Biographical Memoirs Volume 67 (1995) / Chapter Skim
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André Frédéric Courand
André Frédéric Courand
Pages 64-99
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From page 65... ...
ANDRE FREDERIC COURNAND September 24, 1895-February 19, 1988 BY EWALD R WEIBEL THE SUBTITLE OF Andre Cournand's autobiography—The IntellFectuaZ Adventures of a Medical Scientist conveys the essence of his life.
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From page 66... ...
Even before his first year of medical school encled, he was enlisted in the army to serve as auxiliary battalion surgeon, for the most part in the trenches near the German enemy. For his distinguished services tending wounded soldiers at the front he was awarded the Croix de Guerre with three bronze stars.
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From page 67... ...
Here he met, among many other artists of renown, Jacques Lipschitz, one of the leading sculptors of the cubist period, with whom he maintained a lifelong close friendship. It was in this circle that he met his future wife, SibyIle, the younger daughter of Jeanne Bucher and her husband, the Swiss pianist Fritz Blumer.
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From page 68... ...
After a few months of service, partly in a sanatorium, Cournand was offered the possibility to participate in a long-range research project on pulmonary physiology by joining the group of Dickinson Woodruff Richards, a man of his own age but already quite advanced as an investigator. To accept this offer, however, meant not to return to France.
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From page 69... ...
The so-called indirect Fick method then in use calculatec} cardiac output (or total Hood flow) as the ratio of CO2 output from the lung to the CO2 concentration difference between the blood entering and leaving the Jung.
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From page 70... ...
~. The results remained only partially satisfactory, which led Cournand and Richards, some eight years later, to develop the method of right heart catheterization in order to obtain direct samples of mixed venous blood as it enters the Jung In the meantime they directed their attention to some problems that had emerged when studying diseased lungs, namely that gases do not mix evenly in the Jung, particularly in cases with pulmonary emphysema (1937,l,2~.
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From page 71... ...
But we still could not measure blood flow through the lungs and could! not, therefore, move into those broader concepts of cardiopulmonary function which now began to be our goal." The problem still was how to obtain adequate samples of mixed venous blood to reliably apply the Fick principle.
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From page 72... ...
"l reviewed all the cases and returned to New York persuaded that cardiac catheterization could be used safely and would meet our needs," Cournand writes in his autobiography. He then reports that for the next four years, in collaboration with Robert Darling, he carried out experiments in clogs and one chimpanzee and "adapted Bernard's method" to their problem of obtaining samples of mixed venous blood for estimating O2 and CO2 concentrations.
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From page 73... ...
that reported on twenty-one estimations of cardiac output by the direct Fick method. Using both O2 uptake and CO2 clischarge, excellent agreement between the estimates was obtained in all cases.
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From page 74... ...
The foremost problem of shock is hemodynamic deterioration due to severe blood loss. In the shock unit set up at Bellevue Hospital, cardiac catheterization was used to show that with about half the blood volume lost cardiac output became critically depressed, with the result that shock worsened; also, the importance of variable reduction in peripheral blood flow, particularly to the kidneys, was elucidated by Stanley E
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From page 75... ...
Cardiac catheterization also allowed pressures to be re
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From page 76... ...
In the Walter Wile Hamburger Memorial Lecture delivered in 1950 (1950,5) which Cournand considered one of the first recognitions of his work he reviewed the knowledge on the physiology of pulmonary circulation acquired during the few years since his first successful attempt at cardiac catheterization and then went on to discuss the value of "modern physiologic methods" for the study, understanding, and treatment of pulmonary diseases.
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From page 77... ...
; 1952,2~. In his Nobel lecture Richards noted that the advances in surgery of congenital heart disease were under way before cardiac catheterization and that it has moved ahead on its own but that the cardiac catheter has been a primary aid.
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From page 78... ...
He greatly advanced the study of the role of uneven ventilation-perfusion relationship for gas exchange. He pioneered cardiac catheterization in humans and was the first to measure cardiac output with the direct Fick method using mixed venous blood samples and the first to record blood pressure in the right heart and the pulmonary artery.
