Tesi sul tema "ECMO (médecine) – Complications (médecine)"
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Moussa, Mouhamed Djahoum. "Déterminants cliniques, physiopathologiques et pronostics associés aux complications liées à l’hémostase au cours des assistances circulatoires de courte durée à pompe centrifuge". Electronic Thesis or Diss., Université de Lille (2022-....), 2022. http://www.theses.fr/2022ULILS055.
The purpose of this dissertation is to characterize hemostasis-related complications in patients supported by peripheral VA-ECMO to improve their prevention and to optimize the antithrombotic therapeutic approaches in use. In a first study, we qualitatively and quantitatively described the composition of thrombi collected from the VA-ECMO circuits. We observed that these thrombi are mainly made of VWF, fibrin and in a lesser proportion of platelets and RBCs. Our quantitative approach also allowed us to demonstrate the presence of NETs while there was no active septic, confirming the possibility of aseptic NETosis under VA-ECMO. By hierarchical cluster analysis, we identified 2 types of thrombi, each of which may be related to a different mechanism of formation. In this study, the location of thrombi on the VA-ECMO circuit did not impact their compositions, highlighting the heterogeneity of thrombi formed within VA-ECMO and the multifactorial mechanisms that support thrombosis in this setting. In a second study, we compared the performance of surface coatings on VA-ECMO circuits to reduce thrombinoformation and its clinical consequences. Two of the most used coatings in daily practice were compared: the phosphorylcholin-based coating and the polysaccharide-albumin-based coating. We observed a higher rate of thrombotic complications in the phosphorylcholin group without any excess bleeding events or mortality in either group. In addition, compared with thrombi from phosphorylcholin-coated circuit junctions, those from polysaccharide-albumin-coated circuits were poorer in VWF. Our work suggests that the level of anticoagulation should be modulated according to the type of coating of the ECMO circuit.The aim of our third study was to identify the most relevant bleeding events that may guide clinical decision-making for more aggressive clinical management and a greater investment in research. To this end, we compared the association between 3 bleeding classifications with 28-day mortality. The ELSO definition already in use and the BARC classification classes ≥ type 2 were associated with 28-day mortality and thus retained as definitions of major bleeding. Laboratory parameters that are predictors major bleeding according to the ELSO definition were decreased fibrinogen, platelet count, and hemoglobin at cannulations. Body mass index and postcardiotomy etiology were also predictive of ELSO major bleeding. In an additional work related to the topic of the thesis, we studied two of the most used laboratory tests for the monitoring of systemic heparin during VA-ECMO, the APTT and the Anti-Xa activity, to identify the most relevant. First, we studied the relationship between these two tests and then analyzed in a second objective the impact of biological influencing factors on this relationship. Next, we determined their associations with thrombotic and hemorrhagic complications. Although linearly associated, the rate of discordance between their measurements was 39 % for an Anti-Xa reference range of 0.3 - 0.7 IU/mL. Neither APTT nor Anti-Xa was associated with thrombotic or bleeding complications. Taken together, our results highlight the heterogeneity of thrombi from peripheral VA-ECMO, the involvement of numerous causal factors that underline thrombotic and hemorrhagic complications, both not predictable by routine tests. Finally, our work underscored the need for new approaches in thrombotic or hemorrhagic complications management with targets set at an individual level considering both patient and ECMO circuit characteristics
Fernandez, Calahorra Francisco Javier. "Conversions et complications dans la cholecystectomie par laparoscopie : à propos d'une série consécutive de 393 opérés". Bordeaux 2, 1992. http://www.theses.fr/1992BOR23099.
Joannes, Marie-Odile. "Recherche de polymorphysmes génétiques associés à des complications majeures de pathologies prédominantes en Martinique et en Guadeloupe : la drépanocytose et le diabète". Antilles-Guyane, 2009. http://www.theses.fr/2009AGUY0269.
