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Now showing items 1 - 16 of 18

  • ARTIFICIAL-VENTILATION APPARATUS WITH CARDIAC MASSAGE MONITORING

    The invention relates to a respiratory-aid apparatus (1) capable of supplying a stream of gas to a patient (P), comprising a gas-transport pipe (2) for transporting a stream of gas, such as air; measurement means (6) designed to measure at least one parameter representing the stream of gas and to supply at least one signal corresponding to said at least one parameter representing said stream of gas, for example the gas flow rate or pressure; signal-processing means (8) designed to process said at least one signal from the measurement means (6) and to deduce therefrom at least one piece of information (I1, I2, I3) characterising a cardiac massage performed on a patient; and display means (7) designed to display said at least one piece of information (I1, I2, I3) characterising a cardiac massage from the signal-processing means (8). The signal-processing means (8) are preferably capable of determining information representing the work (Wv, WT) provided by the massage or pressure and/or flow rate amplitudes resulting from the massage. The invention also relates to a monitoring method capable of being implemented by such a respiratory-aid apparatus (1).
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  • THORAX SIMULATOR

    The present invention relates to a thorax simulation device (4) comprising a base (16), an air containing system (6) containing a volume of air, an air transfer system (7) and tactile feedback actuation system (8) comprising a movable actuating member (36) and a reciprocating arrangement (14). The actuating member is operationally coupled to the air containing system by a chamber actuating mechanism (42) configured to change the air volume within the air containing system as a function of the displacement of the actuating member. The reciprocating arrangement comprises a traction mechanism (52) configured to apply a traction force on the actuating member, and a compression mechanism (54) configured to apply a compression force on the actuating member, the compression force and traction force acting in opposite directions.
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  • ARTIFICIAL VENTILATION APPARATUS WITH VENTILATION MODES SUITED TO CARDIAC MASSAGE

    The invention relates to a method of controlling a respiratory assistance apparatus delivering a flow of gas, particularly a flow of air, comprising the steps of measuring at least one parameter indicative of said flow of gas; converting said at least one parameter indicative of said flow of gas into at least one signal indicative of said flow of gas; processing said at least one signal indicative of the flow of gas in order therefrom to deduce at least one item of information relating to cardiac massage being performed on a patient in cardiac arrest; on the basis of said at least one deduced item of information, automatically selecting a given ventilation mode from among a number of stored ventilation modes, and controlling the respiratory assistance apparatus by applying the selected ventilation mode. Respiratory assistance apparatus capable of implementing said control method.
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  • Hemodynamic effects of extended prone position sessions in ARDS

    Ruste, Martin   Bitker, Laurent   Yonis, Hodane   Riad, Zakaria   Louf-Durier, Aurore   Lissonde, Floriane   Perinel-Ragey, Sophie   Guerin, Claude   Richard, Jean-Christophe  

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  • New physiological insights in ventilation during cardiopulmonary resuscitation

    Cordioli, Ricardo L.   Grieco, Domenico L.   Charbonney, Emmanuel   Richard, Jean-Christophe   Savary, Dominique  

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  • APPARATUS FOR ARTIFICIAL VENTILATION, WITH MONITORING FOR ABSENCE OF CHEST CONTRACTIONS

    A respiratory assistance apparatus (1) for delivering a flow of gas to a patient (P) comprises a gas delivery conduit (2) for conveying a flow of gas, measuring means (6) designed to measure at least one parameter representative of the flow of gas and to supply at least one signal corresponding to said parameter, signal-processing means (8) designed to process said signal coming from the measuring means and to deduce from said signal at least one item of information relating to performaace and/or discontinued performance of chest contractions (CT), calculating means designed to calculate at least one duration of discontinuation or absence of chest contractions (tNCT), and storage means (12) configured to register said duration of discontinuation or absence of chest contractions.
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  • Assessment of clinical criteria for sepsis—was the cart put before the horse?

    Aublanc, Mylène   Richard, Jean-Christophe  

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  • Influence of Tidal Volume on Alveolar Recruitment

    RICHARD, JEAN-CHRISTOPHE   MAGGIORE, SALVATORE?M.   JONSON, BJORN   MANCEBO, JORDI   LEMAIRE, FRANCOIS   BROCHARD, LAURENT  

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  • Effects of prone position and positive end-expiratory pressure on lung perfusion and ventilation*

    Richard, Jean-Christophe   Bregeon, Fabienne   Costes, Nicolas   Bars, Didier L. E.   Tourvieille, Christian   Lavenne, Franck   Janier, Marc   Bourdin, Ga?l   Gimenez, Gérard   Guerin, Claude  

