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Biomedical subjects

P J Hofschire

Publications and source records attributed to P J Hofschire.

At least 37 records · Page 2Linked to original sources
PubMed1986

Percutaneous cardiac catheterization via the internal jugular vein in infants and children.

Cardiac catheterization was performed via the internal jugular vein in 14 pediatric patients using a percutaneous sheath technique. Patients were 2 months to 16 years old and weighed 3.2-69 kg. We found that a low lateral approach for puncture of the vein was faster and more often successful than the high approach most often utilized in adult patients. No complications occurred in this series of patients. The internal jugular vein is a safe and reliable alternative to the femoral vein for cardiac catheterization if there is obstruction to the inferior vena cava or if it is desirable to leave an indwelling cardiac catheter.

Adolescent↗
PubMed1985

Elevated static pressure and pregnancy well-being.

Static pressure is defined as the pressure existing at all points in the circulation when the heart is stopped and is a determinant of cardiac output and blood pressure. By using the proposed relationship that static pressure = cardiac output X "resistance to venous return," estimates were made of peripheral static pressure in pregnant women. Measurements of cardiac output and venous resistance were accomplished with indirect plethysmographic techniques. Approximately 65% of pregnant women with complications had elevated values for their estimated peripheral static pressure. It is proposed that estimation of peripheral static pressure has both diagnostic and therapeutic applications in women with complications of pregnancy.

Blood Pressure↗
PubMed1985

Rapid calcification of the bovine pericardial valve in adolescence. Critical aortic stenosis, hemolytic anemia, and quantitative renal hemosiderosis.

A 16-year-old boy developed marked calcific stenosis of an Ionescu-Shiley valve that was implanted in the aortic position 42 months before his sudden death. Renal hemosiderosis caused by intravascular hemolysis was quantitated by atomic absorption spectrophotometry. The accelerated calcification of the bovine pericardial valve in our patient supports the view that, in general, xenografts should not be used in adolescents. Frequent follow-up evaluations are imperative in young patients who receive these valves to avoid the irrevocable progression of valvular stenosis and hemolytic anemia.

Adolescent↗
PubMed1985

Combined prostaglandin therapy and ductal formalin infiltration in neonatal pulmonary oligemia.

Prostaglandins and ductal formalin infiltration, singly and together, have been used in efforts to improve pulmonary flow in very ill newborn infants with right ventricular outflow tract obstruction. To evaluate the efficacy of concurrent use of prostaglandins and ductal formalin infiltration, we have reviewed our experience with 25 infants with right ventricular outflow tract obstruction and prostaglandin-ductal formalin infiltration therapy. Prostaglandin therapy was begun 22 +/- 21 hours (range 20 to 93 hours) before and was continued 20 +/- 18 hours (range 0 to 62 hours) following ductal formalin infiltration; prostaglandin administration was initiated at a dose of 0.05 to 0.1 microgram/kg/min and tapered postoperatively. Clinical cyanosis was diminished in 20 of 25 infants (80%) postoperatively. Systemic arterial pH and oxygen saturation both improved following prostaglandin-ductal formalin infiltration therapy from 7.35 to 7.41 (p less than 0.001) and from 35.7 to 50.3 (p less than 0.001), respectively. Persistent ductal patency (mean 219 +/- 191 days) was observed in 17 survivors of the early postoperative period (more than 14 days). Two of five infants who died within 14 days of operation had a widely patent ductus with resultant progressive congestive heart failure. The other three infants died as a result of operative technical problems, dysrhythmias, and thrombotic ductal closure, respectively. No correlation was observed between duration of ductus patency and operatively determined size of ductus, total prostaglandin dose, or duration of prostaglandin infusion. Secondary operative intervention was delayed by 92 +/- 74 days with prostaglandin-ductal formalin infiltration therapy; thus prostaglandin-ductal formalin infiltration therapy may have a role in selected neonates with right ventricular outflow tract obstruction.

Alprostadil↗
PubMed1984

Improvement of left ventricular dysfunction after control of persistent tachycardia.

Five children are described who had persistent, chronic tachycardia and left ventricular dysfunction manifested by decreased left ventricular percent fractional shortening on echocardiogram (five patients) cardiomegaly on chest roentgenogram (three), ventricular or atrial hypertrophy on ECG (three), and symptoms of congestive heart failure (three). After antidysrhythmia therapy and control of the tachycardia, signs and symptoms of congestive heart failure resolved in two infants. Moreover, in each patient signs of cardiomegaly resolved on chest roentgenogram, hypertrophy resolved on ECG, and the fractional shortening improved to normal (mean 20.2% +/- 2.4% SEM before vs 36.2% +/- 2.4%, P = 0.02, after treatment). Evaluation in the child who has dilated cardiomyopathy should include assessment of heart rate and rhythm. Moreover, when persistent tachycardia is found in an asymptomatic child, evaluation of left ventricular function is indicated.

Adolescent↗
PubMed1983

Sustained ventricular tachycardia after repair of tetralogy of Fallot: new electrophysiologic findings.

Ventricular arrhythmia originating from the outflow tract of the right ventricle is a presumed cause of late sudden death in patients after repair of tetralogy of Fallot. Exercise testing has been shown to enhance detection, and phenytoin has been shown to control ventricular arrhythmias in these patients. This study reports new findings in 3 patients who underwent electrophysiologic studies at postoperative cardiac catheterization; in each, sustained ventricular tachycardia was induced and found to originate from the inflow-septal area of the right ventricle. Using serial studies, the same sustained ventricular tachycardia was induced during therapeutic serum concentrations of phenytoin but not after propranolol. No patient had ventricular arrhythmia during a 24-hour electrocardiogram or during exercise. Although no patient had normal hemodynamic function, only 1 patient had right ventricular pressure greater than two-thirds systemic pressure. Each patient had undergone initial intracardiac repair at a relatively late age (3, 9, and 9 years).

Adolescent↗
PubMed1982

Continuous enteral feedings. An important adjunct to the management of complex congenital heart disease.

Eleven infants with complex congenital heart lesions were given continuous enteral infusions after failure to gain weight adequately despite use of hypercaloric formulas and nutritional supplementation. Formulas used before institution of enteral feedings were continued. Dietary and caloric intake and weight measurements were obtained at weekly or monthly intervals. Both mean daily caloric intake and mean daily weight gain were greater after initiation of continuous enteral feedings. Rate of weight gain improved in all 11 children after institution of enteral feedings. Continuous enteral feeding increases weight gain in babies with complex congenital heart disease, allowing earlier and safer surgical intervention.

Body Weight↗