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.

Aberrant PO2 values in proficiency testing

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 &gt; 0.04 for pH, &gt; 10% of the mean or 3.0 mm Hg, whichever was greater, for PCO2; or &gt; 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 (&lt; 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.

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.

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

1973 ◽  
Vol 82 (5) ◽  
pp. 668-683 ◽  
Author(s):  
Joseph H. Ogura ◽  
Michio Suemitsu ◽  
J. Roger Nelson ◽  
Satoru Kawamoto
Keyword(s):  
Nasal Obstruction ◽  
Lower Airway ◽  
Blood Gas ◽  
Pulmonary Resistance ◽  
Control Data ◽  
Mean Values ◽  
Arterial Blood Gas ◽  
Laryngeal Obstruction ◽  
Arterial Blood ◽  
Laryngeal Resistance

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.

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.

Attitudinal study of organ xenotransplantation in patients on the kidney and liver transplant waiting list in a country with a high rate of deceased donation

2011 ◽  
Vol 18 (3) ◽  
pp. 168-175 ◽  
Author(s):  
Laura Martínez-Alarcón ◽  
Antonio Ríos ◽  
Jose A. Pons ◽  
Maria J. González ◽  
Guillermo Ramis ◽  
...  
Keyword(s):  
Liver Transplant ◽  
Waiting List ◽  
High Rate ◽  
Liver Transplant Waiting List

Accuracy of transcutaneous carbon dioxide monitoring in hypotensive patients

2013 ◽  
Vol 31 (4) ◽  
pp. 323-326 ◽  
Author(s):  
Jung-Youn Kim ◽  
Young-Hoon Yoon ◽  
Sung-Woo Lee ◽  
Sung-Hyuk Choi ◽  
Young-Duck Cho ◽  
...  
Keyword(s):  
Blood Gas Analysis ◽  
Gas Analysis ◽  
Mean Difference ◽  
Blood Gas ◽  
Limits Of Agreement ◽  
Arterial Blood Gas ◽  
Blood Gas Monitoring ◽  
Arterial Blood ◽  
Arterial Blood Gas Analysis ◽  
The Mean

ObjectivesContinuous blood gas monitoring is frequently necessary in critically ill patients. Our aim was to assess the accuracy of transcutaneous CO2 tension (PtcCO2) monitoring in the emergency department (ED) assessment of hypotensive patients by comparing it with the gold standard of arterial blood gas analysis (ABGA).MethodsAll patients receiving PtcCO2 monitoring in the ED were included. We excluded paediatric patients, patients with no ABGA results during a hypotensive event, patients whose ABGA was not performed simultaneously with PtcCO2 monitoring, and patients who received sodium bicarbonate for resuscitation. The included patients were classified into hypotensive patients and normotensive patients. A hypotensive patient was defined as a patient showing a mean arterial pressure under 60 mm Hg. The agreement in measurement between PaCO2 tension (PaCO2) and PtcCO2 were investigated in both groups.ResultsThe mean difference between PaCO2 and PtcCO2 was 2.1 mm Hg, and the Bland–Altman limits of agreement (bias±1.96 SD) ranged from −15.6 to 19.7 mm Hg in the 28 normotensive patients. The mean difference between PaCO2 and PtcCO2 was 1.1 mm Hg, and the Bland–Altman limits of agreement (bias±1.96 SD) ranged from −19.5 to 21.7 mm Hg in the 26 hypotensive patients. The weighted κ values were 0.64 in the normotensive patients and 0.60 in the hypotensive patients.ConclusionsPtcCO2 monitoring showed wider limits of agreement with PaCO2 in urgent situations in the ED environment. However, acutely developed hypotension does not affect the accuracy of PtcCO2 monitoring.

scholarly journals Correlation of Venous Blood Gas and Pulse Oximetry With Arterial Blood Gas in the Undifferentiated Critically Ill Patient

2016 ◽  
Vol 33 (3) ◽  
pp. 176-181 ◽  
Author(s):  
Eli Zeserson ◽  
Ben Goodgame ◽  
J. Daniel Hess ◽  
Kristine Schultz ◽  
Cynthia Hoon ◽  
...  
Keyword(s):  
Critically Ill ◽  
Critically Ill Patients ◽  
Pearson Correlation ◽  
Venous Blood ◽  
Blood Gas ◽  
Arterial Blood Gas ◽  
Arterial Blood ◽  
The Mean ◽  
Venous Blood Gas ◽  
Oxygenation Status

