[Continuous ambulatory enteral feeding in hospitalized adults: prospective experience in 98 patients]. / Nutrition entérale continue ambulatoire à l'hôpital, chez l'adulte: expérience prospective chez 98 malades.

The goal of this study, which describes a personal technique of continuous enteral nutrition (CEN) in hospitalized adults on an ambulatory basis, was: to prospectively evaluate, over a 2-year period, its efficacy and tolerance in 98 patients requiring CEN for at least 15 days; to compare its efficacy and tolerance with those of conventional non-ambulatory CEN on a prospectively randomized basis in 16 patients. Ambulatory CEN was given at the rate of 35-45 kcal/kg/d (lipids: 35 p. 100; carbohydrates: 45 p. 100); during day-time, a portable system, including pump, tubes and low-viscosity nutrient solutions, allowed ambulation. Ninety-eight consecutive patients with a minimal level of physical autonomy were treated for intestinal (n = 47), pancreatic (n = 20), esophagogastric (n = 17) diseases, or for malnutrition of other causes for an average of 38 days (15 to 141). The average weight gain (m +/- SD) was 1.2 +/- 5.5 p. 100 of ideal body weight (IBW) and the average nitrogen gain was 0.7 +/- 3.8 g/24 h; weight gain proved significantly lower in patients with inflammatory bowel disease receiving steroids. The clinical tolerance proved excellent, except for 5 cases of transient diarrhea and 9 cases of reposition of the nasogastric tube. A decrease in cholesterolemia below 3.9 mmol/l was noted in 25 p. 100 of patients during CEN. No significant difference between ambulatory and non-ambulatory CEN was observed in terms of evolution of body weight and other anthropometric variables, nitrogen balance, albuminemia, and oxygen consumption; conversely, the CEN experience, evaluated by patients on analogical visual scales, was significantly better endured in the ambulatory group.(ABSTRACT TRUNCATED AT 250 WORDS)

[Automatic continuous calculation in real time of alveolar ventilation (author's transl)]. / Calcul continu automatique en temps réel de la ventilation alvéolaire.

The authors present the steps and rules to be respected for the building-up of a program of automatic calculation in real time of alveolar ventilation, with a programming calculator from the numerization of signals sent by a pneumotachograph and a rapid analyzer of carbon dioxide. Such a program would follow the rapid variations of alveolar ventilation in periods of transition or ventilatory instability. It could easily be adapted to the continuous calculation of carbon monoxide transfer by the method in a stable condition.

Effects of divided doses of neostigmine on the dynamics of decurarization.

In 37 patients the effect of neostigmine administered in divided doses (0.1 to 0.5 mg) on the dynamics of decurarization was studied by evaluating the tidal volume and respiratory rate. It was found that doses of neostigmine caused a continuous rise in tidal volume. Normalization of the tidal volume depended on the dose administered. The rate of decurarization depended also on the duration of the operation and the time of administration of the last d-tubocurarine dose. The proposed method of decurarization enables a safe reversal of d-tubocurarine effect to be obtained with a small dose of neostigmine.

[Transfer of CO after prolonged artificial ventilation (18 young people after their stay in the neuro-surgery department) (author's transl)]. / Etude du transfert de l'oxyde de carbone après ventilation artificielle prolongée. Dix-huit cas dans un service de neuro-chirurgie.

We studied the transfer of CO (TLCO) on 18 young people after their stay in the neuro-surgery department, during which they had been submitted to prolonged artificial ventilation. The values of TLCO measured after the single breath method and that of the steady state are all reduced. No statistical correlation has been brought to light between the length of artificial ventilation, or the FiO2 and the lowering of TLCO, or between the seriousness of the pulmonary complications which occurred and the disturbance of the pulmonary function test. To explain the change of the alveolo-capillary diffusion, different factors can be brought in, such as: artificial ventilation, the toxicity of oxygen, the adult respiratory distress syndrome, but also the presence of brain lesions which by reflex artery, modify the local hemodynamic conditions and the surfactant synthesis.