SICKLE CELL DISEASE (SCD) AND DIABETES MELLlTUS ARE LEADING CAUSES OF MORBIDITY IN MARTINIQUE AND GUADElOUPE. BECAUSE OF THE ASSOCIATION OF SOME GENETIC POLYMORPHISMS AND PATHOlOGIES, WE WONDERED IF SOME GENETIC POLYMORPHISMS COULD PREDICT COMPLICATIONS IN SICKLE CELL PATIENTS AND TYPE 2 DIABETIC WE INVESTIGATED POLYMORPHISM OF GENES INVOLVED IN THE IMMUNE SYSTEM (MYELOPEROXYDASE, HLA, TNF ALPHA, IFN GAMMA, IL6 AND IL10) AS MODULATORS OF INFECTIOUS COMPLICATIONS IN SCD. WE ALSO TRIED TO FIND AN ASSOCIATION BETWEEN FABP2 POLYMORPHISM, METABOLIC SYNDROME AND CARDIOVASCULAR COMPLICATIONS IN T2D SUBJECTS. OUR RESULTS REVEALED AN ASSOCIATION BETWEEN MYELOPEROXIDASE POLYMORPHISM AND INFECTIOUS COMPLICATIONS IN SICKLE CELL PATIENTS JUST AS IFNr POLYMORPHISM. ON THE OTHER HAND, HLA-DRB1*11 COULD HAVE A PROTECTIVE EFFECT AGAINST INFECTIONS. MOREOVER, OUR RESULTS HIGHLIGHTED A PREDOMINANT COMBINATION OF DYSLlPIDEMIA AND OBESITY IN T2D PATIENTS CARRYING THE THREONINE VARIANT OF FABP2
Gérard, Sonia. "Complications maternelles des césariennes". Rouen, 1990. http://www.theses.fr/1990ROUE104M.
Tiprez-Chocoloff, Catherine. "La reconstruction vasculaire après oxygénation extracorporelle en période néonatale : à propos de 26 observations". Lille 2, 1995. http://www.theses.fr/1995LIL2M105.
Courtault, Carine. "Complications des fibrinolyses de thromboses de prothèses mécaniques de valves cardiaques". Bordeaux 2, 2001. http://www.theses.fr/2001BOR2M070.
Gayraud, Laurence. "Bronchiolite oblitérante au cours des transplantations pulmonaires et cardiopulmonaires : apport de la TDM-HR". Bordeaux 2, 1993. http://www.theses.fr/1993BOR23054.
Meyrat, Léon. "Les complications graves des sinusites ethmoidales et frontales : place du traitement médical et chirurgical". Bordeaux 2, 1994. http://www.theses.fr/1994BOR2M126.
Narbey, Noëlle. "Rechute fébrile attribuée à une méningoencéphalite herpétique dans les suites d'un neuropaludisme : complication ou coincidence ? à propos d'un cas". Bordeaux 2, 1995. http://www.theses.fr/1995BOR2M100.
Gouget, Anne-Marie. "Le trouble somatisation". Bordeaux 2, 1997. http://www.theses.fr/1997BOR2M118.
Berdah, Stéphane Victor. "Contribution à l'étude du contrôle réflexe des muscles respiratoires chez l'homme et l'animal". Aix-Marseille 2, 2002. http://www.theses.fr/2002AIX20668.
Bitaly, Jean-Bernard, e Sylvie Bitaly. "Évaluation de l'infection en réanimation traumatologique". Bordeaux 2, 1989. http://www.theses.fr/1989BOR25304.
Coqueugniot, Christine Irène. "Myocardite aigue͏̈ toxoplasmique au cours du sida : à propos d'une observation : revue de la littérature". Bordeaux 2, 1993. http://www.theses.fr/1993BOR2M195.
Brosse, Guillet Nathalie. "Complications infectieuses au cours des aplasies des leucémies aigües". Saint-Etienne, 1989. http://www.theses.fr/1989STET6210.
Castera, Nathalie. "Le pseudo-kyste du pancréas : aspects diagnostiques et thérapeutiques, analyse des dossiers". Bordeaux 2, 1992. http://www.theses.fr/1992BOR23116.
Auréjac-Izard, Sabine. "Embolie amniotique : problèmes physiopathologique et diagnostique, à propos d'un cas". Bordeaux 2, 1998. http://www.theses.fr/1998BOR2M034.
Rodet, Roland. "Pseudarthroses diaphysaires post-traumatiques de jambe : à propos de 83 observations". Bordeaux 2, 1991. http://www.theses.fr/1991BOR2M065.
Promax, Louise Hélène. "Conséquences cardiaques de l'effet Blouse blanche". Bordeaux 2, 1991. http://www.theses.fr/1991BOR23115.
Soupart, Alain. "Contribution à l'approche thérapeutique de l'hyponatrémie et à la prévention des complications neurologiques associées". Doctoral thesis, Universite Libre de Bruxelles, 1996. http://hdl.handle.net/2013/ULB-DIPOT:oai:dipot.ulb.ac.be:2013/212288.
Talbot, Philippe. "Le syndrome du corset plâtre ou cast syndrome : analyse de 13 cas et revue de la littérature". Rouen, 1988. http://www.theses.fr/1988ROUEM095.
Loisel, Françoise. "Hypothalamie et athalamie post-trabéculectomie : intérêt de la pose d'une lentille hydrophile". Caen, 1990. http://www.theses.fr/1990CAEN3042.
