Epidemiological Study of Patients with COVID-19 in Iran (Markazi Province)

Background: The increasing prevalence of SARS-COV-2 infection necessitates further epidemiological studies in the field of this epidemic. Methods: during 66 days (20/02/2020 to 01/06/2020) all patients diagnosed with SARS-COV-2 infection referred to Valiasr Hospital in Arak were monitored. Thus, based on the pre-prepared questionnaire, the information of the mentioned patients was extracted from the Hospital Information System (HIS) by the required formats and after eliminating the incomplete cases, it was aggregated based on coding (to preserve the patients' information). The results were evaluated using spss. v25 software. Results: Out of 535 patients with SARS-COV-2 included in the study, 295 (55%) were male and 240 (45%) were female. Women with a mean age of 61.03 years were significantly (p = 0.009) at a higher age than men with a mean age of 56.59 years. Nearly 60% (304 patients) of patients had a history of underlying disease. Gender comparison of patients with a history of underlying disease infected with SARS-COV-2 infection did not show any significant difference between male and female patients. Comparison of the mean age of the improved and dead patients shows that the mean age of the dead patients with a significant difference (P <0.001) was higher than the improved subjects. This result is also true for people with a history of underlying disease (p<0.0001). The number of patients with arterial oxygen saturation <93% was significantly higher in the group of patients with a history of at least one chronic underlying disease than who did not have any chronic disease (P <0.0001). The mortality rate in ICU patients was significantly higher than those admitted to the normal ward (p < 0.0001). Conclusion: Aging, gender, underlying diseases and arterial oxygen saturation (<93%) at the time of admission have important role in the hospitalization rate, severity of the disease and mortality in patients with COVID-19.

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Controlled Trial of Nebulized Albuterol in Children Younger Than 2 Years of Age With Acute Asthma

PEDIATRICS ◽

10.1542/peds.89.1.133 ◽

1992 ◽

Vol 89 (1) ◽

pp. 133-137 ◽

Cited By ~ 1

Author(s):

Lea Bentur ◽

Gerard J. Canny ◽

Michael D. Shields ◽

Eitan Kerem ◽

Joseph J. Reisman ◽

...

Keyword(s):

Oxygen Saturation ◽

Acute Asthma ◽

Controlled Trial ◽

Arterial Oxygen Saturation ◽

Clinical Status ◽

Previous History ◽

Clinical Score ◽

Arterial Oxygen ◽

Recurrent Wheezing ◽

History Of

To determine the response to nebulized β2 agonist, 28 children younger than 2 years of age who visited the emergency department during an episode of acute asthma were studied. Each subject had a previous history of recurrent wheezing episodes. They were randomly assigned to receive two administrations of either nebulized albuterol (0.15 mg/kg per dose) or placebo (normal saline) with oxygen, 1 hour apart. After two nebulizations, the albuterol-treated patients had a greater improvement in clinical status (respiratory rate, degree of wheezing and accessory muscle use, total clinical score, and arterial oxygen saturation) than the placebo group. None of the patients in the albuterol group experienced a decrease of arterial oxygen saturation of ≥2%. It is conduded that a trial of nebulized β2 agonists is warranted in the treatment of acute asthma in infants and young children.

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Two patterns of daily hypoxic exposure and their effects on measures of chemosensitivity in humans

Journal of Applied Physiology ◽

10.1152/japplphysiol.00545.2007 ◽

2007 ◽

Vol 103 (6) ◽

pp. 1973-1978 ◽

Cited By ~ 23

Author(s):

Michael S. Koehle ◽

A. William Sheel ◽

William K. Milsom ◽

Donald C. McKenzie

Keyword(s):

