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Biomedical subjects

B V Kirkpatrick

Publications and source records attributed to B V Kirkpatrick.

25 records · Page 2Linked to original sources

Pelvic exsanguination following umbilical artery catheterization in neonates.

Umbilical artery catheterization in 400 newborns was followed by umbilical or hypogastric artery perforation with massive extra- and intraperitoneal bleeding in 7 infants. Common predisposing factors were multiple attempts and insertion against resistance. A characteristic clinical picture developed, including hypotension, abdominal distention, and lower abdominal wall induration and ecchymosis, often extending into the genitalia and upper thighs, with absent femoral pulses. Treatment is immediate transfusion and bilateral umbilical and hypogastric artery ligation. One of seven patients survived.

Catheterization↗

Serum vitamin A in premature and term neonates.

Serum vitamin A was determined in premature and term neonates by a specific spectrofluorometric method. Premature neonates (N = 42; gestational age = 32 +/- 0.4 weeks) had a serum vitamin A level (14.9 +/- 0.98 microgram/dl) significantly lower (P less than 0.001) than that of term neonates (N = 51; 22.4 +/- 0.99 microgram/dl). The vitamin A mean serum values of infants of 36 weeks' gestational age were not statistically different from those of the term neonates. Linear regression analysis for serum vitamin A values vs gestational age showed no significant correlation. A linear correlation (P less than 0.05), however, was found between serum vitamin A and serum protein protein concentrations, perhaps indicative of a lower concentration of retinol-binding protein. Since vitamin A is involved in the promotion of mucous-secreting cells, the premature neonate may be at greater risk than the term infant for diseases involving the mucosal epithelium, including necrotizing enterocolitis.

Enterocolitis, Pseudomembranous↗

Changing survival rates in infants with respiratory distress syndrome.

The outcome of 434 infants with respiratory distress syndrome was reviewed for a three-year period, showing that survival rates have increased from 69.6% to 82.7%. Improved techniques in respiratory therapy and patient management have played major roles in lowering mortality rates.

Humans↗

Nosocomial klebsiella infection in a neonatal unit: identification of risk factors for gastrointestinal colonization.

Sequential outbreaks of infection due to gentamicin-resistant Klebsiella pneumoniae (GRKP) types 30 and 19 occurred in the neonatal intensive care unit (NICU) at the Medical College of Virginia in 1977 and 1978. The extensive epidemiologic investigation carried out included a case-control study, careful review of aseptic technique, and cultures from nursery staff and environment. The gastrointestinal (GI) tracts of the patients were the reservoirs for GRKP, and the epidemic strain was transmitted by hands of personnel. The case-control study showed a significant relationship between acquisition of GRKP by patients and oropharyngeal and GI instrumentation, including use of bag resuscitation, oropharyngeal suctioning, and use of nasogastric feeding tubes. The findings of the case-control study were supported by observation of the patient care techniques practiced by NICU staff. Institution of control measures based on results of the epidemiologic investigation of the first outbreak rapidly brought the second outbreak under control, even though cohorting or use of routine isolation was not possible. Whereas GI colonization and hand transmission have been described previously in outbreaks of K. pneumoniae infections in NICUs, this study is the first to document the mode of inoculation of patients' GI tracts by contaminated hands of personnel.

Cross Infection↗