Rationale: Blood gas analysis is often used to assess acid–base, ventilation, and oxygenation status in critically ill patients. Although arterial blood gas (ABG) analysis remains the gold standard, venous blood gas (VBG) analysis has been shown to correlate with ABG analysis and has been proposed as a safer less invasive alternative to ABG analysis. Objective: The purpose of this study was to evaluate the correlation of VBG analysis plus pulse oximetry (SpO2) with ABG analysis. Methods: We performed a prospective cohort study of patients in the emergency department (ED) and intensive care unit (ICU) at a single academic tertiary referral center. Patients were eligible for enrollment if the treating physician ordered an ABG. Statistical analysis of VBG, SpO2, and ABG data was done using paired t test, Pearson χ2, and Pearson correlation. Main Results: There were 156 patients enrolled, and 129 patients completed the study. Of the patients completing the study, 53 (41.1%) were in the ED, 41 (31.8%) were in the medical ICU, and 35 (27.1%) were in the surgical ICU. The mean difference for pH between VBG and ABG was 0.03 (95% confidence interval: 0.03-0.04) with a Pearson correlation of 0.94. The mean difference for pCO2 between VBG and ABG was 4.8 mm Hg (95% confidence interval: 3.7-6.0 mm Hg) with a Pearson correlation of 0.93. The SpO2 correlated well with PaO2 (the partial pressure of oxygen in arterial blood) as predicted by the standard oxygen–hemoglobin dissociation curve. Conclusion: In this population of undifferentiated critically ill patients, pH and pCO2 on VBG analysis correlated with pH and pCO2 on ABG analysis. The SpO2 correlated well with pO2 on ABG analysis. The combination of VBG analysis plus SpO2 provided accurate information on acid–base, ventilation, and oxygenation status for undifferentiated critically ill patients in the ED and ICU.

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 Study of Oxygen Saturation by Pulse Oximetry and Arterial Blood Gas in ICU Patients: A Descriptive Cross-sectional Study

2020 ◽  
Vol 58 (230) ◽  
Author(s):  
Nabin Rauniyar ◽  
Shyam Pujari ◽  
Pradeep Shrestha
Keyword(s):  
Oxygen Saturation ◽  
Pulse Oximetry ◽  
Arterial Oxygen Saturation ◽  
Cross Sectional Study ◽  
Arterial Oxygen ◽  
Blood Gas ◽  
Cross Sectional ◽  
Arterial Blood Gas ◽  
Arterial Blood ◽  
The Mean

Introduction: Pulse oximetery is expected to be an indirect estimation of arterial oxygen saturation. However, there often are gaps between SpO2 and SaO2. This study aims to study on arterial oxygen saturation measured by pulse oximetry and arterial blood gas among patients admitted in intensive care unit. Methods: It was a hospital-based descriptive cross-sectional study in which 101 patients meeting inclusion criteria were studied. SpO2 and SaO2 were measured simultaneously. Mean±SD of SpO2 and SaO2 with accuracy, sensitivity and specificity were measured. Results: According to SpO2 values, out of 101 patients, 26 (25.7%) were hypoxemic and 75 (74.25%) were non–hypoxemic. The mean±SD of SaO2 and SpO2 were 93.22±7.84% and 92.85±6.33% respectively. In 21 patients with SpO2<90%, the mean±SD SaO2 and SpO2 were 91.63±4.92 and 87.42±2.29 respectively. In 5 patients with SpO2 < 80%, the mean ± SD of SaO2 and SpO2 were: 63.40±3.43 and 71.80±4.28, respectively. In non–hypoxemic group based on SpO2 values, the mean±SD of SpO2 and SaO2 were 95.773±2.19% and 95.654±3.01%, respectively. The agreement rate of SpO2 and SaO2 was 83.2%, and sensitivity and specificity of PO were 84.6% and 83%, respectively. Conclusions: Pulse Oximetry has high accuracy in estimating oxygen saturation with sp02>90% and can be used instead of arterial blood gas.

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