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P Monin

Publications and source records attributed to P Monin.

At least 19 recordsLinked to original sources
PubMed1992

Doxapram for the initial treatment of idiopathic apnea of prematurity.

The ventilatory effects of doxapram in the initial pharmacotherapy for apnea in the newborn were evaluated in 8 premature infants with idiopathic apnea. All received doxapram for 48 h at 0.25 mg/kg/h on the first day and 1 mg/kg/h on the second day. The ventilatory effects and the airway occlusion pressure (p0.1) were measured by means of a face mask, and a pneumotachograph. Compared to the pretreatment period, the mean of the frequency of central apnea greater than or equal to 15 s decreased significantly (p less than 0.01) by 48 and 75% during the first and second day, respectively. Both doses significantly increased inspiratory drive measured by airway occlusion pressure by 20% (p less than 0.05) and 32% (p less than 0.01) on the first and second day of drug treatment, respectively. Minute ventilation, tidal volume and mean respiratory flow significantly increased only with 1 mg/kg/h of doxapram, accompanied by a significant decrease in transcutaneous PCO2. No side effects were noted. Data suggested that doxapram alone at a dose of 1 mg/kg/h is effective for the treatment of neonatal apnea.

Apnea↗
PubMed1992

[Hemodynamic and renal adaptation of newborn infants of hypertensive mothers treated with acebutolol].

A prospective study of the hemodynamic and renal changes was undertaken in 11 neonates whose mothers were treated with acebutolol for hypertension during pregnancy, compared with a control group of 11 infants born to normotensive mothers. Monitoring of the cardio-respiratory system was performed for a period of 4 days. Renal function was studied during 2 periods (12-36, 60-84 hours of life). Hemodynamic failure was observed in 5 of 11 children from treated mothers. The data concerning the renal function of treated group showed: 1) a diuresis significantly lower during the first period (p less than 0.05); 2) the absence of significant rise in the glomerular filtration rates during the second period; 3) a lower sodium balance during the 1st and 2nd periods (p less than 0.02 and p less than 0.05), a lower calcium balance during the 1st period (p less than 0.01). No relationship was found between the renal changes and the hemodynamic disturbances. The direct effect of the drug on the glomerular and tubular functions and/or the renal arteriolar vasomotricity could explain these changes in the renal function in the newborns prenatally exposed to acebutolol.

Acebutolol↗
PubMed1991

[Monitoring after total hip prosthesis. Value of semi-quantitative D-dimer assay].

Criteria for positive assay of the D-dimer were defined in order to establish its diagnostic value for phlebitis in the post-operative period. A retrospective study was carried out on the files of 94 patients who had received a total hip prosthesis in 1990. A semi-quantitative assay technique was used to measure the D-dimer because it is the only method giving immediate results. Three criteria were used to classify the results: criterium A: D-dimer greater than or equal to 2 micrograms/ml; criterium B: D-dimer greater than or equal to 4 times the preceding test; absence of both of these criteria. The results were compared to echo-doppler results and confirmed by phlebography when necessary. The incidence of proximal phlebitis was low (2 percent); criterium B showed a 100 percent negative predictability and a 29 percent positive predictability. None of the cases of phlebitis diagnosed with this test had been suspected clinically. This test provides a means of patient screening and spares the need for other explorations.

Echocardiography, Doppler↗
PubMed1991

Respiratory mechanics in spontaneously breathing term and preterm neonates.

The compliance (Crs), resistance (Rrs) and passive time constant (tau rs) of the respiratory system were determined by the single-breath method (sb) in 24 healthy term and preterm newborns. In 22 of them, Crssb was compared to the slope of the pressure-volume curve determined by the multiple occlusion technique (mo), which is not dependent on the assumption of a linear flow-volume relationship. Crssb and Rrs correlated significantly with body weight (kg): Crssb = 0.56 x kg + 1.22 (r = 0.67); Rrs = -20.1 x kg + 134.6 (r = -0.68). No difference in Crs and Rrs between prone and supine positions was found. tau rs was not significantly different between premature (0.21 +/- 0.06 s) and full-term infants (0.21 +/- 0.05 s). Crssb was significantly higher than Crsmo in premature babies (2.27 +/- 0.41 ml.cm H2O-1 vs. 1.98 +/- 0.47 ml.cm H2O-1. This difference may be explained by a continuous braking of expiratory airflow after release of the occlusion, or more likely, by a difference in the lung volume at which Crssb and Crsmo are measured. However, the difference between Crssb and Crsmo (approximately 15%) is in the same range as the intrasubject variability, and is meaningless compared to the alterations of respiratory mechanics observed during neonatal ventilatory disorders. Therefore, the single-breath method appears to be a suitable and noninvasive method to measure respiratory mechanics in nonintubated prematures.

Airway Resistance↗
PubMed1991

Hyperventilation restores autoregulation of cerebral blood flow in postictal piglets.

Autoregulation of cerebral blood flow is impaired in the postictal state. This loss of autoregulation may in part be mediated by a rise in perivascular hydrogen ion and carbon dioxide concentration. We hypothesized that hypocarbia with a concomitant reduction in perivascular hydrogen ion and carbon dioxide concentration would restore autoregulation during the postictal state. We studied autoregulation of cerebral blood flow in 13 ventilated, awake 3- to 4-d-old piglets during the postictal state under normocarbic and hypocarbic conditions. During the postictal state, cerebral blood flow was pressure-passive in normocarbic piglets, whereas the relationship between cerebral blood flow and cerebral perfusion pressure was described by a polynomial curve in hypocarbic piglets. Because hypocarbia restores cerebral blood flow autoregulation in postictal newborn piglets, we speculate that the perivascular hydrogen ion and carbon dioxide concentration contribute significantly to the state of cerebral autoregulation in the postictal subject.

