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Biomedical subjects

W Butt

Publications and source records attributed to W Butt.

69 records · Page 4Linked to original sources
PubMed1987

Effect of heparin concentration and infusion rate on the patency of arterial catheters.

In a prospective randomized controlled trial involving 470 arterial catheters in 470 children, we studied the effect of changing either the concentration or the flow rate of a heparin infusion. Although catheters tended to remain patent longer with a flow rate of 2 ml/h rather than 1 ml/h, the difference was not statistically significant. Increasing the heparin concentration from 1 to 5 U/ml significantly prolonged catheter patency.

Arteries↗
PubMed1986

Clinical experience with systemic vasodilator therapy in the newborn infant.

Newborn infants with impaired myocardial performance may not respond to inotropic drugs and volume loading. Vasodilator therapy was tried in 10 such patients and in most there was improvement in peripheral perfusion, blood pH, arterial oxygenation, blood pressure and urine output. No complications of these drugs were detected. Vasodilator therapy has a role in the management of the acutely sick newborn infant with clinical signs of low cardiac output.

Adult↗
PubMed1986

Duodenal ulceration: a complication of tolazoline therapy.

Tolazoline Hydrochloride is a pulmonary vasodilator that is used for the treatment of pulmonary hypertension of the newborn. Two patients who were receiving Tolazoline by infusion developed duodenal ulceration and subsequent intestinal perforation. This undesirable side effect of Tolazoline may be prevented by the concomitant use of antacids to maintain gastric pH greater than 5.

Duodenal Ulcer↗
PubMed1986

Intravenous paraldehyde for seizure control in newborn infants.

We studied 14 newborn infants with seizures after birth asphyxia or other causes. Paraldehyde was given as a 200 mg/kg IV bolus followed by an infusion of 16 mg/kg/h (10 cases), or as a 400 mg/kg bolus (4 cases). Serum concentrations of paraldehyde were higher in periods of adequate seizure control than in periods of little or no response. Paraldehyde serum concentrations above 10 mg/dl were associated with anticonvulsant effects and were achieved in most neonates with a 2-hour infusion of 200 mg/kg/h. If there is no effect, serum concentrations are probably below 10 mg/dl and an additional 200 mg/kg can be given safely over 1 hour.

Female↗
PubMed1985

Snoring in children: is it pathological?

Some children who snore heavily, have been shown to have periods of apnoea which, if frequent, are known as the obstructive sleep apnoea syndrome (OSA). Twenty patients with OSA, who presented to the Department of Thoracic Medicine, Royal Children's Hospital, Melbourne, over a three-year period, were reviewed. The findings indicated that OSA is more common than is generally supposed and that it can present with a wide range of symptoms. It is important that an early diagnosis of this syndrome is made, to prevent major complications and to allow appropriate therapy.

Adenoidectomy↗
PubMed1985

Hemorrhage and cyst development in the cavum septi pellucidi and cavum Vergae. Report of three cases.

Three newborn preterm infants are reported in whom sonography and CT showed abnormalities of the cavum septi pellucidi and cavum Vergae. Hemorrhage into the cavum was noted in two and an acquired cyst developed in the third. These lesions are rare and appear to be of little clinical significance in the three reported infants. All three had associated intraventricular hemorrhage.

Brain Diseases↗
PubMed1985

Postoperative morphine infusion in newborn infants: assessment of disposition characteristics and safety.

Twelve newborn infants were given morphine intravenously for postoperative analgesia. They received a continuous infusion of 6.2 to 40 micrograms/kg/hr for 9 to 105 hours (mean +/- SEM 59.5 +/- 10.2 hours); in four the infusion was preceded by a loading dose of 50 to 100 micrograms/kg. Morphine plasma concentrations correlated with the rate of infusion, but with large variability. There was a tendency for plasma morphine concentrations to decrease in some patients receiving a constant infusion rate, suggesting improvement in morphine clearance rate. Elimination half-life of morphine (13.9 +/- 6.4 hours) was significantly longer than in older children and adults (about 2 hours). Similarly, morphine concentrations in neonates receiving 20 micrograms/kg/hr for 24 hours were three times higher (52 +/- 31 ng/ml) than in older children receiving the same schedule. Two infants who received 32 and 40 micrograms/kg/hr, respectively, developed generalized seizures. Because of the apparently greater sensitivity to morphine and the lower elimination rate in newborn infants, the infused dose should not exceed 15 micrograms/kg/hr.

