scholarly journals Pulmonary Arteriovenous Malformation as a Cause of Exercise Intolerance in Children: A Case Report

2020 ◽  
Author(s):  
Pierluigi Morreale ◽  
Veronica Notarbartolo ◽  
Giancarlo Allegro ◽  
Francesca Finazzo ◽  
Mario Giuseppe Vallone ◽  
...  
Keyword(s):  
Arteriovenous Malformation ◽  
Arterial Oxygen Saturation ◽  
Oxygen Desaturation ◽  
Exercise Intolerance ◽  
Pulmonary Arteriovenous Malformation ◽  
Arterial Oxygen ◽  
Selective Embolization ◽  
Insidious Onset ◽  
Bubble Test ◽  
Angio Ct

Pulmonary arteriovenous malformation (PAVMs) in children are rare lesions characterized by abnormal low resistance vascular structures connecting a pulmonary artery to a pulmonary vein, resulting in an intrapulmonary right-to-left shunt. The insidious onset and variable signs and symptoms make diagnosis difficult, especially in children. PAVMs  can be single or multiple, congenital or acquired, and up to 47-80% of cases are associated with hereditary hemorrhagic telangiectasia (HHT).We present the  case of a 12-year-old female teenager referred to our center for epistaxis, headache, fatigue and weakness, with evidence of mild oxygen desaturation.  Bubble test showed a right-to-left shunt and pulmonary angio-CT confirmed the diagnosis. Percutaneous selective embolization was performed with full recovery of normal arterial oxygen saturation. When differentiating between mild oxygen desaturation and exercise intolerance in children and adolescents, physicians should be aware of the possibility of PAVMs as a cause. 

scholarly journals Meal Induced Oxygen Desaturation and Dyspnea in Chronic Obstructive Pulmonary Disease

1998 ◽  
Vol 5 (5) ◽  
pp. 361-365 ◽  
Author(s):  
Norman Wolkove ◽  
Li Yi Fu ◽  
Ashok Purohit ◽  
Antoinette Colacone ◽  
Harvey Kreisman
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Arterial Oxygen Saturation ◽  
Care Facility ◽  
Forced Expiratory Volume ◽  
Oxygen Desaturation ◽  
Arterial Oxygen ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Severe Copd

OBJECTIVE: To study arterial oxygen saturation (SpO2) obtained by pulse oximetry and dyspnea during active eating (AE) and passive eating (PE) in patients with severe chronic obstructive pulmonary disease (COPD).DESIGN: Patients were studied on two consecutive days with AE and PE, which occurred in random order. SpO2was recorded for 20 mins before and during eating, and dyspnea was recorded by the patient using a 10 cm visual analogue scale before and upon completion of eating.SETTING: Subjects were in-patients at an intermediate care facility who were hospitalized for pulmonary rehabilitation or for convalescence after an exacerbation of COPD.POPULATION STUDIED: Thirty-five patients with severe COPD (forced expiratory volume in 1 s [FEV1] less than 50% predicted, FEV1to forced vital capacity ratio less than 65%) were studied. Mean age was 70.5±7.1 years.MAIN RESULTS: Mean SpO2decreased significantly (P<0.05) from 91.7±3.4% to 90.1±4.0% during AE, and 91.7±3.2% to 90.8±3.6% during PE. Mean lowest SpO2was lower and percentage of time with SpO2less than 90% was greater during eating compared with corresponding control periods during both AE and PE. Dyspnea increased significantly (P<0.05) from 1.4±1.2 to 3.3±2.3 cm during AE, and from 1.5±1.5 to 2.4±2.2 cm during PE. The increase in dyspnea was significantly greater during AE than PE.CONCLUSIONS: Eating is an activity that can adversely affect SpO2and increase dyspnea in patients with severe COPD. Oxygen desaturation and particularly increased dyspnea may at least in part relate to the recruitment of upper extremity muscles during eating.

scholarly journals Pulse oximetry and factors associated with hemoglobin oxygen desaturation in children with sickle cell disease

Blood ◽  
1993 ◽  
Vol 81 (12) ◽  
pp. 3422-3427 ◽  
Author(s):  
WR Rackoff ◽  
N Kunkel ◽  
JH Silber ◽  
T Asakura ◽  
K Ohene-Frempong
Keyword(s):  
Sickle Cell Disease ◽  
Pulse Oximetry ◽  
Sickle Cell ◽  
Arterial Oxygen Saturation ◽  
Oxygen Desaturation ◽  
Arterial Oxygen ◽  
Acute Chest Syndrome ◽  
Cell Disease ◽  
Factors Associated ◽  
History Of

