Validation of the CORB75 (confusion, oxygen saturation, respiratory rate, blood pressure, and age ≥75 years) as a simpler pneumonia severity rule

Infection ◽  
2013 ◽  
Vol 42 (2) ◽  
pp. 371-378 ◽  
Author(s):  
O. Ochoa-Gondar ◽  
◽  
A. Vila-Corcoles ◽  
T. Rodriguez-Blanco ◽  
I. Hospital ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Oxygen Saturation ◽  
Respiratory Rate ◽  
Pneumonia Severity

scholarly journals The Effect of Live Spontaneous Harp Music on Patients in the Intensive Care Unit

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Ann Marie Chiasson ◽  
Ann Linda Baldwin ◽  
Carrol Mclaughlin ◽  
Paula Cook ◽  
Gulshan Sethi
Keyword(s):  
Blood Pressure ◽  
Intensive Care Unit ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Intensive Care ◽  
Oxygen Saturation ◽  
Respiratory Rate ◽  
Rest Period ◽  
Underlying Mechanism ◽  
To Receive

This study was performed to investigate the effect of live, spontaneous harp music on individual patients in an intensive care unit (ICU), either pre- or postoperatively. The purpose was to determine whether this intervention would serve as a relaxation or healing modality, as evidenced by the effect on patient’s pain, heart rate, respiratory rate, blood pressure, oxygen saturation, and heart rate variability. Each consenting patient was randomly assigned to receive either a live 10-minute concert of spontaneous music played by an expert harpist or a 10-minute rest period. Spontaneous harp music significantly decreased patient perception of pain by 27% but did not significantly affect heart rate, respiratory rate, oxygen saturation, blood pressure, or heart rate variability. Trends emerged, although being not statistically significant, that systolic blood pressure increased while heart rate variability decreased. These findings may invoke patient engagement, as opposed to relaxation, as the underlying mechanism of the decrease in the patients’ pain and of the healing benefit that arises from the relationship between healer, healing modality, and patient.

scholarly journals CONSCIOUS SEDATION FOR MIDDLE EAR SURGERIES: COMPARISON BETWEEN PROPOFOLAND MIDAZOLAM WITH RESPECT TO HEMODYNAMIC EFFECTS

2020 ◽  
pp. 1-4
Author(s):  
Firdos Girkar ◽  
Priyanka Jagavkar
Keyword(s):  
Blood Pressure ◽  
Oxygen Saturation ◽  
Respiratory Rate ◽  
Diastolic Blood Pressure ◽  
Middle Ear ◽  
Conscious Sedation ◽  
Sedation Score ◽  
Arterial Oxygen ◽  
Midazolam Group ◽  
The Difference

Background and aims: Middle ear surgeries can be done under local anesthetic infiltration and titrated dose of sedation. Use of supplemental intravenous sedative hypnotic drugs for these surgeries under local anesthesia can enhance patient comfort and increase acceptance of this technique. Our study was aimed to compare Propofol and Midazolam in equipotent doses for conscious sedation in middle ear surgeries Methods and material: After approval from the Institutional Ethics committee, 60 patients from ASA grade 1 and 2 scheduled for middle ear surgery (Tympanoplasty, mastoidectomy) under local anesthesia were randomly allocated into two groups to receive either Propofol (Group I) or Midazolam (Group II) for conscious sedation. Both the groups received premedication and sedation with 1.5 mcg /kg Fentanyl, Group 1 received Inj. Propofol bolus dose of 0.5-1 mg/Kg I.V, followed by infusion at the rate of 1.5-4.5 mg/kg/hour, to attain a sedation score of 3 and additional bolus doses were given as and when required to maintain a sedation score of 3. Group 2 received Inj. Midazolam bolus dose 0.03 to 0.05 mg/kg I.V followed by infusion at the rate of 0.03 to 0.06 mg/kg/hour to attain a sedation score of 3 and additional bolus doses as and when required to maintain a sedation score of 3. All the patients in both the groups received oxygen by nasal prongs at the flow rate of 4L/min from the start of sedation. Heart rate, systolic blood pressure, diastolic blood pressure, respiratory rate, oxygen saturation was noted at basal level and at an interval of 2 minutes and later every 5 mins for 30 mins then every 15 mins till end of surgery. Result: The results were analyzed using student’s 't’ test and chi square test wherever appropriate. Results: Pulse rate at 30th minute of sedation was not significantly different from the basal value among both the groups. Mean systolic blood pressure (SBP) in Propofol group was 121.33mmHg and 117.27mmHg among Midazolam group at basal which was comparable and the difference was not significant. Mean diastolic blood pressure was 78.47mmHg in Propofol group and 78.07mmHg among Midazolam group at basal which was comparable and the difference was not significant. Mean respiratory rate (breaths/min) among Propofol and Midazolam group were 16.83 and 16.70 respectively at basal which was comparable and the difference was not significant. Mean arterial oxygen saturation (%) among Propofol and Midazolam group were and 98.0 and 98.07 respectively at basal which was comparable and the difference was not significant. Conclusions: After the start of sedation mean diastolic blood pressure did not show any significant change in both the groups throughout the procedure. After the start of sedation mean respiratory rate and arterial oxygen saturation did not show any significant change in both the groups. Both Propofol and Midazolam are equally safe with respect to hemodynamic effects when used in titrated doses.

