PubMed Health⌕ Search

Biomedical subjects

G Marraro

Publications and source records attributed to G Marraro.

At least 19 recordsLinked to original sources
PubMed1992

Inform: conceptual modelling of intensive care information systems.

Intensive care of a patient requires heavy monitoring and versatile therapeutic actions. These produce a huge amount of patient information. A problem exists in managing this data and other information from all supporting activities creating a need for an automated information management system. To have a sound basis for future automated information systems in intensive care unit (ICU), a conceptual model is created to cover both the clinical and other activities of the ICU. The conceptual model consists of data flow diagrams and entity-relationship diagrams with underlying common data dictionary. A modern CASE tool is utilized to build the model. The work forms a part of AIM-INFORM project, which has a purpose to develop information management and decision support systems for high dependency environment.

Computer Simulation↗
PubMed1992

INFORM: European survey of computers in intensive care units.

The aims of this study were (a) to survey and evaluate the impact of information technology applications in High Dependency Environments (HDEs) on organizational, psychological and cost-effectiveness factors, (b) to contribute information and design requirements to the other workpackages in the INFORM Project, and (c) to develop useful evaluation methodologies. The evaluation methodologies used were: questionnaires, case studies, objective findings (keystroke) and literature search and review. Six questionnaires were devised covering organizational impact, cost-benefit impact and perceived advantages and disadvantages of computerized systems in HDE (psychological impact). The general conclusion was that while existing systems have been generally well received, they are not yet designed in such a developed and integrated way as to yield their full potential. Greater user involvement in design and implementation and more emphasis on training emerged as strong requirements. Lack of reliability leading to parallel charting was a major problem with the existing systems. It proved difficult to assess cost effectiveness due to a lack of detailed accounting costs; however, it appeared that in the short term, computerisation in HDEs tended to increase costs. It is felt that through a better stock control and better decision making, costs may be reduced in the longer run and effectiveness increased; more detailed longitudinal studies appear to be needed on this subject.

Case-Control Studies↗
PubMed1992

Simultaneous independent lung ventilation in pediatric patients.

Current methods of ventilation do not allow adequate ventilation of the affected lungs in the presence of unilateral disease, e.g., unilateral atelectasis, diaphragmatic hernia, or lobar emphysema. Using a bilumen endotracheal tube and two independent ventilators, synchronized simultaneous independent lung ventilation (SILV) can be achieved. This technique provides a method of treating unilobar, unilateral, or multifocal lung disease effectively. This article describes the author's methodology and clinical experience with SILV.

Airway Resistance↗
PubMed1991

Acute respiratory failure and pulmonary thrombosis in leukemic children.

Acute respiratory failure (ARF) in an 11-year-old child with pre-T acute lymphoblastic leukemia (ALL) at the beginning of induction therapy was observed, connected with a pulmonary thrombosis and not with an infective origin. A systematic search for this pathology identified six other children with the same pulmonary complication, five of whom where in the early phase of acute nonlymphoblastic leukemia (ANLL) and one in induction therapy for ALL in marrow relapse. At the beginning of the symptomatology, all children presented severe hypoxia and hypercapnia, with no or minimal chest radiograph abnormalities and no clear hemodynamic involvement. In all patients the arteriography and nuclear imaging studies confirmed the diagnosis. The causes of the thrombi could be connected with neoplastic emboli after cell lysis and/or with the vascular damage resulting from antiblastic therapy. Intravenous urokinase treatment and respiratory assistance had been successfully carried out in six of seven children.

Acute Disease↗
PubMed1991

Follow-up on infants treated with porcine surfactant replacement for severe neonatal and infant respiratory distress syndrome: antigenic reactivity evaluation.

