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

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.

scholarly journals Cardiovascular Responses to Tracheal Intubation: A Comparison of Direct Laryngoscopy and Fibreoptic Intubation

1989 ◽  
Vol 17 (1) ◽  
pp. 44-48 ◽  
Author(s):  
S. R. Finfer ◽  
S. I. P. MacKenzie ◽  
J. M. Saddler ◽  
T. G. L. Watkins
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Tracheal Intubation ◽  
Oxygen Saturation ◽  
Arterial Oxygen Saturation ◽  
Macintosh Laryngoscope ◽  
Cardiovascular Responses ◽  
Arterial Oxygen ◽  
Arterial Blood ◽  
Significant Difference

The cardiovascular responses to tracheal intubation using a fibreoptic bronchoscope or Macintosh laryngoscope were compared in twenty in-patients and twenty day-stay patients. Within these groups patients were randomly allocated to direct laryngoscopic or fibreoptic bronchoscopic intubation. Arterial blood pressure, heart rate and arterial oxygen saturation were recorded before induction and at one-minute intervals until four minutes after intubation. In both groups both laryngoscopic and bronchoscopic intubation resulted in a significant rise in blood pressure and heart rate. At no stage was there a significant difference in mean blood pressure in either group, or in heart rate in the day-stay patients, between the different methods of intubation. In the in-patients mean heart rate was significantly higher in those patients intubated with the bronchoscope at three and four minutes after intubation. Time taken for intubation was significantly longer in those patients intubated with the bronchoscope. In no patient did the arterial oxygen saturation fall below 98%.

scholarly journals A comparison of administration of oral chloral hydrate with intranasal dexmedetomidine in sedation of children to perform electroencephalography

2021 ◽  
Vol 43 (1) ◽  
pp. 16-21
Author(s):  
Masoumeh Borhani ◽  
Mohammadreza Habibzadeh ◽  
Amir Shafa
Keyword(s):  
Heart Rate ◽  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Oxygen Saturation ◽  
Respiratory Rate ◽  
Chloral Hydrate ◽  
Arterial Oxygen Saturation ◽  
Arterial Oxygen ◽  
P Value ◽  
Significant Difference

Background: Electroencephalography is a record of the electrical activity of the brain that is used to diagnose brain dysfunction and to determine the location of brain injury and to determine seizure activity. There is. The sedative medication used should not only have an effect on the brain’s electrical activity, but it also calms the baby. Since there have been no studies to compare the effects of intranasal oral hydrate and dexmedetomidine on sedation in children for electroencephalography, this study aimed to compare the effects of intranasal intravenous dexmedetomidine with intramuscular dexmedetomidine on electroencephalography in children. Methods: This clinical trial study was performed on 62 children candidates for electroencephalography in Imam Hossein Pediatric Hospital in Isfahan. Age, weight, and clinical data including sedation score, mean arterial pressure, respiratory rate, arterial oxygen saturation, and heart rate at pre-medication times, 15, 30, 45, and 60 minutes after drug administration. And analyzed. Results: The mean age of the children candidates for electroencephalography was 16.90 ± 1.32, out of which 35 (56.5%) were male. The results showed no significant difference between the two groups in terms of sedation, mean arterial pressure, respiratory rate, and percentage of arterial oxygen saturation (p> 0.05). But the difference between the two groups was statistically significant for the variable heart rate. Heart rate was significantly lower in group B (dexmedetomidine group) than in group A (oral chlorate hydrate group) (p-value = 0.032), and time as an influencing factor in changing mean sedimentation, mean arterial pressure, respiratory rate, and heart rate (p-value <0.05). But there was no significant effect on the change in arterial oxygen saturation percentage (p = 0.478). Conclusion: Chloral hydrate administration was more effective than intranasal dexmedetomidine treatment in maintaining heart rate but overall the results showed no significant difference between the two groups in terms of clinical data and child sedation score in the two groups. Was.

