databases for papers using the key words: carbon dioxide absorption, soda-lime, zeolite. We also had correspondence and contacts with soda lime manufacturers. STUDY SELECTION: All types of articles containing data on CO2 absorption. DATA EXTRACTION: The articles were analysed for the benefits and adverse effects of the various absorbents. DATA SYNTHESIS: Carbon dioxide absorption enables the use of low flow anaesthesia, and a decreased consumption of medical gases and halogenated anaesthetics, as well as reduced pollution. Chemical absorbents (soda-lime and barium hydroxide lime (Baralyme) may produce toxic compounds: carbon monoxide with all halogenated anaesthetics and compound A with sevoflurane. Simple measures against desiccation of the lime prevent carbon monoxide production. The toxicity of compound A, shown in the rat, has not been proven in clinical anaesthesia. Recent improvements in manufacture processes have decreased the powdering of lime. Moreover, filters inserted between the anaesthesia circuit and the patient abolish the risk for powder inhalation.

Anesthesia, Inhalation↗
PubMed1995

[Validity of cerebral angiography via venous route in the diagnosis of brain death].

The success of transplantations relies on uninjured organs i.e., harvested before circulatory failure. At present, french law concerning cerebral death criteria (circulaire ministérielle n. 3 du 21.01.91) requires the association of clinical patterns and 2 repeated, unreactive and flat electroencephalographic (EEG) tracings. Blood and urinary samples also need to be free from any nervous system depressant drug, the patient has not to be hypothermic. These obligations are not always compatible with patients status or local organization. The consequence might be organ loss or delay in harvesting schedule. A review of the literature points out the trap in realization and analysis of EEG in this kind of intensive care patients. Angiogram, on the opposite, is influenced neither by nervous system depressant drug nor by hypothermia. As it is in some other western countries, it should be proposed as the reference.

Adult↗
PubMed1994

[Do halogenated anesthetics protect from ischemic and reperfusion myocardial injuries?].

Ischaemia and reperfusion of the myocardium are associated with cellular injuries leading to a decrease of contractile function and the occurrence of arrhythmias. As reperfusion of an ischaemic heart results in an intracellular overload of calcium, a calcium blocking agent pretreatment has been shown to exert a protective effect. By altering myocardial calcium fluxes, volatile anesthetics might also protect the myocardium from ischaemic damage and reperfusion injuries. A beneficial effect of volatile anesthetics on the ischaemic myocardium has been shown in numerous studies. These agents decrease the severity of ischaemia as well as the incidence of reperfusion arrhythmias and improve recovery of myocardial mechanics during reperfusion. They also preserve myocardial energetics and protect from oxygen-derived free radicals injury. However, some studies do not support these protective effects. The wide discrepancy between the various protocols might explain the discrepancy of the results. Enflurane and halothane seem to be more efficient than isoflurane. This cannot only be explained by different cardiovascular effects, but also by a specific effect on myocardial cells. Halothane and enflurane mainly decrease intracellular calcium availability by a direct effect on sarcoplasmic reticulum, while isoflurane only decreases the transsarcolemnal calcium entry. Enflurane and halothane have more beneficial effects than isoflurane on free radicals induced myocardial injuries. In conclusion, despite a wide diversity between the different studies, halothane and enflurane have better protective properties against ischaemia and reperfusion myocardial injuries than isoflurane.

Animals↗