Chronic Obstructive Pulmonary Disease and Respiratory Acidosis in the Intensive Care Unit

2019 ◽  
Vol 15 (2) ◽  
pp. 79-89 ◽  
Author(s):  
Yamely Mendez ◽  
Francisco E. Ochoa-Martinez ◽  
Tatiana Ambrosii
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Clinical Skills ◽  
Laboratory Data ◽  
Chronic Obstructive Lung Disease ◽  
Respiratory Acidosis ◽  
Blood Gases ◽  
Hospital Length ◽  
Chronic Obstructive ◽  
Arterial Blood

Chronic obstructive lung disease is a common and preventable disease. One of its pathophysiological consequences is the presence of carbon dioxide retention due to hypoventilation and ventilation/perfusion mismatch, which in consequence will cause a decrease in the acid/base status of the patient. Whenever a patient develops an acute exacerbation, acute respiratory hypercapnic failure will appear and the necessity of a hospital ward is a must. However, current guidelines exist to better identify these patients and make an accurate diagnosis by using clinical skills and laboratory data such as arterial blood gases. Once the patient is identified, rapid treatment will help to diminish the hospital length and the avoidance of intensive care unit. On the other hand, if there is the existence of comorbidities such as cardiac failure, gastroesophageal reflux disease, pulmonary embolism or depression, it is likely that the patient will be admitted to the intensive care unit with the requirement of intubation and mechanical ventilation.

scholarly journals Mean difference of Electrolyte Level measured in Arterial Blood gases and measured in Laboratory in Children presenting in Pediatric Intensive Care Unit

2021 ◽  
pp. 3-6
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Pediatric Intensive Care Unit ◽  
Pediatric Intensive Care ◽  
Blood Gases ◽  
P Value ◽  
Arterial Blood Gases ◽  
K Value ◽  
Electrolyte Level ◽  
Arterial Blood

Background: Electrolytes are measured in arterial and venous blood by arterial blood gas analyzer and the auto-analyzers respectively. Objective: To determine the mean difference in electrolyte level in arterial blood gases (ABGs) level versus laboratory serum electrolyte level in the children admitted in the pediatric intensive care unit. Methodology: This cross-sectional study was conducted at department of Pediatrics, the Children’s Hospital and Institute of Child Health, Lahore from 1st December 2015 to 31st May 2016. Total of 125 children fulfilling inclusion criteria were enrolled in the study from pediatric intensive care unit. The ABGs (whole blood) electrolytes were obtained immediately after collection, using ABGs analyzer. Serum electrolytes were analyzed in the central laboratory of the institution. Reports were assessed and levels of sodium and potassium was noted from reports of ABGs and laboratory. Results: Mean NA+ value on ABGs and from laboratory was 134.66 and 132.26 (p= 0.01). Mean K+ value from on ABGs and from laboratory was 4.51 and 4.28. (p= 0.071). In age group 1-5 and 6-10 years, K+ level was high in ABGs value (p-value=0.065 & p-value=0.073). However, in age group 11-15 years K+ level was significantly higher in ABGs value as that of laboratory value (p-value=0.014). The same trend was observed in male and female children that mean NA+ and K+ value with ABGs was significantly higher as compared to that of laboratory value. Conclusion: NA+ and K+ in arterial blood gases level were different from laboratory serum electrolyte level in children admitted to pediatric intensive care unit. Clinician should be aware of differences so that potential misdiagnosis does not occur and unnecessary treatment or investigation can’t be performed.

