The utility of arterial blood gas parameters and chest radiography in predicting appropriate intubations in burn patients with suspected inhalation injury- a retrospective cohort study

Burns ◽  
2021 ◽  
Author(s):  
Minesh Chotalia ◽  
Christine Pirrone ◽  
Muzzammil Ali ◽  
Randeep Mullhi ◽  
Barbara Torlinska ◽  
...  
Keyword(s):  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Chest Radiography ◽  
Retrospective Cohort ◽  
Inhalation Injury ◽  
Burn Patients ◽  
Blood Gas ◽  
Arterial Blood Gas ◽  
Arterial Blood ◽  
Blood Gas Parameters

The Predictive Applicability of Liberal vs Restrictive Intubation Criteria in Adult Patients With Suspected Inhalation Injury—A Retrospective Cohort Study

2020 ◽  
Vol 41 (6) ◽  
pp. 1290-1296
Author(s):  
Minesh Chotalia ◽  
Christine Pirrone ◽  
Thomas Mangham ◽  
Barbara Torlinska ◽  
Randeep Mullhi ◽  
...  
Keyword(s):  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Inhalation Injury ◽  
Adult Patients ◽  
Queen Elizabeth Hospital ◽  
Burn Patients ◽  
Prolonged Intubation ◽  
Number Of Patients ◽  
Highly Sensitive

Abstract This study compares the ability of liberal vs restrictive intubation criteria to detect prolonged intubation and inhalation injury in burn patients with suspected inhalation injury. Emerging evidence suggests that using liberal criteria may lead to unnecessary intubation in some patients. A single-center retrospective cohort study was conducted in adult patients with suspected inhalation injury admitted to intensive care at Queen Elizabeth Hospital, Birmingham between April 2016 and July 2019. Liberal intubation criteria, as reflected in local guidelines, were compared to restrictive intubation criteria, as outlined in the American Burn Association guidelines. The number of patients displaying positive characteristics from either guideline was compared to the number of patients who had prolonged intubation (more than 48 hours) and inhalation injury. In detecting a need for prolonged intubation (n = 85), the liberal criteria had greater sensitivity (liberal = 0.98 [0.94–1.00] vs restrictive = 0.84 [0.75–0.93]; P = .013). However, the restrictive criteria had greater specificity (restrictive = 0.96 [0.89–1.00] vs liberal = 0.48 [0.29–0.67]; P < .001). In detecting inhalation injury (n = 72), the restrictive criteria were equally sensitive (restrictive = 0.94 [0.87–1.00] vs liberal = 0.98 [0.84–1.00]; P = .48) and had greater specificity (restrictive = 0.86 [0.72–1.00] vs liberal = 0.04 [0.00–0.13]; P < .001). In patients who met liberal but not restrictive criteria, 65% were extubated within 48 hours and 90% did not have inhalation injury. Liberal intubation criteria were more sensitive at detecting a need for prolonged intubation, while restrictive criteria were more specific. Most patients intubated based on liberal criteria alone were extubated within 48 hours. Restrictive criteria were highly sensitive and specific at detecting inhalation injury.

scholarly journals Sedative and cardiopulmonary effects of acepromazine, midazolam, butorphanol, acepromazine-butorphanol and midazolam-butorphanol on propofol anaesthesia in goats

2009 ◽  
Vol 80 (1) ◽  
Author(s):  
T.B. Dzikitia ◽  
G.F. Stegmanna ◽  
L.J. Hellebrekers ◽  
R.E.J. Auer ◽  
L.N. Dzikiti
Keyword(s):  
Saline Group ◽  
Control Group ◽  
Blood Gas ◽  
Arterial Blood Gas ◽  
Induction Dose ◽  
Normal Limits ◽  
Arterial Blood ◽  
Blood Gas Parameters ◽  
Induction Of Anaesthesia

The sedative, propofol-sparing and cardiopulmonary effects of acepromazine, midazolam, butorphanol and combinations of butorphanol with acepromazine or midazolam in goats were evaluated. Six healthy Boer - Indigenous African crossbreed goats were by randomised cross-over designated to 6 groups: Group SAL that received saline, Group ACE that received acepromazine, Group MID that received midazolam, Group BUT that received butorphanol, Group ACEBUT that received acepromazine and butorphanol and Group MIDBUT that received midazolam and butorphanol as premedication agents intramuscularly on different occasions at least 3 weeks apart. The degree of sedation was assessed 20 minutes after administration of the premedication agents. Thirty minutes after premedication, the dose of propofol required for induction of anaesthesia adequate to allow placement of an endotracheal tube was determined. Cardiovascular, respiratory and arterial blood-gas parameters were assessed up to 30 minutes after induction of general anaesthesia. Acepromazine and midazolam produced significant sedation when administered alone, but premedication regimens incorporating butorphanol produced inconsistent results. The dose of propofol required for induction of anaesthesia was significantly reduced in goats that received midazolam alone, or midazolam combined with either acepromazine or butorphanol. The quality of induction of anaesthesia was good in all groups, including the control group. Cardiovascular, respiratory and blood-gas parameters were within normal limits in all groups and not significantly different between or within all groups. In conclusion: sedation with midazolam alone, or midazolam combined with either acepromazine or butorphanol significantly reduces the induction dose of propofol with minimal cardiopulmonary effects in goats.

