Effect of Acupuncture on Bronchial Asthma

1976 ◽  
Vol 51 (5) ◽  
pp. 503-509 ◽  
Author(s):  
D. Y. C. Yu ◽  
S. P. Lee
Keyword(s):  
Smooth Muscle ◽  
Bronchial Asthma ◽  
Flow Rate ◽  
Clinical Remission ◽  
Blood Gas ◽  
Arterial Blood Gas ◽  
Arterial Blood ◽  
Before And After ◽  
The Mean ◽  
Needle Acupuncture

1. Needle acupuncture was performed at three sites in twenty patients in a clinical attack of bronchial asthma. 2. In all patients the symptoms of bronchoconstriction improved during the attacks when the correct site was stimulated, and in five patients wheezing was abolished. 3. Stimulation at the correct site produced a significant increase in the mean FEV1·0 (58%) and FVC (29%) but not in maximal mid-expiratory flow rate (MMFR; 76%), when compared with the findings before acupuncture, along with a significant fall in the Pa,co2 and an insignificant fall in Pa,o2. A mild tachycardia was also observed. 4. After acupuncture a greater improvement in FEV1·0, FVC and MMFR was produced by inhalation of isoprenaline. 5. No significant changes in FEV1·0, FVC, MMFR, pulse rate or arterial blood gas tensions occurred after acupuncture at control sites. 6. In four of the patients during clinical remission acupuncture was performed before and after histamine aerosol challenge, but there was no effect on either the severity or the duration of the histamine-induced bronchoconstriction. 7. It is concluded that acupuncture probably reduced the reflex component of the bronchoconstriction, but failed to influence direct smooth muscle constriction caused by histamine.

scholarly journals Severe hypoxaemia in field-anaesthetised white rhinoceros (Ceratotherium simum) and effects of using tracheal insufflation of oxygen

2004 ◽  
Vol 75 (2) ◽  
Author(s):  
M. Bush ◽  
J.P. Raath ◽  
D. Grobler ◽  
L. Klein
Keyword(s):  
Blood Pressure ◽  
Tracheal Intubation ◽  
Blood Gas ◽  
Arterial Blood Gas ◽  
Arterial Blood ◽  
White Rhinoceros ◽  
Severe Hypoxaemia ◽  
Before And After ◽  
Tracheal Insufflation ◽  
Free Ranging

White rhinoceros anaesthetised with etorphine and azaperone combination develop adverse physiological changes including hypoxia, hypercapnia, acidosis, tachycardia and hypertension. These changes are more marked in field-anaesthetised rhinoceros. This study was designed to develop a technique to improve safety for field-anaesthetised white rhinoceros by tracheal intubation and oxygen insufflation. Twenty-five free-ranging white rhinoceros were anaesthetised with an etorphine and azaperone combination for translocation or placing microchips in their horns. Once anaesthetised the rhinoceros were monitored prior to crating for transportation or during microchip placement. Physiological measurements included heart and respiratory rate, blood pressure and arterial blood gas samples. Eighteen rhinoceros were intubated using an equine nasogastric tube passed nasally into the trachea and monitored before and after tracheal insufflation with oxygen. Seven rhinoceros were not intubated or insufflated with oxygen and served as controls. All anaesthetised rhinoceros were initially hypoxaemic (percentage arterial haemoglobin oxygen saturation (% O2Sa) = 49 % + 16 (mean + SD) and PaO2 = 4.666 + 1.200 kPa (35 + 9 mm Hg)), hypercapnic (PaCO2 = 8.265 + 1.600 kPa (62 + 12 mm Hg)) and acidaemic (pHa = 7.171 + 0.073 ). Base excess was -6.7 + 3.9 mmol/ℓ, indicating a mild to moderate metabolic acidosis. The rhinoceros were also hypertensive (systolic blood pressure = 21.861 + 5.465 kPa (164 + 41 mm Hg)) and tachycardic (HR = 107 + 31/min). Following nasal tracheal intubation and insufflation, the % O2Sa and PaO2 increased while blood pHa and PaCO2 remained unchanged.Tracheal intubation via the nose is not difficult, and when oxygen is insufflated, the PaO2 and the % O2Sa increases, markedly improving the safety of anaesthesia, but this technique does not correct the hypercapnoea or acidosis. After regaining their feet following reversal of the anaesthesia, the animals' blood gas values return towards normality.

