scholarly journals Remifentanil Concentration during Target-controlled Infusion of Propofol

2002 ◽  
Vol 30 (5) ◽  
pp. 578-583 ◽  
Author(s):  
D. P. Crankshaw ◽  
C. Chan ◽  
K. Leslie ◽  
A. R. Bjorksten
Keyword(s):  
High Performance ◽  
Sequential Analysis ◽  
Surgical Patients ◽  
Target Concentration ◽  
Blood Concentrations ◽  
Remifentanil Infusion ◽  
Arterial Blood ◽  
Respiratory Parameters ◽  
Significant Difference ◽  
Written Informed Consent

After institutional approval and with written informed consent, eight surgical patients were infused intravenously with remifentanil at 250 ng.kg lean body mass (LBM) -1 .min -1 for 30 min. Cardiovascular and respiratory parameters were recorded and arterial blood samples were taken at regular intervals. In each patient, the same protocol was repeated 40 min later during propofol infused to a target concentration of 3.0 μg.ml -1. Blood concentrations of remifentanil and propofol were assayed using capillary gas chromatography and high performance liquid chromatography techniques respectively. The number of subjects enrolled was determined by testing the successive areas under the remifentanil time-concentration curve (AUC) for significant difference or non-difference using sequential analysis. The median measured propofol concentration was 3.5 (range: 2.6–4.5) μg.ml -1 which did not change significantly during the second remifentanil infusion. The median AUC during propofol infusion was greater than control in all subjects, although there was considerable variation of 94.4 (64.3–129.6) versus 64.6 (34.8–126.9) ng.ml -1 .min; P=0.008, n=8. After 30 min, there was no significant difference in remifentanil concentration during propofol infusion when compared with remifentanil alone of 4.6 (3.2–5.7) versus 3.8 (1.6–4.9) ng.ml -1; P=0.73, n=8. Co-administration of propofol and remifentanil may result in greater remifentanil concentrations than when remifentanil is infused alone.

scholarly journals Clinical agreement and interchangeability of TEG5000 and TEG6s during cardiac surgery

2020 ◽  
Vol 48 (1) ◽  
pp. 43-52
Author(s):  
Qi Wong ◽  
Kelly P Byrne ◽  
Scott C Robinson
Keyword(s):  
Cardiac Surgery ◽  
Reaction Time ◽  
Alpha Angle ◽  
Maximum Amplitude ◽  
Surgical Patients ◽  
Treatment Recommendation ◽  
New Device ◽  
Management Algorithm ◽  
Arterial Blood ◽  
Significant Difference

TEG6s® is a new device introduced by the Haemonetics Corporation and designed to provide the same information as TEG® 5000 (Haemonetics Corporation, Braintree, MA, USA) but with much greater ease of use. We tested whether using citrated TEG6s gave reaction time, maximum amplitude and percentage of clot that had lysed at 30 minutes values similar to a non-citrated TEG5000, to allow clinical interchangeability using our current thrombelastography management algorithm for cardiac surgery. We also examined the agreement between the alpha-angle and functional fibrinogen maximum amplitude in our cardiac surgical patients.  In total, 243 paired arterial blood samples in 99 patients were tested, using TEG5000 (non-citrated) and TEG6s (citrated) after induction of anaesthesia (prior to heparin administration), following protamine administration at the end of the cardiac bypass and whenever a TEG5000 was requested after this by the attending anaesthetist. Bland–Altman plots and Lin’s concordance coefficient were used to compare agreement whereas modified Bland–Altman plots and McNemar’s test were used to illustrate the differences in management recommendations between the two thrombelastography devices.  All 243 samples were compared for reaction time and alpha-angle; 239 samples were compared for maximum amplitude; 136 samples were compared for the percentage of clot that had lysed at 30 minutes; 16 samples were compared for functional fibrinogen maximum amplitude. Lin’s concordance coefficient for these parameters was: reaction time 0.63, alpha-angle 0.39, maximum amplitude 0.5, percentage of clot that had lysed at 30 minutes 0.09 and functional fibrinogen maximum amplitude 0.31. Differences between the two devices became more marked at more abnormal values. Significant differences in median values, suggesting a fixed bias, were found for maximum amplitude and functional fibrinogen maximum amplitude. Differences in treatment recommendation could only be calculated for reaction time and maximum amplitude. Maximum amplitude was found to have a significant difference in treatment recommendation between the two devices using our current thrombelastography management algorithm for cardiac surgery with TEG6s recommending treatment in 11.5% more patients than TEG5000.  Using the TEG6s with our current TEG5000–based thrombelastography management algorithm for cardiac surgery would result in a change in treatment recommendation in at least 10% of our cardiac surgical patients. Agreement between the two thrombelastography devices appears to decrease with increasing patient coagulopathy. New algorithms will need to be developed and tested to validate TEG6s for cardiac surgical patients in our institution.

