EFFECTS OF APROTININ ON PULMONARY FUNCTIONS IN EXPERIMENTAL FAT EMBOLISM: CHANGES IN ARTERIAL BLOOD GAS LEVELS AND SCINTIGRAPHIC FINDINGS

2000 ◽  
Vol 04 (03) ◽  
pp. 189-198
Author(s):  
Mustafa Yel ◽  
Hülya Dalgiç ◽  
Güngör Taştekin ◽  
Mehmet Arazi ◽  
Abdurrahman Kutlu
Keyword(s):  
Fat Embolism ◽  
Control Group ◽  
Blood Gas ◽  
Arterial Blood Gas ◽  
Arterial Blood ◽  
Significant Difference ◽  
Intravenous Saline ◽  
Group 2 ◽  
Embolization Procedure ◽  
Control Group Group

Purpose: To assess the effects of aprotinin on the formation and resolution of fat embolism of the lungs. Methods: The changes in arterial blood gas levels and perfusion scintigraphy were studied by forming experimental standardized fat embolism in rabbits with autogenous fat obtained from their femur medullas. Two groups, each consisting of 14 albino rabbits, were used in this study. Group 1, which received intravenous saline solution, was the control group. Group 2, which received aprotinin, was referred to as the aprotinin group. Autogenous femoral medullary content was used for embolization procedures. Arterial blood gas levels were recorded 72 hours before and 1, 24, 72 hours and 10 days following the embolization procedure. Pulmonary perfusion scintigraphies were performed 72 hours before the embolization procedure and on the first and 72nd hours, and the 10th day. Results: Fat embolism was achieved in all rabbits. Seven rabbits in the control group and one rabbit in the aprotinin group died within an hour after the embolization procedure. According to blood gas levels and perfusion scintigraphic findings, the aprotinin group significantly had less pulmonary fat embolism and recovered faster than the control group, especially during the first 24 hours. There was no significant difference in regression of pulmonary dysfunction between the two groups. Conclusion: The correlation between the blood gas levels and scintigraphic findings suggested that the administration of aprotinin for prophylactic purposes had favorable effects on the development of pulmonary gas exchange disturbance and perfusion defect in fat embolism.

A novel approach to radiographic detection of bucco-palatal/lingual dilacerations: A preliminary study with ImageJ

2021 ◽  
pp. 095441192110307
Author(s):  
Samed Satir ◽  
Muhammed Hilmi Buyukcavus ◽  
Kaan Orhan
Keyword(s):  
Longitudinal Axis ◽  
Control Group ◽  
Single Root ◽  
Novel Approach ◽  
Significant Difference ◽  
Spectrum Feature ◽  
Group 2 ◽  
Imagej Software ◽  
And Control ◽  
Control Group Group

The purpose of our study is to determine whether bucco-palatal/lingual (BPL) root dilacerations (RD), especially in single root teeth, can be determined using the ImageJ program through only one periapical radiography. Extracted teeth without any RD ( n = 8) were determined as the control group (Group 1) and with RD in apical 1/3 part at least 20° with the longitudinal axis in the BPL direction ( n = 8) as the study group (Group 2). With the help of a simple holder system prepared, digital periapical radiographs of all teeth were taken in an anteroposterior position. Histogram analysis of all periapical radiographs was performed using the spectrum feature of ImageJ software. It was aimed to make a dilaceration analysis by comparing the groups using mean, standard deviation, minimum, maximum, and bin width values. As a result of the Mann-Whitney U test, all mean and maximum values showed a statistically significant difference between the study and control groups ( p < 0.05). This pilot study revealed that the ImageJ software can be used to diagnose BPL dilaceration in the apical 1/3 part of the root. It is important for dentists and patients that it can contribute to limiting the radiation dose to which patients will be exposed.

scholarly journals Sedative and cardiopulmonary effects of acepromazine, midazolam, butorphanol, acepromazine-butorphanol and midazolam-butorphanol on propofol anaesthesia in goats

