Management of cardiac arrest caused by coronary artery spasm: epinephrine/adrenaline versus nitrates.

Background: Cardiopulmonary resuscitation guidelines imply the use of epinephrine/adrenaline during cardiopulmonary arrest. However, in cardiac arrest situations resulting from coronary artery spasm (CAS), the use of epinephrine/adrenaline could be deleterious.

Methods And Results: A 49-year-old patient underwent an emergency coronarography with an attempt to stent the coronary arteries.

[Evaluation of the renal function in cardiac surgery with CPB: role of the cystatin C and the calculated creatinine clearance].

Objectives: The evaluation of the renal function in cardiac surgery is difficult. The gold standard remains the creatinine clearance in clinical practice. Cystatin C was recently proposed in order to evaluate the renal function.

[Metabolic acidosis after cardiac surgery with cardiopulmonary bypass revisited with the use of the Stewart acid-base approach].

Introduction: According to the Stewart approach of acid-base regulation, chloride from either volume replacement or cardiopulmonary bypass (CPB) priming solution may induce metabolic acidosis. The alternative hypothesis stands in volume dilution with solutions free of bicarbonate.

Objectives: Evaluate the acid-base status of patients undergoing cardiac surgery with CPB priming containing chloride and bicarbonate.

Cardiac output measurements in off-pump coronary surgery: comparison between NICO and the Swan-Ganz catheter.

Background: The aim of this prospective study was to compare continuous cardiac output measurements of the non-invasive cardiac output system (NICO) with the pulmonary artery catheter during off-pump coronary bypass surgery.

Methods: Twenty-two patients enrolled for off-pump coronary surgery received both a pulmonary artery catheter and a non-invasive cardiac output system for measurement of cardiac output. Data were compared by the Bland-Altman method to calculate the degree of agreement and to analyse if a significant difference existed between the two methods of cardiac output measurements.

Thermal efficiency and environmental performances of a biogas-diesel stationary engine.

Municipal and agricultural waste, and sludge from wastewater treatment represent a large source of pollution. Gaseous fuels can be produced from waste decomposition and then used to run internal combustion engines for power and heat generation. The present paper focuses on thermal efficiency and environmental performances of dual-fuel engines fuelled with biogas.

[Coronary thrombosis on patient with the factor V Leiden mutation].

We report a documented observation of coronary thrombosis occurring in a 25-year-old patient with no risk factor, presenting a hereditary thrombophilia (facteur V Leiden) diagnosed a few months earlier in a context of venous thrombosis. This patient had a spread out anterior myocardial infarction with cardiac arrest due to a ventricular fibrillation; although he was quickly rescued by the mobile intensive Care Unit, the patient died 48 hours later, after cerebral anoxia. The mutation called factor V Leiden is a widely spread hereditary family thrombophilia (5 to 6% of the population) and is characterized by a resistance to activated C protein provoking a hypercoagulable state.

[Coronary spasm during repeated anesthesia].

Coronary arterial spasm observed during the course of two repeated anaesthesias in a patient having undergone aorto-femoral bypass grafting is reported by the authors. Such complications are accompanied by serious ventricular arrhythmias, though transient and healing without sequelae. Clinical and electrocardiographic characteristics of peroperative coronary arterial spasm are underlined.