scholarly journals Rationalising oxygen usage in a level II special newborn care unit in Madhya Pradesh, India

2021 ◽  
Vol 10 (Suppl 1) ◽  
pp. e001386 ◽  
Author(s):  
Jaiprakash Parmar ◽  
Vandana Pawar ◽  
Aarti Warathe ◽  
Manish Singh ◽  
Rajashree Bajaj ◽  
...  
Keyword(s):  
Oxygen Consumption ◽  
Oxygen Delivery ◽  
Newborn Care ◽  
Madhya Pradesh ◽  
Second Phase ◽  
Nasal Injury ◽  
Increased Risk ◽  
Small Set ◽  
Therapy Compliance ◽  
Spontaneously Breathing

Non-judicious oxygen use in preterm infants is associated with increased risk of retinopathy of prematurity, bronchopulmonary dysplasia and longer hospital stay. Despite established guidelines on oxygen therapy, compliance with the best oxygen practices remains suboptimal. Excessive use of oxygen also consumes a large proportion of the annual maintenance budget of special newborn care units (SNCUs) in the districts. In this project, we aimed to reduce the oxygen consumption in the SNCU at Sehore, Madhya Pradesh, India from eight to four cylinders per day, by rationalising the indications, monitoring and method of oxygen delivery.We tested two sets of interventions using the Plan–Do–Study–Act (PDSA) approach. The first intervention was the introduction of a written ‘oxygen policy’ regarding indications of starting/stopping oxygen and the use of saturation targets. The second was using short binasal infant prongs (at 0.5–1 L/min), instead of oxygen hoods as the primary method of oxygen delivery in spontaneously breathing neonates requiring oxygen. In the first PDSA cycle, we assessed the feasibility of the intervention in a small set (n=30) of neonates and later scaled up to all eligible neonates in the second phase.We observed a significant reduction in oxygen consumption (from median (IQR) 8 (7–8) to 3 (3–4) cylinders per day) that can lead to a direct saving of 590 000 Indian rupees (US$9000) per year. There was a significant reduction in the number of neonates on oxygen support on a given day. We did not observe any increase in mortality or nasal injury. The change was sustained for the next 8 months.We conclude that by having a contextual oxygen policy and using nasal prongs instead of oxygen hoods as the preferred delivery method, we can achieve a sustainable reduction in oxygen consumption.

alpha-Adrenergic control of oxygen delivery to myocardium during exercise in conscious dogs

1982 ◽  
Vol 242 (5) ◽  
pp. H805-H809 ◽  
Author(s):  
G. R. Heyndrickx ◽  
P. Muylaert ◽  
J. L. Pannier
Keyword(s):  
Heart Rate ◽  
Blood Flow ◽  
Oxygen Consumption ◽  
Coronary Blood Flow ◽  
Coronary Sinus ◽  
Oxygen Delivery ◽  
Left Ventricular ◽  
Conscious Dogs ◽  
Adrenergic Blockade ◽  
Adrenergic Control

alpha-Adrenergic control of the oxygen delivery to the myocardium during exercise was investigated in eight conscious dogs instrumented for chronic measurements of coronary blood flow, left ventricular (LV) pressure, aortic blood pressure, and heart rate and sampling of arterial and coronary sinus blood. After alpha-adrenergic receptor blockade a standard exercise load elicited a significantly greater increase in heart rate, rate of change of LV pressure (LV dP/dt), LV dP/dt/P, and coronary blood flow than was elicited in the unblocked state. In contrast to the response pattern during control exercise, there was no significant change in coronary sinus oxygen tension (PO2), myocardial arteriovenous oxygen difference, and myocardial oxygen delivery-to-oxygen consumption ratio. It is concluded that the normal relationship between myocardial oxygen supply and oxygen demand is modified during exercise after alpha-adrenergic blockade, whereby oxygen delivery is better matched to oxygen consumption. These results indicate that the increase in coronary blood flow and oxygen delivery to the myocardium during normal exercise is limited by alpha-adrenergic vasoconstriction.

Factors influencing the individual effects of blood transfusions on oxygen delivery and oxygen consumption*

2001 ◽  
Vol 29 (Supplement) ◽  
pp. S173-S179 ◽  
Author(s):  
Mattias Casutt ◽  
Burkhardt Seifert ◽  
Thomas Pasch ◽  
Edith R. Schmid ◽  
Marko I. Turina ◽  
...  
Keyword(s):  
Oxygen Consumption ◽  
Oxygen Delivery ◽  
Blood Transfusions ◽  
Factors Influencing ◽  
Individual Effects ◽  
The Individual

Whole body oxygen consumption and critical oxygen delivery in response to prolonged and severe carbon monoxide poisoning

Resuscitation ◽  
2003 ◽  
Vol 56 (1) ◽  
pp. 97-104 ◽  
Author(s):  
Howard A Smithline ◽  
Kevin R Ward ◽  
Donald A Chiulli ◽  
Heidi C Blake ◽  
Emanuel P Rivers
Keyword(s):  
Carbon Monoxide ◽  
Oxygen Consumption ◽  
Oxygen Delivery ◽  
Carbon Monoxide Poisoning ◽  
Whole Body ◽  
Critical Oxygen

scholarly journals Genetic testing of dogs predicts problem behaviors in clinical and nonclinical samples