Oxygen Saturation ◽

Intermittent Hypoxia ◽

Ventilatory Response ◽

Arterial Oxygen Saturation ◽

Arterial Oxygen ◽

Hypoxic Exposure ◽

Hypoxic Ventilatory Response ◽

The Third ◽

Long Duration ◽

The Mean

The purpose of this study was to compare chemoresponses following two different intermittent hypoxia (IH) protocols in humans. Ten men underwent two 7-day courses of poikilocapnic IH. The long-duration IH (LDIH) protocol consisted of daily 60-min exposures to normobaric 12% O2. The short-duration IH (SDIH) protocol comprised twelve 5-min bouts of 12% O2, separated by 5-min bouts of room air, daily. Isocapnic hypoxic ventilatory response (HVR) was measured daily during the protocol and 1 and 7 days following. Hypercapnic ventilatory response (HCVR) and CO2 threshold and sensitivity (by the modified Read rebreathing technique) were measured on days 1, 8, and 14. Following 7 days of IH, the mean HVR was significantly increased from 0.47 ± 0.07 and 0.47 ± 0.08 to 0.70 ± 0.06 and 0.79 ± 0.06 l·min−1·%SaO2−1 (LDIH and SDIH, respectively), where %SaO2 is percent arterial oxygen saturation. The increase in HVR reached a plateau after the third day. One week post-IH, HVR values were unchanged from baseline. HCVR increased from 3.0 ± 0.4 to 4.0 ± 0.5 l·min−1·mmHg−1. In both the hyperoxic and hypoxic modified Read rebreathing tests, the slope of the CO2/ventilation plot was unchanged by either intervention, but the CO2/ventilation curve shifted to the left following IH. There were no correlations between the changes in response to hypoxia and hypercapnia. There were no significant differences between the two IH protocols for any measures, indicating that comparable changes in chemoreflex control occur with either protocol. These results also suggest that the two methods of measuring CO2 response are not completely concordant and that the changes in CO2 control do not correlate with the increase in the HVR.

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Comparison the Sedation Effect and Satisfaction of Two Combinations, Dexmedetomidine and Fentanyl with Midazolam and Fentanyl, in Patients Undergoing Bronchoscopy

Journal of Contemporary Medical Sciences ◽

10.22317/jcms.v6i6.856 ◽

2021 ◽

Vol 6 (6) ◽

Author(s):

Alireza Kamali ◽

Sepideh Sarkhosh ◽

Hosein Kazemizadeh

Keyword(s):

Blood Pressure ◽

Heart Rate ◽

Oxygen Saturation ◽

Statistical Tests ◽

Arterial Oxygen Saturation ◽

Mean Blood Pressure ◽

Arterial Oxygen ◽

P Value ◽

Double Blind ◽

Significant Difference

Objectives: The aim of this study was to compare sedative effects of dexmedetomidine and fentanyl with midazolam and fentanyl in patients undergoing bronchoscopy. Methods: This study was a double-blind randomized clinical trial that was performed on 92 patients who referred to Amir al Momenin Hospital in Arak for bronchoscopy and underwent ASA 1 or 2 underlying grading procedure. Patients were randomly divided into two groups of dexmedetomidine and fentanyl (D) midazolam and fentanyl (M). Primary vital signs including hypertension and arterial oxygen saturation were monitored and recorded. Then all patients were injected with 2 μg / kg fentanyl as a painkiller and after 3 minutes 30 μg dexmedetomidine in syringe with code A and midazolam 3 mg in syringe with code B were injected to patients by an anesthesiologist. Then the two groups were compared in terms of pain at injection, conscious relaxation, satisfaction of operation, recovery time, hypotension and arterial oxygen saturation and drug side effects and data were analyzed by using statistical tests. Results: There was no significant difference between the two groups in terms of mean age and sex distribution. According to the results of this study, there was no significant difference between the two groups in mean blood pressure (P-value = 0.6) and mean heart rate (P-value = 0.4) at the time of bronchoscopy, but at 5 and 10 minutes after bronchoscopy there was a significant difference, mean blood pressure and heart rate were significantly lower in dexmedetomidine group. Conclusion: Both dexmedetomidine and midazolam drug groups contributed to the development of stable and sedative hemodynamics and satisfaction in patients undergoing bronchoscopy, however, the dexmedetomidine and fentanyl group showed a significant decrease in blood pressure and heart rate compared to midazolam and fentanyl and a weaker decrease in arterial oxygen saturation, and patients with bronchoscopy were more satisfied in the dexmedetomidine group.

