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Biomedical subjects

E K Cotton

Publications and source records attributed to E K Cotton.

12 recordsLinked to original sources
PubMed1979

Partial obstruction of endotracheal tubes in children: incidence, etiology, significance.

We examined 99 endotracheal tubes removed from 81 pediatric patients to determine the incidence of partial endotracheal tube obstruction and predisposing factors. The overall incidence of obstruction was 20.2% (20/99); 14 of the 20 obstructed tubes were occluded less than 50%. General anesthesia during the period of intubation was the only factor significantly associated with an increased incidence of obstruction (p less than 0.05). There was no correlation of obstruction with duration of intubation, the presence of a Murphy-eye side hole, or small tube size. Among the 71 tubes from patients who received general anesthesia, a tube size of 4 mm or less was associated with an increased incidence of obstruction (p less than 0.05). Pressure-flow curves for three different sizes of endotracheal tubes were constructed to determine the increase in resistance produced by different degrees of obstruction. At flow rates that approximated those found in children during quiet breathing, the resistance of tubes that were 50% obstructed was 4 times greater than that found in unobstructed tubes.

Adolescent↗
PubMed1979

Intravenous linoleic acid supplementation in children with cystic fibrosis.

Ten children with CF in matched pairs were infused with either Intralipid or with 10% glucose on a double blind basis every other week for one year. Although statistically there was significantly greater gain in height and weight in the study year compared to the previous year only for the test group, both groups improved more than expected. Cumulative data analysis showed greater improvement for the Intralipid group (23 of a possible 45 points) compared to the glucose group (-2 points; P less than .02). This study indicates the need to better define the role of nutrition in the pathophysiology of CF. Meanwhile, it is recommended that all children with CF have plasma linoleic acid levels measured at least once yearly, and if levels are low, appropriate supplements should be given.

Arachidonic Acids↗
PubMed1978

Nebulized racemic epinephrine by IPPB for the treatment of croup: a double-blind study.

Racemic epinephrine has been advocated for the treatment of croup, but controlled studies have not proved it more effective than saline. Twenty patients (aged 4 months to 5 years) hospitalized with acute croup and persistent inspiratory stridor at rest were randomly assigned to one of two treatment groups: saline or racemic epinephrine, both nebulized and delivered by intermittent positive pressure breathing. Clinical scores were significantly improved (P less than .01) at ten and 30 minutes following the treatment with racemic epinephrine but not at 120 minutes. Racemic epinephrine was significantly more effective than saline at 10 (P less than .01) and 30 minutes (P less than .05) but not at 120 minutes after the treatment. We conclude that nebulized racemic epinephrine is effective treatment for the acute signs of croup.

Acute Disease↗
PubMed1976

Respiratory failure associated with familial depression of ventilatory response to hypoxia and hypercapnia.

Respiratory failure has been associated with depressed ventilatory responses to hypoxia or hypercapnia or both. The possibility that familial factors are responsible for decreased chemosensitivity prompted this study of a child with unexplained respiratory failure and normal lung function. We found his ventilatory response to hypoxia and hypercapnia to be virtually absent. Studies of six healthy immediate family members (parents and siblings) showed that hypoxic response, as measured by an index of the relation between ventilation and hypoxia (index A), was consistently reduced: 45 +/- 8.7 S.E.M. (normal, 127 +/- 8.7) (P less than 0.005). Response to hypercapnia, measured as the slope of the ventilatory response to hypercapnia, was lower than normal, averaging 0.95 +/- 0.16 liters per minute per millimeter of mercury (normal, 1.76 +/- 0.13) (P less than 0.01). The patient's respiratory failure seemed related to deficient ventilatory responses to hypoxia and hypercapnia. It seems likely that this depressed hypoxic response is of familial origin.

Adolescent↗
PubMed1976

Management of life-threatening asthma with intravenous isoproterenol infusions.

Thirty-four patients with life-threatening childhood status asthmaticus were treated with intravenous isoproterenol infusions. Twenty-seven responded favorably; seven failed to respond and underwent mechanical ventilation. Intravenously administered isoporterenol was a useful therapeutic adjunct in the treatment of these severe attacks. Complications in these cases were rare, but cardiac arrhythmia, rebound bronchospasm, and acute mobilization of secretions need to be considered. Further evaluation of the efficacy of intravenous infusions of isoproterenol in status asthmaticus would be valuable.

Adolescent↗
PubMed1976

Home management of bronchopulmonary dysplasia.

Home oxygen was utilized in six infants with BPD with no complications. This program allowed for early discharge of the infants, resulting in a mean financial savings of $18,000 per infant and a more normal family environment for the babies.

Bronchial Diseases↗
PubMed1975

The use of humidity in asthmatic children.

Controversy exists as to the advisability of mist therapy in pulmonary disease. We studied the effects of several forms of humidity on asthmatic airways. Thirty-four children were tested over a period of 8 months as follows: (1) mist with a mean particle size of 3 mu was delivered for 30 min by an ultrasonic nebulizer to 11 children individually in a plastic tent; (2) to another 11 subjects in a tent, mist with a mean particle size of 10 mu was delivered by a jet nebulizer for 30 min;3) 15 patients in a croup room recieved for 30 min water droplets ranging from a microscopic fog to large rain particles (mean 16 mu) generated by a Melco natural fog generator; (4) 10 children were challenged with 3 solutions used commonly for the production of mist: distilled water, half-normal saline, and normal saline. Pulmonary functions were studied on each patient pre- and post-mist exposure. Approximately two thirds of the patients had a significant response, either improvement or deterioration, when challenged with the various forms of mist. No particular group trends were produced either by increasing the mean particle size of humidity, or by using solutions of increasing salinity.

Adolescent↗