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Biomedical subjects

J G Jenkins

Publications and source records attributed to J G Jenkins.

43 records · Page 3Linked to original sources

Effect of premedication on the induction dose of thiopentone in children.

The effective dose of thiopentone in 90% ( ED90 ) of unpremedicated children is 10.5 mg/kg. This is significantly greater (p less than 0.01) than in premedicated children. The ED90 in children premedicated with TDP (a mixture of trimeprazine , droperidol and physeptone with atropine) is 4.2 mg/kg which is significantly less (p less than 0.05) than with trimeprazine and atropine ( ED90 5.2 mg/kg) or papaveretum and hyoscine ( ED90 5.0 mg/kg).

Anesthesia, Intravenous↗

Diaphragmatic paralysis after pediatric cardiac surgery: a retrospective analysis of 34 cases.

Thirty-four cases of diaphragmatic paralysis after pediatric cardiac surgery are reviewed. Differences between pediatric and adult pulmonary physiology account for the increased severity of respiratory distress seen in children with this condition. The efficacy of treatment with endotracheal intubation and continuous positive airway pressure (CPAP) is confirmed. No patient over 3 yr of age required intubation for longer than 2 wk. This finding is consistent with the development of sufficient chest wall stability to compensate for paralysis of the hemidiaphragm. Patients under 3 yr of age, without complicating heart failure, who still required intubation and CPAP 3-4 wk after injury to the phrenic nerve should consider operative plication.

Adolescent↗

Evaluation of pulmonary function in muscular dystrophy patients requiring spinal surgery.

Scoliosis associated with muscular dystrophy frequently necessitates surgical stabilization of the spine. The timing of surgery usually is based on the degree of spinal angulation. Pulmonary function, which deteriorates with age in children with muscular dystrophy, should also be an important consideration in this timing. In a retrospective study of 48 patients who underwent spinal stabilization, preoperative respiratory function tests were correlated with postoperative respiratory complications. The percentage of predicted vital capacity provided the best indicator of outcome and values of less than 30% were associated with major respiratory complications. Spinal fixation failed to arrest the decline in respiratory function in these patients, but it seemed to slow the rate of deterioration compared with preoperative changes. Evaluation of pulmonary function should play a major role in the timing of surgical intervention in muscular dystrophy.

Adolescent↗

Acute hepatic failure following cardiac operation in children.

A retrospective analysis has been performed of children who have undergone cardiac operations during the past 6 years to determine the clinical presentation and management of acute hepatic failure (AHF) in the postoperative period. Eleven patients had a clinical picture of AHF with jaundice, elevation of the levels of serum glutamic oxaloacetic transaminase (SGOT) and serum ammonia, and marked prolongation of the prothrombin time associated with failure of hemostasis. Hypoglycemia developed in seven. All patients had evidence of low cardiac output and acute renal failure. Patients with AHF had evidence of reduced hepatic perfusion during the previous 24 hours with reduced mean arterial pressure and elevated central venous pressure. Six children died of myocardial failure. A modified Fontan procedure was performed in six children, of whom four died. All had a right atrial pressure of 21 torr or greater. Five children survived the acute episode of hepatic failure. The importance of early diagnosis and effective management of complications such as hypoglycemia and the bleeding tendency are emphasized.

Acute Disease↗

Study of heart rate variability in sick newborn infants.

Heart rate variability has been studied in a group of 66 newborn infants for periods of up to 72 hours from birth. Long term variability was reduced in infants suffering from the idiopathic respiratory distress syndrome and this was more marked with severe respiratory distress requiring mechanical ventilation. Persistent reduction in long term variability was associated with increased mortality. Reduction in heart rate variability may be due to high levels of sympathetic activity.

Heart Rate↗

Transcutaneous blood gas monitoring during peritoneal dialysis in the neonate.

Transcutaneous oxygen and carbon dioxide were monitored continuously during peritoneal dialysis in an infant with severe idiopathic respiratory distress syndrome requiring mechanical ventilation. These showed marked changes in blood gases occurring in phase with the cycles of dialysis due to interference with ventilatory function by fluid in the peritoneal cavity. This finding has important implications for the management of infants requiring peritoneal dialysis during mechanical ventilation.

Acute Kidney Injury↗