scholarly journals ORi™: a new indicator of oxygenation

2021 ◽  
Author(s):  
Yusuke Ishida ◽  
Toshio Okada ◽  
Takayuki Kobayashi ◽  
Hiroyuki Uchino
Keyword(s):  
Respiratory Function ◽  
Early Stage ◽  
Anesthetic Management ◽  
Perioperative Period ◽  
Arterial Oxygen ◽  
Reserve Capacity ◽  
Monitoring Method ◽  
Unit Scale ◽  
Noninvasive Monitor ◽  
Near Future

AbstractIn the perioperative period, hypoxemia and hyperoxia are crucial factors that require attention, because they greatly affect patient prognoses. The pulse oximeter has been the only noninvasive monitor that can be used as a reference of oxygenation in current anesthetic management; however, in recent years, a new monitoring method that uses the oxygen reserve index (ORi™) has been developed by Masimo Corp. ORi is an index that reflects the state of moderate hyperoxia (partial pressure of arterial oxygen [PaO2] between 100 and 200 mmHg) using a non-unit scale between 0.00 and 1.00. ORi monitoring performed together with percutaneous oxygen saturation (SpO2) measurements may become an important technique in the field of anesthetic management, for measuring oxygenation reserve capacity. By measuring ORi, it is possible to predict hypoxemia and to detect hyperoxia at an early stage. In this review, we summarize the method of ORi, cautions for its use, and suitable cases for its use. In the near future, the monitoring of oxygen concentrations using ORi may become increasingly common for the management of respiratory function before, after, and during surgery.

scholarly journals General anesthesia with remimazolam in a patient with mitochondrial encephalomyopathy: a case report

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Yuji Suzuki ◽  
Matsuyuki Doi ◽  
Yoshiki Nakajima
Keyword(s):  
Lactic Acidosis ◽  
General Anesthesia ◽  
Mitochondrial Disease ◽  
Muscle Relaxation ◽  
Anesthetic Management ◽  
Perioperative Period ◽  
Mitochondrial Encephalomyopathy ◽  
Anesthesia Induction ◽  
General Anesthetic ◽  
Anesthetic Agents

Abstract Background Systemic anesthetic management of patients with mitochondrial disease requires careful preoperative preparation to administer adequate anesthesia and address potential disease-related complications. The appropriate general anesthetic agents to use in these patients remain controversial. Case presentation A 54-year-old woman (height, 145 cm; weight, 43 kg) diagnosed with mitochondrial encephalomyopathy with lactic acidosis and stroke-like episodes underwent elective cochlear implantation. Infusions of intravenous remimazolam and remifentanil guided by patient state index monitoring were used for anesthesia induction and maintenance. Neither lactic acidosis nor prolonged muscle relaxation occurred in the perioperative period. At the end of surgery, flumazenil was administered to antagonize sedation, which rapidly resulted in consciousness. Conclusions Remimazolam administration and reversal with flumazenil were successfully used for general anesthesia in a patient with mitochondrial disease.

scholarly journals Experts’ opinion on the detection and management of prediabetes in Lebanon

2021 ◽  
Vol 104 (3) ◽  
pp. 003685042110294
Author(s):  
Emile Andari ◽  
Paola Atallah ◽  
Sami Azar ◽  
Akram Echtay ◽  
Selim Jambart ◽  
...  
Keyword(s):  
Risk Factors ◽  
Preliminary Report ◽  
Early Stage ◽  
National Guidelines ◽  
Lifestyle Modifications ◽  
Multiple Tests ◽  
Lebanese Population ◽  
To Come ◽  
Near Future

Given that the complications of type 2 diabetes can start at an early stage, early detection and appropriate management of prediabetes are essential. We aimed to develop an expert opinion on prediabetes in Lebanon to pave the way for national guidelines tailored for the Lebanese population in the near future. A panel of seven diabetes experts conducted a thorough literature review and discussed their opinions and experiences before coming up with a set of preliminary recommendations for the detection and management of prediabetes in Lebanon. Lebanese physicians employ multiple tests for the diagnosis of prediabetes and no national cut-off values exist. The panel agreed that prediabetes screening should be focused on patients exceeding 45 years of age with otherwise no risk factors and on adults with risk factors. The panel reached that fasting plasma glucose (FPG) and HbA1c should be used for prediabetes diagnosis in Lebanon. FPG values of 100–125 mg/dL or HbA1c values of 5.7%–6.4% were agreed upon as indicative of prediabetes. For the management of prediabetes, a three-step approach constituting lifestyle modifications, pharmacological treatment and bariatric surgery is recommended. There should be more focus on research on prediabetes in Lebanon. This preliminary report will be further discussed with the Lebanese Society of Endocrinology, Diabetes and Lipids in 2021 in order to come up with the first Lebanese national guidelines for the detection and management of prediabetes in Lebanon.

