Impaired lung function after intubation and mechanical ventilation for surgical ligation of the ductus arteriosus in preterm infants.

Objective: Significant patent ductus arteriosus (PDA) in the preterm infant has been associated with pulmonary edema and impaired gas exchange. Therefore, surgical ligature of the DA may be required. However, the effects of intubation and mechanical ventilation on the PDA-induced lung dysfunction presently are unknown.

[Umbilical and peripherally inserted venous central catheterization of the newborn].

Umbilical venous and peripherally inserted venous central catheters are widely used to perfuse low-weight preterm and term newborns in intensive care units. This catheter must be inserted carefully and monitored rigorously to prevent complications. This paper develops today's knowledge on the use and complications in the newborn population.

[Central venous catheters in pediatric patients].

Central venous catheterizations are often used in pediatric intensive care units or for long-term intravenous treatment. It consists in positioning the catheter extremity in the venous cava-right atrium junction. Adapted material and techniques are necessary for young children because of particularities in anatomy and the size of the different venous trunks.

Development of a new model to investigate the fetal nociceptive pathways.

Objective: The aim of the study was to develop an experimental model to investigate the fetal nociceptive pathways and fetal analgesia.

Methods: We tested the electromyographic (EMG) response from the biceps femoris to electrical stimulation of the sural nerve in chronically-prepared fetal lambs with and without sufentanil.

Results: An EMG response could be recorded 140 ms after the electrical stimulation above a threshold of current's intensity.

Total spinal anesthesia during combined general-epidural anesthesia in a 7-year-old child.

Total spinal anesthesia (TSA) is a rare complication of lumbar epidural anesthesia through inadvertent spinal injection of local anesthetics following an undiagnosed dural breach or spinal placement of the catheter. TSA has rarely been reported in children. TSA occurred during epidural anesthesia in a 7-year-old child undergoing abdominal surgery.

[Pediatric emergency department policy. Implementation and management of the resuscitation room].

The pediatric resuscitation room is the place where children suffering from vital distress are cared for in the emergency unit. Recommendations for its organization, functioning and evaluation have been ruled on by experts from six medical societies involved in these emergencies. They concern all the hospital's physicians, nurses and administrative directors.

An IBM PC-based system for experimental haemodynamic studies.

An IBM PC-based real-time data acquisition, monitoring and analysis system for experimental haemodynamic studies was developed. Comprehensive haemodynamic signals, such as aortic and left ventricular pressures, aortic and coronary blood flows, two segmental lengths, two segmental thicknesses, electrocardiogram and airway pressure, were acquired and monitored to assess cardiac function. The system performs computer-aided analysis and derivations on a number of haemodynamic parameters and cardiac function indices.

Interregional differences in the systolic and diastolic response of nonischemic myocardium to remote coronary occlusion.

Background: Previous work showed a twofold increase in stiffness of nonischemic myocardium at the base during ischemia of the left anterior wall. Whether the diastolic response of nonischemic myocardium to remote ischemia depends on the localization of the ischemic or the nonischemic area is unknown.

Methods: In dogs with open chests, regional function in ischemic and nonischemic myocardium was assessed (sonomicrometry) before and 5 min after occlusion of the left anterior descending coronary artery (LAD; n = 7) or the left circumflex coronary artery (LCX; n = 7).

Nitrous oxide sedation in pediatric patients undergoing gastrointestinal endoscopy.

Background: The ideal medication to administer to children before gastrointestinal endoscopy procedures has yet to be found. The efficacy of using inhaled nitrous oxide during endoscopy in children was assessed in a pilot study.

Methods: Patients aged 5 to 17 years, referred to our hospital for diagnostic upper gastrointestinal endoscopy or rectosigmoidoscopy procedures, were eligible for enrollment in this study.

Effects and interactions of nitrous oxide, myocardial ischemia, and reperfusion on left ventricular diastolic function.

The effects of nitrous oxide on left ventricular diastolic function and its potential interactions with ischemia-induced diastolic dysfunction have not been described. Accordingly, we investigated the effects of nitrous oxide in ischemic and remote nonischemic myocardium during baseline, 90 min severe low-flow myocardial ischemia (systolic bulge), and reperfusion in 11 open-chest dogs. Anesthesia was maintained with fentanyl infusion (2 micrograms.

