scholarly journals Application Effect Analysis of Three Methods of Heating and Humidification for Weaning Patients in ICU

2021 ◽  
Author(s):  
Yongxing Wu ◽  
Jiyu Bai ◽  
XingQing Zhu ◽  
Zhijing Zhu
Keyword(s):  
Cohort Study ◽  
Partial Pressure ◽  
Academic Medical Center ◽  
Vital Signs ◽  
Carbon Dioxide Partial Pressure ◽  
Blood Gas ◽  
Artificial Airway ◽  
Artificial Nose ◽  
T Tube ◽  
Mechanical Ventilation Duration

Abstract Objectives Adequate humidity and temperature of the inhaled mixed air are important for patients weaning from ventilators. It can not only prevent the damage of dry gas on respiratory tract, but also facilitate the discharge of sputum. We aim to investigate the humidification and heating effects of artificial nose, Venturi device plus thermostatic humidification T-tube (referred as VT), Venturi device plus thermostatic humidification T-tube and PEEP valve (referred as VTP) in critical ill patients with tracheotomy in ICU.Design:Retrospective cohort study.Setting: Tertiary academic medical center.Patients: A total of 166 patients were engaged in this study. Clinical and laboratory examination data were used to determine the heating and humidification performance of 3 different methods.Methods A retrospective, single-center cohort study was conducted in all critically ill patients ready to be weaned from mechanical ventilators. Three groups of patients were compared in terms of vital signs, the effect of artificial airway heating and humidification, and blood gas indicators. Basic patient data (age, gender, mechanical ventilation duration, ICU stay, disease type) were recorded. Vital signs include heart rate, blood pressure, respiratory rate, oxygen saturation; The performance of heating and humidifying the artificial airway were defined as the number of sputum suction and coughing within 24 hours, sputum characteristics, whether there is bloody sputum formation, whether there is phlegm callus formation; Blood gas indicators include pH, oxygen partial pressure, carbon dioxide partial pressure, lactic acid, residual base, and bicarbonate.Results In terms of the heating and humidification performance of patients in ICU, the VT method and the VTP method were significantly superior to those of artificial nasal method.SpO2 was significantly higher in patients treated with the VTP method than that in patients treated with VT.ConclusionCompared with the artificial nose method, the VTP method and VT methods are better. In terms of improving oxygenation, the VTP method could improve the patient's oxygen sum more than the VT mothod.

scholarly journals Application Effect Analysis of Three Methods of Heating and Humidification for Weaning Patients in ICU

2021 ◽  
Author(s):  
Yongxing Wu ◽  
Jiyu Bai ◽  
XingQing Zhu ◽  
Zhijing Zhu
Keyword(s):  
Mechanical Ventilation ◽  
Partial Pressure ◽  
Academic Medical Center ◽  
Vital Signs ◽  
Carbon Dioxide Partial Pressure ◽  
Blood Gas ◽  
Artificial Airway ◽  
Artificial Nose ◽  
T Tube ◽  
Mechanical Ventilation Duration

Abstract Objectives To investigate the effects of artificial nose, Venturi device+thermostatic humidification T-tube, Venturi device+thermostatic humidification T-tube+PEEP valve in patients with tracheotomy in ICU.Design: Cohort study.Setting: Tertiary academic medical center.Patients: A total of 215 patients were engaged in this study. Clinical and laboratory examination data were used to determine the heating and humidification efficiency of 3 different methods.Methods: We conducted randomized controlled trial. Patients who successfully weaned from mechanical ventilation were enrolled, and every patient was randomized to receive one of the above three interventions. Three groups of patients were compared in terms of vital signs, the effect of artificial airway heating and humidification, and blood gas indicators. Basic patient data (age, gender, mechanical ventilation duration, ICU stay, disease type) were recorded. Vital signs include heart rate, blood pressure, respiratory rate, oxygen saturation; The effect of heating and humidifying the artificial airway were defined as the number of sputum suction and coughing within 24 hours, sputum characteristics, whether there is bloody sputum formation, whether there is phlegm callus formation; Blood gas indicators include pH, oxygen partial pressure, carbon dioxide partial pressure, lactic acid, residual base, and bicarbonate.Results: In terms of the heating and humidification effect of patients in ICU, the heating and humidification effect of the Venturi device+T-tube method and the Venturi device+the T-tube +PEEP valve method were significantly superior to those of artificial nasal method (sputum suction number: P =0.0001; sputum scab: P =0.03; Number of cough: P =0.007).SpO2 was significantly higher (P =0.004) in the Venturi device+T tube+PEEP valve than that in the Venturi device+T tube.Conclusion: Compared with the artificial nose method, the T-piece+venturi device and thermostatic heating and humidifying T-tube +PEEP valve method is better. In terms of improving oxygenation, the Venturi device and the thermostatic humidification T tube +PEEP valve could improve the patient's oxygen sum more than the Venturi device and the thermostatic humidification T tube.

