Instability in non-invasive haemoglobin measurement: a possible influence of oxygen administration

2011 ◽  
Vol 55 (7) ◽  
pp. 902-902 ◽  
Author(s):  
E. Gayat ◽  
A. Bodin ◽  
M. Fischler
Keyword(s):  
Non Invasive ◽  
Oxygen Administration ◽  
Haemoglobin Measurement

scholarly journals Oxygen administration for patients with ARDS

2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Shinichiro Ohshimo
Keyword(s):  
Mechanical Ventilation ◽  
Lung Injury ◽  
Positive Pressure ◽  
Respiratory Drive ◽  
Severe Hypoxemia ◽  
Airway Occlusion ◽  
Non Invasive ◽  
Oxygen Administration ◽  
Essential Interventions ◽  
Invasive Techniques

AbstractAcute respiratory distress syndrome (ARDS) is a fatal condition with insufficiently clarified etiology. Supportive care for severe hypoxemia remains the mainstay of essential interventions for ARDS. In recent years, adequate ventilation to prevent ventilator-induced lung injury (VILI) and patient self-inflicted lung injury (P-SILI) as well as lung-protective mechanical ventilation has an increasing attention in ARDS.Ventilation-perfusion mismatch may augment severe hypoxemia and inspiratory drive and consequently induce P-SILI. Respiratory drive and effort must also be carefully monitored to prevent P-SILI. Airway occlusion pressure (P0.1) and airway pressure deflection during an end-expiratory airway occlusion (Pocc) could be easy indicators to evaluate the respiratory drive and effort. Patient-ventilator dyssynchrony is a time mismatching between patient’s effort and ventilator drive. Although it is frequently unrecognized, dyssynchrony can be associated with poor clinical outcomes. Dyssynchrony includes trigger asynchrony, cycling asynchrony, and flow delivery mismatch. Ventilator-induced diaphragm dysfunction (VIDD) is a form of iatrogenic injury from inadequate use of mechanical ventilation. Excessive spontaneous breathing can lead to P-SILI, while excessive rest can lead to VIDD. Optimal balance between these two manifestations is probably associated with the etiology and severity of the underlying pulmonary disease.High-flow nasal cannula (HFNC) and non-invasive positive pressure ventilation (NPPV) are non-invasive techniques for supporting hypoxemia. While they are beneficial as respiratory supports in mild ARDS, there can be a risk of delaying needed intubation. Mechanical ventilation and ECMO are applied for more severe ARDS. However, as with HFNC/NPPV, inappropriate assessment of breathing workload potentially has a risk of delaying the timing of shifting from ventilator to ECMO. Various methods of oxygen administration in ARDS are important. However, it is also important to evaluate whether they adequately reduce the breathing workload and help to improve ARDS.

The usefulness of non‐invasive co‐oximetry haemoglobin measurement for screening pre‐operative anaemia

Anaesthesia ◽  
2020 ◽  
Vol 76 (1) ◽  
pp. 54-60
Author(s):  
Y. H. Ke ◽  
K. Y. Hwang ◽  
T. N. Thin ◽  
Y. E. Sim ◽  
H. R. Abdullah
Keyword(s):  
Non Invasive ◽  
Haemoglobin Measurement

scholarly journals Comparison of four methods to measure haemoglobin concentrations in whole blood donors (COMPARE): a diagnostic accuracy study

2020 ◽  
Author(s):  
Steven Bell ◽  
Michael Sweeting ◽  
Anna Ramond ◽  
Ryan Chung ◽  
Stephen Kaptoge ◽  
...  
Keyword(s):  
Whole Blood ◽  
Blood Donors ◽  
Blood Donation ◽  
Haemoglobin Concentration ◽  
Reference Standard ◽  
Non Invasive ◽  
Haematology Analyser ◽  
Haemoglobin Measurement ◽  
Accuracy Study ◽  
Sensitivity Specificity

