Abstract 281: Cerebral Regional Oxygen Saturation (rSO 2 ) is Useful as a Physiological Monitoring Tool During CPR in the Pre-Hospital Settings. An Analysis of 87 Cases in Osaka, Japan

Circulation ◽  
2019 ◽  
Vol 140 (Suppl_2) ◽  
Author(s):  
Shinji Shigematsu ◽  
Tomohiko Sakai ◽  
Tadahiko Shiozaki ◽  
Mitsuo Ohnishi ◽  
Ryosuke Takegawa ◽  
...  
Keyword(s):  
Oxygen Saturation ◽  
Primary Outcome ◽  
Hospital Setting ◽  
Primary Outcome Measure ◽  
Monitoring Tool ◽  
Non Invasive ◽  
Invasive Method ◽  
Neurologically Intact

Introduction: The simplified monitoring of regional cerebral oxygen saturation (rSO 2 ) is a non-invasive method of measuring cerebral perfusion, but continuous changes in the cerebral rSO 2 values among OHCA patients in the pre-hospital settings have not been sufficiently investigated. Our objective is to investigate the association between the change in rSO 2 pattern and patient outcome. Methods: We recently developed a very small portable rSO 2 monitoring system that can be used in the pre-hospital setting. The system can monitor cerebral rSO 2 immediately after attachment; monitoring is performed continuously during CPR. The system was used from June 2013 to May 2019 in Osaka City, Japan.The primary outcome measure was neurologically intact survival at 1 month. Results: We collected the continuous changes in the cerebral rSO 2 values of 87 OHCA patients during CPR by EMS personnel. The analyses of the continuous changes in the rSO 2 values of the 79 cases in which the rSO 2 value was measured before ROSC revealed two patterns of changes in the cerebral rSO 2 values. In type 1 (increasing rSO 2 type; n=38), the measured rSO 2 gradually increased during CPR or after ROSC. There were 3 patients of neurologically intact survival in type 1. In type 2 (non-increasing rSO 2 type; n=41), the measured rSO 2 did not increase during CPR. There was no patient of neurologically intact survival in type 2. We found an instructive phenomenon in the changes of the cerebral rSO 2 values. Measured rSO 2 dropped after confirmation of ROSC, which suggests that re-arrest had occurred during monitoring. Conclusion: We measured the continuous changes in cerebral rSO 2 values among 87 patients with OHCA in the pre-hospital setting and found 2 patterns and an instructive phenomenon in the continuous changes in rSO 2 values. Increasing type rSO 2 during CPR appeared to be associated with neurologically intact survival at 1 month.

Abstract 281: Is Cerebral Regional Oxygen Saturation (rSO 2 ) Useful as a Physiological Monitoring Tool During CPR in Pre-Hospital Settings? An Analysis of 72 Cases in Osaka, Japan

Circulation ◽  
2018 ◽  
Vol 138 (Suppl_2) ◽  
Author(s):  
Tomohiko Sakai ◽  
Tadahiko Shiozaki ◽  
Mitsuo Ohnishi ◽  
Ryosuke Takegawa ◽  
Jotaro Tachino ◽  
...  
Keyword(s):  
Oxygen Saturation ◽  
Monitoring System ◽  
Cerebral Perfusion ◽  
Medical Service ◽  
Regional Cerebral Oxygen Saturation ◽  
Monitoring Tool ◽  
Non Invasive ◽  
Short Time

