Abstract:
:Patients with tracheobronchial disease frequently require mechanical ventilation during therapy and experience iatrogenic complications such as barotrauma and volutrauma. The purpose of this study was to determine whether perfluorocarbon-associated gas exchange (PAGE) results in lower ventilatory pressures and more efficient ventilation than that provided by conventional ventilation after tracheobronchial mucosal injury caused by smoke inhalation in neonatal piglets. Ten piglets were used for this prospective, randomized study. After administration of a severe smoke inhalation injury, the piglets were randomly assigned to either the perfluorocarbon or control groups. Group 1 served as the control population and received standard (time-cycled, volume-limited) mechanical ventilation. Ventilator settings were adjusted to maintain physiological pH and PO2 at the lowest tidal volume, rate, and end-expiratory pressure possible throughout the study period. Group 2 was administered intratracheal perfluorocarbon as well as identical mechanical ventilation to attain the same physiological pH and PO2. Oxygenation index, peak and mean airway pressures, and arterial blood gas levels were measured throughout the study period and subjected to statistical analysis. Histological comparison of airway and parenchymal tissues confirmed identical patterns of smoke injury in both groups. Carbon monoxide levels were the same in both groups. There was significant barotrauma and volutrauma in the control group, but none in the PAGE group. All controls died from 13 to 17 hours after injury; one PAGE pig died at 23 hours with all others surviving past 24 hours (P = .0021). Peak, plateau, and mean airway pressures were all significantly higher (P < .05) past 12 hours after injury and continued to increase until death in the controls. Arterial blood gases showed significantly (P < .05) decreased pH, PO2, and elevated PcO2 levels in the control group past 12 hours after injury. The oxygenation index was significantly elevated (P < .05) in the control group past 12 hours after injury. PAGE shows potential for improving ventilation and survival immediately after severe smoke inhalation injury and may have clinical applications in other nonhomogeneous lung injuries.
journal_name
J Pediatr Surgjournal_title
Journal of pediatric surgeryauthors
Fitzpatrick JC,Jordan BS,Salman N,Williams J,Cioffi WG Jr,Pruitt BA Jrdoi
10.1016/s0022-3468(97)90177-9subject
Has Abstractpub_date
1997-02-01 00:00:00pages
192-6issue
2eissn
0022-3468issn
1531-5037pii
S0022-3468(97)90177-9journal_volume
32pub_type
杂志文章abstract::Malignant peritoneal mesothelioma (MPM) in children has been rarely described in the literature. During the last 10 years we have seen 2 cases. The first was a 2-year-old boy who died 3 months after surgery. The second is now alive two and a half years after the mesothelioma was found, has undergone 3 laparotomies for...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(85)80120-2
更新日期:1985-06-01 00:00:00
abstract:BACKGROUND:Primary hyperparathyroidism (PHPT) is uncommon in children. The surgical management of PHPT in children has evolved over the past two decades. METHODS:A retrospective study of patients who underwent parathyroidectomy for PHPT diagnosed at age < 18 years and managed at a tertiary referral center for endocrin...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2013.11.059
更新日期:2014-04-01 00:00:00
abstract::In the past 6 years, 50 patients with interstitial emphysema in our newborn nursery were treated with open operative procedures to remove interstitial air. Thirty-one were critically ill newborns with severe progressive pulmonary interstitial emphysema treated with pleurotomies. Five underwent pleurotomies on both sid...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(87)80010-6
更新日期:1987-01-01 00:00:00
abstract:BACKGROUND/PURPOSE:The Duhamel and transanal pull-through (TAPT) techniques have been commonly used for the treatment of children with Hirschsprung disease (HD). However, despite adequate treatment, some patients present with fecal incontinence that severely affects the quality of life (QoL) and lead to psychiatric dis...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2016.10.007
更新日期:2017-03-01 00:00:00
abstract:UNLABELLED:With the need for physicians to help control the rising cost of health care, consideration should be made, when appropriate, to shift more expensive inpatient care (IPC) to the less costly home care (HC) setting. The management of ruptured appendicitis (RA) includes appendectomy and intravenous (IV) antibiot...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/0022-3468(94)90327-1
更新日期:1994-02-01 00:00:00
abstract::Over a period of 18 months, we have inserted 20 Port-a-Caths in 19 children between the ages of 8 1/2 months and 18 years. The smallest child weighed 7 k. Three others weighed less than 12 k. The indication in all cases except two was the administration of cancer chemotherapy. The devices have been in use for periods ...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(87)80625-5