scholarly journals Comparison of the effects of heparin 1000 and 5000 units on arterial blood gases

2020 ◽  
Vol 37 (3) ◽  
pp. 267-273
Author(s):  
Reza Borabadi ◽  
Mostafa Rad ◽  
Mohammad Rakhshani ◽  
Mojtaba Rad
Keyword(s):  
Clinical Trial ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Blood Gases ◽  
Metabolic Parameters ◽  
Arterial Blood Gases ◽  
R Software ◽  
Arterial Blood ◽  
Respiratory Parameters ◽  
Significant Difference

Analysis of arterial blood gases is necessary for managing the respiratory and metabolic parameters of patients in the intensive care unit. The aim of this study was to compare the effects of heparin 1000 and heparin 5000 units on arterial blood gases in patients admitted to the intensive care unit. This study was a triple-blinded clinical trial. A total of 78 patients with head injury were randomly selected from the emergency department of a hospital in an urban area of Iran in 2017. Data was collected using a questionnaire and a checklist of laboratory parameters. Data was analyzed using descriptive and inferential statistical methods via the R software. Statistically significant differences in Na, SaO2, Ca, BEecf (p < 0.001), and HCO3, BEe and K were observed between the two groups (p < 0.01). No statistically significant difference between the values of PaCO2, PH and PaO2 in the two groups were reported (p > 0.05). The results of this study confirmed that heparin 1000 and heparin 5000 units had no effects on respiratory parameters in analyzing arterial blood gases. However, the concentration of heparin had a significant effect on metabolic parameters for the analysis of arterial blood gases and electrolytes.

scholarly journals Comparative Study between Propofol in a Long-chain Triglyceride and Propofol in a Medium/Long-chain Triglyceride during Sedation with Target-controlled Infusion

2005 ◽  
Vol 33 (3) ◽  
pp. 351-355 ◽  
Author(s):  
M. Yamakage ◽  
S. Iwasaki ◽  
S-W. Jeong ◽  
S-I. Ishiyama ◽  
A. Namiki
Keyword(s):  
Plasma Concentration ◽  
High Performance ◽  
Plasma Concentrations ◽  
Pharmacokinetics And Pharmacodynamics ◽  
Blood Concentrations ◽  
Arterial Blood ◽  
Target Controlled Infusion ◽  
Long Chain Triglycerides ◽  
Long Chain ◽  
Long Chain Triglyceride

This study was performed to compare the pharmacological characteristics of propofol in an emulsion of both medium- and long-chain triglycerides (MCT/LCT) with those of propofol in an LCT emulsion, by measuring the sedative level and the plasma concentration of propofol during sedation using a target-controlled infusion (TCI) technique. Forty ASA 1 or 2 adult patients who required spinal anaesthesia for surgery were enrolled in this study. The patients were divided into two groups: a propofol LCT group (n=20) and a propofol MCT/LCT group (n=20). Propofol was injected intravenously at target blood concentrations of 2.0, 3.0 and 4.0 μg.ml–1. The bispectral (BIS®) index was recorded, and arterial blood was drawn to measure the actual plasma concentrations of propofol at each predicted concentration. Propofol was assayed by high-performance liquid chromatography. Propofol MCT/LCT was associated with significantly less pain than propofol LCT (P<0.05). There were no significant differences between the two groups in BIS® index or in plasma concentration of propofol at each predicted concentration. Computer-generated TCI of propofol MCT/LCT during sedation is comparable with that of propofol LCT with respect to pharmacokinetics and pharmacodynamics. The formulation of MCT/LCT has a beneficial effect with respect to less pain on injection.

