Atmospheric and Alveolar Pressures

2011 ◽  
pp. 12-18
Author(s):  
James R. Munis
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Vapor Pressure ◽  
Oxygen Pressure ◽  
Barometric Pressure ◽  
The Body ◽  
The Other ◽  
Arterial Oxygen ◽  
Alveolar Oxygen ◽  
Inspired Oxygen

What you need to know, either to study altitude physiology or to monitor patients in the operating room or intensive care unit, is how to calculate alveolar oxygen pressure (PAO2) and how to compare that calculated value with the measured arterial oxygen pressure (PaO2). ‘P’ denotes pressure, of course (measured in mm Hg or torr, unless otherwise noted). Small capital ‘A’ denotes alveolar. Lowercase ‘a’ represents arterial. ‘PB’ is barometric pressure. ‘R’ is the respiratory quotient, which is simply the ratio of CO2 produced by the body divided by the amount of O2 consumed. ‘PH2O’ is the vapor pressure of water. FIO2 is the fraction of inspired O2, with 1.0 equivalent to 100% inspired oxygen. PIO2 is the partial pressure of inspired oxygen. This difference (PAO2 -PaO2), also termed AaDO2, gives an estimate of how efficiently the lungs are oxygenating the blood. There are several physiologic causes of hypoxemia. Hypoventilation, lowered PIO2, and lowered PB will not increase AaDO2 . The other 3 will.

scholarly journals Psoas Muscle Area Measured with Computed Tomography at Admission to Intensive Care Unit: Prediction of In-Hospital Mortality in Patients with Pulmonary Embolism

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Ibrahim Akkoc ◽  
Mehmet Toptas ◽  
Mazhar Yalcin ◽  
Eren Demir ◽  
Yasar Toptas
Keyword(s):  
Computed Tomography ◽  
Intensive Care Unit ◽  
Pulmonary Embolism ◽  
Intensive Care ◽  
Hospital Mortality ◽  
Arterial Oxygen Saturation ◽  
Psoas Muscle ◽  
The Body ◽  
Arterial Oxygen ◽  
Muscle Area

Aim. Sarcopenia, a core component of physical frailty, is an independent risk factor for suboptimal health outcomes in hospitalized patients, especially in the intensive care patients. Psoas muscle areas can be assessed to identify sarcopenia. The aim of this study was to determine the prognostic value of psoas muscle area measured with CT for the prediction of in-hospital mortality in patients with pulmonary embolism at admission to the intensive care unit. Methods. Patients with an admission abdominal computed tomography scan and requiring intensive care unit (ICU) stay were reviewed. Selected clinical data of patients admitted to intensive care unit for the management of pulmonary embolism were collected. Using CT scan images at the level of L3 vertebra, the psoas muscle area value was obtained by dividing the sum of the right and left psoas muscle areas into the body surface area. Results. In-hospital mortality rate was 22.5% in 89 patients. The pulmonary embolism patients with in-hospital mortality had higher PESI and lower value of psoas muscle area, in addition to the lower systolic blood pressure and arterial oxygen saturation at admission. The increase in the value of psoas muscle area is associated with a decrease in the rate of in-hospital mortality. In patients with in-hospital mortality related to pulmonary embolism, the higher PESI and the lower value of psoas muscle area were considered in accordance with the outcome of patients. Conclusions. For the prediction of in-hospital mortality risk in patients with pulmonary embolism managed in intensive care unit, the psoas muscle area value has a merit to be used among the routine diagnostic procedures after further studies conducted with different severity of pulmonary embolism.

scholarly journals Comparison of three fixation methods for orotracheal intubation in 95 adults

2020 ◽  
Vol 25 (1) ◽  
Author(s):  
Ye Sun ◽  
Hua Fan ◽  
Xiao-Xia Song ◽  
Hua Zhang
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Tracheal Intubation ◽  
Older People ◽  
Endotracheal Intubation ◽  
Orotracheal Intubation ◽  
The Other ◽  
Fixation Methods ◽  
The Difference