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Comparison of Intra and Post-operative Sedation efficacy of Dexmedetomidine-Midazolam and Dexmedetomidine-Propofol for Major Abdominal Surgery

Current Drug Metabolism ◽

10.2174/1389200222666211103121832 ◽

2021 ◽

Vol 22 ◽

Author(s):

Yuanyuan Gao ◽

Fei Yan

Keyword(s):

Clinical Trial ◽

Abdominal Surgery ◽

Oxygen Saturation ◽

General Anesthesia ◽

Arterial Oxygen Saturation ◽

Carbon Dioxide Tension ◽

Major Abdominal Surgery ◽

Arterial Oxygen ◽

Anesthesia Induction ◽

Significant Difference

Background: The effectiveness and side effects of dexmedetomidine (DEX) in combination with midazolam and propofol have not been comparatively studied in a single clinical trial as sedative agents to general anesthesia before. Objective: The objective of this study is to compare intra and post-operative sedation between DEX-Midazolam and DEX-Propofol in patients who underwent major abdominal surgery on the duration of general anesthesia, hemodynamic and sedation effect. Method: This prospective, randomized, double-blinded clinical trial included 50 patients who were 20 to 60 years of age and admitted for major abdominal surgery. The patients were randomly assigned by a computer-generated random numbers table to sedation with DEX plus midazolam (DM group) (n=25) or DEX plus propofol (DP group) (n=25). In the DM group, patients received a bolus dose of 0.1 mg/kg of midazolam and immediately initiated the intravenous (i.v.) infusion of DEX 1 µg/kg over a 10 min and 0.5 µg/kg/hr by continuous i.v. infusion within operation period. In the DP group, patients received pre-anesthetic i.v. DEX 1 µg/kg over 15 min before anesthesia induction and 0.2-1 µg/kg/hr by continuous i.v. infusion during the operative period. After preoxygenation for at least 2 min, during the surgery, patients received propofol infusion dose of 250 μg/kg/min for 15 min then a basal infusion dose of 50 μg/kg/min. The bispectral index (BIS) value, as well as mean arterial pressure (MAP), heart rate (HR), respiratory rate (RR), oxygen saturation (SaO2), percutaneous arterial oxygen saturation (SpO2) and end-tidal carbon dioxide tension (ETCO2) were recorded before anesthesia (T0), during anesthesia (at 15-min intervals throughout the surgical procedure), by a blinded observer. Evidence of apnea, hypotension, hypertension and hypoxemia were recorded during surgery. Results: The hemodynamic changes, including HR, MAP, BIS, VT, SaO2, and RR had a downward tendency with time, but no significant difference was observed between the groups (P>0.05). However, the two groups showed no significant differences in ETCO2 and SPO2 values in any of the assessed interval (P>0.05). In this study, the two groups showed no significant differences in the incidence of nausea, vomiting, coughing, apnea, hypotension, hypertension, bradycardia and hypoxemia (P>0.05). Respiratory depression and Conclusion: Our study showed no significant differences between the groups in hemodynamic and respiratory changes in each of the time intervals. There were also no significant differences between the two groups in the incidence of complication intra and post-operative. Further investigations are required to specify the optimum doses of using drugs which provide safety in cardiovascular and respiratory system without adverse disturbance during surgery.

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Quantification of adult cerebral hemodynamics by near-infrared spectroscopy

Journal of Applied Physiology ◽

10.1152/jappl.1994.77.6.2753 ◽

1994 ◽

Vol 77 (6) ◽

pp. 2753-2760 ◽

Cited By ~ 163

Author(s):

C. E. Elwell ◽

M. Cope ◽

A. D. Edwards ◽

J. S. Wyatt ◽

D. T. Delpy ◽

...