2009 ◽  
Vol 80 (1) ◽  
Author(s):  
T.B. Dzikitia ◽  
G.F. Stegmanna ◽  
L.J. Hellebrekers ◽  
R.E.J. Auer ◽  
L.N. Dzikiti
Keyword(s):  
Saline Group ◽  
Control Group ◽  
Blood Gas ◽  
Arterial Blood Gas ◽  
Induction Dose ◽  
Normal Limits ◽  
Arterial Blood ◽  
Blood Gas Parameters ◽  
Induction Of Anaesthesia

The sedative, propofol-sparing and cardiopulmonary effects of acepromazine, midazolam, butorphanol and combinations of butorphanol with acepromazine or midazolam in goats were evaluated. Six healthy Boer - Indigenous African crossbreed goats were by randomised cross-over designated to 6 groups: Group SAL that received saline, Group ACE that received acepromazine, Group MID that received midazolam, Group BUT that received butorphanol, Group ACEBUT that received acepromazine and butorphanol and Group MIDBUT that received midazolam and butorphanol as premedication agents intramuscularly on different occasions at least 3 weeks apart. The degree of sedation was assessed 20 minutes after administration of the premedication agents. Thirty minutes after premedication, the dose of propofol required for induction of anaesthesia adequate to allow placement of an endotracheal tube was determined. Cardiovascular, respiratory and arterial blood-gas parameters were assessed up to 30 minutes after induction of general anaesthesia. Acepromazine and midazolam produced significant sedation when administered alone, but premedication regimens incorporating butorphanol produced inconsistent results. The dose of propofol required for induction of anaesthesia was significantly reduced in goats that received midazolam alone, or midazolam combined with either acepromazine or butorphanol. The quality of induction of anaesthesia was good in all groups, including the control group. Cardiovascular, respiratory and blood-gas parameters were within normal limits in all groups and not significantly different between or within all groups. In conclusion: sedation with midazolam alone, or midazolam combined with either acepromazine or butorphanol significantly reduces the induction dose of propofol with minimal cardiopulmonary effects in goats.

Feasıbılıty of Transcutaneous Method for Carbon Dıoxıde Monıtorıng in an Intensive Care Unıt

2022 ◽  
Vol 18 ◽  
Author(s):  
Nazlıhan Boyacı ◽  
Sariyya Mammadova ◽  
Nurgül Naurizbay ◽  
Merve Güleryüz ◽  
Kamil İnci ◽  
...  
Keyword(s):  
Carbon Dioxide ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Partial Pressure ◽  
Blood Gas ◽  
Peripheral Oxygen Saturation ◽  
Arterial Blood Gas ◽  
Arterial Blood ◽  
Randomized Controlled Studies ◽  
Significant Difference

Background: Transcutaneous partial pressure of carbon dioxide (PtCO2) monitorization provides a continuous and non-invasive measurement of partial pressure of carbon dioxide (pCO2). In addition, peripheral oxygen saturation (SpO2) can also be measured and followed by this method. However, data regarding the correlation between PtCO2 and arterial pCO2 (PaCO2) measurements acquired from peripheric arterial blood gas is controversial. Objective: We aimed to determine the reliability of PtCO2 with PaCO2 based on its advantages, like non-invasiveness and continuous applicability. Methods: Thirty-five adult patients with hypercapnic respiratory failure admitted to our tertiary medical intensive care unit (ICU) were included. Then we compared PtCO2 and PaCO2 and both SpO2 measurements simultaneously. Thirty measurements from the deltoid zone and 26 measurements from the cheek zone were applied. Results: PtCO2 could not be measured from the deltoid region in 5 (14%) patients. SpO2 and pulse rate could not be detected at 8 (26.7%) of the deltoid zone measurements. Correlation coefficients between PtCO2 and PaCO2 from deltoid and the cheek region were r: 0,915 and r: 0,946 (p = 0,0001). In comparison with the Bland-Altman test, difference in deltoid measurements was -1,38 ± 1,18 mmHg (p = 0.252) and in cheek measurements it was -5,12 ± 0,92 mmHg (p = 0,0001). There was no statistically significant difference between SpO2 measurements in each region. Conclusion: Our results suggest that PtCO2 and SpO2 measurements from the deltoid region are reliable compared to the arterial blood gas analysis in hypercapnic ICU patients. More randomized controlled studies investigating the effects of different measurement areas, hemodynamic parameters, and hemoglobin levels are needed.

