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Biomedical subjects

J Murphy

Publications and source records attributed to J Murphy.

At least 343 records · Page 19Linked to original sources
PubMed1983

Effect of high-frequency oscillation on gas exchange and pulmonary phospholipids in experimental hyaline membrane disease.

Arterial PO2 and PCO2 obtained with 2 modes of mechanical ventilation were compared in 5 premature monkeys with hyaline membrane disease (HMD) during the first 7 h of life. High-frequency oscillation (HFO) (10 Hertz) was compared with conventional positive-pressure ventilation (CMV) by matching the mean airway pressure generated by the 2 systems. Each animal served as its own control; HFO sustained an improved PaCO2 (39 +/- 8 versus 25 +/- 7 mmHg). An insignificant improvement in arterial PO2 was noted. The improved CO2 exchange occurred with a lower peak airway pressure (35 +/- 4 versus 23 +/- 11 cm H2O). Comparison of the postmortem pressure-volume curves and lung and lavage phospholipid concentrations from the animals treated with HFO in the current study to a matched set of animals treated exclusively with CMV in a previous study failed to reveal any differences. We conclude that HFO is effective in eliminating CO2 in experimental HMD without apparently altering lung biochemical or mechanical properties in a manner different from that found with CMV.

Animals↗
PubMed1983

Infants weighing 1,000 grams or less at birth: developmental outcome for ventilated and nonventilated infants.

The neurodevelopmental outcome at a mean age of 40 months was investigated in 23/25 surviving infants of birth weights less than or equal to 1,000 gm. Eight infants required intubation and assisted ventilation and 17 were not ventilated. One ventilated infant was lost to follow-up and one nonventilated infant was a victim of sudden infant death syndrome at age 6 months. Fifteen (65%) had a good outcome but the differences between ventilated and nonventilated infants were striking. Thirteen (81%) of the nonventilated group were normal, but only two ventilated survivors (28%) were normal (P less than 0.05). Cicatricial retrolental fibroplasia occurred in three (43%) of the ventilated survivors and in none of the nonventilated infants (P less than .02). The requirement for assisted ventilation in these very low-birth-weight infants is associated with significant morbidity. Improvement in outcome may depend as much upon better understanding and management of prenatal events as upon improvements in neonatal care.

Developmental Disabilities↗
PubMed1983

Intravenous prophylactic antimicrobial drugs in elective colorectal operations.

In a prospective, randomized, double blind study of 123 patients undergoing elective colorectal surgery, 61 received intravenously erythromycin gluceptate, and 62 received intravenously metronidazole perioperatively together with tobramycin. Three dosages of each drug were given. Eight patients in each treatment group had wound infections. Of these, only three in each treatment group were severe enough to require antibiotic therapy and to cause prolongation of hospitalization. Antibiotic levels in the serums of patients, in skin samples and in intestinal walls showed that metronidazole was most frequently detected at satisfactory concentrations in serum and that skin and the intestinal wall did not contain any detectable antibiotic.

Anti-Bacterial Agents↗
PubMed1983

Prophylactic antibiotics in elective colon surgery.

A double-blind, randomized, prospective study comparing the efficacy of two intravenously administered antibiotics was conducted at Vancouver General Hospital on 98 patients undergoing elective colon surgery. The test drugs, erythromycin gluceptate and metronidazole, were each administered intravenously in 500 mg doses. The first dose was administered with the premedication 1 hour before surgery and the subsequent two doses were administered at 8-hour intervals. All patients received three doses of tobramycin intravenously, 1.5 mg/kg body weight, at the same time as the study drug. Fourteen patients developed wound infections, of which seven were classified as major and seven as minor infections. A major infection was diagnosed when the patient had a fever, required antibiotics, or had a prolonged hospital stay because of the wound infection. Three patients with major infections had received metronidazole and four had received erythromycin. Four patients with minor infections had received metronidazole and three patients had received erythromycin. The two treatment populations were similar with respect to type of surgery, age, gender, weight, and nutritional status. Both drugs were equally well tolerated. The overall wound infection was 14.4%, with no difference between erythromycin and metronidazole.

Adult↗
PubMed1982

Effects of PEEP and tolazoline infusion on respiratory and inert gas exchange in experimental meconium aspiration.

Meconium aspiration syndrome often produces respiratory failure in the neonate. We utilized the multiple inert gas elimination technique to study the effects on respiratory and inert gas exchange of the application of positive end expiratory pressure or continuous infusion of tolazoline HCl. The application of PEEP, with the optimal level of PEEP defined for each animal, produced a decrease in AaDO2 and pulmonary shunt, without an increase in blood flow to low VA/Q areas, or an increase in dead space. Tolazoline infusion, at 2 mg/kg/hour, had no apparent effect on AaDO2 or shunt, or magnitude of low VA/Q regions. Tolazoline therapy was associated with an increase in heart rate and a decrease in systemic blood pressure. We conclude that immediate postaspiration application of PEEP, but not of tolazoline, will diminish pulmonary shunt without creating low VA/Q areas, and therefore will improve gas exchange in MAS.

Animals↗
PubMed1982

The post-fall syndrome. A study of 36 elderly patients.

36 patients aged 65 and over who were admitted to hospital after suffering a fall were examined soon after admission and followed for 4 months. 10 patients developed a severe tendency to clutch and grab and were unable to walk unsupported; 9 of these died or were still in hospital 4 months later. 16 patients showed similar signs but were able to walk independently; 5 of these died or were still in hospital after 4 months. 10 patients had no features of the post-fall syndrome; only 1 of these died within 4 months, and one of the survivors remained in hospital. The syndrome may represent the end result of a positive feed-back relationship between disturbed balance and falls.

Accidents, Home↗
PubMed1982

The effects of internal electronic fetal heart rate monitoring on maternal and infant infections in high-risk pregnancies.

A controlled prospective study of the effects of fetal monitoring on mothers and infants was conducted at Denver General Hospital, Denver, Colorado. A total of 690 high-risk patients in labor were randomly assigned to one of three groups; auscultation alone, electronic fetal monitoring and electronic fetal monitoring with the option to obtain a scalp pH sample. Maternal and neonatal infectious morbidity after vaginal or cesarean delivery was unchanged with internal fetal monitoring. Despite frequent antibiotic prophylaxis (95% cesarean section v. 11% vaginal), cesarean section was the most significant factor associated with increased maternal puerperal infectious morbidity (13.75% cesarean section v. 3.9% vaginal). Although hours of labor, hours of rupture of membranes, hours of internal catheter, number of exams and presence of meconium were not associated with increased maternal infection, prolonged hours of internal catheter usage greater than 8 hours and prolonged rupture of membranes greater than 12 hours were associated with increased antibiotic usage in the neonate.

Colorado↗