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Biomedical subjects

S Fougère

Publications and source records attributed to S Fougère.

8 recordsLinked to original sources
PubMed2002

Bench testing of pressure support ventilation with three different generations of ventilators.

OBJECTIVE: The new generations of intensive care ventilators tend to be more innovative and sophisticated than previous ones, but little is known about their respective performance for delivering pressure support ventilation (PSV) and how they compare to previous generations. DESIGN: Active lung model bench test. APPARATUS: Twenty-two commercially available ventilators classified into three categories: new generation ventilators (after 1993, n=7), previous generation (before 1993, n=6), and recent piston or turbine-based ventilators ( n=9). MEASUREMENTS AND RESULTS: During PSV, the unloading efficacy of the assistance depends on the ventilator's ability to meet inspiratory flow demand. Three levels of flow (0.1 l/s, 0.6 l/s, and 1.2 l/s) were used to simulate inspiratory demand and the net area of the inspiratory airway pressure-time trace was calculated over the first 0.3 s, 0.5 s, and 1 s (Area (0.3), Area (0.5), and Area (tot)) with three levels of PSV (5 cmH(2)O, 10 cmH(2)O, and 15 cmH(2)O). To assess the respective role of pressure support delivery and triggering function, triggering sensitivity was assessed independently by measuring the time delay ( TD (tg)) and the pressure fall (Delta Paw (tg)) with two levels of inspiratory drive. All the new generation ventilators exhibited significantly better results than most of the previous generation ventilators regarding Area (0.3) and TD (tg), indicating large improvements in terms of triggering and pressurisation. CONCLUSION: Regarding PSV and trigger performance, the new generation ventilators - but also some piston and turbine-based ventilators - outperform most of previous generation ventilators.

Benchmarking↗
PubMed2000

[Perfusion instruments: analysis of product surveillance in 1998 and its on-the-job training. Subcommittee 4b for Product Surveillance].

OBJECTIVES: To analyze retrospectively the data base of the French national vigilance reporting system concerning infusion devices during the year 1998. METHODS: Each report has been reviewed and classified, except implantable catheter ports. RESULTS: The study included 309 reports. Among them, 28% concerned infusion pumps and 72% single use devices, i.e. catheters, infusion lines, taps, connectors, etc. We observed six deaths and 23 severe incidents. Only 25% of devices could be formally investigated by manufacturers. The origins of incidents were very different between infusion pumps and single use devices. The first showed simple failures, software errors, maintenance omissions or errors, and problems related to obsolescence of the device. The second revealed manufacturer quality insurance failures, design and utilization errors, and problems related to the technique itself rather than device. DISCUSSION: Our findings are similar to the few data available in international literature. They address the need to obtain an adequacy between the performances of devices which vary with generations of devices and the clinical risks: newest and safest devices should be preferred for the infusion of the most critical drugs.

Catheterization↗
PubMed1997

[What equipment to be chosen, with what criteria, and what requirements?].

The increasing precision of exercise testing modalities has contributing to making it an excellent means of evaluating functional impairment in dyspnea patients. It has become an indispensable diagnostic tool. Interpretation of data acquired during an exercise test depends on the reliability of data collection and the accuracy of the different calculations. The wide variety of available measurement systems (different principles, different methods for measuring lung volumes and ventilatory flow, canalization systems and valves, analyzers) and data processing systems, and the presence of very simple or on the contrary very complicated systems emphasizes the importance of determining quality requirements used for selecting equipment.

Exercise Test↗
PubMed1995

[Ventilators for anesthesia. Models available in France. Criteria for choice].

This update article discusses the criteria for the choice of an anaesthetic machine and provides a short analysis of the main components of the models commercialized in France in 1994. The following items are considered: the design of the machine, the fresh gas delivery system, the anaesthesia breathing system(s), the ventilator and the waste gas scavenging system, the monitors associated with the machine and other criteria such as facility of learning to run the machine and of its daily use, ease of "in-house" maintenance and quality of after-sales service, cost of the machine and of its use (driving gas, disposable equipment).

Anesthesia, Inhalation↗
PubMed1994

[Electric infusion devices: criteria of choice and comparative analysis of 45 models available in France].

This study compared 45 electric infusion devices, either constant flow pumps or syringe pumps, available in France. These devices were tested for start-up delay, time to alarm following occlusion, bolus following occlusion, accuracy of flow rate and pressure output. Ergonomic, environmental and various technical criteria such as safety in continuous perfusion, correct positioning of infusion sets, air in line and end of perfusion detection were also considered. Users can compare these devices in easy to read tables. The newest devices include systems improving the quality of flow.

Ergonomics↗
PubMed1994

[Electric infusion devices].

Electrical infusion devices are specifically aimed to maintain an accurate and constant flow rate. The infused agents can be allocated into three categories of risk, according to their therapeutical index and their infusion rate. Each category requires infusion devices with the corresponding performances. Moreover the choice of a device depends also on ergonomical and environmental criteria as the area of use (e.g. ambulatory patient, transport, neonates, intravenous anaesthesia).

Drug Therapy, Computer-Assisted↗
PubMed1983

Keratinocytes synthesize basal-lamina proteins in culture.

On histologic vertical sections of skin, the epidermis is separated from the dermis by an amorphous thin membrane, the basal lamina. Ultrastructurally, the basal lamina is composed of four areas, including the basal-cell plasma membrane and hemidesmosomes, the lamina lucida, the lamina densa, and the sub-lamina densa fibrillar region. In culture, epidermal keratinocytes are able to produce hemidesmosomes, lamina lucida, and lamina densa. There is no evidence that cultured keratinocytes can produce sub-lamina densa fibrils. Biochemically, the lamina lucida contains two major glycoproteins. One, the bullous pemphigoid antigen, is synthesized by epidermal keratinocytes in vitro. These cells also synthesize laminin, the other glycoprotein of lamina lucida. At the interface between lamina lucida and lamina densa there is probably a heparan sulfate proteoglycan. Whether this proteoglycan is produced by keratinocytes in culture is not known, but the possibility can be considered. Lamina densa contains collagen IV, and this collagen is synthesized by keratinocytes in culture. However, cultured keratinocytes may also synthesize collagen types I, III, and V. Type V is associated with the basal lamina, but its exact location is unknown. Types I and III (if they are produced in vivo) would be situated in the sub-basal lamina region. The problem of fibronectin remains unsolved. There is "some" fibronectin in the lamina lucida, but its origin is not clear.

Animals↗