Vitamin C, Thiamine, and Hydrocortisone in the Treatment of Sepsis: A Meta-Analysis and Trial Sequential Analysis of Randomized Controlled Trials

2021 ◽  
pp. 088506662098780
Author(s):  
Yazan Zayed ◽  
Bashar N. Alzghoul ◽  
Momen Banifadel ◽  
Hima Venigandla ◽  
Ryan Hyde ◽  
...  
Keyword(s):  
Septic Shock ◽  
Length Of Stay ◽  
Vitamin C ◽  
Sofa Score ◽  
Sequential Analysis ◽  
Trial Sequential Analysis ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Icu Length Of Stay ◽  
Significant Difference

Background: There is a conflicting body of evidence regarding the benefit of vitamin C, thiamine, and hydrocortisone in combination as an adjunctive therapy for sepsis with or without septic shock. We aimed to assess the efficacy of this treatment among predefined populations. Methods: A literature review of major electronic databases was performed to include randomized controlled trials (RCTs) evaluating vitamin C, thiamine, and hydrocortisone in the treatment of patients with sepsis with or without septic shock in comparison to the control group. Results: Seven studies met our inclusion criteria, and 6 studies were included in the final analysis totaling 839 patients (mean age 64.2 ± 18; SOFA score 8.7 ± 3.3; 46.6% female). There was no significant difference between both groups in long term mortality (Risk Ratio (RR) 1.05; 95% CI 0.85-1.30; P = 0.64), ICU mortality (RR 1.03; 95% CI 0.73-1.44; P = 0.87), or incidence of acute kidney injury (RR 1.05; 95% CI 0.80-1.37; P = 0.75). Furthermore, there was no significant difference in hospital length of stay, ICU length of stay, and ICU free days on day 28 between the intervention and control groups. There was, however, a significant difference in the reduction of SOFA score on day 3 from baseline (MD −0.92; 95% CI −1.43 to −.41; P < 0.05). In a trial sequential analysis for mortality outcomes, our results are inconclusive for excluding lack of benefit of this therapy. Conclusion: Among patients with sepsis with or without septic shock, treatment with vitamin C, thiamine, and hydrocortisone was not associated with a significant reduction in mortality, incidence of AKI, hospital and ICU length of stay, or ICU free days on day 28. There was a significant reduction of SOFA score on day 3 post-randomization. Further studies with a larger number of patients are needed to provide further evidence on the efficacy or lack of efficacy of this treatment.

scholarly journals Blood Micronutrient and Thyroid Hormone Concentrations in the Oldest-Old

2000 ◽  
Vol 85 (6) ◽  
pp. 2260-2265 ◽  
Author(s):  
Giovanni Ravaglia ◽  
Paola Forti ◽  
Fabiola Maioli ◽  
Barbara Nesi ◽  
Loredana Pratelli ◽  
...  
Keyword(s):  
Thyroid Hormone ◽  
Thyroid Hormones ◽  
Oldest Old ◽  
Serum Zinc ◽  
Blood Levels ◽  
Elderly Age ◽  
Blood Concentrations ◽  
Significant Difference ◽  
Plasma Retinol ◽  
Age Range

Several micronutrients are involved in thyroid hormone metabolism, but it is unclear whether their marginal deficits may contribute to the alterations in thyroid function observed in extreme aging. The relationships among blood concentrations of thyroid hormones and selenium, zinc, retinol, and α-tocopherol were studied in 44 healthy Northern Italian oldest-old subjects (age range, 90–107 yr), selected by the criteria of the SENIEUR protocol. Control groups included 44 healthy adult (age range, 20–65 yr) and 44 SENIEUR elderly (age range, 65–89 yr) subjects. Oldest-old subjects had higher TSH (P &lt; 0.01) and lower free T3 (FT3)/freeT4 (FT4) ratio, zinc, and selenium serum values (P &lt; 0.001) than adult and elderly control subjects. No significant difference was found for plasma retinol and α-tocopherol values. The associations between micronutrients and thyroid hormones were evaluated by multivariate analysis. In oldest-old subjects, plasma retinol was negatively associated with FT4 (P = 0.019) and TSH serum levels (P = 0.040), whereas serum zinc was positively associated with serum FT3 (P = 0.010) and FT3/FT4 ratio (P = 0.011). In younger subjects, no significant association was found among thyroid variables and micronutrients. In conclusion, blood levels of specific micronutrients are associated with serum iodothyronine levels in extreme aging.