SUMMARYObjectiveTo compare four haemoglobin measurement methods in whole blood donors.BackgroundTo safeguard donors, blood services measure haemoglobin concentration in advance of each donation. NHS Blood and Transplant’s (NHSBT) usual method has been capillary gravimetry (copper sulphate), followed by venous HemoCue® (spectrophotometry) for donors failing gravimetry. However, gravimetry/venous HemoCue® results in 10% of donors being inappropriately bled (i.e., with haemoglobin values below the regulatory threshold).MethodsThe following were compared in 21,840 blood donors (aged ≥18 years) recruited from 10 mobile centres of NHSBT in England, with each method compared with the Sysmex XN-2000 haematology analyser, the reference standard: 1) gravimetry/venous HemoCue®; 2) “post donation” approach, i.e., estimating current haemoglobin concentration from that measured by a haematology analyser at a donor’s most recent prior donation; 3) capillary HemoCue®; and 4) non-invasive spectrometry (MBR Haemospect® or Orsense NMB200®). We assessed each method for sensitivity; specificity; proportion of donors who would have been inappropriately bled, or rejected from donation (“deferred”) incorrectly; and test preference.ResultsCompared with the reference standard, the methods ranged in test sensitivity from 17.0% (MBR Haemospect®) to 79.0% (HemoCue®) in men, and from 19.0% (MBR Haemospect®) to 82.8% (HemoCue®) in women. For specificity, the methods ranged from 87.2% (MBR Haemospect®) to 99.9% (gravimetry/venous HemoCue®) in men, and from 74.1% (Orsense NMB200®) to 99.8% (gravimetry/venous HemoCue®) in women. The proportion of donors who would have been inappropriately bled ranged from 2.2% in men for HemoCue® to 18.9% in women for MBR Haemospect®. The proportion of donors who would have been deferred incorrectly with haemoglobin concentration above the minimum threshold ranged from 0.1% in men for gravimetry/venous HemoCue® to 20.3% in women for OrSense®. Most donors preferred non-invasive spectrometry.ConclusionIn the largest study reporting head-to-head comparisons of four methods to measure haemoglobin prior to blood donation, our results support replacement of venous HemoCue® with the capillary HemoCue® when donors fail gravimetry. These results have had direct translational implications for NHS Blood and Transplant in England.

Finite Element Modeling of a Mainstream Capnometer System for Non-Intubated Pediatric Patients Requiring Oxygen Administration

2013 ◽  
Author(s):  
Fumihiko Takatori ◽  
Masayuki Inoue ◽  
Shinji Yamamori ◽  
Seiki Abe ◽  
Matthew R. Maltese ◽  
...  
Keyword(s):  
Carbon Dioxide ◽  
Pediatric Patients ◽  
Invasive Mechanical Ventilation ◽  
Standard Of Care ◽  
Non Invasive ◽  
Gas Entrainment ◽  
Oxygen Administration ◽  
Gas Potential ◽  
Dead Space Ventilation ◽  
Ventilated Patients

Capnometry is the standard of care to measure the amount of carbon dioxide in the proximal airway, detect apnea, tracheal tube dislodgement, and effectiveness of ventilation during invasive mechanical ventilation in critically ill infants, children and adults [1]. Capnometry is not yet standard practice for non-invasively supported or ventilated patients, due to dead space ventilation, inspiratory gas washout, gas entrainment, and potential for rebreathing of gas. Potential capnometry use in non-intubated patients could identify impending respiratory failure, obstructed airways, and improve the safety and effectiveness of non-invasive support for infants and children [2].

scholarly journals Supplemental Learning in Respiratory Physiology for Healthcare Professionals Towards Successful Treatment of COVID-19

2021 ◽  
Vol 12 ◽  
Author(s):  
Helen Wallace ◽  
Robert Angus
Keyword(s):  
Gas Exchange ◽  
Learning Outcomes ◽  
Healthcare Professionals ◽  
Positive Airway Pressure ◽  
Clinical Skills ◽  
Respiratory Physiology ◽  
Lung Mechanics ◽  
Respiratory Impairment ◽  
Non Invasive ◽  
Oxygen Administration

The immunological and pathophysiological response to COVID-19 can cause severe respiratory impairment affecting gas exchange and lung mechanics. Such was the scale of the respiratory support needed during the first wave of the pandemic, that recruitment of non-respiratory clinical staff was essential to help deal with the growing number of cases. It quickly became apparent that it was vital to rapidly equip these healthcare professionals with appropriate physiological knowledge and practical skills if therapies were to be applied effectively. Furthermore, the unravelling of unusual clinical features of COVID-19, further highlighted a need for knowledge of long-established principles of respiratory physiology. An online digital educational resource, or “respiratory learning tool kit” was developed with interactive material including visualisations, animations, and pathophysiological examples to facilitate understanding. The learning outcomes were centred on physiological principles, essential for understanding the pathophysiology relating to COVID-19, and management and treatment. Topics included principles of gas exchange, gas transport, homeostasis and central control of respiration. These basic physiological principles were linked to pathophysiology and clinical skills around oxygen administration and non-invasive supports such as Continuous Positive Airway Pressure (CPAP). From the degree of engagement and evaluation comments, it was clear that the resource successfully achieved its aim—to increase physiological knowledge and its practical understanding, enabling healthcare professionals to practice with confidence in such an uncertain environment.

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