scholarly journals Blood-gas and electrolyte values for Amazon parrots (Amazona aestiva)

2008 ◽  
Vol 28 (2) ◽  
pp. 108-112 ◽  
Author(s):  
Valéria V. Paula ◽  
Denise T. Fantoni ◽  
Denise A. Otsuki ◽  
José O.C. Auler Jr
Keyword(s):  
Plasma Concentration ◽  
Partial Pressure ◽  
Base Excess ◽  
Ulnar Artery ◽  
Carbon Dioxide Partial Pressure ◽  
Blood Gas ◽  
Human Beings ◽  
Bicarbonate Ions ◽  
Arterial Blood ◽  
Acid Base Status

The aim was to provide reference data for blood gas/acid-base status and electrolytes for non-anesthetized Amazon parrots (Amazona aestiva). Thirty-five adult parrots from Tietê ecologic park were utilized. Arterial blood (0.3ml) samples were anaerobically collected from the superficial ulnar artery in heparinized (sodium heparin) 1-ml plastic syringes. The samples were immediately analyzed through a portable analyzer (i-STAT*, Abbot, Illinois, USA) with cartridges (EG7+). These data were grouped in such a way as to present both mean and standard deviation: body weight (360±37g), respiratory rate (82±33 b/m), temperature (41.8±0.6°C), hydrogen potential (7.452±0.048), carbon dioxide partial pressure (22.1±4.0mmHg), oxygen partial pressure (98.1±7.6mmHg), base excess (-7.9±3.1), plasma concentration of bicarbonate ions (14.8±2.8mmol/L), oxygen saturation (96.2±1.1%), plasma concentration of sodium (147.4±2.2mmol/L), plasma concentration of potassium (3.5±0.53mmol/L), plasma concentration of calcium (0.8±0.28mmol/L), hematocrit (38.7±6.2%) and concentration of hemoglobin (13.2±2.1g/dl). This study led us to conclude that, although the results obtained showed hypocapnia and low values of bicarbonate and base excess, when compared to other avian species, these data are very similar. Besides, in spite of the equipment being approved only for human beings, it was considered simple and very useful in the analysis of avian blood samples. By using this equipment we were able to provide references data for non-anaesthetized Amazon parrots.

scholarly journals Different fasting periods in tiletamine-zolezepam-anethetized cats: Glycemia, recovery, blood-gas and cardiorrespiratory parameters

2013 ◽  
Vol 65 (6) ◽  
pp. 1685-1693
Author(s):  
A.P. Gering ◽  
N. Nunes ◽  
M.C.C. Oliveira ◽  
M. Horr ◽  
P.C.F. Lopes ◽  
...  
Keyword(s):  
Carbon Dioxide ◽  
Heart Rate ◽  
Partial Pressure ◽  
Rectal Temperature ◽  
Base Deficit ◽  
Carbon Dioxide Partial Pressure ◽  
Blood Gas ◽  
Preoperative Fasting ◽  
Bicarbonate Concentration ◽  
Hemoglobin Saturation

The effects of different fasting periods on glycemia levels and on cardiorrespiratory parameters in tiletamine-zolazepam-anesthetized cats were evaluated. Twenty one animals were randomly assigned to three groups: 8 hours (G8), 12 hours (G12) or 18 hours (G18) of the preoperative fasting. The tiletamine-zolazepam (2 mg/kg) was administered intravenously. The heart rate (HR), respiratory rate (fR), rectal temperature (T R), glycemia (G), laboratorial glycemia (Glab), venous oxygen partial pressure (PvO2), venous carbon dioxide partial pressure (PvCO2), venous hemoglobin saturation (SvO2), pH, base deficit (BD), bicarbonate concentration (HCO3- ) and haematocrit were evaluated at 90 minutes after the last meal (T0), immediately before anesthesia (T1) and at ten (T2) and thirty (T3) minutes after tiletamine-zolezepam administration. The time between the administration of anesthetic and the cat's trial to elevate head (Th) and the interval between drug administration and aniamal's quadrupedal position (Tqp) were recorded. No differences among groups were recorded for glycemia, HR, PvO2, SvO2, pH, BD, HCO3-, Ht and Tqp. In G12 from T2, glycemia increased and from T1 PvCO2 decreased. At T1, PvO2 increased in all groups. In G8 and G12, from T1, DB and HCO3- decreased. In G12 and G18, from T2, Ht decreased. In G12, the Th mean was higher than G8. In conclusion, in tiletamine-zolazepam-anesthetized cats, the different preoperative fasting did not influence glycemia, blood-gas and cardiorrespiratory parameters. Additionally, there was no relationship between glycemia and anesthesia recovery.

