More reliable oximetry reduces the frequency of arterial blood gas analyses and hastens oxygen weaning after cardiac surgery: A prospective, randomized trial of the clinical impact of a new technology

2002 ◽  
Vol 30 (8) ◽  
pp. 1735-1740 ◽  
Author(s):  
Charles G. Durbin ◽  
Stephanie K. Rostow
Keyword(s):  
Cardiac Surgery ◽  
Randomized Trial ◽  
New Technology ◽  
Clinical Impact ◽  
Prospective Randomized Trial ◽  
Blood Gas ◽  
Arterial Blood Gas ◽  
Arterial Blood ◽  
Blood Gas Analyses

Standard versus  Fiberoptic Pulmonary Artery Catheterization for Cardiac Surgery in the Department of Veterans Affairs

2002 ◽  
Vol 96 (4) ◽  
pp. 860-870 ◽  
Author(s):  
Martin J. London ◽  
Thomas E. Moritz ◽  
William G. Henderson ◽  
Gulshan K. Sethi ◽  
Maureen M. O'Brien ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Pulmonary Artery ◽  
Veterans Affairs ◽  
Cardiac Complications ◽  
Blood Gas ◽  
Department Of Veterans Affairs ◽  
Pulmonary Artery Catheterization ◽  
Arterial Blood Gas ◽  
Arterial Blood ◽  
Blood Gas Analyses

Background Controversy exists regarding the utility of continuous monitoring of mixed venous oxygen saturation (STvo2) during cardiac surgery. During a multicenter, prospective, observational study in the Department of Veterans Affairs (Cooperative Study #5), frequency of use of standard pulmonary artery catheterization (PAC) and STvo2-PAC was recorded. Here the authors relate these data to clinical outcomes. Methods Logistic and Cox regression models evaluating the association of PAC type with mortality, one or more postoperative complications, cardiac complications, time to extubation, and intensive care unit length of stay were constructed. The number of thermodilution cardiac outputs and arterial blood gas analyses performed in the first 24 h postoperatively were compared. Results Data from 3,265 patients undergoing myocardial revascularization (81.7%) or valve replacement-repair (18.3%) were considered. STvo2-PAC was used in 49% and PAC in 51% of patients. In the 14 hospitals, STvo2-PAC was used in all patients in four, in some patients in four, and never in six. No association of STvo2-PAC use with outcome were observed aside from unexplained hospital level effects. A small but statistically significant reduction in the number of arterial blood gas analyses (8 +/- 3 vs. 10 +/- 4, P < 0.0001, STvo2-PAC vs. PAC, respectively) and thermodilution cardiac outputs (14 +/- 8 vs. 15 +/- 9, P < 0.0001, STvo2-PAC vs. PAC, respectively) was observed with use of STvo2-PAC. Conclusions Despite higher cost, STvo2-PAC was commonly used in this cohort. Our analysis failed to detect associations with improved outcomes aside from a small reduction in resource utilization. The precise role of STvo2-PAC remains uncertain.

Hemodynamic responses to oxygen breathing in man

1962 ◽  
Vol 17 (1) ◽  
pp. 75-79 ◽  
Author(s):  
G. W. N. Eggers ◽  
H. W. Paley ◽  
J. J. Leonard ◽  
J. V. Warren
Keyword(s):  
Blood Volume ◽  
Blood Gas ◽  
Peripheral Vascular ◽  
Healthy Male ◽  
Hemodynamic Responses ◽  
Arterial Blood Gas ◽  
Oxygen Breathing ◽  
Arterial Blood ◽  
Radioactive Indicator ◽  
Blood Gas Analyses

Hemodynamic responses to breathing 100% oxygen for an average of 30 min were studied in eight healthy male volunteers. Cardiac output and related determinations were performed with central injections of a radioactive indicator and calculated by the method of Stewart and Hamilton. Arterial blood gas analyses were performed in each phase of the study. Slight but statistically significant decreases in cardiac index and heart rate were observed during oxygen breathing. There was no change in the central blood volume, but a masked increase in pulmonary blood volume may have occurred. Statistically significant increases in peripheral vascular resistance, mean arterial pressure, and both systolic and diastolic arterial pressures occurred during oxygen breathing and persisted at least 40 min after oxygen was discontinued. Submitted on May 1, 1961

Effects of Administration of Intravenous Naloxone on Gas Exchange in Brain-Dead Lung Donors

2009 ◽  
Vol 19 (3) ◽  
pp. 267-271 ◽  
Author(s):  
Christina Eagan ◽  
Cesar A. Keller ◽  
Maher A. Baz ◽  
Michael Thibault
Keyword(s):  
Lung Transplant ◽  
Blood Gas Analysis ◽  
Gas Analysis ◽  
Pulmonary Contusion ◽  
Neurogenic Pulmonary Edema ◽  
Blood Gas ◽  
Arterial Blood Gas ◽  
Arterial Blood ◽  
Arterial Blood Gas Analysis ◽  
Blood Gas Analyses