Introduction: Simplified monitoring system of regional cerebral oxygen saturation (rSO 2 ) is a non-invasive technology for cerebral perfusion, but continuous changes of cerebral rSO 2 values among OHCA patients in pre-hospital settings have been insufficiently investigated. Methods: We recently developed a portable rSO 2 monitoring system that is very small (170х100х50mm in size and 600g in weight) and can use in pre-hospital settings. The sensor pad is attached to the patient’s forehead by the emergency-medical-service (EMS) personnel, and it can monitor cerebral rSO 2 immediately and continuously during CPR, from June 2013 through May 2018 in Osaka City, Japan. Results: We collected continuous changes in cerebral rSO 2 values for 72 OHCA patients during CPR by EMS personnel. Sixty-six cases were measured rSO 2 before ROSC and 6 cases were measured after ROSC. According to the analyses of continuous changes in rSO 2 values of 66 cases, two patterns of changes in cerebral rSO 2 values were found as follows; Type 1: Increasing rSO 2 type (n=30). Measured rSO 2 increased gradually during CPR or after ROSC. Type 2: Not increasing rSO 2 type (n=36) Measured rSO 2 did not increase during CPR. And we found out two phenomena of changes in cerebral rSO 2 values were found as follows; Phenomenon 1: Dropping rSO 2 type (n=3). Measured rSO 2 dropped after confirmation of ROSC or before arrest, which suggests that the re-arrest or arrest occurred during monitoring. Phenomenon 2: Initially decreasing rSO 2 type (n=6). Measured rSO 2 decreased gradually despite performing CPR by EMS personnel, which suggests that short time has passed after arrest. Conclusion: We measured continuous changes in cerebral rSO 2 values among 72 patients with OHCA pre-hospital settings and found the 2 patterns and 2-specific phenomena regarding continuous changes in rSO 2 values. Furthermore, it is needed to collect many cases to establish resuscitation strategies for OHCA by using cerebral rSO 2 monitoring.

Pulse oximetry

2007 ◽  
pp. 327-330
Keyword(s):  
Oxygen Saturation ◽  
Pulse Oximetry ◽  
Optical Density ◽  
Oxygen Delivery ◽  
Tissue Oxygen ◽  
Non Invasive ◽  
Tissue Oxygen Delivery ◽  
Invasive Method ◽  
Beer’S Law ◽  
Light Absorbance

Pulse oximetry 328 When employed correctly, pulse oximetry is a rapid non-invasive method of assessing one of the key components of tissue oxygen delivery: the oxygen saturation of haemoglobin (SaO2). • Based on the laws of light absorbance and optical density (Lambert's law and Beer's law), i.e. the principle that deoxygenated and oxygenated hemoglobin absorb light at different wavelengths....

Development of a non-invasive blood sugar sensor

Impact ◽  
2019 ◽  
Vol 2019 (8) ◽  
pp. 38-40
Author(s):  
Koichi Yamakawa
Keyword(s):  
Blood Sugar ◽  
Blood Sugar Level ◽  
Research Team ◽  
The Body ◽  
Invasive Technique ◽  
Risk Of Infection ◽  
Non Invasive ◽  
Finger Prick

A person with diabetes mellitus, which is commonly referred to as diabetes and exists in two forms (type 1 and type 2) must inject themselves with insulin to manage their blood sugar level. This is because the disease causes a person's blood sugar level to become too high and insulin, a hormone produced in the pancreas, helps the body to use sugar for energy. In type 1 diabetes the body's immune system attacks and destroys the cells that produce insulin and in type 2 the pancreas is unable to make enough insulin or the insulin it does make doesn't work properly. As such, in both types of the disease, insulin must be injected into the body and injecting becomes an essential part of the daily regimes of people with diabetes. As you can imagine, this, coupled with the need to regularly check blood sugar with finger prick tests, can be inconvenient as well as painful. In addition, there is the risk of infection. However, there is currently no alternative. A Japan-based research team is working on developing a non-invasive technique for measuring blood glucose.

scholarly journals Insulin therapy in the hospital setting: a time for a change?

2016 ◽  
Vol 10 (1) ◽  
pp. 23
Author(s):  
Ada Maffettone ◽  
Massimo Rinaldi ◽  
Luigi Ussano ◽  
Andrea Fontanella
Keyword(s):  
Hospital Setting ◽  
The Other ◽  
Hospital Inpatient ◽  
Insulin Administration ◽  
Diabetes Treatment ◽  
Successful Management ◽  
Pros And Cons ◽  
Insulin Pens