Carbon Dioxide Equilibration in Canine Lungs during Rebreathing and Acute Alkalosis

1979 ◽  
Vol 57 (5) ◽  
pp. 385-388 ◽  
Author(s):  
R. D. Latimer ◽  
G. Laszlo
Keyword(s):  
Whole Blood ◽  
Base Excess ◽  
Venous Blood ◽  
Main Pulmonary Artery ◽  
Mixed Venous Blood ◽  
Arterial Blood ◽  
Significant Difference ◽  
Venous Pco2 ◽  
Pulmonary Arterial ◽  
Gas Pressures

1. The left lower lobe of the lungs of six anaesthetized dogs were isolated by the introduction of a bronchial cannula at thoracotomy. Catheters were introduced into the main pulmonary artery and a vein draining the isolated lobe. 2. Blood-gas pressures and pH were measured across the isolated lobe and compared with gas pressures in alveolar samples from the lobe. 3. When the isolated lobe was allowed to reach gaseous equilibrium with pulmonary arterial blood for 30 min, there was no significant difference between alveolar and pulmonary venous Pco2. Mean values of whole-blood base excess were similar in pulmonary arterial and pulmonary venous blood. 4. After injection of 20 ml of 8·4% sodium bicarbonate solution into a peripheral vein, Pco2, pH and plasma bicarbonate concentrations rose in the mixed venous blood. There was no change of whole-blood base excess across the lung, indicating that HCO−3, as distinct from dissolved CO2, did not enter lung tissue in measurable amounts. 5. No systematic alveolar—pulmonary venous Pco2 differences were demonstrated in this preparation other than those explicable by maldistribution of lobar blood flow.

scholarly journals Ozone Response of Leaf Physiological and Stomatal Characteristics in Brassica juncea L. at Supraoptimal Temperatures

Land ◽  
2021 ◽  
Vol 10 (4) ◽  
pp. 357
Author(s):  
Jong Kyu Lee ◽  
Myeong Ja Kwak ◽  
Sang Hee Park ◽  
Han Dong Kim ◽  
Yea Ji Lim ◽  
...  
Keyword(s):  
Brassica Juncea ◽  
Agricultural Production ◽  
Stomatal Density ◽  
Anthropogenic Activities ◽  
Interactive Effects ◽  
Target Concentration ◽  
Stomatal Characteristics ◽  
Elevated O3 ◽  
Significant Difference ◽  
Supraoptimal Temperatures

Plants are affected by the features of their surrounding environment, such as climate change and air pollution caused by anthropogenic activities. In particular, agricultural production is highly sensitive to environmental characteristics. Since no environmental factor is independent, the interactive effects of these factors on plants are essential for agricultural production. In this context, the interactive effects of ozone (O3) and supraoptimal temperatures remain unclear. Here, we investigated the physiological and stomatal characteristics of leaf mustard (Brassica juncea L.) in the presence of charcoal-filtered (target concentration, 10 ppb) and elevated (target concentration, 120 ppb) O3 concentrations and/or optimal (22/20 °C day/night) and supraoptimal temperatures (27/25 °C). Regarding physiological characteristics, the maximum rate of electron transport and triose phosphate use significantly decreased in the presence of elevated O3 at a supraoptimal temperature (OT conditions) compared with those in the presence of elevated O3 at an optimal temperature (O conditions). Total chlorophyll content was also significantly affected by supraoptimal temperature and elevated O3. The chlorophyll a/b ratio significantly reduced under OT conditions compared to C condition at 7 days after the beginning of exposure (DAE). Regarding stomatal characteristics, there was no significant difference in stomatal pore area between O and OT conditions, but stomatal density under OT conditions was significantly increased compared with that under O conditions. At 14 DAE, the levels of superoxide (O2-), which is a reactive oxygen species, were significantly increased under OT conditions compared with those under O conditions. Furthermore, leaf weight was significantly reduced under OT conditions compared with that under O conditions. Collectively, these results indicate that temperature is a key driver of the O3 response of B. juncea via changes in leaf physiological and stomatal characteristics.