scholarly journals Just the Facts: Diagnosis and management of small bowel obstruction

CJEM ◽  
2020 ◽  
Vol 22 (5) ◽  
pp. 648-651
Author(s):  
Brit Long ◽  
Elisha Targonsky ◽  
Alex Koyfman
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Abdominal Pain ◽  
Small Bowel ◽  
Oxygen Saturation ◽  
Respiratory Rate ◽  
Small Bowel Obstruction ◽  
Vital Signs ◽  
Oral Temperature ◽  
Include Blood Pressure

A 63-year-old female patient presents with abdominal pain, vomiting, and abdominal distention. She has previously had a cholecystectomy and hysterectomy. She has had no prior similar episodes, and denies fever, hematemesis, or diarrhea. She takes no medications. Vital signs include blood pressure 123/61 mm Hg, heart rate 97, oral temperature 37.2°C, respiratory rate 18, oxygen saturation 97% on room air. Her abdomen is diffusely tender and distended.

Effects of a closed tracheal suction system on ventilatory and cardiovascular parameters

1992 ◽  
Vol 1 (3) ◽  
pp. 57-61 ◽  
Author(s):  
SA Harshbarger ◽  
LA Hoffman ◽  
TG Zullo ◽  
MR Pinsky
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Oxygen Saturation ◽  
Respiratory Rate ◽  
Arterial Oxygen Saturation ◽  
Control Mode ◽  
Arterial Oxygen ◽  
Acid Base ◽  
Suction System ◽  
Repeated Measures Design

OBJECTIVE: To determine whether patients ventilated in the assist-control mode experienced a change in oxygenation, respiratory rate, inspiratory:expiratory ratio, heart rate, blood pressure or acid-base balance when suctioned with a closed tracheal suction system. DESIGN: A quasi-experimental, within-subject, repeated-measures design was used. SUBJECTS: 18 patients ventilated on a fraction of inspired oxygen of 0.47 +/- 0.17 and 2.3 +/- 5.0 cm H2O positive end-expiratory pressure. INTERVENTIONS: Two suction passes were performed, with measurements at baseline, immediately after the first suction pass, immediately before the second suction pass, immediately after the second suction pass, 2 minutes after the second suction pass and 5 minutes after the second suction pass. No hyperoxygenation was used. RESULTS: Significant differences were seen over time for arterial oxygen saturation, respiratory rate and inspiratory:expiratory ratio. Arterial oxygen saturation decreased to less than 90% in four subjects (range 88% to 89%), with a maximum fall of 9%. No significant differences were seen for heart rate, blood pressure, partial pressure of carbon dioxide, bicarbonate, time to nadir (lowest arterial oxygen saturation) or recovery time. CONCLUSIONS: Subjects ventilated in the assist-control mode and suctioned with a closed tracheal suction system did not experience significant changes in cardiovascular or acid-base parameters when suctioned without hyperoxygenation. Although most subjects did not become desaturated, four subjects experienced desaturation at one or more intervals. To prevent desaturation, hyperoxygenation should be used before and after suctioning with a closed tracheal suction system.

scholarly journals Physiological Responses at Rest and Exercise to High Altitude in Lowland Children and Adolescents