Objective To observe the effect of naloxone on the lung function of potential lung transplant donors with neurogenic pulmonary edema. Design and Interventions Donors aged 16 to 55 years without any factors to contraindicate lung donation (pneumonia, pulmonary contusion, etc) were included. Ventilator settings were standardized to a tidal volume of 10 to 12 mL/kg, an FiO2 of 0.40, and a respiratory rate that kept PCO2 between 35 and 45 mm Hg. Chest physiotherapy, nebulizer treatments, and frequent suctioning were undertaken. Baseline arterial blood gas analysis and an oxygen challenge were performed. The patients were then given 8 to 10 mg of naloxone. Oxygen challenges and arterial blood gas analyses were repeated every 4 to 6 hours. The data were analyzed by using a paired t test, and each patient served as his or her own control. Setting These interventions were performed on the 19 LifeQuest donors who met the set criteria from July 2002 to July 2004. Results The PaO2 on the oxygen challenge immediately after administration of naloxone increased from 329 (SD 177) to 363 (SD 191) mm Hg, although the increase from baseline was not significant. The PaO2 from the second oxygen challenge (median time, 7 hours after administration of naloxone) increased to 413 (SD 177) mm Hg ( P < .01).

scholarly journals The Role of Extracorporeal Membrane Oxygenation in The Protective Lung Strategy after Cardiac Surgery in a Tertiary Intensive Care Unit

2020 ◽  
Vol 2 (2) ◽  
pp. 61-67
Author(s):  
Ibrahim Mungan ◽  
◽  
Sema Turan ◽  
Keyword(s):  
Cardiac Surgery ◽  
Ventilatory Support ◽  
Blood Gas Analysis ◽  
Gas Analysis ◽  
Blood Gas ◽  
Mechanical Ventilatory Support ◽  
Arterial Blood Gas ◽  
Arterial Blood ◽  
Pulmonary Failure ◽  
Arterial Blood Gas Analysis

Background: In cases of respiratory failure, Lung-Protective Ventilation Strategy (LPVS) which limits ventilator-induced lung injury is recommended. However, CO2 retention is a major impediment for LPVS and Extracorporeal membrane oxygenation (ECMO) supplies enough time to the lungs for rest and recovery. We aimed to find out the connection between ECMO usage and the reduction of mechanical ventilatory values in patients who required ECMO therapy after cardiac surgery due to pulmonary failure. Methods: In this retrospective cohort study, we analyzed 21 consecutive patients receiving a venovenous ECMO for pulmonary failure after cardiac surgery and 19 patients non-ECMO group. Demographic variables including age, gender, predicted body weight, and heart rate and the arterial blood gas analysis data, mechanical ventilator parameters and clinical outcomes were derived from institutional database. Results: The mean age of the patients was 55.57 years and ECMO patients were younger than non-ECMO group patients (p=0.005). The other descriptive variables and clinical parameters did not differ between groups statistically. The mechanical ventilator parameters and arterial blood gas analysis were worse in the ECMO group before the procedure (p <0.001) whereas improvement in data was more significant in the ECMO group after the procedure (p<0.001 in Pplateau and PaO2) . The patients in the non-ECMO group stayed longer in hospital (35.68 days vs 16.9 days) and in ICU (31.11 days vs 13.33 days) than the patients in the ECMO group. The duration of the mechanical ventilatory support did not differ between groups. Conclusion: The intensivists had a big dilemma involving the balance between maintaining a sensible blood-gas exchange and protecting the lung from adverse effects of mechanical ventilatory support. The extracorporeal life support –ECMO- was advised until the pulmonary failure was resolved. We found that ECMO support was decreasing the high Plateau Pressure and respiratory rate more than the non-ECMO group.

Iatrogenic Anaemia in the Critically Ill: A Survey of the Frequency of Blood Testing in a Teaching Hospital Intensive Care Unit

2009 ◽  
Vol 10 (4) ◽  
pp. 279-281 ◽  
Author(s):  
Tim Astles
Keyword(s):  
Intensive Care ◽  
Critically Ill ◽  
Teaching Hospital ◽  
Blood Gas Analysis ◽  
Gas Analysis ◽  
Blood Gas ◽  
Arterial Blood Gas ◽  
Day Range ◽  
Arterial Blood ◽  
Blood Gas Analyses

Anaemia in the critically ill remains a contentious issue. Despite adoption of lower haemoglobin levels as transfusion triggers, many patients on intensive care units (ICUs) still require blood transfusions during their illness. One factor that contributes to the critically ill becoming anaemic is regular phlebotomy. Over a two week period, all blood tests performed on patients in a busy, teaching hospital ICU were surveyed to allow calculation of the total volume of blood that had been taken. On average, 52.4 mL of blood was taken per patient per day, and 366.8 mL per patient per week. The most frequently performed tests were arterial blood gas analyses, performed on average 5.8 times per patient per day (range 0–21 times per day). Arterial blood gas analysis alone accounted for taking of 29 mL of blood per patient per day, ie 203 mL per patient per week. Several methods for reducing the amount of blood taken from ICU patients have been identified and discussed. By implementing some of these simple changes in our institution, it would be possible to reduce the volume of blood taken by 43%.

scholarly journals Comparison of peripheral venous and arterial blood gas analyses

Respirology ◽  
2014 ◽  
Vol 19 (5) ◽  
pp. 769-769
Author(s):  
Jun Fujinaga ◽  
Akira Kuriyama ◽  
Toshio Fukuoka
Keyword(s):  
Blood Gas ◽  
Arterial Blood Gas ◽  
Arterial Blood ◽  
Blood Gas Analyses
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