Rotational Thromboelastometry in Neonates Admitted to a Neonatal Intensive Care Unit: A Large Cross-sectional Study

2021 ◽  
Author(s):  
Andreas G. Tsantes ◽  
Rozeta Sokou ◽  
Aikaterini Konstantinidi ◽  
Georgios Ioakeimidis ◽  
Maria Lampridou ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Critical Illness ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Intensive Care ◽  
Laboratory Data ◽  
Disease Onset ◽  
Rotational Thromboelastometry ◽  
Arterial Blood ◽  
Severity Scores

AbstractThe aim of the present study was to assess the coagulation profile in neonatal critical illness using rotational thromboelastometry (ROTEM), and to investigate its association with disease severity and its potential prognostic role in this clinical setting. Over a period of 67 months (July 2014–February 2020) 423 critically ill neonates with confirmed or suspected sepsis, perinatal hypoxia, or respiratory distress syndrome, hospitalized in our neonatal intensive care unit were included in the study. Demographic, clinical, and laboratory data were recorded on admission day and arterial blood was analyzed on ROTEM analyzer using the standard extrinsically activated rotational thromboelastometry assay (EXTEM). Neonatal illness severity scores (Modified NEOMOD [Neonatal Multiple Organ Dysfunction] and SNAPPE [Score for Neonatal Acute Physiology with Perinatal Extension]) were calculated at the same time as ROTEM analysis. Mortality during in-hospital stay was the main outcome measure. Multivariable analyses showed that a 10 mm decrease in EXTEM clot amplitude recorded at 10 minutes (A10) is significantly associated with a higher mortality (odds ratio [OR] = 1.69, 95% confidence interval [CI]: 1.33–2.08). Higher modified NEOMOD (OR = 1.36, 95% CI: 1.26–1.47) and higher SNAPPE scores (OR = 1.06, 95% CI: 1.04–1.08) were also associated with increased mortality. The CT and A10 variables demonstrated the best prognostic performance among the EXTEM parameters for mortality (area under the curve [AUC] = 0.78; 95% CI: 0.69–0.86 and AUC = 0.76; 95% CI: 0.66–0.85, respectively), showing an optimal cut-off CT ≥63 seconds and A10 ≤37 mm. Using optimal cut-off values of the EXTEM parameters for prediction of mortality, neonates with CT ≥63 seconds were 7.4 times more likely to die (OR = 7.40, 95% CI: 3.50–15.65), while neonates with A10 ≤37 mm were 5.8 times more likely to die (OR = 5.88, 95% CI: 2.94–12.50). An EXTEM hypocoagulable profile on disease onset was shown to be an independent risk factor for in-hospital mortality in neonatal critical illness.

scholarly journals Comparison of the effects of heparin 1000 and 5000 units on arterial blood gases

2020 ◽  
Vol 37 (3) ◽  
pp. 267-273
Author(s):  
Reza Borabadi ◽  
Mostafa Rad ◽  
Mohammad Rakhshani ◽  
Mojtaba Rad
Keyword(s):  
Clinical Trial ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Blood Gases ◽  
Metabolic Parameters ◽  
Arterial Blood Gases ◽  
R Software ◽  
Arterial Blood ◽  
Respiratory Parameters ◽  
Significant Difference

Analysis of arterial blood gases is necessary for managing the respiratory and metabolic parameters of patients in the intensive care unit. The aim of this study was to compare the effects of heparin 1000 and heparin 5000 units on arterial blood gases in patients admitted to the intensive care unit. This study was a triple-blinded clinical trial. A total of 78 patients with head injury were randomly selected from the emergency department of a hospital in an urban area of Iran in 2017. Data was collected using a questionnaire and a checklist of laboratory parameters. Data was analyzed using descriptive and inferential statistical methods via the R software. Statistically significant differences in Na, SaO2, Ca, BEecf (p < 0.001), and HCO3, BEe and K were observed between the two groups (p < 0.01). No statistically significant difference between the values of PaCO2, PH and PaO2 in the two groups were reported (p > 0.05). The results of this study confirmed that heparin 1000 and heparin 5000 units had no effects on respiratory parameters in analyzing arterial blood gases. However, the concentration of heparin had a significant effect on metabolic parameters for the analysis of arterial blood gases and electrolytes.