Amsellem, Danièle. "Retards de cicatrisation et moignons d'amputation". Bordeaux 2, 1991. http://www.theses.fr/1991BOR2M209.
Ducamp, Philippe. "Complications cardiaques tardives de la radiothérapie : à propos de deux cas étudiés au CHU Haut-Lévêque (Pessac)". Bordeaux 2, 1999. http://www.theses.fr/1999BOR2M138.
Robine, Antoine. "Hypothermie spontanée et retard mental". Bordeaux 2, 1998. http://www.theses.fr/1998BOR2M084.
Prigent, Annaïg. "Fibrillation ventriculaire spontanément réversible sur cardiopathie ischémique : à propos de 3 cas". Bordeaux 2, 1992. http://www.theses.fr/1992BOR2M106.
Bernard, Virginie. "Les infiltrats inflammatoires dans les sténoses coronariennes primitives et les resténoses après angioplastie : analyse à partir de fragments d'athérectomie". Bordeaux 2, 1997. http://www.theses.fr/1997BOR23033.
Dorsi, Barbara. "Les complications des morsures humaines : à propos d'un cas d'actinomycose cutanée". Bordeaux 2, 2000. http://www.theses.fr/2000BOR2M090.
Langlet, Catherine. "Complications orbito-craniennes des sinusites : à propos de 10 cas". Bordeaux 2, 1990. http://www.theses.fr/1990BOR25039.
Duboze, Muriel. "Cécité acquise au cours de l'hémoglobinose SC : à propos d'un cas". Bordeaux 2, 1999. http://www.theses.fr/1999BOR2M096.
Delouis, Pascale. "Place des anticoagulants dans la prévention et le traitement des accidents thromboemboliques de la grossesse et du post-partum". Bordeaux 2, 1991. http://www.theses.fr/1991BOR23074.
Baladon, Sylvie. "Arrêt circulatoire par tachycardie ventriculaire ou fibrillation ventriculaire au stade aigu de l'infarctus du myocarde : évolution à court, moyen et long terme". Bordeaux 2, 1989. http://www.theses.fr/1989BOR25252.
Fleurat, Erick. "Reprise de prothèse de hanche par implant fémoral personnalisé recouvert d'hydroxyapatite : étude rétrospective de 20 cas opérés entre 1988 et 1991". Bordeaux 2, 1992. http://www.theses.fr/1992BOR23077.
Hazard, Jean-Jacques. "La pathologie du moignon cystique : à propos de cinq observations". Rouen, 1990. http://www.theses.fr/1990ROUE136M.
Faucher, Marion. "Conséquences de l'hypoxie chronique sur la fonction neuromusculaire". Aix-Marseille 2, 2004. http://www.theses.fr/2004AIX20661.
We tried to evaluate the muscular consequences of chronic hypoxemia on peripheral and diaphragmatic muscles. We studied : Transient re-oxygenation of humans suffering from chronic obstructive pulmonary disease (COPD). Diaphragmatic function of patients with severe chronic respiratory failure before and after bilateral lung transplantation (BLT). Breath-hold training of healthy triathletes. Skeletal rat muscles after one-month hypoxemic period (10%). COPD patients had reduced force production, an attenuated " muscle wisdom " and a suppression of exercise oxidative stress. Our observations demonstrated the rapid reversibility of some effects of hypoxemia during transient re-oxygenation. Continuous re-oxygenation (BLT) led to normal diaphragmatic function. Regular training cycling program of healthy triathletes subjects suggested that the practice of breath-holding improved the tolerance to hypoxemia. Animal study allowed us to precise specific effects of chronic hypoxia on a slow and a fast muscle. Both contractile and histological properties of slow muscle shifted to fast muscle caracteristics. These studies clarify specific effects of chronic hypoxemia on function and muscular metabolism. We also observe that oxygenotherapy led to significant modifications in muscular function, which could have consequences on clinical practice
Boceno, Michelle. "Les accidents gravido-cardiaques". Nantes, 1986. http://www.theses.fr/1986NANT3584.
Buttet, Benoît. "Asthme aigu grave : comparaison de l'activité de réanimation médicale du C.H.U. de Nîmes entre 1986-1988 et 1994-1996". Montpellier 1, 1997. http://www.theses.fr/1997MON11140.
Lumbroso, Delphine. "Origine néonatale du syndrome de désacclimatation à l'hypoxie chronique chez le rat". Thesis, Université Laval, 2012. http://www.theses.ulaval.ca/2012/29266/29266.pdf.
Grivet, Anne. "Récidives de toxoplasmose cérébrale au cours du sida : étude descriptive et analytique de 29 cas (C.H.U. bordeaux, 1988-1992)". Bordeaux 2, 1992. http://www.theses.fr/1992BOR2M115.