scholarly journals Blockchain Applications in Agribusiness: A Systematic Review

2021 ◽  
Vol 13 (4) ◽  
pp. 95
Author(s):  
Geneci da Silva Ribeiro Rocha ◽  
Letícia de Oliveira ◽  
Edson Talamini
Keyword(s):  
Complex System ◽  
Systematic Review ◽  
Web Of Science ◽  
Scientific Literature ◽  
Early Stage ◽  
Technological Development ◽  
Economic Sectors ◽  
Future Studies ◽  
Blockchain Technology ◽  
Near Future

Blockchain is a technology that can be applied in different sectors to solve various problems. As a complex system, agribusiness presents many possibilities to take advantage of blockchain technology. The main goal of this paper is to identify the purposes for which blockchain has been applied in the agribusiness sector, for which a PRISMA-based systematic review was carried out. The scientific literature corpus was accessed and selected from Elsevier’s Scopus and ISI of Knowledge’s Web of Science (WoS) platforms, using the PRISMA protocol procedures. Seventy-one articles were selected for analysis. Blockchain application in agribusiness is a novel topic, with the first publication dating from 2016. The technological development prevails more than blockchain applications since it has been addressed mainly in the Computer Sciences and Engineering. Blockchain applications for agribusiness management of financial, energy, logistical, environmental, agricultural, livestock, and industrial purposes have been reported in the literature. The findings suggest that blockchain brings many benefits when used in agribusiness supply chains. We concluded that the research on blockchain applications in agribusiness is only at an early stage, as many prototypes are being developed and tested in the laboratory. In the near future, blockchain will be increasingly applied across all economic sectors, including agribusiness, promoting greater reliability and agility in information with a reduced cost. Several gaps for future studies were observed, with significant value for science, industry, and society.

scholarly journals Remimazolam anesthesia for cardiac surgery with cardiopulmonary bypass: a case report

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Kota Saito ◽  
Sho Ohno ◽  
Makishi Maeda ◽  
Naoyuki Hirata ◽  
Michiaki Yamakage
Keyword(s):  
Cardiac Surgery ◽  
Cardiopulmonary Bypass ◽  
Oxygen Saturation ◽  
Anesthetic Management ◽  
Perioperative Period ◽  
Maze Procedure ◽  
Intraoperative Awareness ◽  
Case Presentation ◽  
Venous Oxygen Saturation ◽  
Index Value

Abstract Background Remimazolam has less cardiovascular depressant effects than propofol in non-cardiac surgical patients. However, the efficacy and safety of remimazolam in cardiac surgery with cardiopulmonary bypass (CPB) have not been reported. We present a case of successful anesthetic management using remimazolam in cardiac surgery with CPB. Case presentation A 76-year-old female was scheduled for mitral valve repair, tricuspid annuloplasty, maze procedure, and left atrial appendage closure. We used remimazolam in induction (6.0 mg/kg/h) and maintenance (0.6–1.0 mg/kg/h) of general anesthesia, and the bispectral index value was maintained in the range of 36 to 48 including the period of CPB. Hemodynamics, mixed venous oxygen saturation, and bilateral regional cerebral oxygen saturation were maintained within acceptable ranges. There was no intraoperative awareness/recall or serious complications associated with remimazolam throughout the perioperative period. Conclusions Remimazolam can be used the same as other existing anesthetics in cardiac surgery with CPB.

Effect of Acute Hemorrhage on Transcutaneous, Subcutaneous, Intramuscular, and Arterial Oxygen Tensions

PEDIATRICS ◽  
1980 ◽  
Vol 65 (5) ◽  
pp. 881-883
Author(s):  
Frederick A. Matsen ◽  
Craig R. Wyss ◽  
Racheal V. King ◽  
Charles W. Simmons
Keyword(s):  
Arterial Oxygen ◽  
Peripheral Blood Flow ◽  
Danger Signal ◽  
Close Approximation ◽  
Monitoring Method ◽  
Acute Hemorrhage ◽  
Tissue Po2 ◽  
Oxygen Tensions ◽  
Arterial Po2 ◽  
Transcutaneous Po2