Keyword(s):

Blood Flow ◽

Cerebral Blood Flow ◽

Infrared Spectroscopy ◽

Oxygen Saturation ◽

Near Infrared Spectroscopy ◽

Near Infrared ◽

Arterial Oxygen Saturation ◽

Cerebral Hemodynamics ◽

Arterial Oxygen ◽

The Mean

Near-infrared spectroscopy was used to measure global cerebral blood flow and volume in 10 healthy adult volunteers. High- and low-cerebral blood flow compartments were detected with mean flows for all 10 subjects of 59 +/- 21 (SD) and 11 +/- 4 ml.100 g-1.min-1, respectively. The mean cerebral blood volume of the group was 2.85 +/- 0.97 ml/100 g. Analysis of spontaneous changes in the cerebral concentrations of oxyhemoglobin and deoxyhemoglobin demonstrated strong correlations between respiratory rate and the oscillation frequency of cerebral oxyhemoglobin concentration (r = 0.99) and arterial oxygen saturation (SaO2) (r = 0.99). An estimate of the mean cerebral oxygen saturation for all subjects averaged 59.4 +/- 12.4% when their mean SaO2 was 91.8 +/- 2.4% (equivalent to 67.6 +/- 13.8% at a normoxic SaO2 of 98%). These results demonstrate that near-infrared spectroscopy can be used as a noninvasive bedside technique for both qualitative and quantitative evaluation of cerebral hemodynamics and oxygenation in adults.

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The Effect of Adjunctive use of Dexmedetomidine and Metoral with Thiopental on Hemodynamic Status, Agitation, and Patient Satisfaction in Patients with Mood Disorders after Electroconvulsive Therapy

Open Access Macedonian Journal of Medical Sciences ◽

10.3889/oamjms.2020.4399 ◽

2020 ◽

Vol 8 (B) ◽

pp. 329-333

Author(s):

Talat Mohammadi ◽

Hamidreza Jamilian ◽

Anita Alaghemand ◽

Alireza Kamali

Keyword(s):

Patient Satisfaction ◽

Oxygen Saturation ◽

Mood Disorders ◽

Electroconvulsive Therapy ◽

Recovery Time ◽

Arterial Oxygen Saturation ◽

The Other ◽

Arterial Oxygen ◽

Hemodynamic Status ◽

The Mean

AIM: The aim of our study was to determine the effect of adjunctive use of dexmedetomidine and metoral with thiopental on hemodynamic status, agitation, patient satisfaction, and duration of seizure in patients with mood disorders in electroconvulsive therapy (ECT). METHODS: This study is a randomized, double-blind, clinical trial. Sixty patients (18–60 years) according to DSM5 criteria had mood disorder and were candidates for ECT. Patients were randomly divided into two groups of 30 each. One group received 5.0 μg/kg dexmedetomidine 10 min before induction of thiopental, and the other group received 5.2 mg intravenous metoprolol immediately before ECT. Patients’ satisfaction, duration of seizure, and arterial oxygen saturation were evaluated. RESULTS: The mean age of both groups was approximately 37 years with the majority of men. No significant difference was found between the two groups in terms of age and sex, blood pressure (BP), heart rate (HR), duration of seizure, and arterial oxygen saturation before ECT. The mean BP and HR in the recovery were lower in the dexmedetomidine group than in the metoral group. Arterial oxygen saturation percentage was not significantly different between the two groups. The recovery time in the dexmedetomidine group was longer than the metoral group (p = 0.001). Post-ECT satisfaction was found to be higher in the dexmedetomidine group than in the metoral group and the mean agitation score was found to be higher in the metoral group. CONCLUSION: Both metoral and dexmedetomidine as adjuvants decrease the hyperdynamic responses of patients after ECT, whereas the effect of dexmedetomidine is more than metoral; on the other hand, neither dexmedetomidine nor metoral has any negative effect on seizure duration, but dexmedetomidine significantly prolonged recovery time as compared to metoral.

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Abstract 15159: Differential Recovery Between Regional Cerebral Oxygen Saturation and Physiological Parameters in Cardiopulmonary Arrest Patients After Return of Spontaneous Circulation

Circulation ◽

10.1161/circ.132.suppl_3.15159 ◽

2015 ◽

Vol 132 (suppl_3) ◽

Author(s):

Goro Tajima ◽

Tadahiko Shiozaki ◽

Yoshihito Ogawa ◽

Tomoya Hirose ◽

Nobuto Mori ◽

...

