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Biomedical subjects

I A Murdoch

Publications and source records attributed to I A Murdoch.

70 records · Page 4Linked to original sources
PubMed1994

Arterial or mixed venous lactate measurement in critically ill children. Is there a difference?

Seven critically ill children had simultaneous measurement of whole blood lactate concentrations obtained from a systemic arterial and mixed venous (pulmonary artery) site. An excellent correlation was found (r = 0.995). The mean difference between arterial and mixed venous values was 0.02 mmol/l and the limits of agreement (+/- 0.22) were -0.20 to 0.24. The differences found were clinically insignificant (two-tailed paired Student's t-test; p = 0.36) and therefore support the continued use of arterial sampling for blood lactate measurement.

Arteries↗
PubMed1993

Rapid diagnosis of the cause of pneumoperitoneum in ventilated asthmatic children.

Two asthmatic children developed a pneumoperitoneum whilst being mechanically ventilated. A quick and accurate diagnosis as to the cause of the pneumoperitoneum was made by analysing the partial pressure of oxygen in the intraperitoneal free gas. This analysis helped to diagnose an intestinal perforation in one child and an air leak from lung barotrauma in the other. There was minimal delay in the surgical treatment of the child with intestinal perforation and in the other, an unnecessary laparotomy was avoided.

Asthma↗
PubMed1993

Core-peripheral temperature gradient in children: does it reflect clinically important changes in circulatory haemodynamics?

Following open heart surgery, changes in core and peripheral skin temperature and changes in the core-peripheral temperature gradient were measured in 10 children. These were correlated with changes in cardiac index, systemic vascular resistance index, mean arterial pressure and urinary output. During the study intervals, which lasted 1 h each, no changes in medical management were made. Using Spearman's rank correlation, only a change in central venous pressure was found to correlate with a change in the core-peripheral temperature gradient. We conclude that a change in the core-peripheral temperature will give valuable information about the patient's intravascular volume.

Blood Pressure↗
PubMed1993

Heparin-induced thrombocytopenia in children.

Two children aged 3 months and 14 years developed heparin-induced thrombocytopenia whilst receiving heparin. The clinical course was complicated by renal vein thrombosis in the 3-month-old infant and subcutaneous haemorrhage requiring resuscitation in the 14-year-old child. Anticoagulant therapy was discontinued immediately in the 3-month-old child. In the 14-year-old child, because of the need for continued anticoagulation therapy, low molecular weight heparin was used until warfarin could be substituted.

Adolescent↗
PubMed1993

Acute renal failure complicating diabetic ketoacidosis.

Two previously healthy children, aged 13 and 14 years, respectively, presented with diabetic ketoacidosis. Both children developed acute renal failure, a rare complication of diabetic ketoacidosis and required dialysis.

Adolescent↗
PubMed1991

Spontaneous hyphaema in childhood.

Between January 1987 and September 1989 three children presented to the childrens' casualty department with spontaneous hyphaema. Physical examination and haematological investigations were sufficient to determine their cause in two cases (sickle cell disease and acute lymphoblastic leukaemia). In the third child an ophthalmological examination under general anaesthesia revealed a granulomatous lesion of the iris consistent with the diagnosis of juvenile xanthogranuloma.

Anemia, Sickle Cell↗
PubMed1991

Balloon dilatation of a stenosed aortic homograft conduit following repair of the common arterial trunk.

An 8-year-old boy, who underwent surgical correction of a common arterial trunk at the age of 10 months, developed stenosis of the 15-mm aortic homograft. Chest x-ray demonstrated calcification of the homograft, and at cardiac catheterization there was a 57 mmHg gradient across the conduit. He underwent balloon dilatation using a 15-mm balloon catheter. After four inflations at a pressure of 5.5 atm, the gradient decreased to 34 mmHg. Six months later he had a Doppler-estimated gradient of 38 mmHg.

Angiography↗
PubMed1991

Treatment of hyperkalaemia with intravenous salbutamol.

Thirteen children with hyperkalaemia were treated by intravenous infusions of salbutamol, 4 micrograms/kg over 20 minutes. Reductions in the mean (SD) plasma potassium concentrations, of 1.48 (0.5) and 1.64 (0.5) mmol/l were obtained at 40 and 120 minutes, respectively, after completion of the infusions. No side effects were noted.

Acute Kidney Injury↗
PubMed1991

Fatal pneumococcal septicaemia associated with asplenia and isomerism of the right atrial appendages.

A 22 month old male infant with isomerism of the right atrial appendages (associated with a complete atrioventricular septal defect, double outlet right ventricle, and pulmonary valve stenosis) died from pneumococcal septicaemia after a 36 hour illness. He had not been given penicillin prophylaxis. Asplenia was confirmed at necropsy. In a survey of 50 paediatric cardiologists in the United Kingdom, 13 (33%) of the 40 (80%) who replied did not advise any prophylactic measures against pneumococcal infection in patients with isomerism of the right atrial appendages.

Heart Atria↗
PubMed1990

Continued need for pneumococcal prophylaxis after splenectomy.

Two children died from pneumococcal infection five and eight years after splenectomy. Pneumococcal vaccination had not been given to either child. When the infection developed both children were not taking prophylactic penicillin. Vaccination and daily penicillin reduce the incidence of this complication and therefore we strongly recommend that both of these measures are continued indefinitely.

Bacterial Vaccines↗
PubMedDate not supplied

Acute pseudoaneurysm formation complicating balloon dilation of native coarctation: treatment by delayed surgical repair.

An 11-year-old boy developed an acute aortic pseudoaneurysm during balloon dilation of unoperated coarctation of the aorta. The pseudoaneurysm occurred despite the fact that the balloon catheter size did not exceed the diameter of the aorta at the diaphragm. Elective delayed surgical repair was successfully performed after 3 weeks of antihypertensive treatment when serial magnetic resonance imaging had demonstrated a reduction in the local tissue swelling.

Acute Disease↗