Search PubMed⌕ Search

Biomedical subjects

A Y Goh

Publications and source records attributed to A Y Goh.

25 records · Page 2Linked to original sources

Respiratory failure requiring ventilation in acute bronchiolitis.

Severe bronchiolitis requiring mechanical ventilation is uncommon and is associated with the risk of barotrauma. We report our experience with 25 (42%) of 60 infants admitted to the Paediatric Intensive Care Unit (PICU) with severe bronchiolitis who required mechanical ventilation. Eighteen patients (72%) had severe hypoxaemia (PaO2/FiO2 < 250). The mean airway pressure required ranged from 5.8 to 15.6 cmH2O with median ventilation duration of 4.0 days (range 2.0-14.0 days). Oxygenation improved significantly within 12 hours of intubation. There was only one death. Mechanical ventilation is required in a subset of patients for severe bronchiolitis and is effective and generally well tolerated.

Acute Disease↗

Swyer-James-MacLeod syndrome.

Swyer-James-MacLeod syndrome is a rare complication of respiratory tract infection occurring in early childhood. We report two children with chronic cough and recurrent wheezing who fulfilled the diagnostic criteria for this disorder: 1) Unilateral loss of lung volume with hyperlucency on chest x-ray. 2) Unilateral reduction in vascularity on CT scan of the chest. 3) Unilateral loss of perfusion on Technetium 99c lung scan.

Child, Preschool↗

Fatal enterovirus 71 encephalomyelitis.

During an outbreak of hand-foot-mouth disease caused by enterovirus 71 (EV-71) in 1997, 4 children presented with sudden cardiopulmonary collapse and minimal neurologic features. All children received cardiopulmonary resuscitation but died within a few hours of admission. Postmortem studies showed infection by EV-71 with extensive damage to the medulla and pons. We postulate an etiologic link between EV-71 and brainstem encephalomyelitis as the cause of pulmonary edema and death.

Child, Preschool↗

Incidence of acute respiratory distress syndrome: a comparison of two definitions.

OBJECTIVES: To determine the incidence and outcome of acute respiratory distress syndrome (ARDS) in children by comparing two commonly used definitions: the lung injury score and the American-European Consensus Conference definition. The causes and risk for developing ARDS were also studied. METHODS: Part prospective and retrospective analysis of 8100 consecutive hospital admissions from 1 June 1995 to 1 April 1997. RESULTS: Twenty one patients fulfilled the criteria for ARDS. Both definitions identified the same group of patients. The incidence was 2.8/1000 hospital admissions or 4.2% of paediatric intensive care unit admissions. The main causes were sepsis and pneumonia. Mortality was 13 of 21. Factors predicting death were a high admission paediatric risk of mortality (PRISM) score (30.38 v 18.75) and the presence of multiple organ dysfunction syndrome (92% v 25%). CONCLUSION: Both definitions identified similar groups of patients. The incidence in this population was higher than that reported elsewhere, but mortality and cause were similar to those in developed countries. Poor outcome was associated with sepsis, a high admission PRISM score, and simultaneous occurrence of other organ dysfunction.

Acute Disease↗

Percutaneous central venous catheterisation in critically ill children.

An 18-month analysis of 52 percutaneously placed central venous catheters in 48 critically ill children was done. Success rate were 91.7% (33/36) and 93.8% (15/16) for femoral and non-femoral catheters respectively. Presence of hypotension (48.1%) and significant coagulopathy (26.9%) did not affect the success rate significantly. Minor bleeding and venous congestion was seen in 5.5% (2/36) of patients with femoral catheters. Infections were found in 2.7% (1/36) of femoral and 6.6% (1/15) of non-femoral catheters. The low incidence of complications and the relative ease of insertion makes the femoral route the preferred site for trainee medical officers in critically ill children when central access is indicated.

Catheterization, Central Venous↗

Intestinal lymphangiectasia--a report of three Chinese children in Malaysia.

This is a report of 3 Chinese children with intestinal lymphangiectasia in Malaysia. Two children responded to a low fat diet and medium-chain triglyceride supplement. The third child has recurrent chylous ascites. None of the children has recurrent infections despite low CD4+ cells and low levels of IgG and IgA. Intestinal lymphangiectasia is a rare congenital disorder of the mesenteric lymphatic that leads to the obstruction of the lymphatics of the intestine and protein losing enteropathy. Restriction of dietary fat intake will usually result in remission. Recurrent chylous ascites is a problem and management can be difficult.

China↗