Abstract Background The present study aimed to compare three fixation methods for orotracheal intubation. Methods Through literature retrieval, the effects of the adhesive/twill tape method, fixator method, and adhesive/twill tape–fixator alternation method on patients with tracheal intubation in the intensive care unit (ICU) were compared. Results The fixator and alternation methods were more effective in protecting the tongue mucosa and teeth. The alternation method was superior to the other two methods in maintaining the position of the endotracheal intubation. However, the difference in facial and lip injuries between the three methods was not statistically significant. Conclusion The fixator method can significantly reduce intraoral injury and is more suitable for older people with weak tongue mucosa and loose teeth. These are worth popularizing among a wider group.

scholarly journals CASE STUDY: ORGANOPHOSPHATE POISONING – ATROPINE-INDUCED PSYCHOSIS IN INTENSIVE CARE UNIT PATIENT

2021 ◽  
pp. 3-4
Author(s):  
VATHSALYA PORANKI
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Intensive Care Unit Patient ◽  
Rural Areas ◽  
Postsynaptic Membrane ◽  
The Body ◽  
Organophosphate Poisoning ◽  
Competitive Antagonist ◽  
Organophosphorus Poisoning

Organophosphate compounds are used as commercial insecticides and applied as aerosols or dust. Consuming these compounds intentionally or unintentionally lead to dangerous conditions even to fatality. The most common obstacle in treating organophosphorus poisoning is the availability of sufficient medical care, equipment to provide proper emergency care observed in rural areas where there is a lot of gap between intensive care and acute care. Atropine use is as an antidote in organophosphorus poisoning. The dose of atropine mainly depends on the organophosphorus toxic doses. Atropine is a competitive antagonist of acetylcholine at the muscarinic postsynaptic membrane. Atropine blocks all the muscarinic effects in the body. This study presents a case of organophosphorus poisoning treated with atropine leading to atropine psychosis. Patient’s conditions, outcomes, and improvements are studied.

Stridor: Intracranial Pathology Causing Postextubation Vocal Cord Paralysis

PEDIATRICS ◽  
1991 ◽  
Vol 87 (1) ◽  
pp. 39-43
Author(s):  
Frank C. Chaten ◽  
Steven E. Lucking ◽  
Edwin S. Young ◽  
John J. Mickell
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Intracranial Pressure ◽  
Intracranial Hypertension ◽  
Vocal Cord ◽  
Vocal Cord Paralysis ◽  
Pediatric Intensive Care ◽  
Laryngeal Nerve ◽  
The Other ◽  
Neurologic Disorders

During an 18-month period in a pediatric intensive care unit, nine patients with vocal cord paralysis were identified using flexible bronchoscopy. When tracheally extubated, each child was found to have stridor. The children ranged in age from 17 days to 5½ years. Two patients had unilateral paralysis, but neither required tracheostomy. Seven patients displayed bilateral abductor vocal cord paralysis. Of these, six patients required tracheostomy. Surgical injury to the recurrent laryngeal nerve was the probable cause in two patients. The other seven patients had neurologic disorders with documented or suspected increases of intracranial pressure. Four of the seven patients with bilateral abductor vocal cord paralysis regained cord mobility within 4 months. Both children with unilateral cord paralysis have no stridor and vocalize well 1 year later. Cord paralysis in the setting of intracranial hypertension probably results from compression or ischemia of the vagus nerve before it exits the skull. Early visualization of the larynx should be done in patients who become stridulous when extubated, especially those with prior thoracic procedures or with neurologic disorders associated with intracranial hypertension.