更新日期:1987-08-01 00:00:00
abstract::Iatrogenic ureteric injuries are an uncommon but difficult problem to manage. Although ureteric injury has been reported during hernia surgery in adults, it has not been reported in children during herniotomy. An 18-month-old male child underwent repair of an inguinal hernia and developed postoperative anuria. Investi...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2012.01.006
更新日期:2012-04-01 00:00:00
abstract:BACKGROUND:We describe an experimental model for transanal endorectal pull-through surgery using the method of de la Torre and Ortega that can be used for training purposes in experimental laboratories. METHODS:Ten rabbits were submitted to the transanal endorectal pull-through technique of de la Torre and Ortega. Ani...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2005.06.031
更新日期:2005-10-01 00:00:00
abstract::The authors report the case of a 7-month-old Japanese infant with congenital intrahepatic portosystemic shunts. He had hypergalactosaemia and hyperammonemia at age 1 month. The diagnosis was made by ultrasonography and angiography. Coil embolization was performed successfully, and then hyperammonemia and hypergalactos...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(99)90785-6
更新日期:1999-06-01 00:00:00
abstract::Postoperative pain control (PPC) in children is a difficult management problem. Systemic narcotics often result in respiratory depression, while nonnarcotic analgesics are associated with inconsistent PPC. This report reviews a 29-month (January 1989 through July 1991) experience with 174 children (aged < 18 years) wh...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/0022-3468(93)90616-s
更新日期:1993-04-01 00:00:00
abstract:PURPOSE:To assess the diagnostic accuracy of limited abdominal ultrasound (US) examination for midgut volvulus (MGV) and to evaluate how clinical practice has changed in a free-standing children's hospital leading to the near obsolescence of upper GI (UGI) studies for the diagnosis of MGV. MATERIALS AND METHODS:All pa...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2020.04.012
更新日期:2020-12-01 00:00:00
abstract::Kasai operation for biliary atresia (BA) and living-related liver transplantation (LRLT) for failed Kasai cases have been performed by the same team in our hospital. Outcome of the treatment for BA in the pretransplantation and posttransplantation era in our institution were compared. As the "pre" group, 35 children f...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(97)90682-5
更新日期:1997-08-01 00:00:00
abstract::Primary laparoscopic repair of Morgagni-Larrey hernia has been described in adult patients but not in children. This is the first report of primary laparoscopic correction in the pediatric age group without using a prosthesis. A Morgagni-Larrey hernia was found incidentally in a 3-year-old-girl. Laparoscopic correctio...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1053/jpsu.2000.8770
更新日期:2000-08-01 00:00:00
abstract::Children with anal atresia often have compromised function. This is especially common with the anatomic "high lesion." Twenty-five patients have been studied using clinical evaluation, computed tomography (CT), and manometry to make an objective evaluation. The patients were an average of 9.6 years old; the male-to-fe...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(05)80274-x
更新日期:1993-02-01 00:00:00
abstract:BACKGROUND/PURPOSE:We aim to justify the need for surgical intervention in our patients with childhood small bowel intussusceptions (SBIs) and review the current concepts in childhood SBI. MATERIALS AND METHODS:We retrospectively reviewed the clinical charts of all patients with surgically confirmed SBI between July 1...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2005.12.028
更新日期:2006-04-01 00:00:00
abstract:BACKGROUND:If creating an obstructive uropathy early in glomerulogenesis produces MCDK (Multicystic Dysplastic Kidney), then a very early obstruction may produce Potter's Syndrome (PS) with oligohydramnios. METHODS:Fetal lambs at 50 days' gestation underwent urethral and urachal ligation using fine SILASTIC (Dow Corni...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1053/jpsu.2000.18305
更新日期:2000-11-01 00:00:00
abstract::Buried penis has been variously attributed to obesity with excessive suprapubic fat, severe phimosis with trapping of the penis within the prepubic tissues, and inadequate fixation of the penile shaft skin at the base resulting in tenting. Previous attempts at surgical correction, by excising suprapubic fat, fixing pe...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/0022-3468(95)90702-5
更新日期:1995-05-01 00:00:00
abstract:OBJECTIVES:The objectives of the study were to provide a review of patients with giant omphalocele managed in a single institution (2001-2006), focusing on medical management in the neonatal period, and to evaluate short-term outcomes. METHODS:Data from 14 neonates with giant ompholocele (abdominal wall defect >5 cm a...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2010.04.011