scholarly journals Twenty-Four Hour Noninvasive Ventilation in Duchenne Muscular Dystrophy: A Safe Alternative to Tracheostomy

2013 ◽  
Vol 20 (1) ◽  
pp. e5-e9 ◽  
Author(s):  
Douglas A McKim ◽  
Nadia Griller ◽  
Carole LeBlanc ◽  
Andrew Woolnough ◽  
Judy King
Keyword(s):  
Respiratory Failure ◽  
Duchenne Muscular Dystrophy ◽  
Muscular Dystrophy ◽  
Noninvasive Ventilation ◽  
Gas Analysis ◽  
Blood Gas ◽  
Safe Alternative ◽  
Arterial Blood Gas ◽  
Arterial Blood ◽  
The Mean

BACKGROUND: Almost all patients with Duchenne muscular dystrophy (DMD) eventually develop respiratory failure. Once 24 h ventilation is required, either due to incomplete effectiveness of nocturnal noninvasive ventilation (NIV) or bulbar weakness, it is common practice to recommend invasive tracheostomy ventilation; however, noninvasive daytime mouthpiece ventilation (MPV) as an addition to nocturnal mask ventilation is also an alternative.METHODS: The authors’ experience with 12 DMD patients who used 24 h NIV with mask NIV at night and MPV during daytime hours is reported.RESULTS: The mean (± SD) age and vital capacity (VC) at initiation of nocturnal (only) NIV subjects were 17.8±3.5 years and 0.90±0.40 L (21% predicted), respectively; and, at the time of MPV, 19.8±3.4 years and 0.57 L (13.2% predicted), respectively. In clinical practice, carbon dioxide (CO2) levels were measured using different methods: arterial blood gas analysis, transcutaneous partial pressure of CO2and, predominantly, by end-tidal CO2. While the results suggested improved CO2levels, these were not frequently confirmed by arterial blood gas measurement. The mean survival on 24 h NIV has been 5.7 years (range 0.17 to 12 years). Of the 12 patients, two deaths occurred after 3.75 and four years, respectively, on MPV; the remaining patients continue on 24 h NIV (range two months to 12 years; mean 5.3 years; median 3.5 years).CONCLUSIONS: Twenty-four hour NIV should be considered a safe alternative for patients with DMD because its use may obviate the need for tracheostomy in patients with chronic respiratory failure requiring more than nocturnal ventilation alone.

scholarly journals Bedside Pulse Oximeters with a Clinical Algorithm Make Economic Sense in the Intensive Care Unit

1996 ◽  
Vol 3 (1) ◽  
pp. 47-51
Author(s):  
David J Leasa ◽  
Jacqueline M Walker
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Pulse Oximeter ◽  
Cost Savings ◽  
Clinical Algorithm ◽  
Arterial Blood Gas ◽  
Arterial Blood ◽  
Before And After ◽  
The Mean ◽  
Pulse Oximeters

OBJECTIVE:To determine the effect on arterial blood gas (ABG) and hospital resource use by introducing a strategy of using bedside oximeters with a clinical algorithm, based on the argument that bedside pulse oximeters make economic sense in the intensive care unit (ICU) if safe patient oxygenation can be ensured at a lower cost than that of existing monitoring options.DESIGN:A before and after design was used to examine the consequences of a pulse oximeter at each bedside in the ICU along with a pulse oximeter clinical algorithm (POCA) describing use for titrating oxygen therapy and for performing ABG analysis.SETTING:A 19-bed multidisciplinary ICU with a six-bed extended ICU (EICU) available to function as a 'step-down' facility.PATIENTS:All patients admitted to the ICU/EICU over two 12-month periods were included.RESULTS:The strategy yielded a 31% reduction in the mean number of ABGs per patient after POCA (20.0±26.1 versus 13.8±16.7, mean ± SD; P<0.001) as well as a potential annual cost savings of $32,831.CONCLUSIONS:Bedside oximeters within the ICU, when used with explicit guidelines, reduce ABG use and result in hospital cost savings.