The observation of low transcutaneous arterial oxygen saturation (SaO2) in otherwise well sickle cell patients has lead to questions about the interpretation of pulse oximetry values in these patients. We undertook a prospective study of children with sickle cell disease to (1) determine the prevalence of, and factors associated with, low transcutaneous SaO2 in clinically well patients, (2) develop an algorithm for the use of pulse oximetry in acutely ill patients, and (3) assess the accuracy of pulse oximetry in these patients. Eighty-six clinically well children with hemoglobin (Hb) SS had a lower mean transcutaneous SaO2 than 22 Hb SC patients and 10 control subjects (95.6% v 99.1% v 99.0%, respectively; p < .001). In Hb SS patients, a history of acute chest syndrome and age greater than 5 years were associated with lower transcutaneous SaO2 (mean 93.8% for those with a history of acute chest syndrome v 97.8% for those without a history of acute chest syndrome, and 94.0% for patients = 5 years old v 97.2% for those < or = 5 years old; P < .001). These associations were not seen in Hb SC patients. During acute illness, Hb SS patients with acute chest syndrome had transcutaneous SaO2 values that were less than 96% and at least 3 points lower than measurements made when they were well. A nomogram was designed to aid in the interpretation of transcutaneous SaO2 in acutely ill Hb SS patients when a comparison value is not available. The accuracy of pulse oximetry was shown by the correlation between SaO2 measured by pulse oximetry and calculated by using the patient's oxygen dissociation curve and PaO2 (r = .97). This study provides evidence that Hb oxygen desaturation is not a universal finding among children with sickle cell disease and identifies factors associated with Hb oxygen desaturation. We conclude that pulse oximetry may be useful to assess whether progressive pulmonary dysfunction begins at an early age in Hb SS patients, and to assess acutely ill patients for the presence of hypoxemia associated with acute chest syndrome.

Pitfalls in the diagnosis of pulmonary arteriovenous malformations

1994 ◽  
Vol 4 (4) ◽  
pp. 408-410
Author(s):  
Michael Schiemmer ◽  
Gerald Tulzer ◽  
Maria Wimmer
Keyword(s):  
Arteriovenous Malformation ◽  
Arteriovenous Malformations ◽  
Arterial Oxygen Saturation ◽  
Pulmonary Angiography ◽  
Arterial Oxygen ◽  
Upper Respiratory Tract ◽  
Upper Respiratory ◽  
The Right ◽  
Enhanced Computed Tomography ◽  
Diagnostic Pitfalls

SummaryA homogeneous opacity of the right upper lobe was found radiographically in a 15-month-old male child during investigation of an upper respiratory tract infection. Based on computerized tomography, the diagnosis was made of a solid tumor of the lung. At thoracotomy, dilated serpentine vessels were found on the surface of the right upper lobe, and the diagnosis of a large arteriovenous malformation was considered. Use of enhanced computed tomography without contrast and failure to note a reduced arterial oxygen saturation were two diagnostic pitfalls. The diagnosis of an arteriovenous malformation was confirmed by pulmonary angiography, and a right upper lobectomy was successfully performed.

scholarly journals Pulse oximetry and factors associated with hemoglobin oxygen desaturation in children with sickle cell disease

Blood ◽  
1993 ◽  
Vol 81 (12) ◽  
pp. 3422-3427 ◽  
Author(s):  
WR Rackoff ◽  
N Kunkel ◽  
JH Silber ◽  
T Asakura ◽  
K Ohene-Frempong
Keyword(s):  
Sickle Cell Disease ◽  
Pulse Oximetry ◽  
Sickle Cell ◽  
Arterial Oxygen Saturation ◽  
Oxygen Desaturation ◽  
Arterial Oxygen ◽  
Acute Chest Syndrome ◽  
Cell Disease ◽  
Factors Associated ◽  
History Of

Abstract The observation of low transcutaneous arterial oxygen saturation (SaO2) in otherwise well sickle cell patients has lead to questions about the interpretation of pulse oximetry values in these patients. We undertook a prospective study of children with sickle cell disease to (1) determine the prevalence of, and factors associated with, low transcutaneous SaO2 in clinically well patients, (2) develop an algorithm for the use of pulse oximetry in acutely ill patients, and (3) assess the accuracy of pulse oximetry in these patients. Eighty-six clinically well children with hemoglobin (Hb) SS had a lower mean transcutaneous SaO2 than 22 Hb SC patients and 10 control subjects (95.6% v 99.1% v 99.0%, respectively; p < .001). In Hb SS patients, a history of acute chest syndrome and age greater than 5 years were associated with lower transcutaneous SaO2 (mean 93.8% for those with a history of acute chest syndrome v 97.8% for those without a history of acute chest syndrome, and 94.0% for patients = 5 years old v 97.2% for those < or = 5 years old; P < .001). These associations were not seen in Hb SC patients. During acute illness, Hb SS patients with acute chest syndrome had transcutaneous SaO2 values that were less than 96% and at least 3 points lower than measurements made when they were well. A nomogram was designed to aid in the interpretation of transcutaneous SaO2 in acutely ill Hb SS patients when a comparison value is not available. The accuracy of pulse oximetry was shown by the correlation between SaO2 measured by pulse oximetry and calculated by using the patient's oxygen dissociation curve and PaO2 (r = .97). This study provides evidence that Hb oxygen desaturation is not a universal finding among children with sickle cell disease and identifies factors associated with Hb oxygen desaturation. We conclude that pulse oximetry may be useful to assess whether progressive pulmonary dysfunction begins at an early age in Hb SS patients, and to assess acutely ill patients for the presence of hypoxemia associated with acute chest syndrome.

