O Corre

Centre Hospitalier Universitaire de Brest, Brest, Brittany, France

Are you O Corre?

Claim your profile

Publications (14)20.17 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: Cardiopulmonary resuscitation guidelines imply the use of epinephrine/adrenaline during cardiopulmonary arrest. However, in cardiac arrest situations resulting from coronary artery spasm (CAS), the use of epinephrine/adrenaline could be deleterious. A 49-year-old patient underwent an emergency coronarography with an attempt to stent the coronary arteries. Radiologic imaging revealed a positive methylergonovine maleate (Methergine, Novartis Pharmaceuticals, East Hanover, NJ) test, with subocclusive CAS in several coronary vessels leading to electromechanical dissociation. Cardiopulmonary resuscitation was performed, and intracoronary boluses of isosorbide dinitrate were given to treat CAS. Epinephrine/adrenaline was not administered during resuscitation. Spontaneous circulation was obtained after cardioversion for ventricular fibrillation, and the patient progressively regained consciousness. Resuscitation guidelines do not specify the use of trinitrate derivatives in cardiac arrest situations caused by CAS. The pros and cons of the use of nitrates and epinephrine/adrenaline during cardiac arrest caused by CAS are analyzed in this case report.
    Heart & lung: the journal of critical care 01/2009; 38(3):228-32. · 1.04 Impact Factor
  • European Journal of Anaesthesiology 02/2008; 25(1):83-4; author reply 84-5. · 2.79 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: The evaluation of the renal function in cardiac surgery is difficult. The gold standard remains the creatinine clearance in clinical practice. Cystatin C was recently proposed in order to evaluate the renal function. The aim of our study was to evaluate the cystatin C in cardiac surgery with CPB. After informed consent and ethical committee agreement, 60 patients operated in cardiac surgery with CPB were prospectively included. Cystatin C,measured and calculated (Cockcroft and MDRD methods) creatinine were compared with the Student t-test and with the Bland and Altman method. p<0,05 was considered as a significant threshold. The reproducibility of the calculated creatinine clearance was better when the urinary collecting time was below 400 minutes. The estimation of the creatinine clearance by the Cockcroft and MDRD methods is better when the clearance is low. A significant correlation between the creatinine clearance and the cystatin C does exist, but the correlation coefficient was low. In case of acute renal dysfunction, the increase of the creatinine occurred earlier than the increase of the cystatin C. In cardiac surgery with CPB, the evaluation of the renal function was not improved by the cystatin C.
    Annales francaises d'anesthesie et de reanimation 05/2007; 26(5):412-7. · 0.77 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: IntroductionAccording to the Stewart approach of acid-base regulation, chloride from either volume replacement or cardiopulmonary bypass (CPB) priming solution may induce metabolic acidosis. The alternative hypothesis stands in volume dilution with solutions free of bicarbonate.ObjectivesEvaluate the acid-base status of patients undergoing cardiac surgery with CPB priming containing chloride and bicarbonate.Material and methodsProspective study.MethodsTwenty-eight patients were prospectively included. Priming of CPB contained 47.4 mmol/l of bicarbonate and 97.7 mmol/l of chloride. Arterial blood samples were taken at 3 timings: prior (T1) and after (T2) CPB, and on arrival in the ICU (T3). Following measurements were performed: Na+, K+, Cl-, Mg++, Ca++, phosphates, albumin, lactate and arterial blood gases.ResultsAfter CPB respiratory acidosis was observed. There was a significant increase of chloride with a decrease in apparent strong ion difference (SIDa). At the same time bicarbonate and base excess (BE) remained constant. A significant but weak correlation between BE and SIDa existed (r2 = 0.06, p = 0.024). On the contrary, no correlation was found between variations of BE and SIDa. However, the correlation was stronger between values and variations of bicarbonate and BE (respectively r2 = 0.605, p < 0.0001 and r2=0.495, p < 0.0001).ConclusionNo metabolic acidosis occurred after cardiac surgery when CPB was primed with bicarbonate. Therefore, it appears that chloride administration is not the main mechanism being involved in the acid-base regulation. This reinforces the hypothesis that metabolic acidosis during CPB may mainly be due to dilution of bicarbonate.
    Annales Françaises d'Anesthésie et de Réanimation. 01/2007;
  • [Show abstract] [Hide abstract]
