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Biomedical subjects

D J Macrae

Publications and source records attributed to D J Macrae.

27 records · Page 2Linked to original sources
PubMed1993

Inhaled nitric oxide for pulmonary hypertension after repair of exomphalos.

Inhaled nitric oxide was used successfully to treat a newborn infant with severe pulmonary hypertension complicating repair of congenital exomphalos. The infant had failed conventional treatment and extracorporeal membrane oxygenation was unsuitable because of the risk of bleeding from the recent laparotomy. Extended treatment with inhaled nitric oxide appears safe and may offer an alternative to mechanical life support in severe cases of neonatal pulmonary hypertension.

Administration, Inhalation↗
PubMed1993

ECMO parallels.

Explore the source record for details and available documents.

Cardiopulmonary Bypass↗
PubMed1991

Diamorphine analgesia after caesarean section. Comparison of intramuscular and epidural administration of four dose regimens.

In a randomised double-blind study, the efficacy, duration of action and side effects of five diamorphine analgesia regimens following Caesarean section are described. The time to next analgesia was shorter in the 5 mg intramuscular group (3.53 hours) than in any of the four epidural groups: 5 mg (5.7 hours, p = 0.007), 2.5 mg (4.76 hours, p = 0.103), 5 mg with adrenaline 1/200,000 (7.2 hours, p = 0.001) and 2.5 mg with adrenaline 1/200,000 (6.05 hours, p = 0.007). Multiple regression analysis showed that the addition of adrenaline significantly increased the duration of action of epidural diamorphine (p less than 0.05). The 5 mg dose with adrenaline showed no advantage when compared with 2.5 mg with adrenaline (p = 0.16). No serious side effects were reported in any group.

Adolescent↗
PubMed1989

Use of an intraaortic balloon pump as a pneumatic ventricular assist device controller.

Using a circulatory analogue, we investigated sequentially the performance of a dedicated ventricular assist device driver and an intraaortic balloon pump when driving a pneumatic ventricular assist device. Each drive device was compared under identical pumping conditions at rates of 40 to 120 cycles/min against two resistances. Our preliminary study showed that a modified intraaortic balloon pump could drive a pneumatic ventricular assist device as effectively as its dedicated driver. The necessary modifications to and possible further development of the intraaortic balloon in this role are discussed.

Assisted Circulation↗
PubMed1988

Effect of the addition of adrenaline to extradural diamorphine analgesia after caesarean section.

In a randomized double-blind study the effect of the addition of adrenaline to extradural diamorphine was assessed in 54 patients after Caesarean section. Patients received extradural diamorphine 5 mg in saline 10 ml with or without adrenaline 1 in 200,000 for postoperative pain relief. Analgesia was profound and of rapid onset in both groups. Duration of analgesia was greater in the adrenaline group (time to next analgesia 12.51 +/- 0.94 h, mean +/- SEM), than in the saline group (9.87 +/- 0.98 h) (P = 0.057). Analgesia was also more consistent in the adrenaline group, with 77% of patients having more than 8 h of good analgesia compared with 48% in the saline group (P less than 0.05). Plasma morphine concentrations, measured in 12 patients, were lower, although not significantly so, in the adrenaline group and mean time to peak concentration markedly delayed. No serious side effects were observed, but there was a higher incidence of vomiting in the adrenaline group.

Cesarean Section↗
PubMed1987

Double-blind comparison of the efficacy of extradural diamorphine, extradural phenoperidine and i.m. diamorphine following caesarean section.

A randomized, double-blind study of the efficacy, duration of action and side effects of three analgesic regimens following Caesarean section is described. Patients received i.m. diamorphine 5 mg, extradural phenoperidine 2 mg or extradural diamorphine 5 mg. Analgesia was of rapid onset in all groups, as judged by reductions in linear analogue pain scores and rank pain scores. Time to next analgesia was significantly greater after extradural phenoperidine (5.96 h) and extradural diamorphine (8.39 h) than after i.m. diamorphine (3.40 h) (P less than 0.001). Itching was reported on direct questioning by 50% of patients in the extradural groups. No serious side effects were reported. Factors affecting the disposition of extradurally administered diamorphine are discussed.

Adult↗
PubMed1986

Profound reduction in morphine clearance and liver blood flow in shock.

In six patients with septic shock apparent liver blood flow was significantly reduced compared with two patients restudied on recovery from shock and a group of four matched unshocked patients undergoing intensive care (287 +/- 23 ml/min vs 870 +/- 164 ml/min; mean +/- SEM). In the shocked patients the elimination half-life of morphine was significantly prolonged (13.2 +/- 3.5 h vs 5.9 +/- 1.4 h; mean +/- SEM) and the systemic clearance of morphine reduced by 53%, in comparison with the non-shocked patients. In both groups, morphine elimination was markedly delayed compared with previously reported observations in normal subjects and surgical patients. Care should be exercised with the use of drugs with a high hepatic extraction ratio in shocked patients.

Aged↗
PubMed1978

Comparison of oestriol in mother and fetus during labour and in the baby at birth.

The progressive rise in pregnancy of oestriol values and their significance in assessing fetal viability is well known, although the exact function of this increase is not understood. In considering the problem it was thought that further information of oestriol levels in mother, fetus and newborn could prove of value. The mean cord plasma oestriol was lower in small-for-dates than in normal cases, but in both groups it was ten times higher than in the relative maternal peripheral veins. In pooled capillary fetal scalp samples the mean oestriol was slightly higher in normal compared with small-for-dates cases. The use of gas chromatography--mass spectrometry was investigated and shown to give an accurate measurement of plasma oestriol levels. The expense of this procedure may be offset by its ability to determine simultaneously the nature and amount of other steroids present.

Birth Weight↗