scholarly journals Reducing inappropriate arterial blood gas testing in a level III intensive care unit: a before-and-after observational study

2020 ◽  
Vol 22 (4) ◽  
pp. 370-377
Author(s):  
Oliver M Walsh ◽  
◽  
Katelyn Davis ◽  
Jonathan Gatward ◽  
◽  
...  
Keyword(s):  
Intensive Care ◽  
Clinical Guideline ◽  
Ventilatory Support ◽  
Clinical Indication ◽  
Blood Gas ◽  
Stable Patient ◽  
Arterial Blood Gas ◽  
Arterial Blood ◽  
Before And After ◽  
Mortality Ratio

Background: Arterial blood gas (ABG) analysis is the most frequently performed test in intensive care units (ICUs), often without a specific clinical indication. This is costly and contributes to iatrogenic anaemia. Objectives: To reduce the number of ABG tests performed and the proportion that are inappropriate. Design, setting and participants: The indications for ABG analysis were surveyed at a 58-bed level III ICU during fortnightly periods before and after a multifaceted educational intervention which included the introduction of a clinical guideline. The number of ABG tests performed during the period July–December 2017 was compared with that for the period July–December 2018. Tests were predefined as inappropriate if performed at regular time intervals, at change of shift, concurrently with other blood tests or after a treatment was ceased on a stable patient or after ventilatory support or oxygen delivery was decreased in an otherwise stable patient. The study was enrolled on the Quality Improvement Projects Register and ethics approval was waived by the local ethics committee. Results: There was a 31.3% bed-day adjusted decrease in number of ABG tests performed (33 005 v 22 408; P < 0.001), representing an annual saving of A$770 000 and 100 litres of blood. The proportion of inappropriate ABG tests decreased by 47.3% (54.2% v 28.6%; P < 0.001) and the number of inappropriate ABG tests per bed-day decreased by 71% (2.8 v 0.8; P < 0.001). Patient outcomes before and after the intervention did not differ (standardised mortality ratio, 0.65 v 0.63; P = 0.22). Conclusion: Staff education and implementation of a clinical guideline resulted in substantial decreases in the number of ABG tests performed and the proportion of inappropriate ABG tests.

scholarly journals Comparison of time taken to obtain an arterial blood gas result at the bedside using the ProximaTM point of care machine vs. a standard remote arterial blood gas analyser: A randomized controlled trial

2020 ◽  
pp. 175114372097384
Author(s):  
Kay Mitchell ◽  
Karen E Salmon ◽  
David Egbosimba ◽  
Gavin Troughton ◽  
Mike PW Grocott
Keyword(s):  
Point Of Care ◽  
Controlled Trial ◽  
Blood Gas ◽  
Sampling System ◽  
Arterial Blood Gas ◽  
Arterial Blood ◽  
The Mean ◽  
Time Away ◽  
Mean Time ◽  
Reduced Time

Introduction The ProximaTM point of care (POC) device enables arterial blood gas (ABG) samples to be analysed without the nurse leaving the patient. The benefits of this for work efficiency have not been evaluated. Methods We compared the time taken to obtain an ABG result using ProximaTM versus a standard ABG sampling system. Twenty patients were randomized to ABG sampling using ProximaTM, or a standard ABG system. Nurses were observed performing all ABG sampling episodes for a minimum of 24 hours and no more than 72 hours. Results The mean time taken to obtain a result using ProximaTM was 4:56 (SD = 1:40) minutes compared to 6:31 (SD = 1:53) minutes for the standard ABG technique (p < 0.001). Mean time away from the patient's bedside was 3.07 (SD = 1:17) minutes using the standard system and 0 minutes using ProximaTM (p < 0.001). Conclusions Reduced time for blood gas sampling and avoidance of time away from patients may have significant patient safety and resource management implications, but the clinical and financial significance were not evaluated.