Although transcutaneous Po2 is a close approximation of arterial Po2 in most neonates, infants in shock often show lower transcutaneous than arterial Po2 values. For a better understanding of this discrepancy, we investigated the effect of acute hemorrhage on transcutaneous, tissue, and arterial Po2 in rabbits. With progressive hemorrhage, transcutaneous and tissue Po2 values declined steeply while arterial Po2 values did not. We speculate that the progressive decrement in transcutaneous and tissue Po2 values with hemorrhage is produced by diminished peripheral blood flow. Rather than representing a failure of the transcutaneous Po2 monitoring method, we speculate that transcutaneous hypoxia with shock may be a clinically valuable danger signal.

scholarly journals Effect of respiratory training apparatus and vibration expectoration vest on expectoration in patients with lung cancer resection

2018 ◽  
Vol 5 (4) ◽  
pp. 285-289
Author(s):  
Xiao-Jing Guo ◽  
Li-Li Wei ◽  
Xin-Hui Li ◽  
Ning- Ning Yu ◽  
Shao-Bo Gao ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Cancer Patients ◽  
Respiratory Function ◽  
Perioperative Period ◽  
Control Group ◽  
Observation Group ◽  
Pulmonary Atelectasis ◽  
Cancer Resection ◽  
Lung Cancer Patients ◽  
Respiratory Training

Abstract Objective The aim of this study was to explore the safe and effective method of expectoration in the preoperative period of patients with lung cancer resection and to promote the rehabilitation of patients. Methods A total of 100 cases of lung cancer patients undergoing elective surgery were divided into the observation group and the control group, with 50 cases in each group. The control group was treated with vibration expectoration vest for expectoration during the perioperative period, and the observation group was treated with respiratory function exerciser that has expectoration function in the perioperative period, three times a day, and the effect was evaluated after 5 days. Results The number of patients in the observation group after the first expectoration time was significantly less than that of the control group (P<0.001). Pain score, pulmonary atelectasis, and pulmonary infection rate of the observation group were significantly lower than those of the control group; the hospitalization time was significantly shorter than that of the control group; and the difference was statistically significant (P<0.05). Conclusions Lobectomy for lung cancer patients with perioperative respiratory training for respiratory function exercise, compared with conventional methods, is helpful for postoperative expectoration and to reduce the incidence of adverse events.

scholarly journals IT Governance Analysis and Design of Microfinance Institution Using COBIT 5 Framework Evaluate, Direct, Monitor (EDM) and Align, Plan, and Organize (APO) Domains (Case Study: PT Sarana Jabar Ventura)

2017 ◽  
Vol 1 (01) ◽  
pp. 1-6
Author(s):  
Fernaldi Jonathan ◽  
Rahmat Mulyana ◽  
Yuli Adam Prasetyo
Keyword(s):  
Early Stage ◽  
It Governance ◽  
Financial Service Authority ◽  
Analysis And Design ◽  
Governance Analysis ◽  
Microfinance Institution ◽  
Small Medium Enterprises ◽  
Medium Enterprises ◽  
Near Future ◽  
A Company

A microfinance institute (LKM/ Lembaga Keuangan Mikro) is a company that focuses in providing funds to small, early-stage, and emerging firms or small medium enterprises. A company that is engaged in financial sector and works under the surveillance of OJK/ FSA (Financial Service Authority) always has some questions whether this company really needs to implement IT Governance best practices or to what extent it does. The research in PT Sarana Jabar Ventura as one of the microfinance institutes using COBIT 5 framework for the domain of EDM (Evaluate-Direct-Monitor) & APO (Align-Plan-Organize) has shown that the existing practice is not adequate enough to align the business to IT and to manage its risk optimally so the IT solution will be beneficial for the business. Therefore, it is necessary to design the IT governance practice here, based on the seven enablers of COBIT 5 which are categorized into 3 aspects: process, people, and technology. The results of this research are design recommendations as follows: IT policy, procedures, organization structure, job description and the supporting tools and technology. It is expected that the company will implement the results in the near future. Keywords—COBIT 5, IT governance, microfinance institution

scholarly journals Multimodal anesthesia and analgesia at the stages of the perioperative period in children with abdominal surgical pathology

2021 ◽  
Vol 24 (1) ◽  
pp. 27-31
Author(s):  
Elmira A. Satvaldieva ◽  
Otabek Ya. Fayziev ◽  
Anvar S. Yusupov
Keyword(s):  
General Anesthesia ◽  
Postoperative Period ◽  
Surgical Intervention ◽  
Anesthetic Management ◽  
Perioperative Period ◽  
Postoperative Recovery ◽  
Surgical Pathology ◽  
Abdominal Organ ◽  
Epidural Blockade ◽  
Abdominal Operations

