RESUMEN
With monochromatic infrared gas spectrometers (MIS), the displayed concentration is computed from measured IR absorption and a gain factor specific for the selected volatile agent (VA). As MIS cannot detect which VA is actually present, the displayed concentration can be very different from the actual one. As bottles and vaporizers are very specific for desflurane, it is impossible to misfill a vaporizer; however an erroneous selection of VA on MIS remains possible. The aim of this study was to assess the displayed concentrations after erroneous vapour selection on the monitor. When either desflurane, or isoflurane or enflurane were delivered at constant concentrations, all VA measured by the MIS, namely desflurane, sevoflurane, isoflurane, enflurane and halothane were successively selected and the displayed concentrations compared with the actual vapour concentration using a Capnomac Ultima (Datex) monitor. Consequences of erroneous selection can be included in three categories: 1) dangerous error, when a displayed concentration is much lower than the actual one, e.g. desflurane or sevoflurane erroneously selected; 2) evident error, when displayed concentration is much higher than 10 vol%; 3) uncomfortable situation, when displayed and actual concentrations are similar, e.g. isoflurane erroneously selected instead of desflurane. This error can only be detected by a careful checking of the device.
Asunto(s)
Anestésicos por Inhalación/análisis , Falla de Equipo , Isoflurano/análogos & derivados , Nebulizadores y Vaporizadores , Desflurano , Seguridad de Equipos , Humanos , Isoflurano/análisis , EspectrofotometríaRESUMEN
Although guidelines for the parenteral use of vitamin preparations in pediatric patients have been published, there are very limited data on the efficiency of these preparations and on the exact needs of infants and children on total parenteral nutrition (TPN). We report here an open, prospective, study of the blood levels of water-soluble vitamins in infants and children on TPN before and during supplementation with a new water-soluble multivitamin formula containing per vial unit: B1, 3 mg; B2, 3.6 mg; B6, 4 mg; niacin, 40 mg; pantothenate, 15 mg; ascorbate, 100 mg; biotin, 60 micrograms; folic acid, 400 micrograms; B12, 5 micrograms. Thirteen children, 9 months to 15 yr old, on home TPN for 1.5 months to 7 yr, and 17 hospitalized infants and children, 1 week to 15 yr old, receiving TPN were studied for 2 weeks to 4 months. Daily doses were given according to age: 1/2 vial if less than 18 months; 1 vial if greater than 18 months and less than 10 years; 1.5 vials if greater than 10 years. Assays for B1, B2, biotin, niacin, plasma and red blood cell (RBC) folates were performed by microbiologic methods, B12 was measured by radioimmunoassay. During the study, B1 levels were consistently above the upper limit of the normal range, B2 and B12 remained in the normal range although there was a slight decrease in B12 values. Almost half of the patients had initially low levels of biotin, niacin, and folates. Biotin, after a significant sharp rise during the first month of supplementation returned to normal range. Niacin levels were initially low in infants and rose toward normal values during treatment.(ABSTRACT TRUNCATED AT 250 WORDS)
Asunto(s)
Nutrición Parenteral Total , Complejo Vitamínico B/sangre , Adolescente , Ácido Ascórbico/administración & dosificación , Ácido Ascórbico/sangre , Ácido Ascórbico/farmacología , Biotina/administración & dosificación , Biotina/sangre , Peso Corporal , Niño , Preescolar , Femenino , Ácido Fólico/administración & dosificación , Ácido Fólico/sangre , Humanos , Lactante , Masculino , Niacina/administración & dosificación , Niacina/sangre , Estudios Prospectivos , Complejo Vitamínico B/administración & dosificaciónRESUMEN
Amylase activity in blood and urine, lipase activity in blood, and amylase/creatinine clearance ratio have been prospectively compared in order to test these parameters against estimation of pancreatic isoamylase. Pancreatic isoamylase had been evaluated by inhibition methodology and not by electrophoresis. One hundred patients admitted for strictly sus-umbilical abdominal pain in emergency unit have been studied. Results show that we do not have in blood specific biochemical marker for acute pancreatitis. Lipase and P isoamylase activity evaluation have about the same specificity. In emergency situation the choice of routine investigation will be rather based on methodological simplicity and lower cost.