Furosemide in Hyaline Membrane Disease

PEDIATRICS ◽  
1978 ◽  
Vol 62 (5) ◽  
pp. 785-788
Author(s):  
Keith H. Marks ◽  
William Berman ◽  
Zvi Friedman ◽  
Victor Whitman ◽  
Cheryl Lee ◽  
...  
Keyword(s):  
Interstitial Fluid ◽  
Hyaline Membrane Disease ◽  
Skinfold Thickness ◽  
Acute Stage ◽  
Control Group ◽  
Arterial Blood Gas ◽  
Cardiorespiratory Function ◽  
Arterial Blood ◽  
Significant Difference ◽  
Hyaline Membrane

In a randomized clinical trial designed to evaluate the effect of diuresis on infants with hyaline membrane disease, seven infants were treated with furosemide (2 mg/kg intravenously) and five received 5% dextrose water in 0.225% sodium chloride (control group). Arterial blood gas analyses performed before and during the six hours after treatment showed no significant difference between control and treated infants. Urine output and urine sodium and calcium loss were significantly increased (P &lt; .05) in the infants receiving furosemide. The diuresis seemed to have no effect on left atrial size determined echocardiographically, whereas measurements of dynamic skinfold thickness suggested mobilization of subcutaneous water. One infant became seriously dehydrated and hypotensive secondary to a massive diuresis. We concluded that furosemide had a potent diuretic effect in infants with hyaline membrane disease but does not improve cardiorespiratory function acutely. This may be because of failure to mobilize pulmonary interstitial fluid in the time period tested. It may also be possible that the presence of pulmonary interstitial fluid does not play an important role in the impairment of gas exchange in the acute stage of hyaline membrane disease.

Respiratory Muscle Strength and its use in COVID-19 pandemic: Role of Lung Function tests (Preprint)

2020 ◽  
Author(s):  
Dr. Anita Agrawal ◽  
Vivek Nalgilkar
Keyword(s):  
Respiratory Muscle ◽  
Blood Gas Analysis ◽  
Gas Analysis ◽  
Muscle Performance ◽  
Control Group ◽  
Arterial Blood Gas ◽  
Arterial Blood ◽  
Arterial Blood Gas Analysis ◽  
Significant Difference