Effects of a closed tracheal suction system on ventilatory and cardiovascular parameters

1992 ◽  
Vol 1 (3) ◽  
pp. 57-61 ◽  
Author(s):  
SA Harshbarger ◽  
LA Hoffman ◽  
TG Zullo ◽  
MR Pinsky
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Oxygen Saturation ◽  
Respiratory Rate ◽  
Arterial Oxygen Saturation ◽  
Control Mode ◽  
Arterial Oxygen ◽  
Acid Base ◽  
Suction System ◽  
Repeated Measures Design

OBJECTIVE: To determine whether patients ventilated in the assist-control mode experienced a change in oxygenation, respiratory rate, inspiratory:expiratory ratio, heart rate, blood pressure or acid-base balance when suctioned with a closed tracheal suction system. DESIGN: A quasi-experimental, within-subject, repeated-measures design was used. SUBJECTS: 18 patients ventilated on a fraction of inspired oxygen of 0.47 +/- 0.17 and 2.3 +/- 5.0 cm H2O positive end-expiratory pressure. INTERVENTIONS: Two suction passes were performed, with measurements at baseline, immediately after the first suction pass, immediately before the second suction pass, immediately after the second suction pass, 2 minutes after the second suction pass and 5 minutes after the second suction pass. No hyperoxygenation was used. RESULTS: Significant differences were seen over time for arterial oxygen saturation, respiratory rate and inspiratory:expiratory ratio. Arterial oxygen saturation decreased to less than 90% in four subjects (range 88% to 89%), with a maximum fall of 9%. No significant differences were seen for heart rate, blood pressure, partial pressure of carbon dioxide, bicarbonate, time to nadir (lowest arterial oxygen saturation) or recovery time. CONCLUSIONS: Subjects ventilated in the assist-control mode and suctioned with a closed tracheal suction system did not experience significant changes in cardiovascular or acid-base parameters when suctioned without hyperoxygenation. Although most subjects did not become desaturated, four subjects experienced desaturation at one or more intervals. To prevent desaturation, hyperoxygenation should be used before and after suctioning with a closed tracheal suction system.

Diving response and arterial oxygen saturation during apnea and exercise in breath-hold divers

2002 ◽  
Vol 93 (3) ◽  
pp. 882-886 ◽  
Author(s):  
Johan P. A. Andersson ◽  
Mats H. Linér ◽  
Elisabeth Rünow ◽  
Erika K. A. Schagatay
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Oxygen Saturation ◽  
Cold Water ◽  
Arterial Oxygen Saturation ◽  
Cycle Ergometer ◽  
Arterial Oxygen ◽  
Breath Hold ◽  
Diving Response ◽  
Face Immersion

This study addressed the effects of apnea in air and apnea with face immersion in cold water (10°C) on the diving response and arterial oxygen saturation during dynamic exercise. Eight trained breath-hold divers performed steady-state exercise on a cycle ergometer at 100 W. During exercise, each subject performed 30-s apneas in air and 30-s apneas with face immersion. The heart rate and arterial oxygen saturation decreased and blood pressure increased during the apneas. Compared with apneas in air, apneas with face immersion augmented the heart rate reduction from 21 to 33% ( P < 0.001) and the blood pressure increase from 34 to 42% ( P < 0.05). The reduction in arterial oxygen saturation from eupneic control was 6.8% during apneas in air and 5.2% during apneas with face immersion ( P < 0.05). The results indicate that augmentation of the diving response slows down the depletion of the lung oxygen store, possibly associated with a larger reduction in peripheral venous oxygen stores and increased anaerobiosis. This mechanism delays the fall in alveolar and arterial Po 2 and, thereby, the development of hypoxia in vital organs. Accordingly, we conclude that the human diving response has an oxygen-conserving effect during exercise.

scholarly journals Physiological Responses at Rest and Exercise to High Altitude in Lowland Children and Adolescents

Life ◽  
2021 ◽  
Vol 11 (10) ◽  
pp. 1009
Author(s):  
Morin Lang ◽  
Guillem Vizcaíno-Muñoz ◽  
Paulina Jopia ◽  
Juan Silva-Urra ◽  
Ginés Viscor
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Oxygen Saturation ◽  
Respiratory Rate ◽  
Children And Adolescents ◽  
Diastolic Blood Pressure ◽  
Arterial Oxygen Saturation ◽  
Submaximal Exercise ◽  
Arterial Oxygen ◽  
Children And Adolescent

