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Biomedical subjects

A D Milner

Publications and source records attributed to A D Milner.

At least 271 records · Page 15Linked to original sources
PubMed1978

BRL10833 in inhibiting exercise-induced bronchoconstriction in asthmatic children.

A double-blind controlled exercise challenge study has been performed in 16 asthmatic chlidren to show the effectiveness of BRL10833 in inhibiting exercise-induced bronchoconstriction. The children attended the respiratory laboratory on four occasions within the space of two weeks; on each occassion a routine 6-min exercise test was performed. At the first visit no drugs were given before the exercise test and all the children demonstrated abnormal exercise-induced bronchoconstriction as measured by peak expiratory flow rate (PEFR), forced expiratory volume in 1 sec (FEV1) and forced vital capacity (FVC). On the other three occasions the children were given sodium cromoglycate, BRL10833 or placebo medications before the exercise test. After sodium cromoglycate administration four children showed complete blocking and four showed partial blocking of exercise-induced bronchoconstriction. After BRL10833 four children showed complete blocking and six showed partial blocking of exercise induced bronchoconstriction. Placebo administration produced complete blocking of exercise-induced bronchoconstriction in three and partial blocking in two children. The results indicated that BRL10833 was almost as effective as sodium cromoglycate in inhibiting exercise-induced bronchoconstriction and placebo, although less effective than the two preparations, did afford protection from exercise-induced bronchoconstriction in some of the children.

Adolescent↗
PubMed1978

Is air trapping important in the maintenance of the functional residual capacity in the hours after birth?

Serial measurements of thoracic gas volume revealed no evidence of air trapping in maintenance of functional residual capacity (FRC) in healthy term babies in the first days of life. Tidal pressue/volume and flow/volume analysis demonstrated intermittent air trapping in only 2 of 19 such babies. Artificial FRC reduction by continuous positive external pressure of 7 cm H20 induced grunting in 4 babies, but otherwise had no effect on spontaneous breathing pattern or on dynamic compliance. Group mean total pulmonary resistance rose by 52.9% but only one baby demonstrated evidence of air trapping. Our findings suggest that FRC is maintained in the immediate neonatal period by some means other than air trapping.

Age Factors↗
PubMed1978

A study of the role of air trapping in the establishment of the functional residual capacity by analysis of pressure/volume and flow/volume loops.

Pulmonary mechanics were measured in 22 normal, full-term babies as soon as quiet, regular breathing was established. The method included construction of tidal resistance profiles, by which it was demonstrated that 'air trapping' is probably not the major factor in establishing and maintaining the functional residual capacity immediately after birth.

Air↗
PubMed1978

Pulmonary pressure/volume relationships during the last phase of delivery and the first postnatal breaths in human subjects.

Intrathoracic pressure and volume changes during delivery and the first postpartum breaths were measured in 17 term infants. The following findings emerged: (1) Infants were often exposed to high pressures during delivery, when significant volumes of lung fluid were expressed. (2) Despite this, none of the infants' lungs reinflated by passive "elastic recoil." (3) The active inspiratory effort required for reinflation was usually small or moderate, and an "opening pressure" did not appear to be necessary for the initial rise in volume. It is believed that diaphragm and intercostal muscle tone falls or disappears during delivery and returns during the first breath.

Delivery, Obstetric↗
PubMed1978

Tidal pressure/volume and flow/volume respiratory loop patterns in human neonates.

1. Tidal pressure/volume and flow/volume respiratory loops were constructed from records obtained during 98 studies on 48 neonates of various ages and gestations. Records were obtained with a total body plethysmograph and an oesophageal balloon. Total pulmonary resistance was computed at five separate levels in the breathing cycle and results were expressed graphically as tidal resistance profiles by plotting total pulmonary resistance against percentage tidal volume above functional residual capacity. 2. Values obtained for standard pulmonary mechanical measurements and thoracic gas volume were similar to those of other workers. In addition six distinctive resistance profile patterns were found and related to different breathing patterns. 3. The technique appeared to be particularly useful in identifying air trapping and also demonstrated that total pulmonary resistance is open to misinterpretation when measured only at the mid-tidal-volume level, as is the present convention.

Airway Resistance↗
PubMed1978

Use of salbutamol powder in childhood asthma.

In this study on 31 asthmatic children, salbutamol powder was as effective as salbutamol aerosol in the older asthmatic child studied daily during a 6-week period. The rotahaler can be used successfully from 3 years and, as measured by the peak expiratory flow rate, salbutamol powder is effective in this young age group.

Adolescent↗
PubMed1978

Recurrent wheezing in the preschool child.

