scholarly journals Comparative study between ketamine-S-dexmedetomidine and ketamine-S-midazolam-methadone in the anesthesia of capuchin monkeys (Sapajus apella)

2022 ◽  
Vol 52 (4) ◽  
Author(s):  
Simone Marques Caramalac ◽  
Andreza Futado de Souza ◽  
Silvana Marques Caramalac ◽  
Verônica Batista de Albuquerque ◽  
Lucas Bezerra da Silva Azuaga ◽  
...  
Keyword(s):  
Respiratory Rate ◽  
Respiratory Acidosis ◽  
Capuchin Monkeys ◽  
Blood Gas ◽  
Arterial Blood Gas ◽  
Chemical Restraint ◽  
Arterial Blood ◽  
Sapajus Apella ◽  
The Mean

ABSTRACT: Anesthetic protocols have been developed to obtain the most effective and safe association in wildlife. This study compared the anesthetic effects and cardiorespiratory parameters of ketamine-S (+) (10 mg/kg)/dexmedetomidine (0.020 mg/kg) (KD ) and ketamine-S (+) (10 mg/kg)/midazolam (0.5 mg/kg)/methadone (1.0 mg/kg) (KMM ) in capuchin monkeys (Sapajus apella). Eight capuchin monkeys were randomly assigned to KD (n = 4) or KMM (n = 4) to evaluate induction, immobilization, and recovery scores, heart and respiratory rate parameters, besides systolic, mean, diastolic arterial pressure and arterial blood gas. There was no difference (P = 0.56) in the quality of induction, immobilization, and anesthetic recovery between the protocols. The time for anesthetic induction was 4 ± 1 min in the KD group and 5 ± 1 min in the KMM group, and these values were statistically equal (P = 0.28). The mean immobilization time in the KD and KMM groups were 35 ± 13 and 33 ± 15 min, respectively. Heart rate was lower in animals in the KD group (P < 0.001), while respiratory rate (P = 0.03), and mean blood pressure (P = 0.046) were higher than that of the animals in the KMM group. Respiratory acidosis occurred in the KMM group, with lower pH (7.25±0.047; P = 0.0055) and higher pCO2 (51 ± 6;mmHg; P = 0.008). Both protocols exhibited good induction quality, immobilization, and anesthetic recovery, despite cardiorespiratory and blood gas alterations observed, which warrants monitoring of cardiorespiratory variables during KD or KMM chemical restraint.

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.

Arterial blood gases

2007 ◽  
pp. 319-326
Keyword(s):  
Decision Making ◽  
Pulse Oximetry ◽  
Respiratory Rate ◽  
Management Strategy ◽  
Blood Gases ◽  
Capillary Blood ◽  
Blood Gas ◽  
Arterial Blood Gas ◽  
Arterial Blood ◽  
Gas Measurements

Arterial blood gas (ABGs) analysis forms the cornerstone of emergency respiratory investigation. In many situations values obtained dictate management strategy and facilitate decision-making. It is an uncomfortable procedure for the patients and if repeated ABGs are required, consider whether less invasive measures, such as respiratory rate, pulse oximetry or capillary blood gas measurements could be used....

A Model Pilot

2020 ◽  
pp. 71-76
Author(s):  
Pat Croskerry
Keyword(s):  
Emergency Department ◽  
Respiratory Rate ◽  
Correct Diagnosis ◽  
Anxiety State ◽  
Blood Gas ◽  
Blurred Vision ◽  
Arterial Blood Gas ◽  
The Past ◽  
Arterial Blood ◽  
Eye Examination

In this case, a 43-year-old male presents to the emergency department complaining of blurred vision during the past few days. He appears apprehensive. His eye examination is completely normal. On the basis of his increased respiratory rate and apprehension, a diagnosis of anxiety state is made, and he is discharged home. He returns the next day with continuing symptoms. On this occasion, an arterial blood gas is ordered, which eventually reveals his correct diagnosis.

scholarly journals Twenty-Four Hour Noninvasive Ventilation in Duchenne Muscular Dystrophy: A Safe Alternative to Tracheostomy

2013 ◽  
Vol 20 (1) ◽  
pp. e5-e9 ◽  
Author(s):  
Douglas A McKim ◽  
Nadia Griller ◽  
Carole LeBlanc ◽  
Andrew Woolnough ◽  
Judy King
Keyword(s):  
Respiratory Failure ◽  
Duchenne Muscular Dystrophy ◽  
Muscular Dystrophy ◽  
Noninvasive Ventilation ◽  
Gas Analysis ◽  
Blood Gas ◽  
Safe Alternative ◽  
Arterial Blood Gas ◽  
Arterial Blood ◽  
The Mean