Aim of the study was assess both the effectiveness and safety of anesthetic management and optimizing postoperative anesthesia under conditions of multimodal anesthesia and analgesia during abdominal operations in children. Patients and methods. The authors examined 58 children aged 1 to 17 years with abdominal operations (malformations, diseases, and abdominal organ injuries). To ensure anesthetic protection, patients underwent combined general anesthesia with propofol and fentanil (induction) with inhalation of sevoflurane + propofol intra venous (maintenance) in combination with epidural blockade with bupivacaine. Results. According to surgical intervention, the arrangement of perioperative analgesic protection provided a favorable correction of the hemodynamic status of patients, a decrease in inhalation anesthetic, promoted a smooth course of the postoperative period, a long painless period, an excellent psychoemotional background, and rapid postoperative recovery.

scholarly journals Ascending Aortic Aneurysm, Wandering towards Old Problem with New Insight

2014 ◽  
Vol 2 (2) ◽  
pp. 49-59
Author(s):  
KK Tiwari ◽  
S Bevilacqua ◽  
A Salvati ◽  
E Varone ◽  
M Solinas ◽  
...  
Keyword(s):  
Aortic Aneurysm ◽  
Early Stage ◽  
Anesthetic Management ◽  
Surgical Techniques ◽  
Aortic Diameter ◽  
Ascending Aortic Aneurysm ◽  
Mortality And Morbidity ◽  
Asymptomatic Patients ◽  
Complex Process ◽  
Patients At Risk

Ascending aortic aneurysm is a silent and highly lethal disease. Generally, ascending aorta grows asymptomatically until it dissect or rupture. In case of acute complication mortality is as high as 90%, whereas if treated on time mortality and morbidity decreases significantly. Pathophysiology of the Ascending aortic aneurysm is a complex process. Aorta itself is an organ and it should not be considered merely as a tube transporting blood from heart to the organs. Several non-invasive and invasive imaging methods are available at disposition to diagnose this indolent killer at early stage. However, discrepancies exists about when to operate these patients. Several other methods has been reported to identify these patients at risk of dissection or rupture. Conservative treatment could be used in patients with small aortic diameter, but effectiveness of such approach is under scrutiny. Emerging endovascular treatment using stents should be advocated with caution. Surgical treatment, the gold standard, is recommended for asymptomatic patients with aortic diameter of 5.5cm, whereas 4-4.5cm for patients with Marfan's disease. Postoperative morbidity and mortality has significantly decreased due to better anesthetic management, improved surgical techniques and progress in preoperative and postoperative care. DOI: http://dx.doi.org/10.3126/jucms.v2i2.11175 Journal of Universal College of Medical Sciences (2014) Vol.2(2): 49-59

scholarly journals Virus-Based Immunotherapy of Glioblastoma

Cancers ◽  
2019 ◽  
Vol 11 (2) ◽  
pp. 186 ◽  
Author(s):  
Miika Martikainen ◽  
Magnus Essand
Keyword(s):  
Immune Responses ◽  
Oncolytic Virus ◽  
Early Stage ◽  
Primary Brain Tumor ◽  
Oncolytic Viruses ◽  
Preclinical Models ◽  
Adjuvant Effect ◽  
Cell Responses ◽  
Near Future ◽  
Stimulation Of

Glioblastoma (GBM) is the most common type of primary brain tumor in adults. Despite recent advances in cancer therapy, including the breakthrough of immunotherapy, the prognosis of GBM patients remains dismal. One of the new promising ways to therapeutically tackle the immunosuppressive GBM microenvironment is the use of engineered viruses that kill tumor cells via direct oncolysis and via stimulation of antitumor immune responses. In this review, we focus on recently published results of phase I/II clinical trials with different oncolytic viruses and the new interesting findings in preclinical models. From syngeneic preclinical GBM models, it seems evident that oncolytic virus-mediated destruction of GBM tissue coupled with strong adjuvant effect, provided by the robust stimulation of innate antiviral immune responses and adaptive anti-tumor T cell responses, can be harnessed as potent immunotherapy against GBM. Although clinical testing of oncolytic viruses against GBM is at an early stage, the promising results from these trials give hope for the effective treatment of GBM in the near future.

Sign in / Sign up

Export Citation Format

Share Document