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Biomedical subjects

D C Shannon

Publications and source records attributed to D C Shannon.

At least 91 records · Page 5Linked to original sources
PubMed1980

Parents' perceptions of the psychological and social impact of home monitoring.

Self-assessments of 133 parents' (74 families) feelings, perceptions, reactions to stresses, and satisfactions during a period of electronic home monitoring are reported. Data were collected during structured interviews by students in a graduate social work program. Although extreme anxiety was prevalent initially, only 27.4% of the parents felt they were very anxious beyond the first month. Social life was restricted in 55.7% but job attendance was seldom affected. Only four parents felt very irritated by the increased demands of the monitored baby. The majority (72.9%) said that the monitor made them feel more comfortable with their baby. Only 14.2% felt that their marriage relationship worsened during the period of monitoring; two couples separated. Most supportive to parents were their spouses, least supportive were friends and relatives. With availability of a psychosocial support system, electronic home monitoring of infants can be conducted by parents without constant and extreme anxiety and, in their judgment, can even be a satisfying experience.

Anxiety↗
PubMed1980

Astrocytoma in an infant with prolonged apnea.

A 4-week-old infant experienced prolonged central sleep apnea requiring resuscitation. At 6 months of age he developed episodic obstructive apnea (diagnosed as laryngospasm by direct laryngoscopy) with an abnormal EEG and a normal computed tomography (CT) scan, and at 14 months of age he developed hemiparesis due to a gemistocytic astrocytoma grade III-IV. Following removal of the mass, he has had occasional seizure activity, but no further episodes of obstructive apnea.

Astrocytoma↗
PubMed1980

Periodic breathing in siblings of sudden infant death syndrome victims.

To determine the incidence of periodic breathing (PB) episodes during sleep, 48 subsequent sudden infant death syndrome siblings and 48 control infants, matched by sex, gestational age, and chronologic age, were studied by home pneumogram technique. The sudden infant death syndrome siblings had a statistically significant increase in the percent of sleep time spent in PB, in the number of episodes/100 minutes of PB, in the longest episode PB, and in the average duration of all episodes of PB. We conclude that PB is present in a higher amount in sudden infant death syndrome siblings as compared to control infants.

Cheyne-Stokes Respiration↗
PubMed1979

Swan-Ganz catheterization in the critically ill newborn.

The authors placed Swan-Ganz catheters in 11 preterm and 2 term infants with severe cardiopulmonary distress. The infants ranged in weight from 1100-4000 g. The procedure was performed in the neonatal ICU by jugular venous cutdown. Intracardiac pressures and oxygen saturations were measured in each chamber entered. The authors also evaluated the presence of right to left shunting through the patent ductus arteriosus and assessed the degree of pulmonary arterial hypertension. In 5 hypoxemic infants, the authors found a patent ductus arteriosus with pulmonary hypertension. Intermittent measurement of PAP served as a guide to further therapy. In 2 infants, the unexpected diagnosis of cyanotic congenital heart disease was made. The placement of flow directed pulmonary arterial catheters in critically ill infants can be performed safely at the bedside and can provide useful diagnostic and therapeutic information.

Blood Gas Analysis↗
PubMed1979

Respiratory and nonrespiratory effects of doxapram in congenital central hypoventilation syndrome.

Doxapram is a respiratory stimulating drug that affects both peripheral chemoreceptors and medullary respiratory and nonrespiratory neurons. We administered doxapram 60 2 infants with congenital central hypoventilation syndrome. In 6 separate trials at a dose range of 0.32 to 2.0 mg per kg of body weight per min, quiet-sleep tidal volume increased from 4.9 +/- 1.0 to 8.5 +/- 0.9 ml per kg of body weight, minute ventilation increased from 140 +/- 38 to 286 +/- 31 ml per kg of body weight per min, and alveolar PCO2 decreased from 60 +/- 5 to 32 +/- 2 mm Hg. In all instances, the maximal quiet-sleep ventilatory response was achieved within 10 min. The ventilatory response to steady-state CO2 breathing was not improved with doxapram. A continuous infusion of doxapram for 5.2 days in one infant successfully maintained normal quiet-sleep ventilation. In both infants, multiple nonrespiratory effects of doxapram occurred; enteral administration was associated only with generalized neuromuscular stimulation, but the 5-day intravenous infusion was also associated with acute hepatotoxicity and a perforated duodenal ulcer. The medullary respiratory neurons in central hypoventilation syndrome may be incapable of responding to doxapram, and the ventilatory responses observed may be due entirely to stimulation of peripheral chemoreceptors. Although quiet-sleep ventilation can be successfully maintained with intravenous and enteral administration of doxapram, and tachyphylaxis has not been observed, we have been unable to avoid at least the neuromuscular manifestations of nonrespiratory medullary stimulation.

Chemical and Drug Induced Liver Injury↗
PubMed1979

Preferential distribution of lobar emphysema and atelectasis in bronchopulmonary dysplasia.

