Relationship between Pulmonary Resistance and Changes in Arterial Blood Gas Tension in Dogs with Nasal Obstruction, and Partial Laryngeal Obstruction

Arterial blood gas tension and pulmonary resistance were measured in dogs with surgically created (A) nasal, and (B) laryngeal obstructions. Preobstruction mean values were obtained in all parameters for normal control data. Postobstruction measurements were made, serially, over a period ranging from three days to three months. Changing the dogs from nose to mouth breathers resulted in significant adverse changes in laryngeal resistance, especially marked in the expiratory phase, decreased Po2 and retention of Pco2 as well as some change in pulmonary resistance. Laryngeal obstruction resulted in significant pre and postobstruction differences in pressure-flow relations in the larynx, k1 and k2 values and arterial hypoxemia. Results suggest some anatomic and physiologic changes occurring in the lower airway as a result of marked nasal and partial laryngeal obstruction.

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Hypoxia among patients on the liver-transplant waiting list

ABCD Arquivos Brasileiros de Cirurgia Digestiva (São Paulo) ◽

10.1590/s0102-67202014000100014 ◽

2014 ◽

Vol 27 (1) ◽

pp. 56-58 ◽

Cited By ~ 8

Author(s):

Lucas Souto NACIF ◽

Wellington ANDRAUS ◽

Kathryn SARTORI ◽

Carlos Marlon BENITES ◽

Vinicius Rocha SANTOS ◽

...

Keyword(s):

Liver Transplant ◽

Waiting List ◽

Blood Type ◽

High Rate ◽

Blood Gas ◽

Mean Values ◽

Arterial Blood Gas ◽

Arterial Blood ◽

The Mean ◽

Liver Transplant Waiting List

Background: Hepatopulmonary syndrome is formed by a triad of liver disease, intrapulmonary vascular dilatation and changes in blood gases. This condition is present in 4-32% of patients with cirrhosis. Aim : To analyze the blood gas changes data of patients in liver-transplant waiting list. Method: Clinical data of 279 patients in liver transplantation waiting list in May 2013 were studied. Overall patient was analyzed by the demographic aspects, laboratorial and image findings on exams that determine lung disease (hypoxemia) in these cirrhotic patients. The mean values and standard deviations were used to examine normally distributed variables. Results: There was a high prevalence of male patients (68%); the mean age was 51(±5,89) years, and the predominant reason for listing was hepatitis C cirrhosis. The MELD score mean was 16±5,89, without prioritization or special situation. The most common blood type was O in 129 cases (46%) and the mean of body max index was 25,94±4,58. Regarding arterial blood gas tests was observed 214 patients with PaO2 <90 mmHg, 80 with PaO2 <80 mmHg and 39 with PaO2 <50 mmHg. In relation to O2 saturation, 50 patients had <90%, 33 <80% and 10 <50%. Conclusion: Was observed a high rate of hypoxemia in patients on waiting list liver transplant. Due to the high severity and morbidity, is suggested better monitoring and therapeutic support to hypoxemic patients on liver transplant waiting list.

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Aberrant PO2 values in proficiency testing

Clinical Chemistry ◽

10.1093/clinchem/39.3.467 ◽

1993 ◽

Vol 39 (3) ◽

pp. 467-471

Author(s):

C E Fonzi ◽

J L Clausen ◽

J Mahoney

Keyword(s):

Proficiency Testing ◽

Repeated Measures ◽

Mean Value ◽

Repeated Measurements ◽

Blood Gas ◽

Mean Values ◽

Arterial Blood Gas ◽

Arterial Blood ◽

Fluorocarbon Emulsion ◽

The Mean

Abstract We prospectively determined the frequency of aberrant vials of fluorocarbon/buffer used for proficiency testing of measurements of pH, PCO2, and PO2, using 20 duplicate vials from 12 lots of fluorocarbon/buffer and two arterial blood gas analyzers in eight reference laboratories. We defined aberrant vials as vials for which both duplicate measurements differed from the mean value of repeated measurements for the specific instrument (for each lot of testing materials) by > 0.04 for pH, > 10% of the mean or 3.0 mm Hg, whichever was greater, for PCO2; or > 10% of the mean or 6 mm Hg, whichever was greater, for PO2. Four of 1620 vials (0.25%) were aberrant, all based on PO2 measurements (< 70 mm Hg); all would have failed in both American/California Thoracic Societies and College of American Pathologists proficiency programs. The average intra-instrument SDs of repeated measures (range of mean values: pH, 7.181-7.631; PCO2, 12.7-65.9; PO2, 32.5-150.1) were 0.0055 for pH, 0.67 mm Hg for PCO2, and 1.65 mm Hg for PO2. Deliberate contamination of the fluorocarbon emulsion with room air, as might occur during sampling from the vial, indicated that only minor increases in PO2 (e.g., 1.0 mm Hg at PO2 of 56 mm Hg) occur when samples are aspirated. Larger increases in PO2 (mean 7.1 mm Hg at a PO2 of 66 mm Hg) occurred when the syringe samples were contaminated with room air. We conclude that isolated aberrant measurements of PO2 in blood gas proficiency testing attributable to vial contents can occur, but the frequency is very low.