During the last decades, the number of lowland children exposed to high altitude (HA) has increased drastically. Several factors may influence the development of illness after acute HA exposure on children and adolescent populations, such as altitude reached, ascent velocity, time spent at altitude and, especially, their age. The main goal of this study was to evaluate the resting cardiorespiratory physiological and submaximal exercise responses under natural HA conditions by means of the six-minute walking test (six MWT). Secondly, we aimed to identify the signs and symptoms associated with acute mountain sickness (AMS) onset after acute HA exposure in children and adolescents. Forty-two children and adolescents, 18 boys and 24 girls aged from 11 to 15 years old, participated in this study, which was performed at sea level (SL) and during the first 42 hours at HA (3330 m). The Lake Louise score (LLS) was recorded in order to evaluate the evolution of AMS symptoms. Submaximal exercise tests (six MWT) were performed at SL and HA. Physiological parameters such as heart rate, systolic and diastolic blood pressure, respiratory rate and arterialized oxygen saturation were measured at rest and after ending exercise testing at the two altitudes. After acute HA exposure, the participants showed lower arterial oxygen saturation levels at rest and after the submaximal test compared to SL (p < 0.001). Resting heart rate, respiratory rate and diastolic blood pressure presented higher values at HA (p < 0.01). Moreover, heart rate, diastolic blood pressure and dyspnea values increased before, during and after exercise at HA (p < 0.01). Moreover, submaximal exercise performance decreased at HA (p < 0.001). The AMS incidence at HA ranged from 9.5% to 19%, with mild to moderate symptoms. In conclusion, acute HA exposure in children and adolescent individuals produces an increase in basal cardiorespiratory parameters and a decrement in arterial oxygen saturation. Moreover, cardiorespiratory parameters increase during submaximal exercise at HA. Mild to moderate symptoms of AMS at 3330 m and adequate cardiovascular responses to submaximal exercise do not contraindicate the ascension of children and adolescents to that altitude, at least for a limited period of time.

Oxygen saturation and hemodynamic response in critically ill, mechanically ventilated adults during intrahospital transport

1995 ◽  
Vol 4 (2) ◽  
pp. 106-111 ◽  
Author(s):  
A Evans ◽  
EH Winslow
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Systolic Blood Pressure ◽  
Oxygen Saturation ◽  
Critically Ill ◽  
Arterial Oxygen Saturation ◽  
Heart Rhythm ◽  
Arterial Oxygen ◽  
Intrahospital Transport ◽  
Mechanically Ventilated

BACKGROUND: Despite the frequency of intrahospital transport of critically ill patients, little research has been done on this topic and the findings are contradictory. OBJECTIVES: To describe arterial oxygen saturation by pulse oximetry, heart rate, heart rhythm, and systolic blood pressure and equipment problems in critically ill, mechanically ventilated adults during intrahospital transport. METHODS: The sample consisted of 36 critically ill, mechanically ventilated adults who required transport out of the intensive care unit for diagnostic testing or procedures within the hospital. Arterial oxygen saturation, heart rate, heart rhythm, and systolic blood pressure were measured at baseline, at least every 5 minutes during transport to and from the test site and at the test site, and every 5 minutes for 15 minutes after return to the unit. Descriptive statistics were used to analyze the data. RESULTS: Nineteen patients (53%) had clinically important changes in arterial oxygen saturation, heart rate, and/or systolic blood pressure. New cardiac arrhythmias developed in two patients. The clinically important changes occurred most frequently at the test/procedure site. Equipment problems such as monitor power failure and ventilator disconnection occurred during transport of 4 patients (11%). Total time out of ICU averaged 62 +/- 30 (range = 26 to 166) minutes. CONCLUSIONS: Transport outside the intensive care unit places the critically ill patient at additional risk. Although transport is often unavoidable, its risks versus benefits should be carefully and collaboratively evaluated for every patient prior to making the decision for transport.