BACKGROUND There is a concern that pulmonary function testing could represent a potential way for COVID 19 transmission due to the congregation of patients with lung disease and because of the potential for coughing and droplet formation surrounding pulmonary function testing procedures There remain many unknowns facts about the possibility of transmission and the data are in evolution; however, the risks of transmission may be significant, and likely to vary based on the prevalence of the virus in the community and the age and severity of lung disease. Pulmonary functions routinely used for screening the COVID 19 patients are pulse oximeter and arterial blood gas analysis techniques. In addition to these two, the impaired respiratory muscle performance can also be tested. It is an underappreciated factor contributing to poor outcomes unfolding during the coronavirus pandemic. While impaired respiratory muscle performance is considered to be rare, it is more frequently encountered in patients with poorer health. The primary aim of this study is to discuss the potential role of respiratory muscle performance from the perspective of the coronavirus pandemic. We have done studies on COPD patients where the impaired respiratory muscle performance is reduced and when we compare that with control group, we realize that this is a good test to identify for COVID 19 patients. OBJECTIVE The purpose of this paper is to discuss the potential role of testing respiratory muscle performance. It can be utilised for screening large population during COVID-19 pandemic. METHODS This work was done at a Premier Medical Institute of Mumbai, which is a tertiary care centre catering to a large number of patients from all over Mumbai and also other parts of the state of Maharashtra. After proper diagnosis from the Chest Physician and labelled as COPD patient, the MIP measurements was conducted. Spirometry was done during the routine procedure. RESULTS In total, 90 subjects with a mean age of 60.3 ± 14.76 years and percentage of forced expiratory volume in 1 second (FEV1) of 89.67+9.92 L were recruited. MIP was significantly higher in control group than COPD. (z=-12.5). The analysis of variance (ANOVA) showed significant difference for maximal inspiratory pressure (p=0.003) between different stages of COPD. The MIP results showed that there was a statistically significant difference between mild and very severe (p=0.0019) as well as between moderate and very severe (p=0.002). The MIP results showed that there was a statistically significant difference between mild and very severe (p=0.0019) as well as between moderate and very severe (p=0.002). A significant positive correlation among maximal static pressure and FEV1 % (r= 0.5) was also observed. MIP thus is an effective technique to measure reduced performance of respiratory muscle strength. CONCLUSIONS In addition to pulse oximeter and arterial blood gas analysis, MIP can be the test of choice to test the impaired respiratory muscle performance in COVID 19 patients. Screening for respiratory muscle impairment in patients with dyspnea or characteristics associated increased risk of severe respiratory complication due to viral infection may be advantageous.

Effect of beta-adrenergic blockade on hyperventilation and exercise tolerance in emphysema

1983 ◽  
Vol 54 (5) ◽  
pp. 1368-1373 ◽  
Author(s):  
R. J. Butland ◽  
J. A. Pang ◽  
D. M. Geddes
Keyword(s):  
Heart Rate ◽  
Exercise Tolerance ◽  
Cycle Ergometer ◽  
Walking Distance ◽  
Time To Exhaustion ◽  
Adrenergic Blockade ◽  
Blood Gas ◽  
Arterial Blood Gas ◽  
Arterial Blood ◽  
Significant Difference

Ventilation, heart rate, and arterial blood gas tensions were measured at rest and during incremental exercise in 10 patients with emphysema after intravenous placebo or 7 mg metoprolol. Metoprolol reduced heart rate by 14% (P less than 0.001) and ventilation by 11% (P less than 0.01), but there was no significant difference in arterial O2 or CO2 tension (Pao2 and PaCO2, respectively). Metoprolol increased the time to exhaustion on a cycle ergometer (P less than 0.05) but did not improve the 12-min walking distance. A double-blind randomized crossover comparison of 4 wk treatment with atenolol (100 mg/day), metoprolol (100 mg/day), or matched placebo was performed in 12 patients with emphysema. Both beta-adrenoceptor antagonists reduced resting heart rate by 33% (P less than 0.001) and resting minute ventilation by 11% (P less than 0.025). There was no change in resting or exercise Pao2 or Paco2. During steady-state exercise on a cycle ergometer, atenolol and metoprolol reduced ventilation by 14 and 4%, respectively. This was accompanied by 11 and 5% reductions in O2 consumption (P less than 0.05) and 13 and 6% falls in CO2 production (P less than 0.05). There were no significant changes in tests of exercise tolerance, but forced expiratory volume in 1 s and forced vital capacity were reduced during beta 1-adrenergic blockade. beta 1-Blocking drugs reduce hyperventilation in emphysema by reducing pulmonary gas exchange without a change in arterial blood gas tensions. Increased airflow obstruction prevents this reduction being of therapeutic value.

scholarly journals Arterialised Capillary Blood Gases in Accident and Emergency Department Patients - a Reliable Alternative to Arterial Sampling?