scholarly journals Determination of Tissue Distribution of Alisol G, a CB1R Antagonist, in Rats by Ultra-High-Performance Liquid Chromatography-Tandem Mass Spectrometry

2021 ◽  
Author(s):  
Chen-Yu Gao ◽  
Jian-Qiang Xi ◽  
Ding-Zhong Song ◽  
Jie Yuan ◽  
Wu-Si Hao ◽  
...  
Keyword(s):  
Mass Spectrometry ◽  
High Performance Liquid Chromatography ◽  
Liquid Chromatography ◽  
Tandem Mass Spectrometry ◽  
High Performance ◽  
Tandem Mass ◽  
Blood Concentrations ◽  
Therapeutic Benefits ◽  
Chromatography Tandem Mass Spectrometry ◽  
Liquid Chromatography Tandem Mass

AbstractPeripheral CB1R blockers without crossing the blood–brain barrier (BBB) have demonstrated therapeutic benefits in metabolic syndromes, including obesity. Among them is Alisol G, a tetracyclic triterpene from Alismatis rhizoma (zexie), which can effectively reduce the weight of obese mice. Results from CP55940-induced [35S] GTPγS cannabinoid-type 1 receptor (CB1R) binding assay show an IC50 of 34.8 μmol/L for Alisol G, implicating its role as a CB1R antagonist. The purpose of our study is to assess whether Alisol G could serve as a peripheral CB1R antagonist for obesity treatment. In this study, we build a simple, reliable, and sensitive method to detect the concentration of Alisol G in rat tissue by ultra-high-performance liquid chromatography-tandem mass spectrometry (UHPLC-MS/MS). The results showed that Alisol G was mainly distributed in intestinal midgut, mucosa and small intestine, with little brain exposure. We suggested that intestine may be the main acting sites of Alisol G. Through comparison of brain and blood concentrations of Alisol G, our data showed that Alisol G cannot penetrate the BBB easily. In conclusion, Alisol G may represent a peripheral CB1R antagonist for the further treatment of obesity.

scholarly journals Metabolomic analysis reveals the interaction of primary and secondary metabolism in white, pale green, and green pak choi (Brassica rapa subsp. chinensis)

2021 ◽  
Vol 64 (1) ◽  
Author(s):  
Hyeon Ji Yeo ◽  
Seung-A Baek ◽  
Ramaraj Sathasivam ◽  
Jae Kwang Kim ◽  
Sang Un Park
Keyword(s):  
Secondary Metabolites ◽  
Brassica Rapa ◽  
High Performance ◽  
Reducing Power ◽  
Total Phenolic ◽  
Pak Choi ◽  
Primary And Secondary Metabolites ◽  
Chlorophyll Contents ◽  
Significant Difference ◽  
Pale Green

AbstractThis study aimed to comprehensively analyze primary and secondary metabolites of three different-colored (white, pale green, and green) pak choi cultivars (Brassica rapa subsp. chinensis) using gas chromatography attached with time-of-flight mass spectrometry (GC-TOFMS) and high-performance liquid chromatography (HPLC). In total, 53 primary metabolites were identified and subjected to partial least-squares discriminant analysis. The result revealed a significant difference in the primary and secondary metabolites between the three pak choi cultivars. In addition, 49 hydrophilic metabolites were detected in different cultivars. Total phenolic and glucosinolate contents were highest in the pale green and green cultivars, respectively, whereas total carotenoid and chlorophyll contents were highest in the white cultivar. Superoxide dismutase activity, 2,2-diphenyl-1-picrylhydraz scavenging, and reducing power were slightly increased in the white, pale green, and green cultivars, respectively. In addition, a negative correlation between pigments and phenylpropanoids was discovered by metabolite correlation analysis. This approach will provide useful information for the development of strategies to enhance the biosynthesis of phenolics, glucosinolates, carotenoids, and chlorophyll, and to improve antioxidant activity in pak choi cultivars. In addition, this study supports the use of HPLC and GC-TOFMS-based metabolite profiling to explore differences in pak choi cultivars.

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