scholarly journals Evaluation of Vital Signs’ Fluctuations and Behavioral Responses in the Assessment of Pain in Patients With Traumatic Brain Injury

2020 ◽  
Author(s):  
atefeh ghanbari ◽  
Ezzat Paryad ◽  
Arefe safati ◽  
Ehsan Kazemnezhad Leyli ◽  
Elaheh Parsasalkisari
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Systolic Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Arterial Oxygen Saturation ◽  
Vital Signs ◽  
Behavioral Responses ◽  
Arterial Oxygen ◽  
Significant Difference ◽  
Pain Detection

Abstract BackgroundTraumatic brain-injured (TBI) patients suffer severe pain. The assessment of behavioral responses and vital signs seems to be necessary for pain detection in these patients, a matter that this study aims to evaluate.MethodsThis cross sectional study uses repeated measures and included ninety-seven TBI patients from Poorsina hospital, Rasht, Iran. Patients’ relevant parameters were recorded using demographic checklist, specifications related to the disease, RASS, CPOT, and FPT tools. The data subsequently were entered into SPSS software V. 21 and were analyze using several tests including Bonferroni’s inferential test and Greenhouse-Geisser test, multiple analysis regression coefficient and general linear model by GEE method.ResultsThe average age of patients was 42.3 ± 18.2. The average consciousness level was 9.30 ± 2.96. There was significant difference between the painful and non-painful stimulations in heart rate, systolic blood pressure and diastolic blood pressure (p <0.001). Heart rate (p < 0.001, r = 0.253), number of respiration (p < 0.001, r = 0.173), systolic (p = 0.002, r = 0.128) and diastolic (p<0.001, r=0.223) blood pressures had a positive correlation with behavioral responses. However, the arterial oxygen saturation showed a negative correlation with behavioral responses (p < 0.001, r = -0.361). Statistical models demonstrated a significant direct relationship between CPOT with heart rate (β = 2.39, p < 0.001) and both systolic blood pressure (β= 1.31, p=0.002) and the fluctuations of diastolic blood pressure (β = 0.690, p = 0.009). ConclusionIt seems that behavioral responses are appropriate indices for pain detection. However, vital signs are not capable of being considered as proper indexes for pain assessment since they changed during several procedures while remained unchanged in other tests.

scholarly journals Effect of Kangaroo mother care on physiological parameters in low birth weight neonates

2019 ◽  
Vol 6 (2) ◽  
pp. 791
Author(s):  
Ankit Ranjan ◽  
Sushma Malik
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Oxygen Saturation ◽  
Respiratory Rate ◽  
Arterial Oxygen Saturation ◽  
Kangaroo Mother Care ◽  
Physiological Parameters ◽  
Arterial Oxygen

Background: Low birth weight (LBW) babies require special care as they suffer from several handicaps, including maintenance of temperature, feeding, adequate weight gain and optimum neurobehavioral adaptation to the external environment. Kangaroo mother care (KMC) is an important modality that helps in the easy transition of the newborn infant to the outside world and overcomes the above problems. This study was planned to assess the effect of KMC on physiological parameters of low birth weight neonates, in a tertiary care hospital.Methods: This was a single-centered prospective observational quasi-experimental study conducted over a period of 18 months on 70 eligible LBW neonates. The arterial oxygen saturation, blood pressure (systolic, diastolic and mean), heart rate and respiratory rate of the neonates were noted. The readings at 1 hour and 2 hours after KMC were compared with that of the reading at 10 minutes prior to initiating KMC to assess the changes in the mentioned physiological parameters.Results: Analysis suggested statistically significant improvement in the arterial oxygen saturation and stabilization of the systolic, diastolic and mean blood pressure, heart rate and respiratory rate with institution of KMC. There was better improvement in the physiological parameters on increasing the duration of KMC from one hour to two hours and these changes were statistically significant.Conclusions: LBW neonates receiving KMC showed significant improvement in oxygen saturation and blood pressure, heart rate and respiratory rate.

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