Keyword(s):

Oxygen Saturation ◽

Cardiopulmonary Arrest ◽

Arterial Oxygen Saturation ◽

Spontaneous Circulation ◽

Physiological Parameters ◽

Arterial Oxygen ◽

Return Of Spontaneous Circulation ◽

Medical Centers ◽

Emergency Medical ◽

Significant Difference

Objective: We aimed to clarify the change in rSO2, blood pressure (BP) and arterial oxygen saturation (SpO2) in CPA patients who got return of spontaneous circulation (ROSC). Method: We measured rSO2 in CPA patients who were transferred to two tertiary emergency medical centers. On arrival, rSO2 sensor was attached to the forehead of patients, and monitored continuously during cardiopulmonary resuscitation. In the patients who got ROSC, we compared change in rSO2 and BP, SpO2, and evaluated the correlation between rSO2 and physiological parameters. Result: There were 79 CPA patients transferred to the tertiary emergency medical centers, and 38 patients got ROSC(Mean Age 74.8,M:F=25:13). rSO2 increased after ROSC, and showed the significance after 10 minutes after ROSC. Median rSO2 just after ROSC (ROSC 0) was 54.4% (47.2-59.5), and 66.0% (61.8-70.0) in 10 minutes after ROSC (ROSC 10) (Figure, p<0.01 ROSC 0 vs ROSC 10). However, in BP and SpO2, there were no significant difference between in ROSC 0 and ROSC 10. BP rather showed lower tendency in ROSC 10 compared to ROSC 0. BP; 97mmHg (82.0-127) vs 82.0mmHg (67.0-120), SpO2; 86.0% (70.8-95.0) vs 93.0% (76.0-98.3) Conclusion: We clarified that there is a delay in rSO2 recovery compared to BP, SpO2 recovery after ROSC in CPA patients. It might be a therapeutic point to correct the delay in rSO2 recovery.

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Oxygen Saturation in Closed-Globe Blunt Ocular Trauma

BioMed Research International ◽

10.1155/2016/8232468 ◽

2016 ◽

Vol 2016 ◽

pp. 1-5

Author(s):

Chongde Long ◽

Xin Wen ◽

Liu-xue-ying Zhong ◽

Yongxin Zheng ◽

Qianying Gao

Keyword(s):

Oxygen Saturation ◽

Ocular Trauma ◽

Diastolic Pressure ◽

Arterial Oxygen Saturation ◽

Systolic Pressure ◽

Case Series ◽

Arterial Oxygen ◽

Significant Difference ◽

Arteriovenous Difference ◽

Blunt Ocular Trauma

Purpose. To evaluate the oxygen saturation in retinal blood vessels in patients after closed-globe blunt ocular trauma.Design. Retrospective observational case series.Methods. Retinal oximetry was performed in both eyes of 29 patients with unilateral closed-globe blunt ocular trauma. Arterial oxygen saturation (SaO2), venous oxygen saturation (SvO2), arteriovenous difference in oxygen saturation (SO2), arteriolar diameter, venular diameter, and arteriovenous difference in diameter were measured. Association parameters including age, finger pulse oximetry, systolic pressure, diastolic pressure, and heart rate were analyzed.Results. The mean SaO2in traumatic eyes (98.1%±6.8%) was not significantly different from SaO2in unaffected ones (95.3%±7.2%) (p=0.136). Mean SvO2in traumatic eyes (57.1%±10.6%) was significantly lower than in unaffected ones (62.3%±8.4%) (p=0.044). The arteriovenous difference in SO2in traumatic eyes (41.0%±11.2%) was significantly larger than in unaffected ones (33.0%±6.9%) (p=0.002). No significant difference was observed between traumatic eyes and unaffected ones in arteriolar (p=0.249) and venular diameter (p=0.972) as well as arteriovenous difference in diameter (p=0.275).Conclusions. Oxygen consumption is increased in eyes after cgBOT, associated with lower SvO2and enlarged arteriovenous difference in SO2but not with changes in diameter of retinal vessels.