2020 ◽  
Author(s):  
Isain Zapata ◽  
M. Leanne Lilly ◽  
Meghan E. Herron ◽  
James A. Serpell ◽  
Carlos E. Alvarez
Keyword(s):  
Body Size ◽  
Problem Behaviors ◽  
Small Body ◽  
Community Sample ◽  
Large Body ◽  
Second Phase ◽  
Logistic Regression Models ◽  
Individual Level ◽  
Increased Risk ◽  
Phenotype Data

AbstractVery little is known about the etiology of personality and psychiatric disorders. Because the core neurobiology of many such traits is evolutionarily conserved, dogs present a powerful model. We previously reported genome scans of breed averages of ten traits related to fear, anxiety, aggression and social behavior in multiple cohorts of pedigree dogs. As a second phase of that discovery, here we tested the ability of markers at 13 of those loci to predict canine behavior in a community sample of 397 pedigree and mixed-breed dogs with individual-level genotype and phenotype data. We found support for all markers and loci. By including 122 dogs with veterinary behavioral diagnoses in our cohort, we were able to identify eight loci associated with those diagnoses. Logistic regression models showed subsets of those loci could predict behavioral diagnoses. We corroborated our previous findings that small body size is associated with many problem behaviors and large body size is associated with increased trainability. Children in the home were associated with anxiety traits; illness and other animals in the home with coprophagia; working-dog status with increased energy and separation-related problems; and competitive dogs with increased aggression directed at familiar dogs, but reduced fear directed at humans and unfamiliar dogs. Compared to other dogs, Pit Bull-type dogs were not defined by a set of our markers and were not more aggressive; but they were strongly associated with pulling on the leash. Using severity-threshold models, Pit Bull-type dogs showed reduced risk of owner-directed aggression (75th quantile) and increased risk of dog-directed fear (95th quantile). Our findings have broad utility, including for clinical and breeding purposes, but we caution that thorough understanding is necessary for their interpretation and use.

scholarly journals Analysis of Management Approach to Newborn Care of Infants Delivered to COVID-19 Positive Mothers at Five Tertiary Care Centers in the UAE over a 7 Month Period 

2021 ◽  
Author(s):  
Monika Kaushal ◽  
Yamuna Tulasi ◽  
Ayush Kaushal ◽  
Aditya Rakhecha ◽  
Rafiq Memon ◽  
...  
Keyword(s):  
Observational Study ◽  
Tertiary Care ◽  
Newborn Care ◽  
Retrospective Observational Study ◽  
Management Approach ◽  
Post Discharge ◽  
Formula Milk ◽  
Increased Risk ◽  
Care Practices ◽  
Tertiary Care Centers

Abstract ObjectivesTo assess newborn care practices, clinical characters and risks of mother to child transmission during rooming in and breastfeeding in infants born to mothers with COVID-19.DesignRetrospective observational study.Participants5 Tertiary care centers located in the UAE. Infants born to mothers diagnosed with COVID-19 at the time of delivery, born between April 1st and October 30th 2020.MethodsIn this retrospective observational study, we analyzed the newborn care practices in various tertiary care hospitals and the rate of transmission of SARS-CoV-2 from mother to infant (vertical or horizontal) while rooming in, breastfeeding and post discharge. Results40 infants were born to mothers with COVID-19 at the time of delivery. One infant tested positive for SARS-CoV-2 after birth and had respiratory symptoms and fever. 23 of the well infants were roomed in during their hospital stay and were breastfed. In 8 cases, the mother and baby were separated and isolated from the time of birth till discharge. 95% of the discharged infants were rooming in with mothers, 45% of the infants were exclusively breastfed and 55% were on mixed feeding (breast milk and formula milk) at the follow-up. None of the infants developed significant health issues or symptoms attributable to SARS-CoV-2.ConclusionThe risk of mother to infant transmission of COVID-19 in the perinatal period is very low. Our study reaffirms the AAP guidelines that rooming in and breastfeeding of newborns born to COVID-19 positive mothers is safe without an increased risk of transmission by following mandated safety precautions.

Deliberate Increase of Oxygen Delivery in the Perioperative Period

2018 ◽  
pp. 34-38
Keyword(s):  
Oxygen Consumption ◽  
High Risk ◽  
Cardiac Index ◽  
Oxygen Delivery ◽  
Myocardial Oxygen Consumption ◽  
Perioperative Period ◽  
Surgical Patients ◽  
Controlled Study ◽  
Surgical Patient ◽  
Mortality And Morbidity

This case focuses on increasing the amount of oxygen delivered to the surgical patient during the perioperative period by asking the question: Does the deliberate increase in oxygen delivery with the use of perioperative dopexamine reduce mortality and morbidity in high-risk surgical patients? Dopexamine is a dopamine analogue that produces peripheral vasodilation and an increase in cardiac index without significant increases in myocardial oxygen consumption. High-risk surgical patients were randomized to control or protocol limbs of the study. This randomized controlled study demonstrated a significant reduction in mortality and morbidity when dopexamine was used to increase oxygen delivery during the perioperative period in high-risk surgical patients.

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