A follow-up was carried out on twenty-two children (thirteen of whom were newborn) who had been treated with porcine surfactant (Curosurf) for respiratory distress syndrome. All the infants were enrolled in the follow-up at different times after surfactant replacement to evaluate the clinical status and the incidence (if any) of respiratory disease, adverse drug effects and allergic conditions. Twelve of the twenty-two children treated completed the follow-up. Seven prematurely-born children died of endocranial haemorrhage; two children died of malignant development of the basal pathology (leukaemia). Treatment with pig surfactant appears to cause no allergic side effects. Skin and laboratory tests performed were negative.

Biological Products↗
PubMed1991

[The effects of administering surfactant to two adolescents with leukemia suffering from respiratory distress].

Two adolescents (12 years old, suffering from acute lymphoid leukaemia (LLA) and 16 years old with acute myeloid leukaemia (LMA)) were treated with porcine surfactant (Curosurf). The indication for this treatment was a severe Respiratory Distress Syndrome (RDS) which appeared during leukaemia treatment. Pulmonary thrombo-embolism was suspected. The surfactant administered improved ventilation and oxygenation, enabling confirmation of the diagnosis which would otherwise have been impossible due to the seriousness of their condition.

Acute Disease↗
PubMed1990

Thiopental efficacy in phenobarbital-resistant neonatal seizures.

The successful treatment with thiopental (10 mg/kg, i.v.) of 9 severely asphyxiated newborns, under artificial ventilation, with neonatal seizures resistant to phenobarbital, is reported in this pilot study. The clinical and electroencephalogram control of seizures was prompt and resolute. No adverse effect on cardiovascular function (heart rate, blood pressure) was observed. The terminal half-life of thiopental averaged 9 h, the total plasma clearance 0.20 l/h/kg, and the steady-state volume of distribution 3.6 l/h/kg. The kinetic profile of the drug compared to phenobarbital and phenytoin in newborns suggests that its action is quicker and shorter lasting. Thus, from these findings, thiopental may offer a useful and handy approach for the safe and effective treatment of phenobarbital-resistant neonatal seizures.

Drug Evaluation↗
PubMed1987

The clinical application of synchronized independent lung ventilation (S.I.L.V.) in pulmonary disease with unilateral prevalence in pediatrics.

The authors report on their results in the clinical use of S.I.L.V. using two synchronized Siemens 900 C Servo Ventilators. The Mallincrodt Broncho-Cath 28 and 35 Fr was used for the independent bronchial intubation of children over five; while for children under three, we used both two separate cuffless tubes of suitable length, and the double lumen tube of our own manufacture (the Marraro bilumen tube). The new method was applied to 13 children aged between 4 hours and 11 years. Duration of S.I.L.V. was between 8 hours and 5 days. The advantages of S.I.L.V. compared to C.V. were increases of F.R.C. and of effective ventilation in the more damaged lung, with a reduction of hyperventilation and consequent barotrauma in the less damaged lung. It was also possible to apply different levels of PEEP in the two lungs, and to reduce the concentration of oxygen in the gases ventilated. In all the patients treated, the application of the new method provided rapid clinical, blood-gas analytical, and radiological improvement. The children electively treated all survived.

Blood Pressure↗
PubMed1985

Elimination kinetics of thiopentone in mothers and their newborn infants.

The elimination kinetics of thiopentone was studied in 7 newborns delivered by Caesarean section and in their mothers who had received the drug for induction of anaesthesia. At delivery, 4-9 min after induction, drug concentrations in cord blood were half those in material blood. The mean half-life of thiopentone in the newborns was about double that in their mothers (15 vs 7 h) confirming a disposition similar to other barbiturates. For the first time renal clearance of thiopentone was estimated in the newborn; 0.074 ml/h/kg. Only 0.0007% (about 2 micrograms) of the maternal dose was recovered in the urine of newborns over 36 h. Pentobarbitone, an active metabolite, was not detected in any specimen. The findings demonstrate the reliability of current anaesthesiological technique (thiopentone-succinylcholine-oxygen) with minimal fetal exposure to the drug.

Cesarean Section↗