Adrenal gland denervation and diving in ducks

1987 ◽  
Vol 252 (6) ◽  
pp. R1143-R1151
Author(s):  
H. J. Mangalam ◽  
D. R. Jones ◽  
A. M. Lacombe
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Adrenal Gland ◽  
Plasma Glucose ◽  
Adrenal Glands ◽  
Blood Gas ◽  
Arterial Blood Gas ◽  
Arterial Blood ◽  
O2 Partial Pressure ◽  
Before And After

The extreme elevation in plasma levels of free norepinephrine (NE) and free epinephrine (EP), which occurs during forced diving of ducks (Anas platyrhynchos), was studied before and after denervation of the adrenal glands. In intact animals both NE and EP concentration increased by up to two orders of magnitude in a 4-min dive but by a significantly lesser amount if the duck breathed O2 before the dive. Denervating the adrenal glands reduced the amounts of both catecholamines (CA) released during dives, plasma EP decreased to 10%, and NE to 50% of values obtained before denervation. Breathing O2 before a dive virtually eliminated CA release in denervates, indicating that hypoxia was the important non-neural releasing agent. Hypoxia was also the most important neural releasing agent compared with hypercapnia, acidosis, or hypoglycemia. Adrenal denervation did not cause significant changes in heart rate, blood pressure, arterial blood gas tensions, pH, or plasma glucose during dives, although denervation caused increased variation in some of these variables. In ducks CA release in dives is largely due to decreasing arterial O2 partial pressure, and full expression of the response is dependent on intact innervation of the adrenal gland.

scholarly journals Hypoxia among patients on the liver-transplant waiting list

2014 ◽  
Vol 27 (1) ◽  
pp. 56-58 ◽  
Author(s):  
Lucas Souto NACIF ◽  
Wellington ANDRAUS ◽  
Kathryn SARTORI ◽  
Carlos Marlon BENITES ◽  
Vinicius Rocha SANTOS ◽  
...  
Keyword(s):  
Liver Transplant ◽  
Waiting List ◽  
Blood Type ◽  
High Rate ◽  
Blood Gas ◽  
Mean Values ◽  
Arterial Blood Gas ◽  
Arterial Blood ◽  
The Mean ◽  
Liver Transplant Waiting List

Background: Hepatopulmonary syndrome is formed by a triad of liver disease, intrapulmonary vascular dilatation and changes in blood gases. This condition is present in 4-32% of patients with cirrhosis. Aim : To analyze the blood gas changes data of patients in liver-transplant waiting list. Method: Clinical data of 279 patients in liver transplantation waiting list in May 2013 were studied. Overall patient was analyzed by the demographic aspects, laboratorial and image findings on exams that determine lung disease (hypoxemia) in these cirrhotic patients. The mean values and standard deviations were used to examine normally distributed variables. Results: There was a high prevalence of male patients (68%); the mean age was 51(±5,89) years, and the predominant reason for listing was hepatitis C cirrhosis. The MELD score mean was 16±5,89, without prioritization or special situation. The most common blood type was O in 129 cases (46%) and the mean of body max index was 25,94±4,58. Regarding arterial blood gas tests was observed 214 patients with PaO2 <90 mmHg, 80 with PaO2 <80 mmHg and 39 with PaO2 <50 mmHg. In relation to O2 saturation, 50 patients had <90%, 33 <80% and 10 <50%. Conclusion: Was observed a high rate of hypoxemia in patients on waiting list liver transplant. Due to the high severity and morbidity, is suggested better monitoring and therapeutic support to hypoxemic patients on liver transplant waiting list.

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