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Biomedical subjects

R B Cotton

Publications and source records attributed to R B Cotton.

51 records · Page 3Linked to original sources
PubMed1980

Impedance cardiographic assessment of symptomatic patent ductus arteriosus.

A modified impedence cardiographic technique was developed using a tetrapolar apnea monitor and minicomputer system. Evaluation of this technique in premature infants with and without symptomatic patent ductus arteriosus indicates that the magnitude of the cardiac-related deflection in the impedance signal is useful in the assessment of ductus shunting. Since the infant under study is involved only by the attachment of two double electrodes to the thorax, continuous assessment of ductur shunting is possible without disturbing routine care.

Cardiography, Impedance↗
PubMed1980

Effect of positive-end-expiratory-pressure on right ventricular output in lambs with hyaline membrane disease.

Right and left ventricular outputs, pulmonary and systemic blood flows, and blood flows in both directions through the ductus arteriosus were measured before and during positive-end-expiratory-pressure in 5 premature lambs with induced hyaline membrane disease. During positive-end-expiratory-pressure, right ventricular output increased in all lambs without any significant change in left ventricular output or pulmonary vascular resistance. Left-to-right ductus flow decreased in lambs which initially had large left-to-right ductus shunts. significant right-to-left ductus flow did not occur before or during positive-end-expiratory-pressure.

Animals↗
PubMed1978

Medical management of small preterm infants with symptomatic patent ductus arteriosus.

During 1975, 38 of 44 infants with a birth weight of less than or equal to 1,500 gm who developed pulmonary edema and congestive heart failure due to a patent ductus arteriosus were managed medically until the ductus closed spontaneously days or weeks later. Overall survival was 71%, and there were no deaths among 11 infants weighing more than 1,250 gm. Pulmonary complications were prevalent and were attributed to the extensive use of mechanical ventilation required to control pulmonary edema. The results of this study document the results to be expected when small preterm infants with a symptomatic patent ductus arteriosus are managed without surgical or pharmacologic intervention and provide a basis for the rational design of clinical trials evaluating other management approaches.

Blood Transfusion↗
PubMed1978

Randomized trial of early closure of symptomatic patent ductus arteriosus in small preterm infants.

As a result of randomized assignment, 15 preterm infants weighing 1,500 gm or less at birth and who had a symptomatic PDA were treated according to a medical management protocol, and ten according to an early surgical closure protocol. All infants required mechanical ventilation at the time of study entry, which was one week after birth. Birth weight, gestational age, age at onset of congestive failure, age at study entry, and the initial morbidity of members of the two groups were similar. The nine surviving infants managed according to the surgical closure protocol were weaned from mechanical ventilation sooner, had a decreased need for digoxin and furosemide, achieved gastrointestinal function sooner, and had a smaller hospital bill than the 12 survivors of the medical management group. These results indicate that infants with a symptomatic PDA still requiring mechanical ventilation at one week after birth will benefit from surgical closure of the ductus at that time.

Digoxin↗
PubMed1972

Intensive care.

Explore the source record for details and available documents.

Acute Kidney Injury↗
PubMedDate not supplied

Nursery epidemic due to multiply-resistant Klebsiella pneumoniae: epidemiologic setting and impact on perinatal health care delivery.

Gram-negative bacilli frequently cause epidemics in high-risk newborn intensive care units. Recently, an epidemic caused by a multiply-resistant K. pneumoniae, serotype 21, occurred in the Vanderbilt University intensive care nursery. The background of this outbreak included an increasing endemic nosocomial sepsis rate, operation of the facility in excess of rated capacity, and increasingly inadequate nurse-to-patient staffing ratios. The epidemic lasted 11 weeks; 26 (12%) of the 232 infants at risk in the unit became colonized. Five infants developed systemic illness and one died. Cohorting, reinforcement of strict handwashing and isolation procedures, and closure of the unit to outborn admissions resulted in rapid termination of the outbreak. Followup studies performed on infants colonized with the epidemic bacterium demonstrated persistent fecal shedding up to 13 months following discharge from the hospital. This epidemic had a detrimental influence on high-risk newborn and obstetric health care delivery in an area encompassing portions of three states. Under a system of progressively more sophisticated referral units, nosocomial infections occurring at a tertiary center can have an impact on other hospitals within the network.

Carrier State↗