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From page 79... ...
this highest distinction. Follomng the Nobel Prize, broad recognition flowed freely.
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From page 80... ...
Radioactive tracer gases were introduced and used in various ways to estimate the degree of uneven ventilation en cl perfusion of airspaces and to find new ways of determining pulmonary hemodynam~cs. Cournand and Richards had for a long time nurtured an interest in introducing structural studies into their program, as Richards noted even in his Nobel lecture.
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From page 81... ...
In 1964 Andre Cournand retired as director of the Cardiopulmonary Laboratory at Bellevue Hospital, and a few years later the laboratory he had established thirty-two years earlier was closed. This ended a most productive period of research that can be dividect into three main phases: the first ten years were devoted chiefly to developing new methods of investigation; the stucly of heart and circulation followed; and finally, exploration of the Jung and pulmonary circulation along several tracks.
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From page 82... ...
Clearly, he had an excellent background of a practical nature, and I should say that three features of his scientific career demonstrate his sense of responsibility in his own scientific work: the fact that he strived for investi
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From page 83... ...
He looked back at the development of cardiopulmonary physiology from Claude Bernard to his own time. And finally, he wrote a biographical memoir on Dickinson Woodruff Richards, a very personal portrait of his lifelong partner to whom he was bouncl, as he said, in "a friendship tof which]
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From page 84... ...
NOTE 1. Dickinson Woodruff Richards, by Andre Frederic Cournand.
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From page 85... ...
ANDRE FREDERIC COURNAND 85 BIOGRAPHICAL DATA ED U CATI O N 1914 B.A., University of Paris, Faculties of Arts and of S clences 1930 M.D., University of Paris, Faculty of Medicine PROFESSIONAL APPOINTMENTS 1935-88 1951-61 1961-64 196~88 1965-69 1926-30 Interne des Hopitaux de Paris 1930-68 Resident, Attending Physician, Consultant, and Director of Cardiopulmonary Laboratory, Bellevue Hospital, New York Columbia University College of Physicians and Surgeons Professor of Medicine Professor of Clinical Physiology Professor Emeritus Member of the Institute for the Study of Science in Human Affairs
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From page 86... ...
Commandeur des Palmes Academiques (France) 1946 1950 1956 1958 1959 1962 1966 1969 1970 1971 1975 Andreas Retzius Silver Medal of the Swedish Society of Internal Medicine Lasker Award, U.S.
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From page 87... ...
Applicability of rebreathing method for determining mixed venous CO2 in cases of chronic pulmonary disease.
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From page 88... ...
Graphic tracings of respiration in study of pulmonary disease.
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From page 89... ...
Comparison of results of the normal ballistocardiogram and a direct Fick method in measuring the cardiac output in man.
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From page 90... ...
Recording of right heart pressures in normal subjects and in patients with chronic pulmonary disease and various types of cardiocirculatory disease.
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From page 91... ...
Studies of the pulmonary circulation at rest and during exercise in normal individuals and in patients with chronic pulmonary disease.
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From page 92... ...
Himmelstein. Studies of pulmonary circulation and gas exchange in 3 cases following the resolution of various diffuse miliary infiltrations of the lungs.
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From page 93... ...
The Fourth Walter Wile Hamburger Memorial Lecture, Institute of Medicine of Chicago: Some aspects of the pulmonary circulation in normal man and in chronic cardiopulmonary diseases. Circulation 2:641.
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From page 94... ...
Cardiopulmonary function in chronic pulmonary disease. In The Harvey Lecture Series vol.
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From page 95... ...
Influence of acetylcholine on human pulmonary circulation under normal and hypoxic conditions.
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From page 96... ...
The effect of acetylcholine on the human pulmonary circulation under normal and hypoxic conditions.
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From page 97... ...
Utilization of oxygen in the lungs of patients with diffuse, non-obstructive pulmonary disease. Trans.
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From page 98... ...
Karger. 1975 Cardiac catheterization: Development of the technique, its contributions to experimental medicine, and its initial applications in
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From page 99... ...
The Sciences 21:7. 1985 Special lecture: Origin and historical development of clinical physiology in pulmonary disease.
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