The influence of intra-aortic balloon counter pulsation on central venous blood oxygen saturation

Perfusion ◽  
2021 ◽  
pp. 026765912110559
Author(s):  
Ayman Mohamed ◽  
Sameh Aboulnaga ◽  
Fayez Hamwi ◽  
Amr S Omar ◽  
Abdulrasheed Pattath ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Oxygen Saturation ◽  
Venous Blood ◽  
Blood Gases ◽  
Left Ventricular ◽  
Arterial Oxygen ◽  
Secondary Outcome ◽  
Central Venous ◽  
Significant Difference

Objectives We aim at identifying the changes in venous blood saturation values that associates intra-aortic balloon pump (IABP) in cardiac surgery patients with reduced left ventricular function (LVF). Methods A retrospective observational study was conducted in a cardiothoracic intensive care unit (CTICU) in a tertiary cardiac center over 5 years in Qatar. A total of 114 patients with at least moderate impairment of LVF with ejection fraction (EF) less than 40% were enrolled. According to the association of IABP, patients were segregated into two groups with and without IABP (groups 1, 40 patients and group 2, 74 patients). Sequential arterial and venous blood gases were analyzed. The primary outcome was to analyze the changes in the central venous saturation (ScvO2) in both groups and the secondary outcome was to analyze whether these changes affect the overall outcome in terms of intensive care unit (ICU) length of stay. Results There was no significant difference between both groups with regard to age, preoperative EF, hemoglobin, and arterial oxygen saturation (SaO2) in blood gases. Patients with IABP have a higher cScvO2 when compared to the other group (71.5 ± 12.5 vs 63.5 ± 9.3, 68.3 ± 12.6 vs 60.1 ± 9.5, 62.7 ± 10.8 vs 55.63 ± 8.1, and 60.6 ± 7.6 vs 54.9 ± 8.1; p = 0.04, 0.05, 0.03, and 0.5, respectively). However, generalized estimating equations (GEE) analysis showed that compared with the participants showing that there is a decreasing trend in mean levels within the groups during follow-ups, overall difference between both groups’ mean levels was not statistically significant. Conclusions In this study, we observed that after cardiac surgeries, patients with IABP had non-significant higher ScvO2 when compared with a corresponding group with moderate impairment of LVF. Further prospective studies are required to validate these findings.

scholarly journals Bedside Computer Programs in the Intensive Care Unit

1982 ◽  
Vol 10 (3) ◽  
pp. 217-222 ◽  
Author(s):  
T. E. Oh ◽  
P. D. Cameron
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Parenteral Nutrition ◽  
Patient Management ◽  
Computer Programs ◽  
Physiological Data ◽  
Inspired Oxygen

An inexpensive home microcomputer is used in an intensive care unit to facilitate patient management. The computer's rapid and accurate calculations are used to regulate inspired oxygen, infuse drugs and plan parenteral nutrition. Patient physiological data are processed to derive cardiovascular, respiratory and renal variables which help to monitor and evaluate patient progress.

Association Between Hemogram Parameters and Survival of Critically Ill Patients

2017 ◽  
Vol 34 (6) ◽  
pp. 511-513 ◽  
Author(s):  
Ibrahim Karagoz ◽  
Gulali Aktas ◽  
Hamit Yoldas ◽  
Isa Yildiz ◽  
Muhammet Nur Ogun ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Prognostic Factors ◽  
Critically Ill Patients ◽  
Laboratory Data ◽  
Demographic Characteristics ◽  
The Other ◽  
Platelet Volume ◽  
Icu Patients ◽  
Laboratory Variables

Aim: Recently, hemogram parameters, such as mean platelet volume (MPV), had been proposed as novel inflammatory and prognostic factors. In present retrospective analysis, we aimed to determine and compare MPV of survived and dead patients whom admitted to intensive care unit (ICU) of our institution. Methods: We recorded hemogram parameters and other laboratory data and demographic characteristics of patients treated in ICU. Patients are divided into 2 groups—dead patients and survived patients. Laboratory data of survived patients compared to those of dead patients. Results: Age, gender, and other laboratory variables were not significantly different between dead and survived patients. On the other hand, MPV of survived patients was significantly higher than that of the dead patients ( P = .001). Conclusion: We think that elevated MPV levels in an ICU patient should alert clinicians for worse outcome. Physicians should be more careful in the management of these patients.