The chest roentgenograms of 142 neonates who survived mechanical ventilation for respiratory distress syndrome (N = 99) and prolonged apnea (N = 43) were reviewed. Thirty-seven infants had bronchopulmonary dysplasia (BPD) and 17 of these developed lobar hyperinflation of the right lower lobe and collapse of the right upper lobe. Regional lung function was measured with a xenon 133 technique in three of these infants and in five other patients who either died or were lost to follow-up. All had BPD with right lower lobe overinflation. Ventilation was less in the lower regions than the upper regions bilaterally (P less than .001), indicating that the hyperinflation of the lower lobes was not compensatory for upper lobe collapse but was due to emphysema. Mean regional perfusion was equal in the upper and lower regions of the chest. This preferential distribution of lobaremphysema and ipsilateral atelectasis in BPD tended to present and regress simultaneously, but in many infants it lasted as long as eight weeks. Only one infant with persistent atelectasis developed pneumonia. The best mode of therapy appears to be supportive.

Apnea↗
PubMed1979

Periodic breathing in infants with near-miss sudden infant death syndrome.

Twelve-hour nocturnal home recordings of respiration and heart rates were obtained during sleep in 32 infants with near-miss sudden infant death syndrome (SIDS) and in 32 control infants, and the recordings were analyzed for periodic breathing. An episode of periodic breathing was defined as three or more apneic pauses of three or more seconds. The duration of respirations interrupting the pauses was 20 seconds or less. Analysis revealed a statistically significant difference (P less than .001) between the two groups, using criteria of percent of periodic breathing episodes, number of periodic breathing episodes/100 min of recorded sleep time, average duration of all episodes, and duration of the longest episode of periodic breathing. It is concluded that periodic breathing is present in excessive amounts during sleep in infants with near-miss sudden infant death syndrome.

Apnea↗
PubMed1979

Neurologic sequelae in the survivors of neonatal intraventricular hemorrhage.

We report our experience with the neurologic sequelae (at a mean follow-up of 24 months) among the 15 surviving infants who have had neonatal intraventricular hemorrhage (IVH) documented by computerized tomographic (CT) brain scan. Neurologically six infants (40%) are normal, six infants (40%) mildly impaired, and three infants (20%) moderate to severely impaired. The neurologic outcome correlated to the degree of hemorrhage seen in the CT scans when IVH was classified into four grades. None of the other neonatal factors examined showed significant correlation with the outcome.

Cerebral Hemorrhage↗
PubMed1978

Inappropriate antidiuretic hormone secretion in premature infants with cerebral injury.

We describe 11 premature infants with the syndrome of inappropriate antidiuretic hormone secretion (SIADH). The syndrome is far more common than the single case report in the literature would indicate. All the infants had either asphyxiation at birth, intracranial hemorrhage, or meningitis. Of the nine children available for follow-up observation, seven demonstrated serious neurological sequelae. The diagnosis of SIADH in the premature neonate may be difficult to establish due to the complexity of precipitating factors.

Brain Diseases↗
PubMed1978

Monitoring occlusion and accidental extubation of tracheostomy tubes in children.

Twelve infants and children with tracheostomies have been monitored for occlusion or accidental extubation in hospital and at home using a thermistor-electronic monitor. The patients ranged from 1 month to 6 years of age and have been monitored for 1 to 16 months. The device sounds an alarm when it fails to sense the warming of air on expiration. It is electrically safe, simple to operate and has been well accepted by parents. The thermistor-monitor has permitted the psychologic and economic advantages of earlier hospital discharge especially for the smaller infants. In two infants, and on three occasions in one, use of the device was life-saving. The device is applicable for use in patients of any age, with endotracheal or tracheostomy tubes.

Child, Preschool↗
PubMed1978

Care of infants with near-miss sudden infant death syndrome.

The purpose of this study was to evaluate the effectiveness of home management of life-threatening apnea in infants with near-miss sudden infant death syndrome (SIDS). A total of 84 infants were monitored with apnea monitors for an average of seven months (range 1 to 27). A group of 27 infants had episodes of apnea requiring resuscitation during home monitoring, all of whom were successfully resuscitated by their parents on at least one occasion using bag and mask resuscitation, and 17 infants required more than one resuscitation. Subsequent resuscitation was unsuccessful with four infants. Infants who experienced more than ten episodes of prolonged sleep apnea (apnea longer than 20 seconds) during home monitoring had a significantly increased risk of requiring resuscitation than other infants being studied. With the use of home monitoring of these infants and parents trained in cardiopulmonary resuscitation, the survival rate was 93.4%.

Apnea↗
PubMed1977

Abnormal regulation of ventilation in infants at risk for sudden-infant-death syndrome.

To test whether alveolar hypoventilation and an abnormal ventilatory response to inhaled carbon dioxide explains some episodes of sudden-infant-death syndrome, we assessed ventilatory control during quiet sleep in 12 normal infants and 11 infants who had required at least two resuscitations because of prolonged apnea (greater than 20 seconds) during sleep (aborted form of the syndrome). Infants with the aborted syndrome hypoventilated during quiet sleep (alveolar partial pressure of carbon dioxide, 38.9+/-3.5 mm Hg) as compared to normal infants (35.1+/-1.9, P less than 0.01). In addition, the ventilatory response to carbon dioxide breathing during quiet sleep was impaired (mean change in minute ventilation per change in partial pressure of carbon dioxide 22.1+/-8.9, as compared to 63.1+/-19.1 ml per kilogram per minute per millimeter of mercury in controls [p less than 0.001]). Three infants with the "aborted syndrome" subsequently died during sleep at home; autopsy, done in two, revealed no apparent cause of death. We conclude that infants who have had an episode consistent with sudden-infant-death syndrome have a defect in the regulation of alveolar ventilation.

Apnea↗