更新日期:2010-08-01 00:00:00
abstract::Fibrinolytic agents have been used successfully in the management of loculated empyema; however, their use in the treatment of intraabdominal abscesses is limited. The authors describe the case of a 4-week-old girl with intraabdominal abscesses secondary to intestinal perforation that were not amenable to percutaneous...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(03)00275-6
更新日期:2003-08-01 00:00:00
abstract::The nutritional and metabolic complications following intestinal resection and ileostomy for necrotizing enterocolitis (NEC) in low birth weight preterm infants often necessitate repeated prolonged hospitalization for salt and water imbalance and reliance on total parentaral nutrition (TPN). The traditional concerns a...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(87)80432-3
更新日期:1987-02-01 00:00:00
abstract:PURPOSE:The purpose of this study was to compare the incidence and type of technical complications seen in a concurrent series of pyloromyotomies done open and laparoscopically. METHODS:The medical records of all patients who underwent pyloromyotomy for congenital hypertrophic pyloric stenosis over a 66-month period w...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2003.11.047
更新日期:2004-03-01 00:00:00
abstract::A classification of vaginal anomalies has been derived, which permits logical operative decisions. This tool allows the assignment of increasingly involved reconstructive operations to progressively more complex vaginal anatomies. The outcome of this approach in 49 vaginal reconstructions performed in 36 patients over...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/0022-3468(95)90573-1
更新日期:1995-02-01 00:00:00
abstract:AIM:The objective of this study is to investigate which central venous catheter dressing is most secure. BACKGROUND:Central venous catheter insertion is a common procedure. A secure dressing is essential to prevent early line displacement. Many different dressings are used, but there is no consensus in choosing an opt...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2008.10.103
更新日期:2009-02-01 00:00:00
abstract:PURPOSE:We present a new fistulectomy method for the second pharyngeal arch remnants. MATERIALS AND METHODS:Between 1991 and 2003, 4 patients have been treated with a new fistulectomy method. SURGICAL PROCEDURE:Under general anesthesia with nasotracheal intubation, the neck and mouth are prepared as one operative fie...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2005.07.045
更新日期:2005-11-01 00:00:00
abstract:BACKGROUND:There is limited time within the clinical workflow of most pediatric surgeons to obtain a comprehensive, well informed consent. This study evaluates whether ad-lib access to an online video on the consent dialogue enhances the consent process for inguinal hernia repair (IHR) in children. METHODS:The study w...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jpedsurg.2019.09.047
更新日期:2020-01-01 00:00:00
abstract:PURPOSE:Multiple visits for the evaluation, treatment, and follow-up of straightforward surgical problems are inconvenient, can result in lost work for the parents, and missed school for the child. We hypothesized that with proper previsit screening, patients with select diagnoses can be evaluated in an outpatient clin...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2011.10.047
更新日期:2012-01-01 00:00:00
abstract::The effects of truncal vagotomy and pyloroplasty and proximal gastric vagotomy on gastric acid hypersecretion, hypergastrinemia, and growth after massive bowel resection were studied in beagle puppies. In puppies with 80% enterectomy, neither type of vagotomy alters significantly the postprandial hypersecretion of aci...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(79)80011-1
更新日期:1979-08-01 00:00:00
abstract::Extrahepatic portal hypertension was induced in rats by portal venous constriction. Portal pressures on the fourth postconstriction day were significantly elevated in PVC rats when compared to control rats. Splenoportograms showed decreased hepatic flow and venous collaterals. Histologic sections showed gastric mucosa...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/0022-3468(75)90363-2
更新日期:1975-10-01 00:00:00
abstract::Only three primary peritoneal mesotheliomas in children have been previously reported. We describe a 6-wk-old girl with a papillary peritoneal mesothelioma of low grade malignancy. This is probably a congenital mesothelioma and is the youngest patient reported to date. ...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(83)80093-1
更新日期:1983-06-01 00:00:00
abstract:BACKGROUND/PURPOSE:The preferred treatment for children with major pancreatic ductal injury remains controversial. This report compares our results using early operation with previously reported series using both operative and nonoperative management. METHODS:This is a retrospective analysis of all children with pancr...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1053/jpsu.2001.20711
更新日期:2001-02-01 00:00:00