Search PubMed⌕ Search

Biomedical subjects

Rebecca M McGuigan

Publications and source records attributed to Rebecca M McGuigan.

4 recordsLinked to original sources
PubMed2006

Splanchnic perfusion pressure: a better predictor of safe primary closure than intraabdominal pressure in neonatal gastroschisis.

BACKGROUND/PURPOSE: Both measured intraabdominal pressure (IAP) and calculated splanchnic perfusion pressure (SPP) have been advocated for use in operative management of gastroschisis. We directly compared these 2 clinical indices. METHODS: Institutional review board-approved multi-institutional retrospective review from 3 centers with 112 subjects. Splanchnic perfusion pressure was recorded as mean arterial pressure-IAP. We compared the clinical utility of IAP and SPP using univariate and multivariate regression analyses. RESULTS: Calculated mean SPP was higher among neonates requiring silo placement compared to those without (39.0 +/- 1.9 vs 33.7 mm Hg, P < .01). Measured IAP levels were similar between groups (11.5 +/- 1.1 vs 10.0 +/- 0.5, mm Hg, P < .4). On a receiver operating characteristic curve, the inflection point for more than 90% specificity for silo placement was at an SPP of 44. In multivariate regression analysis adjusting for all factors below, SPP was independently associated with silo placement (odds ratio 1.2, 95% confidence interval 1.1-1.3, P < .01), and IAP was not (odds ratio 1.2, 95% confidence interval <1.0-1.5, P < .1). CONCLUSIONS: These data suggest that SPP is a stronger predictor than IAP for the ability to achieve primary closure in the management of neonatal gastroschisis. We infer from these data that intraoperative SPP of more than 43 mm Hg may obviate the need for silo placement.

Female↗
PubMed2004

Is splanchnic perfusion pressure more predictive of outcome than intragastric pressure in neonates with gastroschisis?

BACKGROUND: The purpose of this study is to determine whether calculated splanchnic perfusion pressure (SPP) is more predictive of outcome than measured intragastric pressure (IGP) in patients with gastroschisis. METHODS: Retrospective chart review from 1997 through 2003 of 12 patients with gastroschisis. RESULTS: Eight total patients with gastroschisis underwent reduction and had adequate data for analysis. One patient underwent reduction on day of life (DOL) 6; the remainder underwent reduction on DOL 1. All patients had postreduction IGP <20 mm Hg. The correlation coefficient of IGP and date of extubation was 0.20 and of SPP and date of extubation was -0.51. The correlation coefficient of IGP and return of bowel function was -0.06 and of SPP and return of bowel function was -0.50. CONCLUSION: SPP may be more predictive of outcome than IGP after gastroschisis repair.

Abdomen↗
PubMedDate not supplied

Acute lung injury using oleic acid in the laboratory rat: establishment of a working model and evidence against free radicals in the acute phase.

OBJECTIVE: To determine the optimal model of acute respiratory distress syndrome (ARDS) using oleic acid in our laboratory and to measure the presence or absence of free radicals in this model. DESIGN: This protocol consisted of 2 phases. During the first phase, various conditions were tested, to include different doses (30 or 50 microliters) of oleic acid, different levels of support (with and without mechanical ventilation), and different injury time periods (sacrifice 4 or 8 hours after injection). During the second phase, animals were randomly assigned to experimental (injured) and control (noninjured) groups for the measurement of free radicals by nitrotyrosine Western blot and by the conversion of hydroethidine to ethidium bromide by superoxide. SETTING: Multidisciplinary laboratory and animal surgery suite. PARTICIPANTS: Twenty-seven male Sprague-Dawley rats. RESULTS: During the first phase, several animal deaths occurred in the high-dose, ventilated groups, whereas there were no deaths in the nonventilated animals. On hematoxylin and eosin stain, injury was greatest in the animals that received the higher dose of oleic acid and that were sacrificed at 8 hours. In the protocol's second phase, oxygen radical assays were negative for all experimental and control lungs. CONCLUSIONS: During this study, we successfully established a working animal model of ARDS for our laboratory. Our findings to date suggest that free radicals do not contribute to oleic acid lung injury in the early stages.

Animals↗