Animals↗
PubMed1990

Effect of sympathetic nervous system on cerebral blood flow in the newborn piglet.

The role of the sympathetic nervous system on cerebral blood flow (CBF) autoregulation was evaluated in newborn piglets. Six animals were studied after ablation of the right superior sympathetic ganglion and compared to 6 control animals. Mean arterial blood pressure (MABP) was decreased by successive blood withdrawal and CBF was measured by radioactive microspheres. In denervated animals, MABP and CBF correlated positively according to a parabolic curve showing an absence of autoregulation when MABP is above 50 mm Hg (y = 0.079x2 - 5.9x + 154, p less than 0.01). In control animals, CBF remains stable throughout the experiment (y = 0.28x + 5). These data suggest a shift to the left of the upper limit of the autoregulation range in denervated animals and consequently a poor adaptation to increased MABP.

Animals↗
PubMed1990

[Respiratory tract infection and sudden infant death].

Among the risk factors for sudden infant death, respiratory tract infections are often reported. In this review, after a presentation of the particularities of the respiratory functions in the infant, the interactions between infection and ventilatory function are discussed.

Apnea↗
PubMed1990

Pelizaeus-Merzbacher disease. Contribution of magnetic resonance imaging to an early diagnosis.

The lesions of the cerebral white matter which characterize Pelizaeus-Merzbacher disease are classically observed at pathological examination. An early diagnosis can now be obtained by magnetic resonance imaging (MRI). In an eutrophic first son born at term, stridor, nystagmus-like eye movements and axial hypotonia were noted immediately after birth and pyramidal signs appeared at 2 months, the only extra-clinical finding at that age being prolonged latencies of evoked visual potentials. An MRI exploration, performed at 3 months, showed that compared with the grey matter the white matter emitted a low-intensity signal on the T1-weighted sequence and a high-intensity signal on the T2-weighted sequence (signal inversion), such diffuse and symmetrical MRI abnormalities being typical of dysmyelination. When combined with suggestive clinical signs, these abnormalities confirm the diagnosis of Pelizaeus-Merzbacher disease, even in the absence of a familial history, and make it possible to warn the parents of the poor prognosis and the risk of recurrence among future sons.

Brain↗
PubMed1989

Autoregulation of cerebral blood flow. Effect of phenobarbital and pancuronium in the newborn piglet.

The effect of phenobarbital and pancuronium on cerebral blood flow (CBF) and CBF autoregulation are studied in newborn piglets after chemically induced seizures with bicuculline. Given 3 or 15 min after the onset of seizures, phenobarbital significantly reduces CBF (59 +/- 11 and 56 +/- 17 vs. 84 +/- 24 ml/min/100 g - p less than 0.01). Moreover, during graded hypotension induced by graded haemorrhage, phenobarbital provides reestablishment of CBF autoregulation altered by seizures. In the same experimental model, pancuronium induces in control animals a rise of CBF (61 +/- 15 vs. 38 +/- 11 ml/min/100 g - p less than 0.001). During graded hypotension pancuronium is associated to a loss of CBF autoregulation (r = 0.76, p less than 0.001). Given as an adjunct treatment, in case of seizures, pancuronium has no significant effect on changes in cerebral haemodynamics. From these data, we conclude that pancuronium jeopardizes the haemodynamic adaptation to the induced hypovolemia and that phenobarbital may present a protective effect on cerebral haemodynamics and the subsequent risk for ischaemia or haemorrhage.

Animals↗
PubMed1979

Giant lobar emphysema--neonatal diagnosis.

Giant emphysema of a lung lobe has distinctive features. Classically there is overdistension of the affected lung lobe, with one lobe only being involved, and, 50% of cases occur in the newborn infant [1, 4, 8]. The authors describe a particularly severe example with marked mediastinal shift and initially the hemithorax on the side of the lesion was opaque. Angiography was carried out and followed by resection when the infant was 4 months old.

Angiocardiography↗
PubMed1979

Transcutaneous PO2 monitoring (tcPO2) in the newborn during apneic spells, convulsions, cardiac catheterizations, and exchange transfusions.

Continuous transcutaneous PO2 recording improves the monitoring of critically ill infants and newborns submitted to invasive procedures such as exchange transfusions or cardiac catheterization. The measurement of tcPO2 in babies with apneic spells or seizures gives a better understanding of these respiratory disorders. It is reasonable to recommend the continuous monitoring of PO2 with a transcutaneous electrode in neonatal intensive care units.

Apnea↗
PubMed1978

[The persistence of foetal circulation. Neonatal pulmonary arterial hypertension. Favourable action of tolazoline (author's transl)].

Alongside reversible secondary pulmonary arterial hypertension accompanying neonatal respiratory distress, there are primary PAH leading to the persistence of the foetal circulation. This is a true functional neonatal heart disease which may occur alone or be seen in association with another form of neonatal distress such as respiratory distress secondary to the inhalation of amniotic fluid. Any neonatal hypoxaemia irreductible by classical methods should suggest the possibility of persistent pulmonary arteriolar vasoconstriction and lead, in the absence of systemic hypotension, to the administration of vasodilators. These data remain in the preliminary stage and further studies, in particular pharmacological, of these drugs are necessary.

Heart Defects, Congenital↗