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Atrial fibrillation associated with carbon monoxide poisoning

Undersea and Hyperbaric Medicine ◽

10.22462/04.06.2019.14 ◽

2019 ◽

pp. 203-206

Author(s):

Mevlut Demir ◽

◽

Muslum Sahin ◽

Ahmet Korkmaz ◽

◽

...

Keyword(s):

Atrial Fibrillation ◽

Carbon Monoxide ◽

Sinus Rhythm ◽

Partial Pressure ◽

Motor Vehicle ◽

Carbon Monoxide Poisoning ◽

Venous Blood ◽

Blood Gas ◽

Arterial Blood Gas ◽

Arterial Blood

Carbon monoxide intoxication occurs usually via inhalation of carbon monoxide that is emitted as a result of a fire, furnace, space heater, generator, motor vehicle. A 37-year-old male patient was admitted to the emergency department at about 5:00 a.m., with complaints of nausea, vomiting and headache. He was accompanied by his wife and children. His venous blood gas measures were: pH was 7.29, partial pressure of carbon dioxide (pCO2) was 42 mmHg, partial pressure of oxygen (pO2) was 28 mmHg, carboxyhemoglobin (COHb) was 12.7% (reference interval: 0.5%-2.5%) and oxygen saturation was 52.4%. Electrocardiogram (ECG) examination showed that the patient was not in sinus rhythm but had atrial fibrillation. After three hours the laboratory examination was repeated: Troponin was 1.2 pg/ml and in the arterial blood gas COHb was 3%. The examination of the findings on the monitor showed that the sinus rhythm was re-established. The repeated ECG examination confirmed the conversion to the sinus rhythm. He was monitored with the normobaric oxygen administration.

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d-Cystine di(m)ethyl ester reverses the deleterious effects of morphine on ventilation and arterial blood gas chemistry while promoting antinociception

Scientific Reports ◽

10.1038/s41598-021-89455-2 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Benjamin Gaston ◽

Santhosh M. Baby ◽

Walter J. May ◽

Alex P. Young ◽

Alan Grossfield ◽

...

Keyword(s):

Gas Exchange ◽

Intracellular Signaling ◽

Dimethyl Ester ◽

Diethyl Ester ◽

Blood Gas ◽

Negative Effects ◽

Arterial Blood Gas ◽

Arterial Blood ◽

Gas Chemistry ◽

Ventilatory Drive

AbstractWe have identified thiolesters that reverse the negative effects of opioids on breathing without compromising antinociception. Here we report the effects of d-cystine diethyl ester (d-cystine diEE) or d-cystine dimethyl ester (d-cystine diME) on morphine-induced changes in ventilation, arterial-blood gas chemistry, A-a gradient (index of gas-exchange in the lungs) and antinociception in freely moving rats. Injection of morphine (10 mg/kg, IV) elicited negative effects on breathing (e.g., depression of tidal volume, minute ventilation, peak inspiratory flow, and inspiratory drive). Subsequent injection of d-cystine diEE (500 μmol/kg, IV) elicited an immediate and sustained reversal of these effects of morphine. Injection of morphine (10 mg/kg, IV) also elicited pronounced decreases in arterial blood pH, pO2 and sO2 accompanied by pronounced increases in pCO2 (all indicative of a decrease in ventilatory drive) and A-a gradient (mismatch in ventilation-perfusion in the lungs). These effects of morphine were reversed in an immediate and sustained fashion by d-cystine diME (500 μmol/kg, IV). Finally, the duration of morphine (5 and 10 mg/kg, IV) antinociception was augmented by d-cystine diEE. d-cystine diEE and d-cystine diME may be clinically useful agents that can effectively reverse the negative effects of morphine on breathing and gas-exchange in the lungs while promoting antinociception. Our study suggests that the d-cystine thiolesters are able to differentially modulate the intracellular signaling cascades that mediate morphine-induced ventilatory depression as opposed to those that mediate morphine-induced antinociception and sedation.