The number of people with diabetes mellitus worldwide is expected to be more than double from 171 million in 2000 to 366 million in 2030. Approximately 25% of all hospital inpatient days are affected by diabetes. In Italy there are more than 12,000 hospitalizations excesses for 100,000 people per year, with a huge economic impact. Ever since its discovery in the 1920s, insulin has been the milestone of type 1 diabetes treatment and its use is increasingly necessary for the successful management of type 2 diabetes. Often patients believe that injecting insulin can be painful, inconvenient and embarrassing; generally they are afraid of gaining weight and of hypoglycemia. On the other side, physician’s concerns regarding insulin administration include potential dosing errors and patient non-compliance. Ever since its discovery in the mid-1920s, insulin was administered subcutaneously using a vial and syringe. In 1985 the first pen device was launched. Currently disposable insulin pens are the most used and preferred by patients in the daily use, but are not routinely used for diabetic inpatients. In this paper we will focus on the pros and cons of insulin administration with pens in the hospital setting.

NON-INVASIVE BLOOD OXYGEN SATURATION MONITORING (SpO2) USING TRANSMITTANCE FOR PULSE OXIMETER

2019 ◽  
Vol 31 (06) ◽  
pp. 1950043
Author(s):  
Anupama Sarkar ◽  
Vineet Sinha ◽  
Sadhana A. Mandlik ◽  
J. Kathirvelan
Keyword(s):  
Embedded System ◽  
Oxygen Saturation ◽  
Low Cost ◽  
Vital Role ◽  
Critical Conditions ◽  
Blood Oxygen Saturation ◽  
Respiratory Problems ◽  
Non Invasive ◽  
Photo Detectors ◽  
Invasive Method

Measuring oxygen saturation of blood (SpO2) clinically plays a vital role in patient’s health monitoring. In fact, monitoring oxygen level is necessary for people having respiratory problems (pulmonary hypertension) and in other critical conditions. The primary motivation of this work is to develop a low cost computer-based oxygen saturation monitoring system using an embedded system along with lab windows CVI platform. The process of calculating the level of oxygen saturation in the blood using non-invasive method is also called as pulse oximetry, which consists of LED and photo detectors, using MSP430FG4618 microcontroller. The MSP430 employed in designing the microcontroller firmware program for digitization and transmission of the data from sensor to the computer. NI-based Lab windows/CVI Platform was developed as a part of this project to receive, plot, save data and determine the accuracy of SpO2 value. In this proposed system, we have achieved the maximum accuracy of 99.49% which is better than the previously developed methods. The proposed system is also designed with the low cost and low power consuming modules.

scholarly journals Omics-based biomarkers in the diagnosis of diabetes

2019 ◽  
Vol 31 (2) ◽  
Author(s):  
Wei Zien Gan ◽  
Valsala Ramachandran ◽  
Crystale Siew Ying Lim ◽  
Rhun Yian Koh
Keyword(s):  
Metabolic Diseases ◽  
Early Screening ◽  
Glucose Levels ◽  
Non Invasive ◽  
Life Threatening ◽  
Autoantibody Detection ◽  
Relationship Of ◽  
The Relationship

AbstractDiabetes mellitus (DM) is a group of metabolic diseases related to the dysfunction of insulin, causing hyperglycaemia and life-threatening complications. Current early screening and diagnostic tests for DM are based on changes in glucose levels and autoantibody detection. This review evaluates recent studies on biomarker candidates in diagnosing type 1, type 2 and gestational DM based on omics classification, whilst highlighting the relationship of these biomarkers with the development of diabetes, diagnostic accuracy, challenges and future prospects. In addition, it also focuses on possible non-invasive biomarker candidates besides common blood biomarkers.

