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Biomedical subjects

Y Costes

Publications and source records attributed to Y Costes.

At least 19 recordsLinked to original sources
PubMed1993

[Is the malleable mattress harmful for the spinal cord?].

When the inside pressure of mouldable mattress is lowered isotropic deformation can be harmful for spinal cord. The axial force is measured placing stress gauge in a metallic manikin and in corpse (T2-L1), then on the cephalic top of volunteers. When soles and head are included in an usual mattress, during the retraction stress values raise up to 484 N at 262 mbar for manikin, to 150 N at 315 mbar for corpse, to 102 N at 310 mbar for cephalic top of the volunteers. In comparison, a prototype was tested. Results were improved on metallic models but not on human corpses or volunteers. This test allowed us a better understanding of the mechanism of the stress. It is possible to propose precautionary measures during patient immobilization (to provide a space between soles, head and mattress) and to build a new stressless mattress.

Beds↗
PubMed1993

[A multifunctional anesthesia device: the K circuit].

A practical versatile anaesthesia device is described. An electrical pump provides room air to carry anaesthetic vapours. O2 can also be added if desired. Energy is supplied either by built-in batteries (12 volts = autonomy 6 hours) or external electric mains (12-30 volts or 220 alternative volts). The optimal recommended anaesthetic circuit is the Modified D Mapleson Circuit for economy in oxygen and anaesthetic vapours (for an adult only 6 l are needed). A non-rebreathing circuit can also be used: so draw-over ventilation or the use of an auto-inflating bag are possible when no electric power is available. If mechanically controlled ventilation is necessary, a specific ventilator can be adapted. This apparatus has already been manufactured and is very practical on the battle field or in developing countries.

Accidents↗
PubMed1992

[Choice of respirators for anesthesia].

Criteria of quality of gases and vapours supply, ventilator, patient's circle circuit and monitoring devices are recalled to help the anesthetist to choose his anesthesia machine. Advantages of compact or modular apparatus are discussed. Four, now wellknown, anesthesia machines (modulus II+, Siemens 900 D+SAC985, Roche Kontron 4300 and Engstrom Elsa) were analysed in clinical controlled ventilation and in simulated spontaneous ventilation to study the imposed work of breathing. Results are discussed with regard to safety rules and to ergonomics, bearing in mind their respective prices. Comparison is made with an original "bisontin" prototype.

Anesthesia, Inhalation↗
PubMed1992

[Automatic measurement of blood pressure: limits of oscillometric technique].

Non invasive blood pressure (NBP) measures are currently used in anesthesiology. The accuracy of this oscillometric technic has been tested with healthy patients, but not often with a wide pattern of pathology. The aim of this study is to point out the reliability of NBP during vascular surgery with patients suffering from arterial disease and atherosclerosis. It compares outcome with simultaneous catheter arterial blood pressure measurement (template technic). In this conditions, oscillometric method underestimates the systolic pressure value, and overestimates the diastolic one. The higher the level of arterial pressure is, the larger is the difference between this methods. It is clear that the automatic oscillometric technic is not so reliable if hypertension or atherosclerosis disease occurs. In order to improve this technic, automatic measures must take in account the degrees of arterial rigidity in its outcome.

Automation↗
PubMed1992

[Surgery of the aortic bifurcation and heart diseases: peroperative hemodynamics].

During aorto-biiliac by-pass, patients with heart disease are exposed at many haemodynamic problems. Mixed venous oxygen saturation monitoring help anesthetist along clamping and unclamping periods. This study concerning 13 patients with pre-operative NYHA class II and III congestive heart disease, discusses therapeutic algorithm especially for choosing inotropic or vasodilatator drugs.

Aged↗
PubMed1992

[Considerations on the monitoring of soda lime. Consideration technique].

The choice of ethyl violet as a pH indicator in soda lime is not the best. Color change happens too late because pH alteration of the surface of soda lime is slower than in the core of the canister. Clinical and comparative measurement of wall temperature of two in series canisters is a good precaution. If the down stream canister is warmer than the upstream one, you must change the latter.

Anesthesia, Closed-Circuit↗
PubMed1992

[The reliability of slow flow isoflurane vaporizers].

Two new vaporizers for isoflurane were tested and verified with very low flows: Ohmeda Tec 5 and Penlon PPV Sigma vaporizers. This work completes a previous one [1]. The Ohmeda Tec 5 appeared to be quite reliable. The Penlon vaporizer gave pretty good results too. However a gas flow with vibratory component can affect the result by decreasing dramatically the concentration of inhaled isoflurane.