BACKGROUND: Almost all patients with Duchenne muscular dystrophy (DMD) eventually develop respiratory failure. Once 24 h ventilation is required, either due to incomplete effectiveness of nocturnal noninvasive ventilation (NIV) or bulbar weakness, it is common practice to recommend invasive tracheostomy ventilation; however, noninvasive daytime mouthpiece ventilation (MPV) as an addition to nocturnal mask ventilation is also an alternative.METHODS: The authors’ experience with 12 DMD patients who used 24 h NIV with mask NIV at night and MPV during daytime hours is reported.RESULTS: The mean (± SD) age and vital capacity (VC) at initiation of nocturnal (only) NIV subjects were 17.8±3.5 years and 0.90±0.40 L (21% predicted), respectively; and, at the time of MPV, 19.8±3.4 years and 0.57 L (13.2% predicted), respectively. In clinical practice, carbon dioxide (CO2) levels were measured using different methods: arterial blood gas analysis, transcutaneous partial pressure of CO2and, predominantly, by end-tidal CO2. While the results suggested improved CO2levels, these were not frequently confirmed by arterial blood gas measurement. The mean survival on 24 h NIV has been 5.7 years (range 0.17 to 12 years). Of the 12 patients, two deaths occurred after 3.75 and four years, respectively, on MPV; the remaining patients continue on 24 h NIV (range two months to 12 years; mean 5.3 years; median 3.5 years).CONCLUSIONS: Twenty-four hour NIV should be considered a safe alternative for patients with DMD because its use may obviate the need for tracheostomy in patients with chronic respiratory failure requiring more than nocturnal ventilation alone.

scholarly journals Comparison of time taken to obtain an arterial blood gas result at the bedside using the ProximaTM point of care machine vs. a standard remote arterial blood gas analyser: A randomized controlled trial

2020 ◽  
pp. 175114372097384
Author(s):  
Kay Mitchell ◽  
Karen E Salmon ◽  
David Egbosimba ◽  
Gavin Troughton ◽  
Mike PW Grocott
Keyword(s):  
Point Of Care ◽  
Controlled Trial ◽  
Blood Gas ◽  
Sampling System ◽  
Arterial Blood Gas ◽  
Arterial Blood ◽  
The Mean ◽  
Time Away ◽  
Mean Time ◽  
Reduced Time

Introduction The ProximaTM point of care (POC) device enables arterial blood gas (ABG) samples to be analysed without the nurse leaving the patient. The benefits of this for work efficiency have not been evaluated. Methods We compared the time taken to obtain an ABG result using ProximaTM versus a standard ABG sampling system. Twenty patients were randomized to ABG sampling using ProximaTM, or a standard ABG system. Nurses were observed performing all ABG sampling episodes for a minimum of 24 hours and no more than 72 hours. Results The mean time taken to obtain a result using ProximaTM was 4:56 (SD = 1:40) minutes compared to 6:31 (SD = 1:53) minutes for the standard ABG technique (p < 0.001). Mean time away from the patient's bedside was 3.07 (SD = 1:17) minutes using the standard system and 0 minutes using ProximaTM (p < 0.001). Conclusions Reduced time for blood gas sampling and avoidance of time away from patients may have significant patient safety and resource management implications, but the clinical and financial significance were not evaluated.

THE STUDY ON ARTERIAL BLOOD GAS IN PATIENTS WITH ACUTE STROKE

2017 ◽  
pp. 37-45
Author(s):  
Xuan Tai Nguyen ◽  
Dinh Toan Nguyen
Keyword(s):  
Ischemic Stroke ◽  
Acute Stroke ◽  
Scale Score ◽  
Negative Correlation ◽  
Hemorrhagic Stroke ◽  
Respiratory Acidosis ◽  
Blood Gas ◽  
Arterial Blood Gas ◽  
Arterial Blood ◽  
Time Of Admission

