Arterial blood gases during and their dynamic changes after cardiopulmonary resuscitation: A prospective clinical study

Background: Chronic pleural empyema (CPE) is the last phase of the triphasic process of pleural empyema development. Lung decortication is the corner stone in management of chronic empyema. This study aimed to objectively evaluate the efficacy of conventional decortication operation in chronic pleural empyema in adult patients. Also to prove that decortication of variable sizes of chronic empyema thoracis lesions is followed by improvement considering respiratory impairment. Methods: This prospective clinical study was conducted on 103 patients undergoing elective lung decortication operation for management of chronic empyema. All patients were subjected to the history taking, general examination, chest examination, computed tomography (CT), pulmonary function test and arterial blood gases. Postoperative evaluation was done in outpatient clinic 6 months post operatively including: Full clinical examination, investigations (acute phase reactants, CT chest, PFT and arterial blood gases. Results: Total leucocytic count, ESR 1st hour, ESR 2nd hour and CRP were significantly decreased in post than pre. FEV1 and FVC were significantly increased in post than pre (P <0.001). FEV1 / FVC Ratio was significantly decreased in post than pre (P <0.001). Transverse and antero-posterior diameters of affected hemithorax were significantly increased in post than pre (P <0.001, 0.019 respectively). Transverse and antero-posterior diameters of normal hemithorax were insignificantly different between post and pre. PaO2 and SpO2 were significantly increased in post than pre (P <0.001). PaCO2 was significantly decreased in post than pre (P <0.001). Conclusions: The improvement in the lung function, arterial blood gases, transverse and antero-posterior diameter of affected and normal hemithorax was proposed to have resulted from the decortication in chronic empyema thoracis. Decortication of variable sizes of chronic pleural empyema lesions is followed by objective improvement considering respiratory impairment.

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Arterial Blood Gases Fail to Reflect Acid-Base Status During Cardiopulmonary Resuscitation

Survey of Anesthesiology ◽

10.1097/00132586-198610000-00047 ◽

1986 ◽

Vol 30 (5) ◽

pp. 298

Author(s):

M. H. WEIL ◽

W. GRUNDLER ◽

M. YAMAGUCHI ◽

S. MICHAELS ◽

E. C. RACKOW

Keyword(s):

Cardiopulmonary Resuscitation ◽

Blood Gases ◽

Arterial Blood Gases ◽

Acid Base ◽

Arterial Blood ◽

Acid Base Status

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Extracorporeal cardiopulmonary resuscitation for post-operative cardiac arrest: indications, techniques, controversies, and early results – what is known (and unknown)

Cardiology in the Young ◽

10.1017/s1047951111001685 ◽

2011 ◽

Vol 21 (S2) ◽

pp. 109-117 ◽

Cited By ~ 21

Author(s):

Paul J. Chai ◽

Jeffrey P. Jacobs ◽

Heidi J. Dalton ◽

John M. Costello ◽

David S. Cooper ◽

...

Keyword(s):

Cardiac Arrest ◽

Cardiopulmonary Resuscitation ◽

Extracorporeal Membrane Oxygenation ◽

Cardiac Disease ◽

Blood Gases ◽

Arterial Blood Gases ◽

Extracorporeal Cardiopulmonary Resuscitation ◽

Arterial Blood ◽

Selection Of Patients ◽

Selection Of

AbstractExtracorporeal cardiopulmonary resuscitation may be defined as the use of extracorporeal membrane oxygenation for the support of patients who do not respond to conventional cardiopulmonary resuscitation. Data from national and international paediatric databases indicate that the use of extracorporeal cardiopulmonary resuscitation is increasing. Guidelines from the American Heart Association suggest that any patient with refractory cardiopulmonary resuscitation and potentially reversible causes of cardiac arrest is a candidate for extracorporeal cardiopulmonary resuscitation. One possible framework for selection of patients for extracorporeal cardiopulmonary resuscitation includes dividing patients on the basis of favourable or unfavourable characteristics. Favourable characteristics include cardiac disease, witnessed event in the intensive care unit, ability to deliver effective cardiopulmonary resuscitation, active patient monitoring present, favourable arterial blood gases, and early institution of extracorporeal membrane oxygenation. Unfavourable characteristics potentially include non-cardiac disease, an unwitnessed cardiac arrest, ineffective cardiopulmonary resuscitation, and severely acidotic arterial blood gases. Considering the significant resources and cost involved in the use of extracorporeal cardiopulmonary resuscitation, its use needs to be critically examined to improve outcomes, assess neurological recovery and quality of life, and help identify populations and other factors that may help guide in the selection of patients for successful extracorporeal cardiopulmonary resuscitation.

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