Atrial fibrillation associated with carbon monoxide poisoning

2019 ◽  
pp. 203-206
Author(s):  
Mevlut Demir ◽  
◽  
Muslum Sahin ◽  
Ahmet Korkmaz ◽  
◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Carbon Monoxide ◽  
Sinus Rhythm ◽  
Partial Pressure ◽  
Motor Vehicle ◽  
Carbon Monoxide Poisoning ◽  
Venous Blood ◽  
Blood Gas ◽  
Arterial Blood Gas ◽  
Arterial Blood

Carbon monoxide intoxication occurs usually via inhalation of carbon monoxide that is emitted as a result of a fire, furnace, space heater, generator, motor vehicle. A 37-year-old male patient was admitted to the emergency department at about 5:00 a.m., with complaints of nausea, vomiting and headache. He was accompanied by his wife and children. His venous blood gas measures were: pH was 7.29, partial pressure of carbon dioxide (pCO2) was 42 mmHg, partial pressure of oxygen (pO2) was 28 mmHg, carboxyhemoglobin (COHb) was 12.7% (reference interval: 0.5%-2.5%) and oxygen saturation was 52.4%. Electrocardiogram (ECG) examination showed that the patient was not in sinus rhythm but had atrial fibrillation. After three hours the laboratory examination was repeated: Troponin was 1.2 pg/ml and in the arterial blood gas COHb was 3%. The examination of the findings on the monitor showed that the sinus rhythm was re-established. The repeated ECG examination confirmed the conversion to the sinus rhythm. He was monitored with the normobaric oxygen administration.

scholarly journals Ambulance dispatch of older patients following primary and secondary telephone triage in metropolitan Melbourne, Australia: a retrospective cohort study

BMJ Open ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. e042351
Author(s):  
Kathryn Eastwood ◽  
Dhanya Nambiar ◽  
Rosamond Dwyer ◽  
Judy A Lowthian ◽  
Peter Cameron ◽  
...  
Keyword(s):  
Cohort Study ◽  
Older Adult ◽  
Retrospective Cohort Study ◽  
Older Patients ◽  
Retrospective Cohort ◽  
Vital Signs ◽  
Telephone Triage ◽  
Ambulance Dispatch ◽  
Emergency Ambulance ◽  
Primary Triage

BackgroundMost calls to ambulance result in emergency ambulance dispatch (direct dispatch) following primary telephone triage. Ambulance Victoria uses clinician-led secondary telephone triage for patients identified as low-acuity during primary triage to refer them to alternative care pathways; however, some are returned for ambulance dispatch (secondary dispatch). Older adult patients are frequent users of ambulance services; however, little is known about the appropriateness of subsequent secondary dispatches.ObjectivesTo examine the appropriateness of secondary dispatch through a comparison of the characteristics and ambulance outcomes of older patients dispatched an emergency ambulance via direct or secondary dispatch.DesignA retrospective cohort study of ambulance patient data between September 2009 and June 2012 was conducted.SettingThe secondary telephone triage service operated in metropolitan Melbourne, Victoria, Australia during the study period.ParticipantsThere were 90 086 patients included aged 65 years and over who had an emergency ambulance dispatch via direct or secondary dispatch with one of the five most common secondary dispatch paramedic diagnoses.Main outcome measuresDescriptive analyses compared characteristics, treatment and transportation rates between direct and secondary dispatch patients.ResultsThe dispatch groups were similar in demographics, vital signs and hospital transportation rates. However, secondary dispatch patients were half as likely to be treated by paramedics (OR 0.51; CI 0.48 to 0.55; p<0.001). Increasing age was associated with decreasing treatment (p<0.005) and increasing transportation rates (p<0.005).ConclusionSecondary triage could identify patients who would ultimately be transported to an emergency department. However, the lower paramedic treatment rates suggest many secondary dispatch patients may have been suitable for referral to alternative low-acuity transport or referral options.

