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Biomedical subjects

M C Rogers

Publications and source records attributed to M C Rogers.

At least 91 records · Page 5Linked to original sources
PubMed1980

Monitoring cerebral electrical function in the ICU.

The cerebral function monitor (CFM) (Devices Unlimited) is a single-channel, bipolar ECG device modified for continuous recording of cortical electrical activity. We have found the CFM useful in the Pediatric Intensive Care Unit (PICU), particularly in seizure patients, patients with increased intracranial pressure, and after cardiorespiratory arrest. The device and our experience with its use in the PICU are described in this paper.

Brain Edema↗
PubMed1980

Control of cerebral circulation in the neonate and infant.

Although much information is known about the factors controlling cerebral blood flow in the adult, there are significant physiological differences between the neonate, infant, and the adult. Therefore, it is not possible directly to transfer information concerning control of cerebral blood flow in the adult to the pediatric age population. A review of age-related differences in critical values of arterial oxygen tension (PaO2), arterial carbon dioxide tension (PaCO2), systemic arterial pressure and cerebral perfusion pressure (CCP) confirms that it is necessary to establish critical values in neonates and infants for each of these variables, as well as for any possible sympathetic nervous system influences on cerebral blood flow.

Adolescent↗
PubMed1980

Resuscitation and intensive care monitoring following immersion hypothermia.

Neurologic recovery occurred in a 3-year-old patient following immersion hypothermia and prolonged cardiopulmonary resuscitation. Recognition of hypothermia in the near-drowning victim is imperative for appropriate resuscitative efforts. Intensive care monitoring (intracranial pressure, pulmonary artery catheterization) facilitates patient management and optimum neurologic recovery.

Child, Preschool↗
PubMed1979

Neurogenic pulmonary edema in childhood.

Three patients presenting with pulmonary edema associated with head trauma and increased intracranial pressure are described. Pulmonary edema is a clearly recognized complication of head trauma; the pathogenic mechanisms appear to be regulated by increased intracerebral pressure, sympathetically induced vascular hypertension, and increased pulmonary capillary permeability. If there is evidence that neurogenic pulmonary edema is the underlying etiology, therapeutic modalities should be directed at reducing intracranial pressure and strict attention paid to the interaction between intrathoracic and intracranial pressures in order to avoid the high mortality rate associated with this condition.

Adolescent↗
PubMed1979

Pharmacology and use of muscle relaxants in infants and children.

Succinylcholine is a short-acting depolarizing neuromuscular blocker used to facilitate intubation; pancuronium is a longer-acting, nondepolarizing agent commonly employed to control ventilation in pediatric patients. The neuromuscular block produced by both drugs may be modified by patient age, acid-base and electrolyte status, body temperature, and drugs such as aminoglycoside antibiotics; adjustment in dose or in technique of administration may be required. Cardiovascular side-effects, primarily arrhythmias, are occasionally associated with the use of either agent. In contrast to that of succinylcholine, the paralysis from pancuronium is pharmacologically reversible with the combination of atropine and neostigmine.

Action Potentials↗
PubMed1979

Intracranial pressure in the cat during nitroglycerin-induced hypotension.

Intracranial pressure measurements were made during nitroglycerin-induced hypotension in the cat anesthetized with halothane. A total of 48 individual observations were made in eight animals. The administration of sufficient nitroglycerin to decrease mean arterial pressure from a control value of 87 +/- 7 torr by 12 +/- 4 torr resulted in an increase in mean intracranial pressure from a control value of 7 +/- 2 torr to 12 +/- 2 torr. Larger decreases in mean blood pressure were associated with larger increases in intracranial pressure. The increase in intracranial pressure was similar to that previously reported for nitroprusside, and greater as well as more reproducible than that reported for trimethaphan. Thus, nitroglycerin may produce significant increases in intracranial pressure, and this may be a limiting factor in its clinical use.

Anesthesia, Inhalation↗
PubMed1979

Experimental evaluation of 2F transthoracic thermodilution cardiac outputs in small animals.

Cardiac output can be measured with a computer using a 2F transthoracic catheter placed during surgery. When injections are made into a central venous catheter, this technique allows for cardiac output measurements to be made in children with complex congenital heart disease not appropriate for placement of a transvenous pulmonary artery catheter. Using rabbits similar in size to the infants most likely to need this technique, 26 experimental comparisons of thermodilution and indocyanine green dye cardiac outputs were made with cardiac outputs as low as 0.2-0.4 liter/min. The relationship between green dye and thermodilution was statistically significant (p less than 0.001) and almost linear (r = 0.92). This documents the validity of both the 2F transthoracic catheter technique in the low range of cardiac outputs appropriate for infants and children.