2020 ◽  
Vol 7 (2) ◽  
Author(s):  
Faheem Shakur ◽  
Suzanne Mason
Keyword(s):  
Blood Gases ◽  
Blood Gas Analysis ◽  
Gas Analysis ◽  
Capillary Blood ◽  
Blood Gas ◽  
Arterial Blood Gas ◽  
Arterial Blood ◽  
Arterial Blood Gas Analysis ◽  
Significant Difference ◽  
Emergency Department Patients

OBJECTIVES: Many patients with respiratory complaints who present to the Accident & Emergency (A & E) department have an arterial blood gas analysis performed at some point. It is our belief that there is no difference between arterial and capillary blood gas values in patients presenting to the A & E department. It is also anticipated that body temperature and blood pressure may play a part, so these will also be reported and associations will be investigated. METHODS: Patients who require arterial blood gas analysis at any stage during their stay in the A & E department at the Northern General hospital of Sheffield are eligible for inclusion in the study. In total there were 32 patients. PROCEDURE:Transvasin cream was applied to the ear lobe to improve local blood flow by dilating the capillaries. When ten minutes have elapsed after the application of the Transvasin cream, a capillary sample is taken from the ear lobe by the researchers. CONCLUSION: From the t-tests conducted, no significant difference was seen between the arterial and capillary blood gas samples for the parameters pO2 and O2 saturation. However, for pCO2, pH and [HCO3] there were significant differences observed. This result seems to disagree with the findings of most other studies that have so far shown stronger correlations generally for pH, pCO2 and bicarbonate, than for oxygen measuring parameters.

scholarly journals Blood Gas Analysis in Neonatal Tetanus

2018 ◽  
Vol 34 (1-2) ◽  
pp. 44-7
Author(s):  
Taslim S. Soetomenggolo ◽  
Dwi Putro Widodo ◽  
Jimmy Passat ◽  
Sofyan Ismael
Keyword(s):  
Metabolic Acidosis ◽  
Blood Gas Analysis ◽  
Gas Analysis ◽  
Neonatal Tetanus ◽  
Common Finding ◽  
Blood Gas ◽  
Acid Base Balance ◽  
Arterial Blood Gas ◽  
Arterial Blood ◽  
Significant Difference

We reviewed the results of arterial blood gas analysis in 127 patients with neonatal tetanus on admission, and in 52 of such patients on the day before they died. All patients were hospitalized at the Department of Child Health, Cipto Mangunkusumo Hospital, Jakarta. On admission, most patients showed uncompensated metabolic acidosis. The mortality of patients wjth pH ofless than 7 was 100%. There was no significant difference between the mortality of patients with pH 7.35-7.45 and those with pH of less than 7.35. Analysis of acid-base balance indicated that ventilatory fw1ure was the most common finding in 52 patients who subsequently died. We recommend using intravenous fluid containing a combination of 5% dextrose and sodium bicarbonate with 4 : 1 (vol/vol) ratio from the fust day of hospitalization to reduce the possibility of the development of ongoing metabolic acidosis in patients with neonatal tetanus. Maintaining adequate ventilation is mandatory ln such patients.

Assessing the Use of Portable Blood Gas Measurements (iSTAT Instrument) in Emergency Air Transport

2020 ◽  
Vol 154 (Supplement_1) ◽  
pp. S14-S15
Author(s):  
Anjana Murali ◽  
Marion Jones ◽  
Frank Guyette ◽  
Sarah Wheeler
Keyword(s):  
Quality Control ◽  
Point Of Care ◽  
Hospital Setting ◽  
Blood Gas ◽  
Arterial Blood Gas ◽  
Arterial Blood ◽  
Significant Difference ◽  
Medical Transport ◽  
Gas Measurements ◽  
Flight Measurements