Life ◽  
2021 ◽  
Vol 11 (10) ◽  
pp. 1009
Author(s):  
Morin Lang ◽  
Guillem Vizcaíno-Muñoz ◽  
Paulina Jopia ◽  
Juan Silva-Urra ◽  
Ginés Viscor
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Oxygen Saturation ◽  
Respiratory Rate ◽  
Children And Adolescents ◽  
Diastolic Blood Pressure ◽  
Arterial Oxygen Saturation ◽  
Submaximal Exercise ◽  
Arterial Oxygen ◽  
Children And Adolescent

During the last decades, the number of lowland children exposed to high altitude (HA) has increased drastically. Several factors may influence the development of illness after acute HA exposure on children and adolescent populations, such as altitude reached, ascent velocity, time spent at altitude and, especially, their age. The main goal of this study was to evaluate the resting cardiorespiratory physiological and submaximal exercise responses under natural HA conditions by means of the six-minute walking test (six MWT). Secondly, we aimed to identify the signs and symptoms associated with acute mountain sickness (AMS) onset after acute HA exposure in children and adolescents. Forty-two children and adolescents, 18 boys and 24 girls aged from 11 to 15 years old, participated in this study, which was performed at sea level (SL) and during the first 42 hours at HA (3330 m). The Lake Louise score (LLS) was recorded in order to evaluate the evolution of AMS symptoms. Submaximal exercise tests (six MWT) were performed at SL and HA. Physiological parameters such as heart rate, systolic and diastolic blood pressure, respiratory rate and arterialized oxygen saturation were measured at rest and after ending exercise testing at the two altitudes. After acute HA exposure, the participants showed lower arterial oxygen saturation levels at rest and after the submaximal test compared to SL (p < 0.001). Resting heart rate, respiratory rate and diastolic blood pressure presented higher values at HA (p < 0.01). Moreover, heart rate, diastolic blood pressure and dyspnea values increased before, during and after exercise at HA (p < 0.01). Moreover, submaximal exercise performance decreased at HA (p < 0.001). The AMS incidence at HA ranged from 9.5% to 19%, with mild to moderate symptoms. In conclusion, acute HA exposure in children and adolescent individuals produces an increase in basal cardiorespiratory parameters and a decrement in arterial oxygen saturation. Moreover, cardiorespiratory parameters increase during submaximal exercise at HA. Mild to moderate symptoms of AMS at 3330 m and adequate cardiovascular responses to submaximal exercise do not contraindicate the ascension of children and adolescents to that altitude, at least for a limited period of time.

“Cardio - respiratory effects in children aged 6-12 years in their first dental visit

2018 ◽  
Vol 14 (1) ◽  
Author(s):  
M González
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Oxygen Saturation ◽  
Respiratory Rate ◽  
Dental Visit ◽  
Systemic Diseases ◽  
Waiting Room ◽  
Cross Sectional ◽  
Respiratory Effects ◽  
Before And After

Objetive: A descriptive, cross-sectional studywas performed to determine the cardiorespiratoryeffects in child’s first dental visit to thePediatric Dental Clinic at Alas Peruanas University,without the presence of any pre-existingcondition, such as pain, previous traumatic dentalvisits, use of medications and systemic diseases. Material and méthodos: To accomplish this, heart rate, oxygen saturation, blood pressure,body temperature and respiratory rate were recordedon 70 children before (waiting room) andafter first dental visit (operating room) using afinger pulse oximeter, digital sphygmomanometer,thermometer and a wristwatch.  Results:showed basal and postoperative body temperatureregistered 36° C and 36.1° C, respectively.Basal systolic blood pressure registered 96 mmHg and postoperative 93 mm Hg, and basaldiastolic blood pressure registered 63 mm Hgand postoperative 63 mm Hg. Basal oxygen saturationregistered 96% and postoperative 93%.Basal heart rate registered 88 bpm and postoperative85 bpm. Basal respiratory rate registered20 bpm and postoperative 20 bpm. The authorconcluded that significant cardiorespiratorychanges exist during first dental visit, existingsignificant differences in oxygen saturation andrespiratory rate recorded before and after dentalcare.

scholarly journals Just the Facts: Postintubation sedation in the emergency department