P1578Outcomes in patients with renal impairment and myocardial injury or infarction identified by high-sensitivity cardiac troponin testing: a secondary analysis of the High-STEACS trial

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
P J Gallacher ◽  
E Miller-Hodges ◽  
A Shah ◽  
A Anand ◽  
K K Lee ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Renal Function ◽  
Renal Impairment ◽  
Cardiac Troponin ◽  
Myocardial Injury ◽  
Primary Outcome ◽  
Secondary Analysis ◽  
High Sensitivity

Abstract Background Patients with renal impairment are at increased risk of myocardial infarction (MI), but the interpretation of cardiac troponin is challenging in this setting. The use of high-sensitivity cardiac troponin (hs-cTn) assays increases the detection of myocardial injury, yet may contribute to uncertainty in the diagnosis of MI in those with renal impairment. Purpose To describe the diagnosis and outcomes of patients with myocardial injury or infarction identified using a hs-cTnI assay, stratified by renal function. Methods In a pre-specified secondary analysis of a stepped-wedge cluster-randomised controlled trial, we identified consecutive patients with a hs-cTnI concentration greater than the sex-specific 99th centile between June 2013 and March 2016. The diagnoses of type 1 or type 2 MI were adjudicated and classified according to the 4th Universal Definition of Myocardial Infarction. Renal impairment was defined as an estimated glomerular filtration rate (eGFR) of <60 mL/min/1.73m2.The primary outcome of type 1 or type 4b MI or cardiovascular death was compared in patients with and without renal impairment at 1 year. Results A measure of renal function was available in 47,334 (98.0%) patients, of whom 7,933 (16.8%) had renal impairment (mean age 76±12 years; 54% female). Plasma hs-cTnI concentrations were >99th centile in 47.9% (3,800/7,933) of patients with renal impairment and 16.3% (6,439/39,401) of patients with normal renal function. In those with and without renal impairment, the adjudicated diagnosis was type 1 MI in 35.2% (1,336/3,800) and 55.8% (3,596/6,439) of patients, and type 2 MI in 12.6% (480/3,800) and 9.7% (626/6,439) of patients, respectively (P<0.001 for both). In patients with hs-cTnI concentrations >99th centile, the primary outcome occurred in 24.9% (945/3,800) of patients with renal impairment, compared to 12.1% (779/6,439) of patients with normal renal function (P<0.001). In patients with type 1 MI, the primary outcome occurred in 32.6% (436/1,336) of those with renal impairment and 11.7% (419/3,596) of those without (P<0.001). In patients with type 2 MI, the primary outcome occurred in 20.4% (98/480) and 9.9% (62/626) of patients with and without renal impairment, respectively (P<0.001). Conclusion Almost half of all patients with suspected acute coronary syndrome and renal impairment have hs-cTnI concentrations greater than the sex-specific 99th centile. Whilst only one in three had a diagnosis of type 1 MI, an elevated troponin concentration was associated with a poorer prognosis in those with concomitant renal impairment compared to those without, irrespective of the index diagnosis. Acknowledgement/Funding British Heart Foundation

scholarly journals COVID -19: Case report of assertive treatment in diabetic patients

2021 ◽  
Vol 7 (1) ◽  
pp. 009-014
Author(s):  
Glayson Guimarães Morais Ferreira ◽  
Luciene dos Santos Ferreira Guimarães
Keyword(s):  
Case Report ◽  
Socioeconomic Inequality ◽  
The Body ◽  
Tetracycline Hydrochloride ◽  
Diabetic Patients ◽  
Non Invasive ◽  
Invasive Method ◽  
Impacting Factors ◽  
Type 2 Diabetic

COVID 19 is currently one of the most impacting factors in world society, both because of the ineffectiveness of pharmacological measures and because of socioeconomic inequality. Diabetes is one of the comorbidities that makes the body more vulnerable to the development of severe COVID-19. Diabetes does not increase the patient's risk of becoming infected with the new coronavirus, but it does increase the chances of complications from the infection. This study uses a descriptive and observational methodology of the assertive evolution of the COVID-19 case report. It is a descriptive, exploratory, non-invasive method, with mediated intervention, in a 42-year-old male patient, type 2 diabetic, undergoing pharmacological monitoring and in treatment of lichenoid pityriasis with 500mg tetracycline hydrochloride, on alternate days. During treatment for pityriasis lichenoid, the patient contracted the coronavirus, changing the antibiotic for daily use, resulting in the remission of symptoms after 3 days of medication. This new scenario opens the possibility for clinical and scientific research through randomized studies of the antibiotic tetracycline hydrochloride 500 mg, to investigate its action on the viral replication of the new coronavirus.

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