Abstract Hyper and hypoventilation of patients on ventilators leads to poor outcomes. Traditionally, mechanical ventilation protocols in air medical transport are guided by pulse oximetry (SpO2) and continuous end tidal CO2 (EtCO2), which can lead to over-ventilation of patients. The use of portable blood gas measurements is a desirable adjunct in the air medical transport setting due to the complexity and duration of management of critical patients with only limited, noninvasive monitoring options. Previously, protocols relied on SpO2 and EtCO2 to control ventilator settings during in-flight patient management. The iSTAT is a hand-held point of care device often used in acute hospital setting to obtain arterial blood gas results within minutes using a disposable test cartridge and small specimen size. However, iSTAT use in air medical transport has been limited due to analytical and durability concerns in the uncontrolled helicopter environment. The purpose of this study was to test these concerns including the effects of vibrations on the microfluidic transport of blood in the cartridge, pressure changes at altitude on the processing of the cartridge, and temperature changes on the iSTAT instrument between readings during in-flight use. To ensure accurate inflight testing, we assessed precision and accuracy of inflight blood gas measurements compared to pre- and post- flight measurements on quality control material. Precision of initial instrument verification met the manufacturer’s coefficient of variation (CV) claims (lactate = 3.59%, pH = 0.059%, pCO2 = 4%, pO2 = 3%). Initial accuracy was assessed by instrument comparison. Bias of iSTAT compared to the laboratory radiometer ABL800 instrument was acceptable for clinical use (lactate = -7.95%, pH = -0.041%, pCO2 = 1%, pO2 = -2%). For the majority of tests (pH, pCO2, pO2, HCO3, BE, and SO2) we found no significant differences between inflight absolute values compared to pre- and post- flight measurements by one-way anova (p&gt;0.05), and no significant difference in precision (CV) between in air and pre- and post- flight measurements for both low and high quality control samples. In measuring lactate levels, we found significant differences between inflight absolute values compared to pre- and post- flight measurements (p&lt;0.0001) but these were determined to be clinically insignificant (mean (mmol/L): preflight = 6.87, inflight = 6.77, postflight = 6.69). Vibration and pressure differences in air compared to on land were therefore considered clinically insignificant. To keep the instruments at an operable temperature in flight between readings, we found utility in using an insulated lunch box with additional styrofoam placed in the bottom to prevent heat transfer. Most importantly, improved clinical outcomes from proper ventilation of patients were achieved. The results of this study demonstrate that the iSTAT instrument provides clinically accurate blood gas measurements in air as compared to standard in-hospital use.

Placement of finger oximeter on the ear: comparison with oxygen saturation values taken from the finger

2021 ◽  
Vol 30 (11) ◽  
pp. 666-670
Author(s):  
Joanna Shakespeare ◽  
Edward Parkes ◽  
Catherine Gilsenan ◽  
Asad Ali
Keyword(s):  
Oxygen Saturation ◽  
Response To Treatment ◽  
Blood Gas ◽  
Arterial Blood Gas ◽  
Non Invasive ◽  
Arterial Blood ◽  
Non Invasive Ventilation ◽  
Significant Difference ◽  
Probe Placement ◽  
Finger Probe

Pulse oximetry is widely used to assess oxygen saturation (SpO2) in order to guide patient care and monitor the response to treatment. However, inappropriate oximeter probe placement has been shown to affect the measured oximetry values in healthy and normoxic outpatients. This study evaluated how treatment decisions might be impacted by SpO2 values obtained using a finger probe placed on the pinna of the ear in a cohort of 46 patients receiving non-invasive ventilation compared with values obtained from a probe on the finger and the results of arterial blood gas (ABG) (SaO2) analysis. Bland-Altman analysis was performed to evaluate agreement between the methods. Finger probe saturation was not statistically different from SaO2, with a mean difference of -0.66% (P>0.05). Saturation from the ear was significantly different (-4.29%; P<0.001). Subgroup analysis in hypoxic patients (SaO2<90%) showed a significant difference between ABG SaO2, and finger and ear SpO2. The study provides evidence that placement of a finger probe on the ear is unsafe clinical practice, potentially leading to patient mismanagement.

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