Complex, Isolated Pulmonary Arteriovenous Malformation in Two Children With Severe Cyanosis.

2021 ◽  
pp. 215013512110535
Author(s):  
Iyad AL-Ammouri ◽  
Alexander Rabadi ◽  
Sufian Abdel Hafez ◽  
Raed Al-Taher ◽  
Amjad Bani Hani ◽  
...  
Keyword(s):  
Arteriovenous Malformation ◽  
Arteriovenous Malformations ◽  
Exercise Intolerance ◽  
Pulmonary Arteriovenous Malformation ◽  
Pulmonary Arteriovenous Malformations ◽  
Segmental Artery ◽  
Anatomical Features ◽  
Surgical Ligation

We present two cases of Isolated complex pulmonary arteriovenous malformations in two children presenting with cyanosis and exercise intolerance. We present the anatomical features and the management of each case. One patient was treated with surgical ligation of the draining vein, and one patient was treated percutaneously by closure of the feeding segmental artery.

scholarly journals Effect of Diazepam Sedation on Arterial Oxygen Saturation and Patient Tolerance During Esophagogastroduodenoscopy

1997 ◽  
Vol 3 (3) ◽  
pp. 171-175
Author(s):  
G. M. Malik ◽  
M. Mubarik ◽  
S. A. Kadla ◽  
J. A. Basu ◽  
H. Tajamul
Keyword(s):  
Oxygen Saturation ◽  
Arterial Oxygen Saturation ◽  
Endoscopic Procedure ◽  
Oxygen Desaturation ◽  
Arterial Oxygen ◽  
Age Group ◽  
Number Of Patients ◽  
Patient Tolerance ◽  
The Impact

The impact of intravenous (I/V) diazepam sedation on arterial oxygen saturation (SaO2) and patient tolerance was studied in 100 patients in the age group of (27–60) years, who were subjected to esophagogastroduodenoscopy (EGD) for different indications. Equal number of patients in the same age group, who did not receive the sedation acted as controls. It was observed that SaO2 showed a transient fall during the first few minutes of the endoscopic procedure even without sedation and diazepam administration did not significantly (p > 0.05) aggravate this oxygen desaturation. It was also observed that diazepam sedation increased the procedure tolerance of the patients when compared with controls (p < 0.01). In conclusion, it was inferred that I/V diazepam may act as a safe and favourable sedative for EGD.

Pulmonary Arteriovenous Malformation Treatment with Detachable Balloon: A Case Report

1996 ◽  
Vol 34 (5) ◽  
pp. 595 ◽  
Author(s):  
Young Min Han ◽  
Ho Young Song ◽  
Jeong Min Lee ◽  
Jin Young Chung ◽  
Sang Young Lee ◽  
...  
Keyword(s):  
Case Report ◽  
Arteriovenous Malformation ◽  
Pulmonary Arteriovenous Malformation ◽  
Detachable Balloon

Psychophysiological Responses of Pilots in Hypoxia Training at 7000 and 7500 m

2020 ◽  
Vol 91 (10) ◽  
pp. 785-789
Author(s):  
Dongqing Wen ◽  
Lei Tu ◽  
Guiyou Wang ◽  
Zhao Gu ◽  
Weiru Shi ◽  
...  
Keyword(s):  
Heart Rate ◽  
Psychomotor Performance ◽  
Physiological Responses ◽  
Arterial Oxygen Saturation ◽  
Arterial Oxygen ◽  
Awareness Training ◽  
Similar Frequency ◽  
Psychophysiological Responses ◽  
The Mean ◽  
Training Protocol

INTRODUCTION: We compared the physiological responses, psychomotor performances, and hypoxia symptoms between 7000 m and 7500 m (23,000 and 24,600 ft) exposure to develop a safer hypoxia training protocol.METHODS: In altitude chamber, 66 male pilots were exposed to 7000 and 7500 m. Heart rate and arterial oxygen saturation were continuously monitored. Psychomotor performance was assessed using the computational task. The hypoxic symptoms were investigated by a questionnaire.RESULTS: The mean duration time of hypoxia was 323.0 56.5 s at 7000 m and 218.2 63.3 s at 7500 m. The 6-min hypoxia training was completed by 57.6% of the pilots and 6.1% of the pilots at 7000 m and at 7500 m, respectively. There were no significant differences in pilots heart rates and psychomotor performance between the two exposures. The Spo2 response at 7500 m was slightly severer than that at 7000 m. During the 7000 m exposure, pilots experienced almost the same symptoms and similar frequency order as those during the 7500 m exposure.CONCLUSIONS: There were concordant symptoms, psychomotor performance, and very similar physiological responses between 7000 m and 7500 m during hypoxia training. The results indicated that 7000-m hypoxia awareness training might be an alternative to 7500-m hypoxia training with lower DCS risk and longer experience time.Wen D, Tu L, Wang G, Gu Z, Shi W, Liu X. Psychophysiological responses of pilots in hypoxia training at 7000 and 7500 m. Aerosp Med Hum Perform. 2020; 91(10):785789.

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