    Objectives. Prone positioning is frequently used during acute respiratory distress syndrome. However, mechanisms by which it improves oxygenation are poorly understood, as well as its interaction with positive end-expiratory pressure. This study was conducted to decipher the respective effects of positive end-expiratory pressure and posture during lung injury on regional lung ventilation, perfusion and recruitment assessed by positron emission tomography. Design: Experimental study. Setting. Research laboratory of a university hospital. Subjects: Six female piglets. Interventions. After oleic acid-induced lung injury, all animals were studied in supine and prone position at both positive end-expiratory pressure 0 and positive end-expiratory pressure 10 cm H(2)O. Measurements and Main Results: In each experimental condition, regional lung perfusion and ventilation were assessed with positron emission tomograph using intravenous (15)O-labeled water and inhaled nitrogen-13. Nonaerated lung weight was assessed with positron emission tomograph, and alveolar recruitment was defined as the difference of nonaerated lung weight between conditions. Positive end-expiratory pressure was associated with significant alveolar recruitment (130 +/- 85 and 65 +/- 29 g of lung in supine and prone position, respectively [p 0.05 vs. 0]), whereas recruitment induced by posture was not statistically significant (77 +/- 97 g with positive end-expiratory pressure 0 and 13 +/- 19 g with positive end-expiratory pressure 10 [p > 0.05 vs. 0]). Regardless the posture, positive end-expiratory pressure redistributed both perfusion and ventilation toward dependent regions. Recruitment by positive end-expiratory pressure was restricted to dorsal regions in supine position, but extended diffusely along the ventral-to-dorsa I dimension in prone position. Prone position was associated with recruitment in dorsal regions with concomitant derecruitment in ventral regions, magnitude of this being reduced by positive end-expiratory pressure. Prone position redistributed ventilation toward dorsal and ventral regions at positive end-expiratory pressure 0 and positive end-expiratory pressure, respectively. Finally, prone position redistributed perfusion toward ventral regions, to an extent amplified by positive end-expiratory pressure. Conclusions. Positive end-expiratory pressure and posture act synergistically by redistributing lung regional perfusion toward ventral regions, but have antagonistic effects on regional ventilation.
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  • Preload dependence indices to titrate volume expansion during septic shock: a randomized controlled trial

    Richard, Jean-Christophe   Bayle, Frédérique   Bourdin, Gael   Leray, Véronique   Debord, Sophie   Delannoy, Bertrand   Stoian, Alina   Wallet, Florent   Yonis, Hodane   Guerin, Claude  

    In septic shock, pulse pressure or cardiac output variation during passive leg raising are preload dependence indices reliable at predicting fluid responsiveness. Therefore, they may help to identify those patients who need intravascular volume expansion, while avoiding unnecessary fluid administration in the other patients. However, whether their use improves septic shock prognosis remains unknown. The aim of this study was to assess the clinical benefits of using preload dependence indices to titrate intravascular fluids during septic shock. In a single-center randomized controlled trial, 60 septic shock patients were allocated to preload dependence indices-guided (preload dependence group) or central venous pressure-guided (control group) intravascular volume expansion with 30 patients in each group. The primary end point was time to shock resolution, defined by vasopressor weaning. There was no significant difference in time to shock resolution between groups (median (interquartile range) 2.0 (1.2 to 3.1) versus 2.3 (1.4 to 5.6) days in control and preload dependence groups, respectively). The daily amount of fluids administered for intravascular volume expansion was higher in the control than in the preload dependence group (917 (639 to 1,511) versus 383 (211 to 604) mL, P = 0.01), and the same held true for red cell transfusions (178 (82 to 304) versus 103 (0 to 183) mL, P = 0.04). Physiologic variable values did not change over time between groups, except for plasma lactate (time over group interaction, P <0.01). Mortality was not significantly different between groups (23% in the preload dependence group versus 47% in the control group, P = 0.10). Intravascular volume expansion was lower in the preload dependence group for patients with lower simplified acute physiology score II (SAPS II), and the opposite was found for patients in the upper two SAPS II quartiles. The amount of intravascular volume expansion did not change across the quartiles of severity in the control group, but steadily increased with severity in the preload dependence group. In patients with septic shock, titrating intravascular volume expansion with preload dependence indices did not change time to shock resolution, but resulted in less daily fluids intake, including red blood cells, without worsening patient outcome. Clinicaltrials.gov NCT01972828. Registered 11 October 2013.
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  • Intensive alveolar recruitment strategy in the post-cardiac surgery setting: one PEEP level may not fit all

    Bitker, Laurent   Richard, Jean-Christophe  

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  • Low ventilation associated with chest compression, an old observation that requires new physiological interpretation

    Charbonney, Emmanuel   Savary, Dominique   Badat, Bilal   Grieco, Domenico L.   Richard, Jean-Christophe  

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  • Respective effects of end-expiratory and end-inspiratory pressures on alveolar recruitment in acute lung injury*

    Richard, Jean-Christophe   Brochard, Laurent   Vandelet, Philippe   Breton, Lucie   Maggiore, Salvatore M.   Jonson, Bjorn   Clabault, Karine   Leroy, Jacques   Bonmarchand, Guy  

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  • Influence of respiratory rate on gas trapping during low volume ventilation of patients with acute lung injury

    Richard, Jean-Christophe   Brochard, Laurent   Breton, Lucie   Aboab, Jé   Vandelet, Philippe   Tamion, Fabienne   Maggiore, Salvatore   Mercat, Alain   Bonmarchand, Guy  

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  • Where are we with recruitment maneuvers in patients with acute lung injury and acute respiratory distress syndrome?

    Richard, Jean-Christophe   Maggiore, Salvatore   Mercat, Alain  

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  • ARTIFICIAL VENTILATION APPARATUS ABLE TO DELIVER VENTIALTION AND MONITORING WHICH ARE SPECIFIC TO THE PATIENTS RECEIVING CARDIAC MASSAGE

    The invention relates to a respiratory assistance apparatus (1) such as a medical ventilator, comprising a gas circuit (2, 16) with at least one inhalation branch (2) able to carry a respiratory gas intended to be administered to a patient under cardiac arrest during cardio pulmonary resuscitation; measurement means (6) suited to and designed for measuring at least one parameter indicative of said flow of gas and converting said at least one parameter indicative of said flow of gas into at least one signal indicative of said flow of gas; and a signal processing and control means (5, 8) suited to and designed for processing said at least one signal indicative of the flow of gas supplied by the measurement means (6) and deducing from said at least one signal indicative of the flow of gas information relating to the phases of compression and relaxation of a cardiac massage on the patient under cardiac arrest and controlling the motorised micro blower (40) and exhalation valve (19) accordingly in response to the phases detected.
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