    ABSTRACT: According to the Stewart approach of acid-base regulation, chloride from either volume replacement or cardiopulmonary bypass (CPB) priming solution may induce metabolic acidosis. The alternative hypothesis stands in volume dilution with solutions free of bicarbonate. Evaluate the acid-base status of patients undergoing cardiac surgery with CPB priming containing chloride and bicarbonate. Prospective study. Twenty-eight patients were prospectively included. Priming of CPB contained 47.4 mmol/l of bicarbonate and 97.7 mmol/l of chloride. Arterial blood samples were taken at 3 timings: prior (T1) and after (T2) CPB, and on arrival in the ICU (T3). Following measurements were performed: Na(+), K(+), Cl(-), Mg(++), Ca(++), phosphates, albumin, lactate and arterial blood gases. After CPB respiratory acidosis was observed. There was a significant increase of chloride with a decrease in apparent strong ion difference (SIDa). At the same time bicarbonate and base excess (BE) remained constant. A significant but weak correlation between BE and SIDa existed (r(2) = 0.06, p=0.024). On the contrary, no correlation was found between variations of BE and SIDa. However, the correlation was stronger between values and variations of bicarbonate and BE (respectively r(2)=0.605, p<0.0001 and r(2)=0.495, p<0.0001). No metabolic acidosis occurred after cardiac surgery when CPB was primed with bicarbonate. Therefore, it appears that chloride administration is not the main mechanism being involved in the acid-base regulation. This reinforces the hypothesis that metabolic acidosis during CPB may mainly be due to dilution of bicarbonate.
    Annales francaises d'anesthesie et de reanimation 01/2007; 26(1):10-6. · 0.77 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: The aim of this prospective study was to compare continuous cardiac output measurements of the non-invasive cardiac output system (NICO) with the pulmonary artery catheter during off-pump coronary bypass surgery. Twenty-two patients enrolled for off-pump coronary surgery received both a pulmonary artery catheter and a non-invasive cardiac output system for measurement of cardiac output. Data were compared by the Bland-Altman method to calculate the degree of agreement and to analyse if a significant difference existed between the two methods of cardiac output measurements. Perioperatively, the non-invasive cardiac output underestimated cardiac output, but postoperatively overestimated it. The limits of agreement were larger during surgery compared to the postoperative period (-3.1; +2.5 vs. -1.4; +2.2 L min(-1)). Perioperatively, cardiac output measured with the pulmonary artery catheter varied from 0.5 to 7.5 L min(-1) (mean 3.6 L min(-1)) and with the non-invasive cardiac output from 0.5 to 8.4 L min(-1) (mean 3.9 L min(-1)). Postoperatively, these were 2.5-7.7 L min(-1) (mean 4.5 L min(-1)) and 2.3-8.4 L min(-1) (mean 4.9 L min(-1)), respectively. During off-pump cardiac surgery, the non-invasive cardiac output reliably measures cardiac output and does it more rapidly than a pulmonary artery catheter and may be more useful in order to detect rapid haemodynamic changes.
    European Journal of Anaesthesiology 11/2006; 23(10):848-54. · 2.79 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: An abstract is unavailable. This article is available as HTML full text and PDF.
    European Journal of Anaesthesiology 05/2006; 23:85. · 2.79 Impact Factor
  • European Journal of Anaesthesiology 01/2006; 22(12):951-2; author reply 952-3. · 2.79 Impact Factor
  • European Journal of Anaesthesiology - EUR J ANAESTH. 01/2005; 22:14-15.
  • European Journal of Anaesthesiology - EUR J ANAESTH. 01/2005; 22.
  • [Show abstract] [Hide abstract]
    ABSTRACT: We report a documented observation of coronary thrombosis occurring in a 25-year-old patient with no risk factor, presenting a hereditary thrombophilia (facteur V Leiden) diagnosed a few months earlier in a context of venous thrombosis. This patient had a spread out anterior myocardial infarction with cardiac arrest due to a ventricular fibrillation; although he was quickly rescued by the mobile intensive Care Unit, the patient died 48 hours later, after cerebral anoxia. The mutation called factor V Leiden is a widely spread hereditary family thrombophilia (5 to 6% of the population) and is characterized by a resistance to activated C protein provoking a hypercoagulable state. The unexpected arterial thrombosis, very rare in that case, can be extremely serious and raises the question of a preventive medication such as antiplatelet agent or low-molecular-weight heparin as soon as the genetic abnormally has been proved to be symptomatic.
    Annales Françaises d Anesthésie et de Réanimation 06/2002; 21(5):440-4. · 0.84 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: An abstract is unavailable. This article is available as HTML full text and PDF.
    European Journal of Anaesthesiology 01/2002; 19:4. · 2.79 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: We report a documented observation of coronary thrombosis occurring in a 25-year-old patient with no risk factor, presenting a hereditary thrombophilia (facteur V Leiden) diagnosed a few months earlier in a context of venous thrombosis. This patient had a spread out anterior myocardial infarction with cardiac arrest due to a ventricular fibrillation; although he was quickly rescued by the mobile Intensive Care Unit, the patient died 48 hours later, after cerebral anoxia. The mutation called factor V Leiden is a widely spread hereditary family thrombophilia (5 to 6% of the population) and is characterized by a resistance to activated C protein provoking a hypercoagulable state. The unexpected arterial thrombosis, very rare in that case, can be extremely serious and raises the question of a preventive medication such as antiplatelet agent or low-molecular-weight heparin as soon as the genetic abnomaly has been proved to be symptomatic.
    Annales Francaises D Anesthesie Et De Reanimation - ANN FR ANESTH REANIM. 01/2002; 21(5):440-444.
  • [Show abstract] [Hide abstract]
    ABSTRACT: An abstract is unavailable. This article is available as HTML full text and PDF.
    European Journal of Anaesthesiology 01/2002; 19:10. · 2.79 Impact Factor