Anesthesia, Inhalation↗
PubMed1991

[Arrhythmia in anesthesia and intensive care].

There is a high incidence of dysrhytmias in the operating room and I.C.U. Calling again diagnosis criteria using common leads of the E.E.G. leads to suggest a treatment approach taking the main effect of non cardiac factors in account, before the use of antiarrhythmic drugs. The Puech classification takes many data into consideration: electrophysiological properties, cardiac disease and trigger mechanism of dysrythmias. So, it is a better practice in a dysrythmia therapy to examine all these characteristics in order to choose an adjusted treatment.

Anesthesia, General↗
PubMed1990

[Value of the radionetwork of the transportation company in Besançon for alarm forwarding].

The C.B. users offered for a few years a way for putting-out the distress on the highway. There were 2,000 in Besançon and surroundings in 1982. Today they are becoming no existent. Since then a new system of alarm run is born with 150 buses, 178 kilometers of net-travel and a sweep frequency of 10 min from 6h30 a.m., to 8h p.m, and of 30 min until 12h p.m. The 250 "C.T.B." drivers assume a regular surveillance of the urban and suburban highways. A standard message in used between the C.T.B. (Besançon Company of Buses.) regulation and Samu 25, regulation which allows to fix circumstances, place of road accident and inventory of casualties: 27 emergency calls are received in 1987, 50 in 1988. It might be possible to use other private or public radiotelephonic network.

Communication↗
PubMed1990

[Repetitive inhalation anesthesia in rats].

Inhalational anesthesia in the rat seems a good process, by a rapid induction and awakening if a steady state ventilation-perfusion ratio and no pollution are obtained. Animals are cooped up in an "induction-box" which is joined to a scavenger system. Anesthesia maintenance is assumed with a Bain circuit and allows short and frequent anesthesia. Isoflurane does not markedly decrease circulatory and respiratory factors at low concentration (2%). So any anaesthetist can do himself such a practical system.

Anesthesia, Inhalation↗
PubMed1990

[Flumazenil and volatile anesthetics. Study of possible interferences in rats].

Many works suggest contradictory experimental or clinical results of flumazenil effects during inhalation anaesthesia. In ten rats anaesthesia was induced with 5% isoflurane or halothane during one minute and maintained during 5 minutes with 1% the same halogene anaesthetic in 50% N2O and O2. Then 0.2 mg of flumazenil or a same volume of placebo were administered intraperitoneally and during the last 5 minutes, the rats were exposed in 1% volatile anesthetic gas flow. Sleep times were measured in terms of reestablishment of the righting reflex. Each rat was anesthetized four time: halothane and isoflurane, with flumazenil or placebo. In those conditions, there were no significant changes in sleep times either the anaesthesia were associated, with flumazenil or with placebo.

Anesthesia Recovery Period↗
PubMed1990

[The indirect calorimeter, "do it yourself"].

An original metabolic calculator is realized with common and fiable transducers: a "microgaz Roche Kontron 7640" gives the PiO2-PeO2 and PeCO2 (Clark and Stow Severinghaus electrods), a pneumotachograph Gould 17212 (or the reliable integrated flow meter of the respirator) gives the expiratory minute volume. These values are inserted in an micro computer (Sharp PC 1261). The soft is wrote so that results are not altered when high FiO2 are used. Consumption of lipids and glucids is displayed in percentage when diuresis and urea values are entered. This device is compared with a well known expenditure monitor: Deltatrac (Datex): simultaneous measures are carried out in patients with miscellaneous diseases (15 series of 10 measures). Regression curves appear to be very reliable, as well for VO2(r = 0.98), VCO2 (r = 0.94) energy expenditure (0.97) as for R.Q (r = 0.77).

Calorimetry↗
PubMed1989

[Cutaneous microvascularization after tissue expansion: experimental study in rats. Proposal of a method for monitoring the expansion by measuring the transcutaneous pressure of oxygen].

Major complications can occur during cutaneous expansion. They appear to be related to microcirculatory disorders. An experimentation in the rat demonstrated a significant difference in the results depending on the protocol adopted (slow or rapid expansion). Complications occurred in the case of rapid expansion. The results for TcPO2, histology and capillaroscopy corroborate the clinical data. The authors show that measurement of the TcPO2 has a predictive value in relation to complications. They propose the use of this technique in human clinical practice. The TcPO2 and the cutaneous oxygenation index allows control of tissue expansion in order to prevent the development of complications.

Animals↗