Biomedical subjects

J B Shah

Publications and source records attributed to J B Shah.

9 recordsLinked to original sources

PubMed1998

Umbilical artery catheters and blood flow velocities in the superior mesenteric artery: effect of insertion, removal, aspiration, and bolus infusion.

PURPOSE: We studied whether umbilical artery catheters (UACs) affect blood flow in the superior mesenteric artery (SMA) of neonates. METHODS: Noninvasive duplex pulsed Doppler sonography was used to measure peak systolic velocity, end-diastolic velocity, and mean flow velocity in the SMA. The resistance index and pulsatility index were calculated from these data. Thirty-two infants weighing 450-2,520 g at birth were enrolled in the study. Gestational age at birth was 24-37 weeks. Eighteen infants were studied before and after UAC insertion. Twenty infants were studied before and after UAC removal. Eleven infants with UACs were studied before and during aspiration of blood from the UAC and during bolus infusion of 5% dextrose solution into the UAC. Data were compared before and after UAC insertion; before and after UAC removal; and before and during aspiration and during bolus infusion. RESULTS: Blood flow velocities and vascular resistance were similar in all comparisons except for increases in end-diastolic and mean velocities after UAC insertion. CONCLUSIONS: Insertion and removal of UACs, aspiration of blood from UACs, and bolus infusion of fluids into UACs do not diminish blood flow velocity or increase vascular resistance in the SMA.

Blood Flow Velocity↗

PubMed1994

Safety and potential efficacy of an aerosolized surfactant in human sepsis-induced adult respiratory distress syndrome.

OBJECTIVE: To evaluate the safety and potential efficacy of aerosolized surfactant in intubated patients with adult respiratory distress syndrome (ARDS). DESIGN: A prospective, double-blind, placebo-controlled, randomized, parallel, multicenter pilot clinical trial. PATIENTS: A total of 51 patients with sepsis-induced ARDS were entered into the study within 18 hours of developing sepsis or sepsis syndrome. INTERVENTION: Patients were randomized into four treatment groups in a 2:1:2:1 ratio, as follows: 12 hours of surfactant per day, 12 hours of 0.6% saline per day, 24 hours of surfactant per day, and 24 hours of 0.6% saline per day. Surfactant or saline was aerosolized continuously for up to 5 days using an in-line nebulizer that aerosolized only during inspiration. MAIN OUTCOME MEASURES: Ventilatory data, arterial blood gases, and hemodynamic parameters were measured at baseline, every 4 or 8 hours during the 5 days of treatment, 24 hours after treatment, and 30 days after treatment, at which time mortality was also assessed. Safety was evaluated throughout the 30 days of the study. RESULTS: Surfactant was administered safely in ventilated patients when given continuously throughout the 5 days using the nebulizer system. Although there were no differences in any physiological parameters between the treatment groups, there was a dose-dependent trend in reduction of mortality from 47% in the combined placebo group to 41% and 35% in the groups treated with 12 hours and 24 hours of surfactant per day, respectively. CONCLUSIONS: Aerosolized surfactant was well tolerated when administered on a continuous basis for up to 5 days; however, at the doses given, it did not result in significant improvements in patients with sepsis-induced ARDS.

APACHE↗

PubMed1994

Extracorporeal membrane oxygenation in the successful treatment of traumatic adult respiratory distress syndrome: case report and review.

We present the case of a 25-year-old, 28-week pregnant woman with two gunshot wounds to the chest. Extracorporeal membrane oxygenation (ECMO) was begun within 12 hours, despite poor results in prior studies and the need for anticoagulation postoperatively, since oxygenation was rapidly deteriorating despite aggressive treatment. The patient ultimately made a full recovery.

Adult↗

PubMed1989