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Measuring Biexponential Transverse Relaxation of the ASL Signal at 9.4 T to Estimate Arterial Oxygen Saturation and the Time of Exchange of Labeled Blood Water into Cortical Brain Tissue

Journal of Cerebral Blood Flow & Metabolism ◽

10.1038/jcbfm.2012.156 ◽

2012 ◽

Vol 33 (2) ◽

pp. 215-224 ◽

Cited By ~ 18

Author(s):

Jack A Wells ◽

Bernard Siow ◽

Mark F Lythgoe ◽

David L Thomas

Keyword(s):

Oxygen Saturation ◽

Arterial Oxygen Saturation ◽

Arterial Oxygen ◽

Transverse Relaxation ◽

Exchange Time ◽

Relative Contribution ◽

A Value ◽

Tissue Space ◽

Biexponential Model ◽

The Mean

The transverse decay of the arterial spin labeling (ASL) signal was measured at four inflow times in the rat brain cortex at 9.4 T. Biexponential T2 decay was observed that appears to derive from different T2 values associated with labeled water in the intravasculature (IV) and extravascular (EV) compartments. A two compartment biexponential model was used to assess the relative contribution of the IV and EV compartments to the ASL signal, without assuming a value for T2 of labeled blood water in the vessels. This novel methodology was applied to estimate the exchange time of blood water into EV tissue space and the oxygen saturation of blood on the arterial side of the vasculature. The mean exchange time of labeled blood water was estimated to be 370 ± 40 ms. The oxygen saturation of the arterial side of the vasculature was significantly less than 100% (~85%), which may have implications for quantitative functional magnetic resonance imaging studies where the arterial oxygen saturation is frequently assumed to be 100%.

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Exercise intensity typical of mountain climbing does not exacerbate acute mountain sickness in normobaric hypoxia

Journal of Applied Physiology ◽

10.1152/japplphysiol.00329.2012 ◽

2012 ◽

Vol 113 (7) ◽

pp. 1068-1074 ◽

Cited By ~ 20

Author(s):

Kai Schommer ◽

Moritz Hammer ◽

Lorenz Hotz ◽

Elmar Menold ◽

Peter Bärtsch ◽

...

Keyword(s):

Oxygen Uptake ◽

Oxygen Saturation ◽

Maximal Oxygen Uptake ◽

Arterial Oxygen Saturation ◽

Acute Mountain Sickness ◽

Normobaric Hypoxia ◽

Arterial Oxygen ◽

Moderate Exercise ◽

Significant Difference ◽

Mountain Sickness

Physical exertion is thought to exacerbate acute mountain sickness (AMS). In this prospective, randomized, crossover trial, we investigated whether moderate exercise worsens AMS in normobaric hypoxia (12% oxygen, equivalent to 4,500 m). Sixteen subjects were exposed to altitude twice: once with exercise [3 × 45 min within the first 4 h on a bicycle ergometer at 50% of their altitude-specific maximal workload (maximal oxygen uptake)], and once without. AMS was evaluated by the Lake Louise score and the AMS-C score of the Environmental Symptom Questionnaire. There was no significant difference in AMS between the exposures with and without exercise, neither after 5, 8, nor 18 h (incidence: 64 and 43%; LLS: 6.5 ± 0.7 and 5.1 ± 0.8; AMS-C score: 1.2 ± 0.3 and 1.1 ± 0.3 for exercise vs. rest at 18 h; all P > 0.05). Exercise decreased capillary Po2 (from 36 ± 1 Torr at rest to 31 ± 1 Torr), capillary arterial oxygen saturation (from 72% at rest to 67 ± 2%), and cerebral oxygen saturation (from 49 ± 2% at rest to 42 ± 1%, as assessed by near-infrared spectroscopy; P < 0.05), and increased ventilation (capillary Pco2 27 ± 1 Torr; P < 0.05). After exercise, the increase in ventilation persisted for several hours and was associated with similar levels of capillary and cerebral oxygenation at the exercise and rest day. We conclude that moderate exercise at ∼50% maximal oxygen uptake does not increase AMS in normobaric hypoxia. These data do not exclude that considerably higher exercise intensities exacerbate AMS.

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