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Biomedical subjects

C E Hunt

Publications and source records attributed to C E Hunt.

At least 127 records · Page 7Linked to original sources
PubMed1977

The effect of independent variations in inspiratory-expiratory ratio and end expiratory pressure during mechanical ventilation in hyaline membrane disease: the significance of mean airway pressure.

The specific aspects of the respiratory cycle during mechanical ventilation that allow for optimum gas exchange are still controversial. To further clarify the relationship of inspiratory:expiratory ratio and positive end expiratory pressure to optimum ventilation and oxygenation, five premature lambs with severe hyaline membrane disease were ventilated with volume-present infant ventilators at I:E ratios of 1:4 and 1:1 and PEEP levels of 0, 5, and 10 cm H2O. For each I:E ratio/PEEP combination, pH, Pao2, PaCO2, PAO2, PACO2, peak inspiratory pressure, mean inspiratory pressure, and mean airway pressure were measured and compared. Optimum ventilation and oxygenation were related to MAP, but not to I:E ratio, PIP, or MIP. As MAP increased from 6 to 14 cm H2O, progressive improvement in Pao2, PaCO2 (A-a) DO2 and (a-A) DCO2 was evident. Above 14 cm H2O, there was progressive deterioration in these measurements. There was also a direct relationship between MAP and mean pleural pressure. These results indicate that during mechanical ventilation there is an optimum MAP at which gas exchange is best. Since MAP changes with any change in PIP, PEEP, or I:E ratio, it provides a useful composite measure of all pressures transmitted to the airways by the ventilator.

Airway Resistance↗
PubMed1976

An in vivo mass spectrometer system for the continuous monitoring of Po2 and Pco2.

A mass spectrometer blood gas catheter system for the continuous in vivo analysis of Po2 and Pco2 has been presented. This system has been experimentally evaluated and demonstrated to be reliable and reproducible over a period of 30 hr following insertion of the catheter in the abdominal aorta. Although the present catheter design does not allow insertion through an existing umbilical arterial line in neonates, a clinical evaluation will be undertaken when a more flexible catheter becomes available.

Animals↗
PubMed1976

Animal models of diabetes and obesity, including the PBB/Ld mouse.

Diabetes mellitus occurs in many animals species. However, only a few have been utilized in systematic studies designed to answer unsolved problems associated with the disorder in man such as molecular basis, pathogenesis of the vascular and neural lesions, and the roles of diet, exercise and obesity. Among the animal models available, rodents have been studied most thoroughly for a number of reasons: a) short generation time (sexually mature at about 3 mo of age, gestation time 21 days) and life-span is approximately 3 yr; b) hyperglycemia and/or obesity is known to be inherited in several species; c) environmental factors can be controlled easily in the laboratory because of small size; and d) economic considerations. The better-known rodent diabetes/obesity syndromes may be categorized as follows: 1) hyperglycemic with ketoacidosis, nonobese (Chinese hamster, South African hamster); 2) hyperglycemic with insulin hypersecretion, moderate obesity and may develop ketoacidosis (diabetic mouse (db/db), spiny mouse, sand rat); and 3) less pronounced hyperglycemia with hyperinsulinemia, insulin "resistance" and marked obesity (obese (ob/ob), yellow (Ay) and New Zealand obese (NZO) mice, and the Zucker "fatty" rat). The PBB/Ld mouse, described here in detail for the first time, is a new strain of mouse that also fits into the latter category. Members of this strain following maturity develop an obesity that is characterized by increasing cellularity of adipose tissue, increased serum immunoreactive insulin, reduced glucose tolerance, fatty liver, and hyperlipidemia. Therefore, this strain of mouse represents another model for study of adult onset obesity.

Adipose Tissue↗
PubMed1975

Paralysis of the diaphragm.

Diaphragmatic paralysis has been mentioned infrequently as a cause of respiratory symptoms in children. During a three-year period, diaphragmatic paralysis has occurred in 12 neonates following birth trauma (six) or thoracotomy (six) and in four older children following thoracotomy. Spontaneous recovery occurred in all four older children and in five of the 12 neonates. Although two neonates became asymptomatic despite persistent paralysis, the remaining five neonates required prolonged intermittent positive-pressure breathing; two eventually died of secondary pneumonia, and three became asymptomatic only after plication of the affected diaphragm.

Adolescent↗
PubMed1975

Clinical use of the membrane oxygenator.

Since April 1973 we have treated nine patients with extracorporeal membrane oxygenation (ECMO), utilizing the spiral coil membrane lung. One patient is a long-term survivor. All patients except one showed substantial improvement in peripheral arterial oxygen tension. Four adults and two neonates were treated for critical hypoxia. Two patients were treated for cardiac failure but failed to show improved myocardial function. Complications involving perfusion circuitry, cannulation, chronic systemic heparinization, thrombocytopenia, and renal failure have been managed with minimal difficulty. However, irreversible pulmonary, neurologic, hepatic, or gastrointestinal damage due to hypoxia present before the institution of ECMO was associated with lethal complications. The ECMO has supplied adequate oxygenation to this group of nine critically hypoxic patients. Institution of ECMO at an earlier date in patients with critical hypoxia would provide a higher likelihood of survival.

Acute Kidney Injury↗
PubMed1975

Necrotizing enterocolitis.

The clinical course of 54 patients with necrotizing enterocolitis has been compared to a matched group of 98 control patients. On the day of life that NEC occurred, all 54 NEC patients and 63% of controls were receiving standard formula feedings, both at 80/cal/kg/day. Stool cultures at the time revealed a significantly increased frequency of Klebsiella in NEC as compared to control patients. Our data suggest that the combined presence of certain intestinal bacteria and enteric feedings, perhaps requiring a background of mucosal ischemia, may be of etiologic significance in the development of NEC and its radiologic hallmark, pneumatosis intestinalis.

Birth Weight↗
PubMed1975

Patent ductus arteriosus complicating respiratory distress syndrome.

PDA was diagnosed in 76 (19%) of 396 patients with RDS. Evidence of excessive pulmonary blood flow and CHF developed in 15 (20%). CHF was not recognized prior to 10 days of age in any patient. All 15 with CHF were initially managed medically. Seven improved; three died of other causes. Five patients who failed medical management were surgically treated; all survived operation, but only two were improved.

Autopsy↗