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Biomedical subjects

C J Vallis

Publications and source records attributed to C J Vallis.

9 recordsLinked to original sources
PubMed1996

Is delayed surgery really better for congenital diaphragmatic hernia?: a prospective randomized clinical trial.

Delayed surgery has become widely accepted in the management of congenital diaphragmatic hernia after comparing outcomes only with historical retrospective controls. It was the aim of this study to compare early and delayed hernia repair in a randomized prospective clinical trial. Fifty-four infants were randomized to receive either early repair (within 4 hours of admission) or delayed repair (more than 24 hours after birth). The survival rate was higher for the delayed group (57% v 46%), but the difference was not significant (difference: -11; 95% confidence limits: -37.5, 15.5). There were no significant differences between the two groups with respect to length of hospital stay, ventilator dependency, or survival time. Recorded preoperative risk factors were similar for the two groups. Eight infants in the delayed repair group died without having undergone surgery. The optimum time for surgery still needs clarification.

Blood Gas Analysis↗
PubMed1996

A double-blind comparison of morphine infusion and patient controlled analgesia in children.

The analgesia provided after major abdominal surgery in 30 children by continuous morphine infusion and patient controlled analgesia, also using morphine, was compared using a double-blind, double-dummy design. The groups of children were comparable in age, weight, duration of operation and sex ratio. Pain assessment was carried out by a single observer using a visual analogue scale and the Poker Chip Tool. Assessments took place during two four-hour periods, one on the day of operation and one the following day. Children aged between nine and 15 years achieved better pain relief with patient controlled analgesia. No difference could be shown in children aged between five and eight years.

Adolescent↗
PubMed1996

Morphine consumption and respiratory depression in children receiving postoperative analgesia from continuous morphine infusion or patient controlled analgesia.

Thirty children, aged between five and 15 years, were randomly allocated to receive postoperative analgesia from continuous morphine infusion (CMI) or patient controlled analgesia (PCA), also using morphine. The children's morphine consumption, respiratory rates, oxygen saturations and observation points during which they were sleeping were recorded during two periods, one on the day of operation and one the following day. The median dose of morphine consumed by the children using PCA was significantly larger than that consumed by the children having continuous infusions. Children aged between nine and 15 years using PCA had significantly lower minimum respiratory rates and minimum oxygen saturations than similarly aged children receiving continuous infusions. There was no significant difference between the PCA and CMI groups in the number of observation times that the children were asleep or in the minimum respiratory rates and minimum oxygen saturations in the awake and sleeping children.

Adolescent↗
PubMed1987

Anaesthesia in the prune-belly syndrome. A review of 36 cases.

Between 1959 and 1984, 36 children with the prune-belly syndrome underwent 133 operations at the Hospital for Sick Children, Great Ormond Street. The anaesthetic and surgical problems have been reviewed. Minor postoperative respiratory tract infections followed eight anaesthetics. Three deaths occurred in the postoperative period. In two of these there were multifactorial causes, not directly related to the prune-belly syndrome. One death was related to the sequelae of the syndrome. Normal doses of muscle relaxants are recommended when intermittent positive pressure ventilation is used during anaesthesia. Monitoring of the patient's respiratory state and active physiotherapy are advisable postoperatively. Analgesics should be used with caution.

Anesthesia, General↗
PubMed1981

Intravascular mixed venous oxygen tension monitoring. An analysis of electrode performance in 100 patients.

A lengthened umbilical artery catheter incorporating an oxygen electrode (Searle) was flow-guided to the pulmonary artery in 48 out of 62 attempts (77.4%). In the last 70 catheters used, electrode performance was evaluated over a total of 3687 h by comparison with an ABL2 (Radiometer) blood-gas analyser; 654 comparisons were made, of which 255 resulted in recalibration of the electrode output. When sampling intervals were within 6 h, in more than 80% of the comparisons the difference between in vivo and in vitro measurement was within +/- 0.4 kPa (+/- 3 mm Hg). Twenty-four electrodes were removed sooner than clinically indicated (mean useful life 48.5 h) because of failure of oxygen or pressure measurements.

Blood Gas Analysis↗