Animals↗
PubMed1979

Swan-Ganz catheterization in the critically ill newborn.

The authors placed Swan-Ganz catheters in 11 preterm and 2 term infants with severe cardiopulmonary distress. The infants ranged in weight from 1100-4000 g. The procedure was performed in the neonatal ICU by jugular venous cutdown. Intracardiac pressures and oxygen saturations were measured in each chamber entered. The authors also evaluated the presence of right to left shunting through the patent ductus arteriosus and assessed the degree of pulmonary arterial hypertension. In 5 hypoxemic infants, the authors found a patent ductus arteriosus with pulmonary hypertension. Intermittent measurement of PAP served as a guide to further therapy. In 2 infants, the unexpected diagnosis of cyanotic congenital heart disease was made. The placement of flow directed pulmonary arterial catheters in critically ill infants can be performed safely at the bedside and can provide useful diagnostic and therapeutic information.

Blood Gas Analysis↗
PubMed1979

Effects of closed-chest cardiac massage on intracranial pressure.

Closed-chest cardiac massage results in a marked increase in intrathoracic pressure and unusual patterns of blood flow. Among the physiological consequences of these changes appears to be a marked increase in intracranial pressure associated with chest compression as documented by the following patient case studies. While temporary, the marked nature of this rise in intracranial pressure suggests that the technique of closed-chest massage may, in itself, be responsible for clinically significant alterations in cerebral hemodynamics.

Adolescent↗
PubMed1979

Behavioral assessment for pediatric intensive care units.

Two studies were conducted to analyze behaviors of staff and patients on a Pediatric Intensive Care Unit (PICU). In the first study, behavioral observation procedures were employed to assess patient state, physical position, affect, verbal behaviors, visual attention and activity engagement, and staff verbal behavior. On the average, one-third of the patients were judged to be conscious and alert but markedly nonengaged with their environment. In the second study, a member of the hospital staff provided alert patients with individual activities to determine whether a simple environmental manipulation could positively affect behavior of children in intensive care. Employing a reversal design, the activity intervention was found to increase attention and engagement and positive affect, and to decrease inappropriate behavior. Both studies demonstrate that behavioral assessment procedures can provide an empirical basis for designing PICU routines affecting children's psychosocial status, and, thus, complement current procedures designed to provide quality medical care.

Adolescent↗
PubMed1979

Raised intracranial pressure: its management in Neisseria meningitidis meningoencephalitis.

Further reduction in morbidity and mortality from bacterial meningitis is unlikely to stem from innovations in antibiotic management. Emphasis must therefore be directed toward prevention, more rapid diagnosis, and improved therapy for maintaining the integrity of the CNS. Raised intracranial pressure is frequently associated with bacterial meningitis. In selected patients with bacterial meningitis and clinical evidence of elevated intracranial pressure, monitoring and aggressive treatment of this pressure could be crucial to survival.

Adolescent↗
PubMed1975

Percutaneous catheterization of the radial artery in the critically ill neonate.

Percutaneous catheterization of the radial artery appears to be a simple and safe alternative to catheterization of the umbilical artery for monitoring critically ill neonates. This avoids the serious and potentially fatal complications associated with use of the umbilical arterial catheter, and it is also applicable to monitoring of neonates in whom the umbilical artery is no longer patent. We observed no serious sequelae in cannulation of the radial artery and think that the technique should be used more widely.

Arm↗
PubMed1975

Prevention of apnea and bradycardia in low-birthweight infants.

The efficacy of theophylline in preventing severe apnea was evaluated in 17 low-birthweight infants (mean weight, 1,400 gm). Apnea was detected and accurately quantified by 13-hour pneumogram recordings and correlated with serum theophylline levels. Nursing observations coupled with on-line alarm systems detected only 39% of severe apneic episodes as compared to the pneumogram recording technique. Theophylline in six hourly oral doses(1.5 to 4.0 mg/kg) yielded two-hour serum concentrations of 6.6 to 11.0 mug/ml which completely controlled apneic spells exceeding 20 seconds in duration and markedly reduced 10- 19-second apneic episodes and any resultant bradycardia. At these serum levels, toxicity was not observed. Therapy with theophylline should be instituted at a dose of 2 to 3 mg/kg every six hours and the optimum therapeutic dose should be individualized as determined by objective quantitation of apnea and serum theophylline concentration.

Apnea↗