[Errors in the measurement and interpretation of pulmonary artery pressure values evaluated by the Swan-Ganz method]. / Erreurs de mesure et d'interprétation des valeurs des pressions artérielles pulmonaires évaluées selon la méthode de Swan-Ganz.

The data collected by way of the catheter has for goal to give a better therapeutic treatment and is therefore directly related to the quality of the analysis of the signal. The fidelity of the measurements depend on the performance of the material used and also to other distortions linked to their utilization. In intensive care and in perioperative resuscitation, the interpretation must also take into account the possible interference from physiopathologic mechanisms which are sometimes very complex and can modify results in a number of situations both clinical and therapeutic and in particular when they are accompanied by vascular and respiratory perturbations.

[The detection of thromboembolism in orthopedic traumatology: the value and limitations of D-dimer determination by the latex method]. / Détection thromboembolique en orthopédie traumatologie: intérêt et limite du dosage du D-dimère par la méthode au latex.

We studied the usefulness of plasma D-dimer determination by a latex agglutination test used as a deep venous thrombosis (DVT) detection method in patients undergoing recent orthopaedic or traumatologic surgery. Asymptomatic patients with a level of D-dimer up to 1.5 micrograms/ml suffered phlebographic venous thrombosis in 49.3% of the cases. Because a predictive value of negative test of 0.77 the latex assay cannot be recommended for screening in symptomatic DVT. However, post operative measurement of cross linked fibrin derivatives in plasma may play a role in the selection of asymptomatic patients for venography.

[An open study on the efficacy and tolerance of a low molecular weight heparin (CY 216) in the therapeutic treatment of deep venous thrombi in orthopedics]. / Etude ouverte de l'efficacité et de la tolérance d'une héparine de bas poids moléculaire (CY 216) dans le traitement curatif des thromboses veineuses profondes en orthopédie.

A prospective clinical trial was performed to evaluate the efficacy and safety of a low molecular weight heparin (nadroparine, CY 216) in the treatment of patients with deep venous thrombosis following recent orthopaedic surgery or trauma. Forty-three patients received nadroparine subcutaneously, 100 IU AXa.kg-1 every 12 hours for a period of 10 days. A quantitative assessment of deep vein thrombosis was made according Marder's scoring after 10 days of treatment. A substantial lysis was observed in 73 per cent and a revascularisation in 52 per cent of the patients. These results are statistically significant, although not correlated with the clinical symptoms and the size of the thrombi. Tolerance was assessed on the rate of bleeding events: a minor bleeding occurred in 6 per cent of the patients. Laboratory adjustment was performed in 8 per cent of the cases. The results of this study suggest that nadroparine administered subcutaneously at a fixed daily dose of 200 IU AXa.kg-1 is as efficient and safe as unfractionated heparin in the treatment of early venous thrombosis following orthopaedic surgery or trauma.

[Non controlled prospective study of the efficacy and tolerance of a low molecular weight heparin]. / Etude prospective non contrôlée de l'efficacité et de la tolérance d'une héparine de bas poids moléculaire (tédelparine) dans la prophylaxie thrombo-embolique en chirurgie traumatologique du col du fémur.

A prospective trial has been carried out on 50 patients to test the efficacy and tolerance of low molecular weight heparin in surgery involving a high risk of thromboembolic complications. Tedelparin shows a tendency to reduce the frequency of post-operative thromboembolic disease in post-traumatic hip surgery. The effectiveness of the different low molecular weight heparins still remains to be quantified by comparative pharmacological studies. The alternative use of these treatments, whose high tolerance level make suitable for geriatric surgery do not exempt them from the biological monitoring of platelet count as they do not exclude the risk of heparin induced thrombocytopenia syndrome.

[Prevention of thromboembolism using low molecular weight heparin and hemodilution in traumatologic geriatric surgery of the femur neck]. / Prophylaxie thrombo-embolique par héparine de bas poids moléculaire et hémodilution en chirurgie traumatologique gériatrique du col du fémur.

A routine method of prophylaxis of thromboembolic disease is evaluated on 181 elderly patients undergoing post-traumatic hip surgery. A low incidence of proximal thrombosis and fatal embolism is noted and rated as a beneficial effect of the association of low molecular weight heparin therapy and moderate hemodilution; it is also connected with a precocious diagnosis of the thrombotic complications--before the proximal extension of silent thromboses--by the measurement of specific fibrin derivatives used as a screening technique in order to select the patients who will have to undergo venographical examination.