Half-Life↗
PubMed1985

Morphine-induced seizures in newborn infants.

Two neonates suffered from generalized seizures during the course of intravenous morphine sulfate for post-operative analgesia. They received morphine in doses of 32 micrograms/kg/hr and 40 micrograms/kg/hr larger than a group of 10 neonates who received 6-24 micrograms/kg/hr and had no seizures. Plasma concentrations of morphine in these neonates was excessive (60 and 90 mg/ml). Other known reasons for seizures were ruled out and the convulsions stopped a few hours after cessation of morphine and did not reoccur in the subsequent 8 months. It is suggested that post-operative intravenous morphine should not exceed 20 micrograms/kg/ml in neonates.

Humans↗
PubMedDate not supplied

Device closure of an atrial septal defect following successful balloon valvuloplasty in a neonate with critical pulmonary valve stenosis and persistent cyanosis.

Persistent cyanosis after successful balloon valvuloplasty for neonatal critical pulmonary valve stenosis is often related to poor right ventricular compliance and right-to-left shunting at the atrial level. A successful catheter closure of an atrial septal defect was performed with a dramatic increase in systemic oxygen saturation alleviating the need for a surgical systemic-to-pulmonary artery shunt.

Catheterization↗
PubMedDate not supplied

An evaluation of changes in composition and contamination of salvaged blood from the cardiopulmonary bypass circuit of pediatric patients.

OBJECTIVE: To review changes that occur during an 18-hour period in composition and bacterial contamination of blood salvaged from the cardiopulmonary bypass (CPB) circuit of pediatric patients. DESIGN: Prospective, blinded study. SETTING: Pediatric tertiary multidisciplinary intensive care unit. PATIENTS: One hundred and one children who underwent CPB. OUTCOME MEASURES: The degree of bacterial contamination and biochemical and hematologic alterations of blood salvaged from the CPB and any increased blood loss associated with reinfusion of this blood. INTERVENTION: The salvaged blood from the CPB circuit was collected into 1 L blood transfer packs after CPB. This blood was then stored at room temperature for 18 hours. Sampling occurred immediately after CPB and at 6 and 18 hours for biochemic and hematologic assay and for the detection of bacterial organisms. The amount of chest drainage loss was assessed in the first 18 hours after bypass. The type and amount of intravenous fluid infused also was recorded. RESULTS: Bacterial contamination occurred in three samples (two at 6 hours and in one of the preceding at 18 hours) of the 101 units of salvaged blood. All three positive cultures grew a coagulase-negative staphylococcus. Sodium and potassium remained within normal physiologic values. The glucose values declined from 15.8 to 13.4 mmol/L, and the hemoglobin values increased from 0.4 to 0.5 gm/dl. The reinfusion of the salvaged blood (and any other blood or blood products) to 31 of the 101 patients averaged 14.2 ml/kg/24 hr, with a mean chest drainage loss of 4.9 ml/kg/24 hr. The remaining 70 patients received 12.5 ml/kg/hr of either plasma expanders or blood, with a mean chest drainage loss of 6.0 ml/kg/24 hr. CONCLUSIONS: The results of this study demonstrate minimal chemical deterioration and limited microbiologic contamination in blood that was salvaged from the CPB circuit and stored at room temperature for an 18-hour period. No increase in postoperative bleeding was noted from the use of this blood. These results suggest it may be safe to reinfuse salvaged blood after CPB in pediatric patients for up to 18 hours; however, a prospective clinical trial is needed to validate these findings.

Blood↗