scholarly journals The impact of open vs closed suction on cardio- respiratory parameters in mechanically ventilated patients

2021 ◽  
Vol 8 (7) ◽  
pp. 33-38
Author(s):  
Shadia Hamoud Alshahrani ◽  
◽  
Absar Ahmed Qureshi ◽  
Premalatha Paulsamy ◽  
Krishnaraju Venkatesan ◽  
...  
Keyword(s):  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Sampling Procedure ◽  
Ventilator Support ◽  
Mechanically Ventilated ◽  
Closed Suction ◽  
Respiratory Parameters ◽  
The Impact ◽  
Series Study ◽  
Ventilated Patients

Suctioning of the endotracheal tube in ventilated patients is one of the ways to maintain the airway open. There arevarious risks associated with this procedure. Suctioning methods that are appropriate for the situation can help to avoid acute problems. The purpose of this study was to compare the effects of open vs closed suction on cardiorespiratory parameters in patients on mechanical ventilations. Patients hospitalized to Neuro-ICU and Medical ICU with ventilator support was studied in a non-randomized clinical trial with a time series study design. Sixty samples were chosen using a convenient sampling procedure, including 30 for open suction and 30 for closed suction. Before and during suction, data such as demographic factors and cardio-respiratory parameters such as respiratory rate, heart rate, mean arterial pressure, and SpO2 were measured. In this study, statistically significant changes (p=0.001) in Mean Arterial Pressure (MAP) and SpO2 were identified when open and closed suction systems were compared. According to the findings, closed suction has a significant favourable impact on cardiopulmonary parameters. Keywords: Cardio Respiratory parameters, mechanical ventilation, SpO2, Mean Arterial Pressure (MAP), opensuction, closed suction

Abstract 477: Diverse Actions of the EP4 Prostaglandin E2 Receptor in Blood Pressure Control

Hypertension ◽  
2013 ◽  
Vol 62 (suppl_1) ◽  
Author(s):  
Marcela Herrera ◽  
Matthew A Sparks ◽  
Beverky H Koller ◽  
Thomas M Coffman
Keyword(s):  
Smooth Muscle ◽  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Smooth Muscle Cells ◽  
Prostaglandin E2 ◽  
Ductus Arteriosus ◽  
Muscle Cells ◽  
High Salt ◽  
Ang Ii ◽  
The Impact

Prostaglandin E2 (PGE2) is a major prostanoid produced by the kidney having the potential to influence renal blood flow, Na excretion, and thus mean arterial pressure (BP). PGE2 actions are mediated by four distinct E-prostanoid (EP) receptor isoforms: EP1-EP4. The EP4 receptor (EP4R) triggers macula densa stimulation of renin, induces vasodilation, and may inhibit epithelial sodium transport. Thus, the impact of EP4Rs on BP may differ with the sites of PGE2 synthesis and pattern of EP4R activation within the kidney. To examine the role of EP4R on BP regulation we generated EP4R-deficient mice. Because deletion of EP4R in utero causes peri-natal mortality due to persistent patent ductus arteriosus, we carried out conditional deletion by crossing EP4flox/flox with a transgenic line with tamoxifen-inducible Cre expression in all tissues. Resting mean arterial pressure (MAP) measured by radiotelemetry was increased by 5±1mm Hg (p<0.05) in mice with total-body EP4R-deficiency (EP4R-TBKO) vs. controls. In addition, EP4R-TBKOs had an exaggerated increase in MAP with high-salt (6% NaCl) feeding (MAP increase: 5±1 vs. 2±1mmHg for controls; p<0.05) and during angiotensin II (Ang II)-dependent hypertension (MAP increase: 37±2 vs. 24±3mmHg for controls; p<0.05). We next hypothesized that exaggerated hypertension in the EP4R-TBKOs was due to elimination of compensatory EP4R-depedent vasodilation mediated by direct actions in vascular smooth muscle cells (VSMCs). Accordingly, we generated mice lacking EP4R in VSMCs (EP4R-SMKOs) using EP4flox/flox and transgenic mice with tamoxifen-inducible expression of Cre limited to smooth muscle cells. In contrast to the EP4R-TBKOs, elimination of EP4R only from VSMC reduced resting MAP by 5±1mm Hg (p<0.04) but did not affect the BP response to high salt feeding (MAP change: 2±1 vs. 2±1 mm Hg; ns) or chronic Ang II infusion (MAP increase: 29±3 vs. 34±4 mm Hg; ns). Thus, the EP4R modulates resting MAP but its specific impact may vary between EP4R populations in different cell lineages. EP4Rs resist the development of salt- and Ang II-dependent hypertension. These anti-hypertensive actions are not mediated by direct effects of EP4R in VSMCs, but may involve EP4R in endothelium, brain, or kidney epithelia.

scholarly journals Impact of blood pressure changes in cerebral blood perfusion of patients with ischemic Moyamoya disease evaluated by SPECT

2020 ◽  
pp. 0271678X2096745
Author(s):  
Zhao Liming ◽  
Sun Weiliang ◽  
Jia Jia ◽  
Liang Hao ◽  
Liu Yang ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Moyamoya Disease ◽  
Emission Computed Tomography ◽  
Study Cohort ◽  
Pressure Changes ◽  
The Impact

