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P Koeberlé

Publications and source records attributed to P Koeberlé.

6 recordsLinked to original sources

[Severe obstetric complications nescessitating hospitalization and intensive care: a ten year retrospective study].

OBJECTIVES: To assess the serious maternal morbidity during pregnancy, delivery and post partum, which led to an hospitalization in a medical or surgical intensive care unit. STUDY DESIGN: A Retrospective study was carried out on a period of ten years, from July 1986 to July 1996, in the University Teaching Hospital of Besançon. PATIENTS: The criterions of inclusion come from the definition of the serious maternal morbidity decided by the Inserm: any admission of a pregnant woman in a medical or surgical intensive care unit in the 42 days of the post-partum, whatever the term of the pregnancy and the type of the post-partum, extra uterine pregnancy, spontaneous miscarriage and medical or voluntary abortion. METHODS: Forty-six patient's medical file hospitalized in a medical or surgical intensive care unit between July, 1st 1986 and July, 31st 1996, have been studied. RESULTS: The analysis of the cause underline the gravity of the pathologies handled with young patients and initially healthy, the short length of controlled ventilation and hospitalization, the avoidability of great number of transfer in an intensive care unit, and the lack of hospitalization due to anaesthesia. The frequency of hospitalisation in an intensive care unit during and after the pregnancy was estimated at 0.17% of lives births. CONCLUSION: The serious maternal morbidity could be an indicator of the quality of the obstetrics cares which would complete the study of the maternal mortality. The potential gravity of the complication of the pregnancy and the delivery require better care of this patients.

Adult↗

[Obstetrical epidural analgesia: an epidemiological in Bourgogne and Franche-Comté 1993].

Many publications report the number of epidural analgesias carried out for the last years in English-speaking countries. On the other hand, very little information exists about the incidence of obstetrical epidural analgesia performed in South and Central Europe, particularly in France. A retrospective study within the regions of Bourgogne and Franche-Comté was carried out for the year 1993 firstly, to determine the number of obstetrical epidural analgesias performed and the drugs used; and secondly, to describe the organization and the problems encountered. The result of this study leads to one major question: what is the best type of organization in order to guarantee the highest safety, given the increasing demand for epidural analgesia in obstetrics?

Analgesia, Epidural↗

[Hemodynamic effect of intrathecal clonidine].

Intrathecal administration of bupivacaine and clonidine results in a significant prolongation of both motor and sensitive blocks but side effects-hypotension and bradycardia-are observed. We compared two groups of patients allocated randomly. One group received intrathecal bupivacaine-morphine and the other one received clonidine-bupivacaine-morphine. In the group which received clonidine a blood pressure decrease was observed from 2nd to 8th hour, independently from the sympathetic block and easily corrected by i.v. ephedrine. Some possible explanations are discussed. No complications due to clonidine were observed.

Aged↗

[Angioneurotic edema and anesthesia: preparation and perioperative monitoring].

Hereditary angioneurotic oedema is an autosomal dominant disease associated with serum deficiency of functional C1-inhibitor. It is characterized by periodic swelling of subcutaneous tissues, abdominal viscera and upper airways. Lethal acute episodes of oedema can occur during anaesthesia and surgery. It is essential to prepare such patients before surgery. This article describes three cases (kidney transplantation, caesarean section, normal delivery) and the various preventive measures used to avoid acute episodes during anaesthesia and surgery. Antibrinolytic agents, androgens, fresh frozen plasma, C1-inhibitor concentrate can be administered. Their various indications are discussed.

Adult↗

[Recent data on the mechanism of action of theophylline].

Since Sutherland's work simply based on the inhibition of phosphodiesterase was questioned, other researches have been carried out, indicating that many mechanisms located in the nervous system, the smooth muscle, and the immunity system interfere. The participation of receptors to adenosine, intracellular calcium ions, regulating calciproteins and autacoids such as prostaglandins was the purpose of numerous experimental researches that allow today to fill up the gap left by the fact that the inhibitor of phosphodiesterase was questioned. However, there are not sufficient but there are many seducing research and hypotheses.

Adenosine↗