An update report on the harmonization of adult reference intervals in Australasia

2018 ◽  
Vol 0 (0) ◽  
Author(s):  
Gus Koerbin ◽  
Ken Sikaris ◽  
Graham R.D. Jones ◽  
Robert Flatman ◽  
Jillian R. Tate
Keyword(s):  
Royal College ◽  
Clinical Chemistry ◽  
Metrological Traceability ◽  
Reference Intervals ◽  
Evidence Based ◽  
Blood Gas ◽  
Arterial Blood Gas ◽  
The Past ◽  
Arterial Blood ◽  
Blood Gas Parameters

Abstract The Australasian Association of Clinical Biochemists (AACB) has over the past 5 years been actively working to achieve harmonized reference intervals (RIs) for common clinical chemistry analytes using an evidence-based checklist approach where there is sound calibration and metrological traceability. It has now recommended harmonized RIs for 18 common clinical chemistry analytes which are performed in most routine laboratories and these have been endorsed by the Royal College of Pathologists of Australasia (RCPA). In 2017 another group of analytes including urea, albumin and arterial blood gas parameters were considered and suggested harmonized RIs proposed. This report provides an update of those harmonization efforts.

scholarly journals The effects of lung volume reduction treatment on diffusing capacity and gas exchange

2020 ◽  
Vol 29 (158) ◽  
pp. 190171
Author(s):  
Marlies van Dijk ◽  
Karin Klooster ◽  
Nick H.T. Ten Hacken ◽  
Frank Sciurba ◽  
Huib. A.M. Kerstjens ◽  
...  
Keyword(s):  
Gas Exchange ◽  
Lung Volume ◽  
Diagnostic Techniques ◽  
Volume Reduction ◽  
Diffusing Capacity ◽  
Blood Gas ◽  
Lung Volume Reduction ◽  
Arterial Blood Gas ◽  
Arterial Blood ◽  
Blood Gas Parameters

Lung volume reduction (LVR) treatment in patients with severe emphysema has been shown to have a positive effect on hyperinflation, expiratory flow, exercise capacity and quality of life. However, the effects on diffusing capacity of the lungs and gas exchange are less clear. In this review, the possible mechanisms by which LVR treatment can affect diffusing capacity of the lung for carbon monoxide (DLCO) and arterial gas parameters are discussed, the use of DLCO in LVR treatment is evaluated and other diagnostic techniques reflecting diffusing capacity and regional ventilation (V′)/perfusion (Q′) mismatch are considered.A systematic review of the literature was performed for studies reporting on DLCO and arterial blood gas parameters before and after LVR surgery or endoscopic LVR with endobronchial valves (EBV). DLCO after these LVR treatments improved (40 studies, n=1855) and the mean absolute change from baseline in % predicted DLCO was +5.7% (range −4.6% to +29%), with no real change in blood gas parameters. Improvement in V′ inhomogeneity and V′/Q′ mismatch are plausible explanations for the improvement in DLCO after LVR treatment.

Arterial blood gas parameters of normal foals born at 1500 metres elevation

2009 ◽  
Vol 42 (1) ◽  
pp. 59-62 ◽  
Author(s):  
E. S. HACKETT ◽  
J. L. TRAUB-DARGATZ ◽  
J. E. KNOWLES Jr. ◽  
S. F. TARR ◽  
D. A. DARGATZ
Keyword(s):  
Blood Gas ◽  
Arterial Blood Gas ◽  
Arterial Blood ◽  
Blood Gas Parameters

Methicillin-ResistantStaphylococcus aureusPneumonia in Critically Ill Trauma and Burn Patients: A Retrospective Cohort Study

2017 ◽  
Vol 18 (2) ◽  
pp. 196-201 ◽  
Author(s):  
Kristen L. Bunnell ◽  
Andrew R. Zullo ◽  
Christine Collins ◽  
Charles A. Adams
Keyword(s):  
Cohort Study ◽  
Critically Ill ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Burn Patients
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