scholarly journals Analysis of Arterial Blood Gas Values Based on Storage Time Since Sampling: An Observational Study

2021 ◽  
Vol 11 (3) ◽  
pp. 517-521
Author(s):  
Alejandro Montero-Salinas ◽  
Marta Pérez-Ramos ◽  
Fernando Toba-Alonso ◽  
Leticia Quintana-DelRío ◽  
Jorge Suanzes-Hernández ◽  
...  
Keyword(s):  
Lactic Acid ◽  
Observational Study ◽  
Partial Pressure ◽  
Group Analysis ◽  
Initial Time ◽  
Blood Gas ◽  
Initial Sample ◽  
Arterial Blood Gas ◽  
Arterial Blood ◽  
Prospective Longitudinal

Aim. To evaluate the influence of time on arterial blood gas values after artery puncture is performed. Method. Prospective longitudinal observational study carried out with gasometric samples from 86 patients, taken at different time intervals (0 (T0), 15 (T15), 30 (T30) and 60 (T60) min), from 21 October 2019 to 21 October 2020. The study variables were: partial pressure of carbon dioxide, bicarbonate, hematocrit, hemoglobin, potassium, lactic acid, pH, partial pressure of oxygen, saturation of oxygen, sodium and glucose. Results. The initial sample consisted of a total of 90 patients. Out of all the participants, four were discarded as they did not understand the purpose of the study; therefore, the total number of participants was 86, 51% of whom were men aged 72.59 on average (SD: 16.23). In the intra-group analysis, differences in PCO2, HCO3, hematocrit, Hb, K+ and and lactic acid were observed between the initial time of the test and the 15, 30 and 60 min intervals. In addition, changes in pH, pO2, SO2, Na and glucose were noted 30 min after the initial sample had been taken. Conclusions. The variation in the values, despite being significant, has no clinical relevance. Consequently, the recommendation continues to be the analysis of the GSA at the earliest point to ensure the highest reliability of the data and to provide the patient with the most appropriate treatment based on those results.

Reference intervals for venous blood gas measurement in adults

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Kirsty L. Ress ◽  
Gus Koerbin ◽  
Ling Li ◽  
Douglas Chesher ◽  
Phillip Bwititi ◽  
...  
Keyword(s):  
Partial Pressure ◽  
Meta Analysis ◽  
Venous Blood ◽  
Reference Interval ◽  
Reference Intervals ◽  
Published Data ◽  
Blood Gas ◽  
Arterial Blood Gas ◽  
Arterial Blood ◽  
Venous Blood Gas

AbstractObjectivesVenous blood gas (VBG) analysis is becoming a popular alternative to arterial blood gas (ABG) analysis due to reduced risk of complications at phlebotomy and ease of draw. In lack of published data, this study aimed to establish reference intervals (RI) for correct interpretation of VBG results.MethodsOne hundred and 51 adult volunteers (101 females, 50 males 18–70 y), were enrolled after completion of a health questionnaire. Venous blood was drawn into safePICO syringes and analysed on ABL827 blood gas analyser (Radiometer Pacific Pty. Ltd.). A non-parametric approach was used to directly establish the VBG RI which was compared to a calculated VBG RI based on a meta-analysis of differences between ABG and VBGResultsAfter exclusions, 134 results were used to derive VBG RI: pH 7.30–7.43, partial pressure of carbon dioxide (pCO2) 38–58 mmHg, partial pressure of oxygen (pO2) 19–65 mmHg, bicarbonate (HCO3−) 22–30 mmol/L, sodium 135–143 mmol/L, potassium 3.6–4.5 mmol/L, chloride 101–110 mmol/L, ionised calcium 1.14–1.29 mmol/L, lactate 0.4–2.2 mmol/L, base excess (BE) −1.9–4.5 mmol/L, saturated oxygen (sO2) 23–93%, carboxyhaemoglobin 0.4–1.4% and methaemoglobin 0.3–0.9%. The meta-analysis revealed differences between ABG and VBG for pH, HCO3−, pCO2 and pO2 of 0.032, −1.0 mmol/L, −4.2 and 39.9 mmHg, respectively. Using this data along with established ABG RI, calculated VBG RI of pH 7.32–7.42, HCO3− 23 – 27 mmol/L, pCO2 36–49 mmHg (Female), pCO2 39–52 mmHg (Male) and pO2 43–68 mmHg were formulated and compared to the VBG RI of this study.ConclusionsAn adult reference interval has been established to assist interpretation of VBG results.

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