Objectives: 1) To investigate the variation in arterial blood gas in patients with acute stroke according to ischemic stroke and hemorrhagic stroke. 2) To determine the correlation and relevance between arterial blood gas and Glasgow scale score, NIHSS, volume of brain damage on computed tomography imaging. Subjects and methods: A cross-sectional study was done in 70 patients with acute stroke. Results: Reduced rates of PCO2, PO2, SaO2 at the time of admission were 56.2%, 25%, 18.8% in ischemic stroke and 44.4%, 72.2%, 63% in hemorrhagic stroke. At the time of 24 hours, these rates were 75%, 56.2%, 50% in ischemic stroke and 50%, 79.6%, 70.4% in hemorrhagic stroke. At the time of 48 hours, these rates were 68.7%, 50%, 18.8% in ischemic stroke and 53.7%, 59.3%, 44.4% in hemorrhagic stroke. Respiratory acidosis was only present at hemorrhagic stroke. Respiratory alkalosis was in both stroke style and had the highest proportion. At the time of admission, SaO2 was negatively correlated with damage volume (r=- 0.264, p<0.05). HCO3- correlated with Glasgow (r=0.323; p<0.01) and NIHSS (r=-0.274; p<0.05). At the time of 24 hours, there was a negative correlation between PO2 (r=-0.375, p=0.001) and SaO2 (r =-0.39, p<0.01) with NIHSS. There was a negative correlation between PO2 (r=-0.435) and SaO2 (r=-0.457) with damage volume (p <0.0001). At the time of 48 hours, there was a negative correlation between PCO2, PO2 and SaO2 with NIHSS (r=-0.312, p<0.01, r=-0.35, p=0.01 and r=-0.0270, p<0.05). PCO2 was positively correlated with Glasgow (r = 0.260, p <0.05). There was a negative correlation between PO2 (r = - 0.391, p = 0.001) and SaO2 (r = - 0.421, p <0.001) with damage volume. Conclusions: In stroke patients, disturbances on ABG they are surfered from (acid-base disorders, hypoxemia) affect directly or indirectly on brain cells. Secondary brain damages could be well prevented if these disturbances is diagnosed and treated promptly. Key words: Stroke, arterial blood gas, Glasgow scale score, NIHSS

scholarly journals Hypoxia among patients on the liver-transplant waiting list

2014 ◽  
Vol 27 (1) ◽  
pp. 56-58 ◽  
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.

Effect of Acupuncture on Bronchial Asthma

1976 ◽  
Vol 51 (5) ◽  
pp. 503-509 ◽  
Author(s):  
D. Y. C. Yu ◽  
S. P. Lee
Keyword(s):  
Smooth Muscle ◽  
Bronchial Asthma ◽  
Flow Rate ◽  
Clinical Remission ◽  
Blood Gas ◽  
Arterial Blood Gas ◽  
Arterial Blood ◽  
Before And After ◽  
The Mean ◽  
Needle Acupuncture

1. Needle acupuncture was performed at three sites in twenty patients in a clinical attack of bronchial asthma. 2. In all patients the symptoms of bronchoconstriction improved during the attacks when the correct site was stimulated, and in five patients wheezing was abolished. 3. Stimulation at the correct site produced a significant increase in the mean FEV1·0 (58%) and FVC (29%) but not in maximal mid-expiratory flow rate (MMFR; 76%), when compared with the findings before acupuncture, along with a significant fall in the Pa,co2 and an insignificant fall in Pa,o2. A mild tachycardia was also observed. 4. After acupuncture a greater improvement in FEV1·0, FVC and MMFR was produced by inhalation of isoprenaline. 5. No significant changes in FEV1·0, FVC, MMFR, pulse rate or arterial blood gas tensions occurred after acupuncture at control sites. 6. In four of the patients during clinical remission acupuncture was performed before and after histamine aerosol challenge, but there was no effect on either the severity or the duration of the histamine-induced bronchoconstriction. 7. It is concluded that acupuncture probably reduced the reflex component of the bronchoconstriction, but failed to influence direct smooth muscle constriction caused by histamine.

scholarly journals Automatic real-time analysis and interpretation of arterial blood gas sample for Point-of-care testing: Clinical validation

PLoS ONE ◽  
2021 ◽  
Vol 16 (3) ◽  
pp. e0248264
Author(s):  
Sancho Rodríguez-Villar ◽  
Paloma Poza-Hernández ◽  
Sascha Freigang ◽  
Idoia Zubizarreta-Ormazabal ◽  
Daniel Paz-Martín ◽  
...  
Keyword(s):  
Metabolic Acidosis ◽  
Metabolic Alkalosis ◽  
Point Of Care ◽  
Respiratory Acidosis ◽  
Blood Gas ◽  
Acid Base ◽  
Predictive Values ◽  
Arterial Blood Gas ◽  
Arterial Blood ◽  
Global Accuracy