CJEM ◽  
2020 ◽  
Vol 22 (6) ◽  
pp. 764-767
Author(s):  
Hans Rosenberg ◽  
Ariel Hendin ◽  
Erin Rosenberg
Keyword(s):  
Blood Pressure ◽  
Emergency Department ◽  
Heart Rate ◽  
Respiratory Distress ◽  
Oxygen Saturation ◽  
Respiratory Rate ◽  
Video Laryngoscopy

A 67-year-old male presents to the emergency department (ED) in respiratory distress secondary to pneumonia. His oxygen saturation is 86% on a nonrebreather, respiratory rate is 32 respirations/minute, blood pressure 147/72 mmHg, heart rate 121 beats/minute, and temperature is 38.7° Celsius. The decision is made to intubate the patient. Fentanyl and propofol are used for analgesia and sedation, and rocuronium is used for paralysis. Using video laryngoscopy, the patient is successfully intubated, and now the ED team is awaiting your orders for the postintubation sedation care of this patient.

Just the Facts: The Five F's of Focused Echocardiography in Shock

CJEM ◽  
2020 ◽  
Vol 22 (5) ◽  
pp. 655-657
Author(s):  
Paul Atkinson ◽  
Mandy Peach ◽  
David Lewis
Keyword(s):  
Lung Cancer ◽  
Blood Pressure ◽  
Emergency Department ◽  
Heart Rate ◽  
Systolic Blood Pressure ◽  
Oxygen Saturation ◽  
Respiratory Rate ◽  
Sinus Tachycardia ◽  
History Of ◽  
Focused Echocardiography

A 60-year-old female presents to the emergency department (ED) with a 3-day history of fatigue and mild breathlessness. She has a history of lung cancer. Her vitals indicate shock with a heart rate of 140 bpm, a systolic blood pressure (SBP) of 65 mmHg, a respiratory rate of 28, with an oxygen saturation of 90% on 100% a nonrebreather mask, and a normal temperature at 36°C. Her electrocardiograph (ECG) shows sinus tachycardia. She appears mottled and pale.

Sole Use of Dexmedetomidine Has Limited Utility for Conscious Sedation during Outpatient Colonoscopy

2005 ◽  
Vol 103 (2) ◽  
pp. 269-273 ◽  
Author(s):  
Przemyslaw Jalowiecki ◽  
Robert Rudner ◽  
Maciej Gonciarz ◽  
Piotr Kawecki ◽  
Michal Petelenz ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Side Effects ◽  
Oxygen Saturation ◽  
Respiratory Rate ◽  
Hemodynamic Instability ◽  
Treatment Regimens ◽  
Administration Regimen ◽  
Prolonged Recovery ◽  
Group D

Background This study evaluated the ability of dexmedetomidine to provide analgesia and sedation for outpatient colonoscopy, examining outcomes including cardiorespiratory variables, side effects, and discharge readiness. Methods Sixty-four patients were randomly assigned to one of three treatment regimens. In group D, patients received 1 microg/kg dexmedetomidine over 15 min followed by an infusion of 0.2 microg x kg x h. Group P received meperidine (1 mg/kg) with midazolam (0.05 mg/kg), and group F received fentanyl (0.1-0.2 mg intravenous) on demand. The assessment included measurements of heart rate, blood pressure, oxygen saturation, respiratory rate, quality of sedation/analgesia, and an evaluation of the recovery time. Results The study was terminated before the planned 90 patients had been recruited because of adverse events in group D. In all groups, negligible hemoglobin oxygen saturation and respiratory rate variations were observed. In group D, there was a significantly larger decrease in heart rate (to approximately 40 beats/min in 2 of 19 cases) and blood pressure (to less than 50% of the initial value in 4 of 19 patients). Supplemental fentanyl was required in 47% of patients receiving dexmedetomidine to achieve a satisfactory level of analgesia (vs. 42.8% of patients in group P and 79.2% of patients in group F). Vertigo (5 patients), nausea/vomiting (5 patients), and ventricular bigeminy (1 patient) were observed only in group D. Time to home readiness was longest in group D (85 +/- 74, 39 +/- 21, and 32 +/- 13 min in groups D, P and F, respectively; P = 0.007). Conclusions The use of dexmedetomidine to provide analgesia/sedation for colonoscopy is limited by distressing side effects, pronounced hemodynamic instability, prolonged recovery, and a complicated administration regimen.

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