Asunto(s)
Pruebas Enzimáticas Clínicas , Glicósido Hidrolasas/metabolismo , Isoamilasa/metabolismo , Pancreatitis/diagnóstico , Enfermedad Aguda , Amilasas/metabolismo , Femenino , Estudios de Seguimiento , Humanos , Lipasa/sangre , Lipasa/metabolismo , Masculino , Estudios ProspectivosRESUMEN
Epidural narcotics have been shown to produce prolonged pain relief in chronic cancer pain. The technical hazards of daily injections and risks of infection with percutaneous catheters have delayed implementing this treatment. A completely implantable daily epidural morphine delivery system has been developed. Its technique and efficiency are presented.
Asunto(s)
Morfina/administración & dosificación , Dolor/tratamiento farmacológico , Espacio Epidural , Femenino , Humanos , Inyecciones/instrumentación , Persona de Mediana Edad , Neoplasias/fisiopatología , Dolor/etiologíaAsunto(s)
Peritonitis/tratamiento farmacológico , Povidona Yodada/administración & dosificación , Povidona/análogos & derivados , Irrigación Terapéutica/métodos , Anciano , Niño , Humanos , Yodo/sangre , Persona de Mediana Edad , Peritonitis/cirugía , Periodo Posoperatorio , Povidona Yodada/uso terapéutico , Cuidados PreoperatoriosAsunto(s)
Adyuvantes Anestésicos , Antieméticos , Encéfalo/efectos de los fármacos , Butirofenonas/uso terapéutico , Hipnóticos y Sedantes , Antieméticos/administración & dosificación , Antieméticos/efectos adversos , Nivel de Alerta/efectos de los fármacos , Temperatura Corporal/efectos de los fármacos , Butirofenonas/administración & dosificación , Butirofenonas/efectos adversos , Estado de Conciencia/efectos de los fármacos , Sistema Digestivo/efectos de los fármacos , Discinesia Inducida por Medicamentos , Glándulas Endocrinas/efectos de los fármacos , Tractos Extrapiramidales/efectos de los fármacos , Femenino , Sistema de Conducción Cardíaco/efectos de los fármacos , Hemodinámica/efectos de los fármacos , Humanos , Hipnóticos y Sedantes/administración & dosificación , Hipnóticos y Sedantes/efectos adversos , Metabolismo/efectos de los fármacos , Psicosis Inducidas por Sustancias , Respiración/efectos de los fármacos , Choque/prevención & control , Suicidio , Contracción Uterina/efectos de los fármacosAsunto(s)
Antipsicóticos , Butirofenonas , Antagonistas Adrenérgicos alfa/farmacología , Animales , Conducta Animal , Butirofenonas/antagonistas & inhibidores , Butirofenonas/metabolismo , Fenómenos Químicos , Química , Sinergismo Farmacológico , Electroencefalografía , Cinética , Receptores Dopaminérgicos/farmacologíaAsunto(s)
Fenotiazinas/uso terapéutico , Trastornos Psicóticos/tratamiento farmacológico , Antipsicóticos/uso terapéutico , Sistema Nervioso Autónomo/efectos de los fármacos , Sistema Nervioso Central/efectos de los fármacos , Humanos , Hipertermia Maligna/inducido químicamente , Fenotiazinas/efectos adversos , Fenotiazinas/farmacologíaAsunto(s)
Reserpina/análogos & derivados , Reserpina/farmacología , Animales , Sistema Nervioso Autónomo/efectos de los fármacos , Sistema Nervioso Central/efectos de los fármacos , Interacciones Farmacológicas , Humanos , Hipertensión/tratamiento farmacológico , Trastornos Mentales/tratamiento farmacológico , Reserpina/metabolismo , Reserpina/uso terapéuticoRESUMEN
It is impossible not to note the small number of epidural anaesthetics given for obstetrics in France. The rarity of centres where it is offered by a team of specially trained anaesthetists and obstetricians contrasts with the increase in demand from the patients themselves. Study of the number of epidural anaesthetics predictable in obstetrics according to the criteria of indication indicates that the procedure could be used in as many as 30 to 50 per cent of deliveries. This implies a need for an increase in the number of anaesthetists, i.e. an increase not so much in the total number as in those trained in obstetrics with experience of epidural anaesthesia. Similar changes are necessary in hospital organisation, in such a way that the place of the anaesthetist in the maternity unit is recognised officially, this recognition being strengthened by routine out-patient consultation with all patients during their pregnancy. The economic aspect of a possible increase in the number of epidural anaesthetics carried out in France and in the number of anaesthetists performing the procedure is envisaged in terms of salaries in the public hospital system, costing of the procedure by the Social Security and the true cost of epidural anaesthesia.