The bronchoconstrictor response to exercise was measured in 29 healthy children and in 23 children with recurrent wheezing attacks, using the Wright low-range peak flow meter and a modification of the forced oscillation technique. None of the healthy children showed significant change in airflow obstruction after a 6-minute run, whereas 20 of the 23 wheezy children showed a mean rise in total respiratory resistance of 65-5%. All 23 children showed a fall in airflow obstruction after inhaling salbutamol solution.

Airway Obstruction↗
PubMed1978

Nebulised sodium cromoglycate in the preschool wheezy child.

A double-blind controlled study of 14 preschool children with recurrent wheezing episodes was performed to show the effectiveness of nebulised sodium cromoglycate in inhibiting exercise-induced bronchoconstriction in this age group. All 14 children showed markedly less exercise-induced bronchoconstruction after nebulised sodium cromoglycate, 13 of them to a degree indistinguishable from results obtained in normal healthy children in the same age group. Nebulised water afforded protection from exercise-induced bronchoconstriction in some children. This study gives further evidence that sodium cromoglycate is an effective therapeutic agent in children under the age of 5 years.

Airway Obstruction↗
PubMed1978

At what age do bronchodilator drugs work?

Using a modification of the forced oscillation technique we have measured respiratory resistance before and after nebulised salbutamol therapy in 32 wheezing children aged 7 months to 3 years 7 monts. 12 of the children were also studied in a total body plethysmograph. No child under 18 months of aged showed a greater than 5% fall in resistance or any fall in thoracic gas volume. In contrast, 18 of 20 children over 20 months of age showed a fall in resistance greater than 20%.

Age Factors↗
PubMed1978

Effects of delivery by caesarean section on lung mechanics and lung volume in the human neonate.

Lung function tests were carried out in the first 6 hours of life on 26 babies born by vaginal delivery and 10 born by caesarean section. The babies born by caesarean section had a mean thoracic gas volume of only 19.7 ml/kg body weight compared with 32.7 ml/kg for the babies born vaginally. We conclude that this is owing to an excess of lung fluid in the babies born by caesarean section.

Airway Resistance↗
PubMed1978

Treatment of acute viral croup.

Total respiratory resistance (RT) was measured before and after nebulised alpha-adrenergic stimulant therapy in 8 children aged 4 to 18 months who had the clinical symptoms of acute viral croup. In 7 children there was a mean fall in RT of 30% after treatment, associated with an improvement in their clinical condition. This improvement was shortlived, the resistance returning to pretreatment levels within 30 minutes. The remaining child showed no improvement after phenylephrine but was subsequently found to have acute epiglottitis. Nebulised water did not produce any change, indicating that the response was not due to moisture alone.

Acute Disease↗
PubMed1978

Alpha and beta adrenergic stimulants in bronchiolitis and wheezy bronchitis in children under 18 months of age.

Total respiratory resistance was measured before and after nebulised phenylephrine in 5 babies (age range 7 to 17 months) with wheezy bronchitis, and in 2 babies (aged 2 and 6 months) with bronchiolitis. None showed a change in resistance after treatment. Total respiratory resistance was measured before and after nebulised adrenaline in another 14 babies (age range 4 to 13 months) with bronchiolitis. No fall in resistance was noted in any baby after treatment whether or not it was given by a conventional or an ultrasonic nebuliser. We conclude that alpha- and beta-adrenergic stimulants are ineffective in bronchiolitis and wheezy bronchitis in children under 18 months of age.

Aerosols↗
PubMed1978

Longitudinal studies of infants with the Wilson-Mikity syndrome. Clinical, radiological and mechanical correlations.

Simple clinical measurements were performed on a group of 23 very low birth weight babies (less than 1500 g and less than 32 weeks gestation), and combined with pulmonary function studies in 13 cases. The studied included a special single-breath analysis, or Tidal Resistance Profile, which enabled us to detect air trapping. 2 infants developed classical Wilson-Mikity syndrome and 2 further infants exhibited a milder, shorter form of the same disorder. All 4 survived. Results suggest that all infants in this maturity group are at risk of developing Wilson-Mikity syndrome, and that it comprises a wide spectrum of respiratory dysfunction.

Humans↗
PubMed1978

Relationship of intra-oesophageal pressure to mouth pressure during the measurement of thoracic gas volume in the newborn.

During the measurement of thoracic gas volume, mouth pressure changes were compared to oesophageal pressure changes using an oesophageal balloon system. In individual babies the correlation was high, with r values in excess of 0.98. In other babies the correlation was less satisfactory due to cardiac contractions producing artefacts in the oesophageal pressure trace. The overall correlation obtained from analysing 155 respiratory efforts in a group of 21 babies studied on 23 occasions exceeded an r value of 0.90. We conclude that it is valid to use an oesophageal balloon system to measure changes in intrathoracic pressure.

Esophagus↗