Perrouty, Bruno. "Les complications neurologiques des myxomes cardiaques". Montpellier 1, 1988. http://www.theses.fr/1988MON11153.
Javorschi, Sandrine. "Evolution de l'hémostase avec l'âge : effet de la pathologie thrombotique et résistance à la protéine C activée". Bordeaux 2, 1996. http://www.theses.fr/1996BOR2P053.
Durando, Didier. "Fréquence des cancers dans une population de malades en suppléance rénale au CHU de Nîmes". Montpellier 1, 1996. http://www.theses.fr/1996MON11082.
Rupp, Paul-Antoine. "Spondylarthropathie destructive découverte par une paraplégie progressive chez un patient dialysé depuis 12 ans, évolution favorable aprés chirurgie". Bordeaux 2, 1993. http://www.theses.fr/1993BOR2M119.
Chassé, Michael. "Impact de l'obésité sévère en postopératoire de chirurgie coronarienne et valvulaire". Thesis, Université Laval, 2010. http://www.theses.ulaval.ca/2010/26985/26985.pdf.
Agnes, Frédéric. "La cicatrisation périphérique du disque inter-vertébral". Bordeaux 2, 1990. http://www.theses.fr/1990BOR25221.
Leroux, Lionel. "Suivi à long terme après revascularisation myocardique par athérectomie directionnelle". Bordeaux 2, 2001. http://www.theses.fr/2001BOR23006.
Nelzy, Marie-Line. "Complications neurologiques des électrisations à propos d'un cas : revue de la littérature". Bordeaux 2, 1994. http://www.theses.fr/1994BOR2M187.
Verdier, Gilles. "Accouchement par voie basse chez la femme antérieurement césarisée : proposition d'une conduite obstétricale active, expérience de la Maternité B (1992-1994)". Bordeaux 2, 1995. http://www.theses.fr/1995BOR23007.
Boukhettala, Nabile. "Étude du métabolisme protéique intestinal et de sa modulation nutritionnelle dans un modèle de mucite chimio-induite chez le rat". Rouen, 2010. http://www.theses.fr/2010ROUENR02.
Study of intestinal protein metabolism and its nutritional modulation in a model of chemotherapy-induced mucositis in rats. Mucositis, a common side effect of chemotherapy, is characterized by alterations in functional and anatomical damage of the intestinal barrier. Its severity cati lead to a reduction or cessation of treatment for cancer. There is currently no specific treatment of chemotherapy-induced mucositis. The objectives of this work were to characterize, in chemotherapy-induced mucositis in rats, intestinal protein metabolism, to assess the impact of inhibition of lysosomal proteolytic pathway and to evaluate the effects of specific diet to protect the intestinal mucosa (Clinutren Protect ®, CP) that contains whey protein, glutamine and TGF-f3. For this, a model of mucositis induced by subcutaneous injections of 2. 5 mg / kg methotrexate (MTX) in Sprague-Dawley rats was used. We observed in rats treated with MTX a decrease of protein synthesis rate and jejuna mucin content, and an increase of proteolytic activity of cathepsin D (lysosomal pathway). These changes were independent of the drop in food intake associated with chemotherapy. The targeted inhibition of lysosomal pathway by injecting E64 has limited the decrease of body weight and decrease of food intake and intestinal damages induced by MTX. A pre-treatment with the specific CP diet was compared to a placebo diet. During the acute phase of mucositis, improved jejunal parameters were observed in rats CP: Partial preservation of villus height, the rate of protein synthesis, activities of cathepsin D and proteasome 26S. During the recovery phase, weight gain and food intake were higher in the CP group. Then, we evaluated the effect of CP during repeated administration of MTX to reproduce the situation of repeated courses of chemotherapy. In CP rats, a decrease of body weight, food intake and Lean body mass (measured by DEXA) was less marked and intestinal damage score less than in controls. In conclusion, chemotherapeutic treatment (MTX) alters intestinal protein metabolism independently of reduced food intake. Moreover, our results suggest that lysosomal pathway could be a target to prevent the side effects of chemotherapy. Finally, CP reduces intestinal damage and improves the nutritional status in rats, both during a single administration and repeated administration of MTX. These results should be confirmed in a tumor-bearing model and cancer patients
Pichou, Florent. "Complications veineuses des abcès hépatiques amibiens, à propos d'un cas". Bordeaux 2, 1998. http://www.theses.fr/1998BOR2M035.
Woné, Frédéric. "Les anévrysmes infectieux de l'aorte, à propos d'un cas d'anévrysme infectieux de l'aorte thoracique à Clostridium". Bordeaux 2, 1996. http://www.theses.fr/1996BOR2M007.