Annales de l'anesthésiologie française
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The authors bring not only the results of their experience but a solution of the respiratory problems during anaesthesia in suspension laryngoscopy, thanks to the devising of a new intubation probe and a pre-set automatic insufflator with varying volum flow.
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The object of this study is to examine the properties of dopamine at the hemodynamic and renal level in 16 patients with decompensated chronic cardiopathies or very serious cardiogenic shock due to myocardial infarction. The results show an increase in the cardiac index in 75 p. 100 of the cases with a favourable diminution of the arterio-venous difference in O2 and of the pulmonary arterial resistances. The most noticeable and the most constant effect is the recovery and increase of the diuresis. Positive chronotropic and bathmotropic effects were observed which necessitated the limitation of prescription of dopamine in those subjects showing signs of disturbances in ventricular excitability.
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The following hemodynamic parameters: cardiac frequency, peripheral arterial pressure, pulmonary pressure and cardiac output were measured by direct catheterisation, as the total peripheral vascular resistance and the systolic ejection volume were calculated from the registered results. The cardiac frequency and the pulmonary arterial pressure were practically not modified in our patients, though we have observed a statistically significant decrease of systolic (-30p. 100) and diastolic (-27p. 100) arterial pressure. The total peripheral vascular resistance shows a marked diminution (-20p. 100) after giving Ethrane? for ten minutes. If it is possible that one part, surely important, of the cardiac output, is preserved under Ethrane anesthesia by a significant decrease of the total peripheral vascular resistance, a myocardial depression might be questionned, the decrease of cardiac output at 30 minutes being more important than the decrease of the total peripheral vascular resistance.
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Seven patients presenting a state of shock were treated with dopamine. The authors remark an undeniable effect on arterial pressure which rises again and on the diuresis.