Our aim was to determine the impact of targeted blood pressure modifications on cerebral blood flow in ischemic moyamoya disease patients assessed by single-photon emission computed tomography (SPECT). From March to September 2018, we prospectively collected data of 154 moyamoya disease patients and selected 40 patients with ischemic moyamoya disease. All patients underwent in-hospital blood pressure monitoring to determine the mean arterial pressure baseline values. The study cohort was subdivided into two subgroups: (1) Group A or relative high blood pressure (RHBP) with an induced mean arterial pressure 10–20% higher than baseline and (2) Group B or relative low blood pressure (RLBP) including patients with mean arterial pressure 10–20% lower than baseline. All patients underwent initial SPECT study on admission-day, and on the following day, every subgroup underwent a second SPECT study under their respective targeted blood pressure values. In general, RHBP patients showed an increment in perfusion of 10.13% (SD 2.94%), whereas RLBP patients showed a reduction of perfusion of 12.19% (SD 2.68%). Cerebral blood flow of moyamoya disease patients is susceptible to small blood pressure changes, and cerebral autoregulation might be affected due to short dynamic blood pressure modifications.

scholarly journals Effects of mean arterial pressure on arousal in sedated ventilated patients with septic shock: a SEPSISPAM post hoc exploratory study

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Youenn Jouan ◽  
Valérie Seegers ◽  
Ferhat Meziani ◽  
Fabien Grelon ◽  
Bruno Megarbane ◽  
...  
Keyword(s):  
Septic Shock ◽  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Exploratory Study ◽  
Post Hoc ◽  
Ventilated Patients

scholarly journals Comparison of the Baska Mask® and Endotracheal Tube on Hemodynamic and Respiratory Parameters in Septoplasty Cases

2021 ◽  
Vol 122 (1) ◽  
pp. 5-13
Author(s):  
Hatice Selçuk Kuşderci ◽  
Mümtaz Taner Torun ◽  
Mesut Öterkuş
Keyword(s):  
Heart Rate ◽  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Endotracheal Tube ◽  
Airway Pressure ◽  
Demographic Data ◽  
Airway Device ◽  
Supraglottic Airway ◽  
Safe Alternative ◽  
Respiratory Parameters

Laryngeal mask (LM) types have been used as an airway device for an alternative to the standard endotracheal tube (ETT). One of the novel type of LM, the Baska Mask®, can be a safe alternative among the airway devices. The purpose of this study is to compare the effects of the new generation supraglottic airway device the Baska Mask® and the ETT on hemodynamic parameters (heart rate, mean arterial pressure), airway pressure and end tidal carbon dioxide (EtCO2) in patients undergoing general anesthesia. After the approval of the ethics committee, 70 patients who underwent septoplasty were included in the study. Written informed consent forms were taken from these patients. Demographic data of the patients were recorded. Hemodynamic data of patients were measured and recorded preoperative, during induction, at the time of intubation 1th, 3th and 5th minute and during extubation. Also, airway pressure and EtCO2 values of the patients were measured and recorded at the time of intubation, 1th, 3th and 5th minutes. Demographic data were similar in both groups. Mean arterial pressure, heart rate and airway pressure were lower in the group 2 (the Baska Mask® group) than in the group 1 (ETT group) and the difference was statistically significant (p<0.05). EtCO2 values were similar in both groups. No patients had tube leakage. In terms of hemodynamic and respiratory parameters the Baska Mask® is more advantageous than the ETT in short-term surgeries.

Impact of Serum Phosphate in Mechanically Ventilated Patients With Severe Sepsis and Septic Shock

2018 ◽  
Vol 35 (5) ◽  
pp. 485-493 ◽  
Author(s):  
Christopher J. Miller ◽  
Bruce A. Doepker ◽  
Andrew N. Springer ◽  
Matthew C. Exline ◽  
Gary Phillips ◽  
...  
Keyword(s):  
Septic Shock ◽  
Mechanical Ventilation ◽  
Severe Sepsis ◽  
Clinical Outcomes ◽  
Serum Phosphate ◽  
Mechanically Ventilated ◽  
Mechanically Ventilated Patients ◽  
Sepsis And Septic Shock ◽  
The Impact ◽  
Ventilated Patients

Background: Hypo- and hyperphosphatemia are common in severe sepsis and septic shock. Published outcome data in patients with phosphate derangements primarily focus on hypophosphatemia and the general critically ill population. This study aimed to determine the impact of serum phosphate on clinical outcomes in patients with severe sepsis and septic shock. Methods: A retrospective cohort analysis of adult mechanically ventilated patients with severe sepsis or septic shock was performed. Patients were randomly selected from an internal intensive care unit (ICU) database at an academic medical center in the United States and screened for inclusion and exclusion criteria. Time-weighted phosphate was calculated using all phosphate measurements obtained during ICU admission. The associations between time-weighted phosphate and duration of mechanical ventilation, 28-day mortality, and ICU and hospital length of stay were evaluated using linear or logistic regression as appropriate. Results: One-hundred ninety-seven patients were evaluated: 33 were categorized as hypophosphatemia, 123 as normophosphatemia, and 41 as hyperphosphatemia. Patients with time-weighted hyperphosphatemia had a higher Simplified Acute Physiology Score III score and incidence of septic shock. Significantly higher rates of 28-day mortality were observed among those with time-weighted phosphate levels above 3.5 mg/dL. However, both time-weighted hypo- and hyperphosphatemia were associated with decreased duration of mechanical ventilation. For every 0.5 mg/dL increase in time-weighted phosphate referent values from 4.0 to 6.0, the duration of mechanical ventilation decreased by 8% to 26%. For every 0.5 mg/dL decrease in time-weighted phosphate referent values from 3.0 to 1.0, significant decreases in duration of mechanical ventilation ranged from 14% to 41%. Conclusion: Time-weighted hyperphosphatemia may be associated with increased mortality in mechanically ventilated patients with severe sepsis or septic shock. However, time-weighted hypo- and hyperphosphatemia were associated with decreased duration of mechanical ventilation. Future studies should further describe the impact of hypo- and hyperphosphatemia on clinical outcomes among critically ill patients with severe sepsis or septic shock.

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