Biomedical subjects

S J Squire

Publications and source records attributed to S J Squire.

4 recordsLinked to original sources

PubMed1992

Positional oxygenation changes in air-transported neonates.

The effect of position on oxygenation was compared in 24 critically ill, premature neonates during pressurized, fixed-wing transport. The purpose of the study was to assess if there is a significant change in the arterial oxygen tension in the supine, prone, or prone-free positions during air transport. Neonates with endotracheal tubes in place who (1) had radiologic evidence of hyaline membrane disease, (2) had an umbilical artery catheter in place, and (3) required at least 1 hour of air transport to a level III intensive care center were admitted into the study after parental consent. There was an average 8% increase in oxygenation in the prone and prone-free positions when compared with the supine position. Although this difference might be considered clinically significant for the critically ill premature neonate, there was no statistically significant difference in arterial oxygen tension among the three positions tested in this study.

Aircraft↗

PubMed1990

Comparing two methods of umbilical artery catheter placement.

This study compared the conventional method of umbilical artery catheter placement with a side-entry method. Criteria for comparison were: (1) frequency of correct placement; (2) time required for placement; and (3) incidence of bleeding. Newborn infants less than 3 hours of age who required placement of a umbilical artery catheter were admitted into the study with parental consent. The sample size was 32 catheter attempts (16 conventional method and 16 side-entry method). The side-entry method resulted in more successful catheter placements and required less time without incidence of bleeding. With the conventional method, there were five failures to place the catheter and three incidents of bleeding, resulting in a total blood loss of 14 cc.

Catheterization↗

PubMedDate not supplied

Comparing two methods of topical anesthesia used before intravenous cannulation in pediatric patients.

INTRODUCTION: The purpose of this study was to compare the efficacy of two methods of topical anesthesia before venipuncture or intravenous cannulation of pediatric patients to assess which type of topical anesthetic would better alleviate pain in the least amount of time with the greatest success rate of cannulation. METHODS: This study was a randomly controlled trial of 100 preoperative pediatric patients aged 5 to 21 years. The following methods of topical anesthesia were compared: (a) iontophoresis of a topical solution of 2% lidocaine with epinephrine 1:100,000 using a Phoresor Dose Controller (PDC) with Numby Stuff electrodes and a eutectic mixture of local anesthetic and (b) 2.5% lidocaine and 2.5% prilocaine (eutectic mixture of local anesthetics [EMLA] cream). RESULTS: Children reported less pain with iontophoresis (M = 0.08) compared with EMLA cream (M = 1.88, P < .001). Time to accomplish topical anesthesia was shorter with iontophoresis (13 minutes) compared with EMLA cream (60 minutes, P < .001). Failure to accomplish venipuncture occurred 5 times with the iontophoresis method and 8 times with the EMLA method (not significant). No dermal burns resulted from use of iontophoresis. DISCUSSION: We conclude that use of iontophoresis in pediatric patients is safe, rapid, and significantly more effective than is EMLA cream in reducing pain associated with venipuncture or intravenous cannulation.

Administration, Topical↗

PubMedDate not supplied

Patterns of postnatal weight changes in infants with very low and extremely low birth weights.

OBJECTIVE: To describe (1) short-term postnatal weight loss and gain patterns in infants with very low and extremely low birth weights and (2) the variables that may affect these weight change patterns. DESIGN: Descriptive, retrospective review. SETTING: University hospital in the intermountain western United States. SUBJECTS: Sixty-two charts of infants admitted to a university neonatal intensive care unit from July 1990 through November 1992 were reviewed. Infants who weighed 1000 grams or less were categorized as extremely low birth weight (ELBW) and infants weighing 1001 to 1500 grams were categorized as very low birth weight (VLBW). Each group was comprised of 31 infants. Fifty percent of the sample were male, and 50% were female. Eighty-five percent of the sample were Anglo-American, and 15% were non-Anglo-American. MEASURES: Data were collected on a three-part data collection tool and included demographic and treatment variables. RESULTS: A significant difference was found in the maximum percent weight lost between the two groups, with the ELBW group losing a mean of 14.77% of birth weight and the VLBW group losing a mean of 11.35% of birth weight (t = 2.45, p < 0.05). The day the infants reached their nadir weight was significantly different between the two groups. The ELBW group reached their nadir on day of life 7, and the VLBW group reached their nadir on day of life 6 (t = 2.00, p < 0.05). No significant difference was noted in the time to return to birth weight between the two groups, with a mean of 15 days to return to birth weight. Factors associated with postnatal weight changes were intraventricular hemorrhage, use of diuretics and steroids, day of life when nadir weight occurred, and maximum percent of weight lost. Many of the independent variables were significantly interrelated to each other (r = -0.90 to r = 0.91, p < 0.01 to p < 0.001). However, only the variables that correlated with time to return to birth weight were entered into the regression analysis. These variables included number of days diuretics were given before return to birth weight, maximum percent of weight lost, and day of life the infants reached their nadir weight. Number of days diuretics were given before return to birth weight correlated significantly with time to return to birth weight (r = 0.77, F = 26.66, p < 0.0001) although maximum percent of weight lost and day of life the infants reached their nadir weight had a minimal effect. CONCLUSIONS: Further research into the effects of diuretic therapy on weight changes in this population of infants may lead to interventions to minimize the negative effects of diuretics on return to birth weight. In addition, the older growth charts may not be applicable to this population of infants. Generation of new growth charts that provide growth curves based on these data could be useful in developing nutritional therapies that would promote growth and possibly decrease the length of hospital stay for these infants.

Birth Weight↗