scholarly journals Cerebrospinal Fluid Penetration and Pharmacokinetics of Vancomycin Administered by Continuous Infusion to Mechanically Ventilated Patients in an Intensive Care Unit

2000 ◽  
Vol 44 (5) ◽  
pp. 1356-1358 ◽  
Author(s):  
Jacques Albanèse ◽  
Marc Léone ◽  
Bernard Bruguerolle ◽  
Marie-Laure Ayem ◽  
Bruno Lacarelle ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Cerebrospinal Fluid ◽  
Intensive Care ◽  
Continuous Infusion ◽  
The Other ◽  
Mechanically Ventilated ◽  
Mechanically Ventilated Patients ◽  
Csf Penetration ◽  
Group Serum ◽  
Ventilated Patients

ABSTRACT Cerebrospinal fluid (CSF) penetration and the pharmacokinetics of vancomycin were studied after continuous infusion (50 to 60 mg/kg of body weight/day after a loading dose of 15 mg/kg) in 13 mechanically ventilated patients hospitalized in an intensive care unit. Seven patients were treated for a sensitive bacterial meningitis and the other six patients, who had a severe concomitant neurologic disease with intracranial hypertension, were treated for various infections. Vancomycin CSF penetration was significantly higher (P< 0.05) in the meningitis group (serum/CSF ratio, 48%) than in the other group (serum/CSF ratio, 18%). Vancomycin pharmacokinetic parameters did not differ from those obtained with conventional dosing. No adverse effect was observed, in particular with regard to renal function.

scholarly journals Association between administered oxygen, arterial partial oxygen pressure and mortality in mechanically ventilated intensive care unit patients

Critical Care ◽  
2008 ◽  
Vol 12 (6) ◽  
pp. R156 ◽  
Author(s):  
Evert de Jonge ◽  
Linda Peelen ◽  
Peter J Keijzers ◽  
Hans Joore ◽  
Dylan de Lange ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Oxygen Pressure ◽  
Partial Oxygen Pressure ◽  
Mechanically Ventilated ◽  
Partial Oxygen

Postoperative treatment of the patient with obstructive sleep apnea

2000 ◽  
Vol 122 (2) ◽  
pp. 233-236 ◽  
Author(s):  
Keith M. Ulnick ◽  
Richard F. Debo
Keyword(s):  
Intensive Care Unit ◽  
Obstructive Sleep Apnea ◽  
Intensive Care ◽  
Sleep Apnea ◽  
Sleep Apnea Syndrome ◽  
Study Groups ◽  
Postoperative Treatment ◽  
Arterial Oxygen ◽  
Obstructive Sleep ◽  
Increased Risk

>OBJECTIVE The postoperative management of patients with obstructive sleep apnea syndrome (OSAS) has been based primarily on the potential loss of the airway. Our hypothesis is that not all patients with OSAS require placement in the intensive care unit after surgery. METHODS We undertook a prospective, nonrandomized study (N = 38). Data included demographics, polysomnograms, body mass index (BMI), and postoperative course, including any complications within 72 hours. RESULTS The average respiratory disturbance index was 66, and the average BMI was 29. The average preoperative and postoperative maximal arterial oxygen desaturation values were 82% and 94%, respectively. Patients with BMIs less than 35 did not have desaturation values below 90%. No complications occurred. DISCUSSION Within the first 72 hours after surgery, no complications were observed in our study groups. Patients with BMIs greater than 35 were at increased risk for postoperative desaturations. The uncomplicated OSAS patient, one without significant comorbid factors, can be treated in a safe and prudent fashion outside of an intensive care unit.

Sign in / Sign up

Export Citation Format

Share Document