Background Point-of-care arterial blood gas (ABG) is a blood measurement test and a useful diagnostic tool that assists with treatment and therefore improves clinical outcomes. However, numerically reported test results make rapid interpretation difficult or open to interpretation. The arterial blood gas algorithm (ABG-a) is a new digital diagnostics solution that can provide clinicians with real-time interpretation of preliminary data on safety features, oxygenation, acid-base disturbances and renal profile. The main aim of this study was to clinically validate the algorithm against senior experienced clinicians, for acid-base interpretation, in a clinical context. Methods We conducted a prospective international multicentre observational cross-sectional study. 346 sample sets and 64 inpatients eligible for ABG met strict sampling criteria. Agreement was evaluated using Cohen’s kappa index, diagnostic accuracy was evaluated with sensitivity, specificity, efficiency or global accuracy and positive predictive values (PPV) and negative predictive values (NPV) for the prevalence in the study population. Results The concordance rates between the interpretations of the clinicians and the ABG-a for acid-base disorders were an observed global agreement of 84,3% with a Cohen’s kappa coefficient 0.81; 95% CI 0.77 to 0.86; p < 0.001. For detecting accuracy normal acid-base status the algorithm has a sensitivity of 90.0% (95% CI 79.9 to 95.3), a specificity 97.2% (95% CI 94.5 to 98.6) and a global accuracy of 95.9% (95% CI 93.3 to 97.6). For the four simple acid-base disorders, respiratory alkalosis: sensitivity of 91.2 (77.0 to 97.0), a specificity 100.0 (98.8 to 100.0) and global accuracy of 99.1 (97.5 to 99.7); respiratory acidosis: sensitivity of 61.1 (38.6 to 79.7), a specificity of 100.0 (98.8 to 100.0) and global accuracy of 98.0 (95.9 to 99.0); metabolic acidosis: sensitivity of 75.8 (59.0 to 87.2), a specificity of 99.7 (98.2 to 99.9) and a global accuracy of 97.4 (95.1 to 98.6); metabolic alkalosis sensitivity of 72.2 (56.0 to 84.2), a specificity of 95.5 (92.5 to 97.3) and a global accuracy of 93.0 (88.8 to 95.3); the four complex acid-base disorders, respiratory and metabolic alkalosis, respiratory and metabolic acidosis, respiratory alkalosis and metabolic acidosis, respiratory acidosis and metabolic alkalosis, the sensitivity, specificity and global accuracy was also high. For normal acid-base status the algorithm has PPV 87.1 (95% CI 76.6 to 93.3) %, and NPV 97.9 (95% CI 95.4 to 99.0) for a prevalence of 17.4 (95% CI 13.8 to 21.8). For the four-simple acid-base disorders and the four complex acid-base disorders the PPV and NPV were also statistically significant. Conclusions The ABG-a showed very high agreement and diagnostic accuracy with experienced senior clinicians in the acid-base disorders in a clinical context. The method also provides refinement and deep complex analysis at the point-of-care that a clinician could have at the bedside on a day-to-day basis. The ABG-a method could also have the potential to reduce human errors by checking for imminent life-threatening situations, analysing the internal consistency of the results, the oxygenation and renal status of the patient.

scholarly journals Arterial Blood Gas Analysis of Critically Ill Corona Virus Disease 2019 Patients

2021 ◽  
pp. 51-63
Author(s):  
Jitendra Lakhani ◽  
Sajani Kapadia ◽  
Hetal Pandya ◽  
Roop Gill ◽  
Rohit Chordiya ◽  
...  
Keyword(s):  
Metabolic Acidosis ◽  
Critically Ill ◽  
Virus Disease ◽  
Respiratory Acidosis ◽  
Respiratory Alkalosis ◽  
Gas Analysis ◽  
Blood Gas ◽  
Arterial Blood Gas ◽  
Arterial Blood ◽  
Corona Virus

Background/Aims: The aim of present study was to find out profile and sequential pattern of Arterial Blood Gas (ABG) in critically ill Corona Virus Disease 2019 (COVID-19) patients. Study Design: Observational prospective study. Methodology: A total of 80 Reverse Transcription Polymerase Chain Reaction (RT PCR) positive cases; that needed ICU admission for their life-threatening conditions were included in this study done at teaching hospital of Gujarat, India. Non consenting patients and patients who could not be followed up as per protocol were excluded. Data of Arterial Blood Gas (ABG), performed on admission, day 5 and day 10 were taken for the analysis. Patients were followed up till they remained in ICU. Results: Of 80 patients, 3 patients had normal, 24 patients (30%) had primary disorder on ABG while 53 patients (66.25%) had mixed disorders. The most common ABG abnormality observed was respiratory alkalosis with metabolic acidosis in 16 patients (20%) while respiratory alkalosis with metabolic alkalosis in 15 patients (18.75%). There was difference in ABG pattern observed among survivors and non-survivors (P=.04); of which conspicuous was presence of “respiratory acidosis with metabolic acidosis” in 5 non-survivors (15.63%), which was not seen in survivors. Of 80 patients admitted in COVID ICU; 2 improved after day 1; 6 after day 5; 40 after day 10, making total of 48 patients surviving COVID critical condition. Of 32 non-survivors, 14 died within twenty-four hours of admission, 14 within first 5 days and 04 after 10 days of ICU stay. Conclusion: ABG done on admission and serially in severe COVID-19 patients gives useful information on underlying pathophysiology. Mixed ABG pattern was more common than single disorder which can be sign of multi-organ involvement.  Respiratory acidosis with metabolic acidosis was observed significantly higher in non-survivors. Respiratory alkalosis as a part of single or mixed pattern on ABG was the most common pattern found in critically ill COVID patients.

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