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Analysis of Arterial Blood Gas Values Based on Storage Time Since Sampling: An Observational Study

Nursing Reports ◽

10.3390/nursrep11030048 ◽

2021 ◽

Vol 11 (3) ◽

pp. 517-521

Author(s):

Alejandro Montero-Salinas ◽

Marta Pérez-Ramos ◽

Fernando Toba-Alonso ◽

Leticia Quintana-DelRío ◽

Jorge Suanzes-Hernández ◽

...

Keyword(s):

Lactic Acid ◽

Observational Study ◽

Partial Pressure ◽

Group Analysis ◽

Initial Time ◽

Blood Gas ◽

Initial Sample ◽

Arterial Blood Gas ◽

Arterial Blood ◽

Prospective Longitudinal

Aim. To evaluate the influence of time on arterial blood gas values after artery puncture is performed. Method. Prospective longitudinal observational study carried out with gasometric samples from 86 patients, taken at different time intervals (0 (T0), 15 (T15), 30 (T30) and 60 (T60) min), from 21 October 2019 to 21 October 2020. The study variables were: partial pressure of carbon dioxide, bicarbonate, hematocrit, hemoglobin, potassium, lactic acid, pH, partial pressure of oxygen, saturation of oxygen, sodium and glucose. Results. The initial sample consisted of a total of 90 patients. Out of all the participants, four were discarded as they did not understand the purpose of the study; therefore, the total number of participants was 86, 51% of whom were men aged 72.59 on average (SD: 16.23). In the intra-group analysis, differences in PCO2, HCO3, hematocrit, Hb, K+ and and lactic acid were observed between the initial time of the test and the 15, 30 and 60 min intervals. In addition, changes in pH, pO2, SO2, Na and glucose were noted 30 min after the initial sample had been taken. Conclusions. The variation in the values, despite being significant, has no clinical relevance. Consequently, the recommendation continues to be the analysis of the GSA at the earliest point to ensure the highest reliability of the data and to provide the patient with the most appropriate treatment based on those results.

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Reference intervals for venous blood gas measurement in adults

Clinical Chemistry and Laboratory Medicine (CCLM) ◽

10.1515/cclm-2020-1224 ◽

2020 ◽

Vol 0 (0) ◽

Author(s):

Kirsty L. Ress ◽

Gus Koerbin ◽

Ling Li ◽

Douglas Chesher ◽

Phillip Bwititi ◽

...

Keyword(s):

Partial Pressure ◽

Meta Analysis ◽

Venous Blood ◽

Reference Interval ◽

Reference Intervals ◽

Published Data ◽

Blood Gas ◽

Arterial Blood Gas ◽

Arterial Blood ◽

Venous Blood Gas

AbstractObjectivesVenous blood gas (VBG) analysis is becoming a popular alternative to arterial blood gas (ABG) analysis due to reduced risk of complications at phlebotomy and ease of draw. In lack of published data, this study aimed to establish reference intervals (RI) for correct interpretation of VBG results.MethodsOne hundred and 51 adult volunteers (101 females, 50 males 18–70 y), were enrolled after completion of a health questionnaire. Venous blood was drawn into safePICO syringes and analysed on ABL827 blood gas analyser (Radiometer Pacific Pty. Ltd.). A non-parametric approach was used to directly establish the VBG RI which was compared to a calculated VBG RI based on a meta-analysis of differences between ABG and VBGResultsAfter exclusions, 134 results were used to derive VBG RI: pH 7.30–7.43, partial pressure of carbon dioxide (pCO2) 38–58 mmHg, partial pressure of oxygen (pO2) 19–65 mmHg, bicarbonate (HCO3−) 22–30 mmol/L, sodium 135–143 mmol/L, potassium 3.6–4.5 mmol/L, chloride 101–110 mmol/L, ionised calcium 1.14–1.29 mmol/L, lactate 0.4–2.2 mmol/L, base excess (BE) −1.9–4.5 mmol/L, saturated oxygen (sO2) 23–93%, carboxyhaemoglobin 0.4–1.4% and methaemoglobin 0.3–0.9%. The meta-analysis revealed differences between ABG and VBG for pH, HCO3−, pCO2 and pO2 of 0.032, −1.0 mmol/L, −4.2 and 39.9 mmHg, respectively. Using this data along with established ABG RI, calculated VBG RI of pH 7.32–7.42, HCO3− 23 – 27 mmol/L, pCO2 36–49 mmHg (Female), pCO2 39–52 mmHg (Male) and pO2 43–68 mmHg were formulated and compared to the VBG RI of this study.ConclusionsAn adult reference interval has been established to assist interpretation of VBG results.

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