Myocardial ischemia and reperfusion are associated with an increased stiffness of remote nonischemic myocardium.

During and after an ischemic injury, maintenance and recovery of cardiac function may critically depend on remote nonischemic myocardium. Graded myocardial ischemia is associated with an approximately 50% increase in stiffness of nonischemic myocardium. We determined whether this increase in stiffness is unique to the ischemic period or persists during reperfusion.

Effects and interactions of myocardial ischaemia and alterations in circulating blood volume on canine left ventricular diastolic function.

We have determined the effects of alterations in preload on ischaemia-induced diastolic dysfunction in anaesthetized beagles instrumented to measure left ventricular pressure and regional dimensions. Low-flow regional ischaemia decreased peak lengthening rates in ischaemic (mean -26 (SEM 6) mm s-1, P < 0.01) and non-ischaemic (-8.

The influence of preload on post-systolic shortening in ischaemic myocardium.

Post-systolic shortening is a wall motion abnormality defined as shortening of cardiac muscle after the end of ejection and usually regarded as a manifestation of ischaemia. This study was designed to determine whether changes in preload may alter the magnitude of ischaemia-induced post-systolic shortening. Eleven beagles were anaesthetized (halothane 0.

[A study of blood loss during surgery for scoliosis. Posterior approach in 319 adolescents].

A retrospective study including 319 patients was realized from 1984 to 1993 in order to evaluate during scoliosis surgery the incidence on bleeding of the type of scoliosis and the anesthetic procedure. Blood losses were below one litre thus reducing the homologous blood transfusions. The patient was in prone position on a modified Wilson frame which facilitates venous return from the dorsal region.

Post-ischemic diastolic dysfunction.

Though a sustained post-ischemic decrease in contractile function has been clearly established, post-ischemic diastolic function has not been thoroughly investigated. Accordingly, 11 anesthetized (isoflurane 1%) open-chest beagles were instrumented to measure left ventricular pressure and dimensions (circumferential length and wall thickness) in an apicoanterior area supplied by the left anterior descending coronary artery (LAD). Pressure-dimension relations were modified by stepwise infusion and withdrawal of 200 mL of the animals' own blood during baseline, 45 minutes partial occlusion of the LAD (systolic bulging), and 60 minutes after the onset of reperfusion.

Response of atrial natriuretic factor to surgical pericardial drainage in patients with chronic pericardial effusion.

Previous studies have demonstrated the importance of atrial transmural pressure in the secretion of atrial natriuretic peptide. These studies have been performed in patients with pericardial effusion and hemodynamic compromise. The response of atrial natriuretic peptide to the drainage of chronic pericardial effusion without clinical evidence of tamponade is unknown.

[Cryoanesthesia by freon spray for venepuncture in children].

This prospective study was designed to assess the quality of skin analgesia provided by cryoanesthesia induced by a spray of freon (dichloro-tetrafluoro-ethane) for venous cannulation (22 or 24 Gauge cannulas). Eighty children between the ages of 5 and 15 years were allocated to two groups: 40 children had a conventional venepuncture, 40 others had a venepuncture under cryoanesthesia. The spray of freon was applied for ten seconds on the area of skin to be anaesthetised.

[Nociceptive flexion reflex. Principles and applications of the threshold determination].

The threshold for the pain flexion reflex in the lower limb can be used to determine the potency in man of analgesic drugs acting centrally. A new apparatus is, the "algometre", described. Bipolar electrical stimulation (5 stimuli of 1 ms over a period of 10 ms) is applied to the saphenous nerve just behind the external malleolus.

[Resection and reconstruction of the carina with separate two-lung high-frequency jet ventilation].

Carinal resection and reconstruction via a right transpleural approach in an hypoxemic patient provides difficult maintenance of satisfactory gas exchange when one lung ventilation is inadequate. The present case report concerns a 62-year-old patient with chronic obstructive airways disease and a carinal squamous cell carcinoma. He underwent tracheobronchial reconstruction surgery by Barclay's procedure through a right postero-lateral thoracotomy.