The addition of haloperidol, propofol, or midazolam to sufentanil for intravenous sedation in the intensive care unit using bispectral index

2018 ◽  
Vol 4 (1) ◽  
pp. 34 ◽  
Author(s):  
Baris Tukenmez, MD ◽  
Dilek Memis, MD ◽  
Zafer Pamukcu, MD
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Bispectral Index ◽  
Biochemical Parameters ◽  
Blood Gases ◽  
Arterial Blood Gases ◽  
Infusion Group ◽  
Arterial Blood ◽  
Midazolam Infusion ◽  
Short Period

Aim: Inadequate sedative techniques may adversely affect morbidity and mortality in the intensive care unit (ICU), and the search for the ideal sedative agent continues. Combinations of hypnotics and opiates have are commonly used for sedation. In this study, the authors aimed to assess whether or not the addition of a haloperidol, propofol, or midazolam infusion decreased the sufentanil requirements by using bispectral index (BIS).Material and Methods: The study involved 60 patients in the ICU. All patients received 0.5 μg/kg sufentanil IV bolus. Immediately after, group S received 0.25 μg/kg sufentanil infusion, group SH received sufentanil infusion + haloperidol 3 mg/h infusion, group SP received sufentanil infusion + propofol 25 μg/kg/min infusion, and group SM received sufentanil infusion + midazolam 0.04 mg/kg/h infusion, for 6 hours. Average BIS values 61-80 and Ramsay Sedation Score 2-5 were kept at a range of by decreasing or increasing sufentanil levels in all groups and hourly sufentanil consumption was determined. Hemodynamic and biochemical parameters and arterial blood gases were determined at baseline and were repeated in study hours. Results: There was no significant difference in hemodynamic and biochemical parameters and arterial blood gases among the groups. Propofol, midazolam, haloperidol infusion, when added to sufentanil infusion, decreased the consumption of sufentanil in all the measured times (p < 0.001).Conclusions: The authors aimed to determine the effects of haloperidol, propofol, or midazolam infusion when added to sufentanil infusion in a short period of time. The authors found that propofol, midazolam, and haloperidol infusion decreased the sufentanil requirements in ICU patients.

scholarly journals Low prevalence of bronchial asthma and chronic obstructive lung disease among intensive care unit patients with COVID‐19

Allergy ◽  
2020 ◽  
Vol 75 (10) ◽  
pp. 2703-2704 ◽  
Author(s):  
Sergey Avdeev ◽  
Sergey Moiseev ◽  
Michail Brovko ◽  
Andrey Yavorovskiy ◽  
Karina Umbetova ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Lung Disease ◽  
Bronchial Asthma ◽  
Obstructive Lung Disease ◽  
Chronic Obstructive Lung Disease ◽  
Chronic Obstructive ◽  
Low Prevalence

scholarly journals A Written Guideline Implementation Can Lead to Reductions in Laboratory Testing in an Intensive Care Unit

1997 ◽  
Vol 25 (1) ◽  
pp. 33-37 ◽  
Author(s):  
S. M. Mehari ◽  
J. H. Havill ◽  
C. Montgomery
Keyword(s):  
Intensive Care Unit ◽  
Cardiac Surgery ◽  
Intensive Care ◽  
Laboratory Testing ◽  
Cost Savings ◽  
Blood Gases ◽  
Arterial Blood Gases ◽  
Blood Tests ◽  
Arterial Blood ◽  
The Impact

The impact of developing guidelines for laboratory testing in an Intensive Care Unit (ICU) was examined. Targeted blood tests were recorded on fifty cardiac surgery and fifty general intensive care patients retrospectively. Following the introduction of guidelines, the study was repeated with prospective data collection. Comparison of the samples before and after the intervention showed a 25.9% reduction in all blood tests and a 17.1% reduction in arterial blood gases in the post cardiac surgery group. In general ICU patients, the drop in all tests was 16.6% and in arterial blood gases 21.9%. The cost savings from the cardiac surgery sample was N.Z.$3,637 and general ICU N.Z.$3,166, giving a sum total of N.Z.$6,803 in 100 patients. The potential cost savings for the annual admissions of 1,200 patients is N.Z.$81,636. This study shows that written guidelines can bring about major cost reduction in the short-term.

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