scholarly journals Oxygen-Helium Gas Mixture «Heliox» for the Treatment of Respiratory Failure in Patients with New Coronavirus Infection Covid-19 (Randomized Single-Center Controlled Trial)

2021 ◽  
Vol 10 (3) ◽  
pp. 430-437
Author(s):  
R. E. Lakhin ◽  
A. D. Zhdanov ◽  
A. V. Shchegolev ◽  
K. V. Zhdanov ◽  
V. V. Salukhov ◽  
...  
Keyword(s):  
Intensive Care ◽  
Respiratory Failure ◽  
Oxygen Saturation ◽  
Saturation Index ◽  
Treatment Protocol ◽  
Control Group ◽  
Hemoglobin Oxygen Saturation ◽  
Atmospheric Air ◽  
Helium Mixture ◽  
Coronavirus Infection

Introduction. Treatment of respiratory failure in pneumonia caused by coronavirus infection (COVID-19) is still an unsolved problem that requires a comprehensive approach and the development of new methods that expand the range of possibilities of modern therapy. There is evidence that the heated oxygenhelium mixture has a positive effect on gas exchange in the infiltration zone by improving both ventilation and diffusion.AIM of study. To evaluate the effectiveness of the inclusion of a heated oxygen-helium mixture HELIOX (70% Helium/ 30% Oxygen) in the complex intensive care of respiratory failure of pneumonia caused by SARS-CoV-2 infection.Material and methods. The study included 60 patients with confirmed viral pneumonia caused by COVID-19. The patients were randomized into two groups: group 1 (n=30) — patients who were treated with the standard COVID-19 treatment protocol with the heated oxygen-helium mixture HELIOX, and group 2 (control) (n=30) — patients who received standard therapy. Lethality was studied for 28 days, the time in days until a steady increase in SpO2>96% was achieved when breathing atmospheric air; the time until the patient is transferred from the intensive care unit (ICU) to the general department.Results. Inhalation of the HELIOX mixture (70% Helium / 30% Oxygen) resulted in a faster recovery of the hemoglobin oxygen saturation index (SpO2). Starting from day 3, these differences became statistically significant. The time in days from inclusion in the study to a persistent increase in the degree of oxygen saturation of hemoglobin (SpO2>96%) when breathing atmospheric air in the group with inhalation of the HELIOX mixture was less — 8 (7; 10), compared to 10 (8;13) in the control group (p=0.006). In the group with inhaled HELIOX mixture, the median treatment time in the ICU was 8 (7; 9.5) days vs 13 (8; 17) days (p<0.001) in the comparison group.Conclusions. Inhalation of the HELIOX mixture (70% Helium / 30% Oxygen) led to a faster recovery of the hemoglobin oxygen saturation index SpO2, which contributed to reduction in the duration of oxygen therapy and a decrease in mortality.

Correlation and prediction of oxygen index from oxygen saturation index in neonates with acute respiratory failure

2021 ◽  
Author(s):  
Gunlawadee Maneenil ◽  
Nutchana Premprat ◽  
Waricha Janjindamai ◽  
Supaporn Dissaneevate ◽  
Manapat Phatigomet ◽  
...  
Keyword(s):  
Respiratory Failure ◽  
Acute Respiratory Failure ◽  
Oxygen Saturation ◽  
Strong Correlation ◽  
Oxygen Index ◽  
Saturation Index ◽  
Pearson Correlation ◽  
Invasive Mechanical Ventilation ◽  
Term Infants ◽  
Arterial Blood

Objective: To evaluate the correlation between the oxygen index (OI) and the oxygen saturation index (OSI, measured by pulse oximetry and noninvasively) in neonates with acute respiratory failure and to predict the OI from the OSI. Study Design: A retrospective cohort study was conducted in neonates requiring invasive mechanical ventilation who had arterial blood gas between 2018 to 2019 at a neonatal intensive care unit. The correlation between OI and OSI was analyzed by using the Pearson correlation coefficient. Results: A total of 636 measurements from 68 neonates (35 preterm and 33 terms) were recruited into the study. There was a strong correlation between the OI and the OSI (r = 0.90) in all neonates. The correlation between the OI and the OSI in persistent pulmonary hypertension of the newborn, congenital cyanotic heart disease, and other causes of respiratory failure also showed a strong correlation (r = 0.88, 0.93, and 0.88, respectively). The correlation was strong in neonates with an oxygen saturation less than 85% (r = 0.88), those with oxygen saturation ranging from 85% to 95% (r = 0.87), and also in preterm and term infants (gestational age < 28, 28−34, 34−36, and ≥ 37 weeks, r = 0.87, 0.92, 0.89, and 0.90, respectively). There were strong accuracy measures of the OI for OI cutoffs of 5, 10, 15, and 20 (area under the curve > 0.85). The equation relating the OI and OSI was represented by: OI = (2.3 × OSI) – 4. Conclusions: The OSI has a strong correlation with the OI, is a reliable assessor of the severity of respiratory failure in neonates without arterial sampling, and has high accuracy when the OI < 40.

scholarly journals A new look at the correction of COVID-19-mediated pulmonary gas exchange disorders

2021 ◽  
Vol 102 (3) ◽  
pp. 362-372
Author(s):  
I S Simutis ◽  
G A Boyarinov ◽  
M Yu Yuriev ◽  
D S Petrovsky ◽  
A I Kovalenko ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Gas Exchange ◽  
Sodium Succinate ◽  
Intensive Therapy ◽  
Infusion Therapy ◽  
Control Group ◽  
Electrolyte Balance ◽  
Study Group ◽  
Coronavirus Infection

Aim. To assess the effect of meglumine sodium succinate on the effectiveness of basic therapy in correcting gas exchange abnormalities in patients with severe COVID-19 infection complicated by bilateral community-acquired pneumonia. Methods. The analysis of the effectiveness of therapy of 12 patients with a diagnosis of New coronavirus infection COVID-19 (confirmed), severe form U07.1. Complication: bilateral multifocal pneumonia was carried out. The patients were divided into two groups: 7 received, as part of standard therapy, a solution of meglumine sodium succinate in a daily dose of 5 ml/kg during stay in the intensive care unit; 5 patients received a similar volume of Ringer's solution and formed the control group. In the arterial and venous blood of all patients, the indicators of acid-base state and water-electrolyte balance, glycemia and lactatemia were measured at several stages: (1) at admission to the intensive care unit, (2) 24 hours after the start of intensive therapy, (3) after 812 hours, (4) after 24 hours. On the 28th day of observation, mortality, the duration of treatment in the intensive care unit and the incidence of thrombotic complications in the groups were assessed. The Friedman nonparametric hypothesis test was used to assess intragroup dynamics, and the nonparametric Mannhitney U test for intergroup comparisons. Results. In the group of patients who received meglumine sodium succinate, there was a significant decrease in the incidence of thromboembolic events during 28 days of treatment: myocardial ischemia event rate ratio from 0.89 [95% confidence interval (CI) 0.191.16] in the control group to 0.55 (95% CI 0.060.81) in the study group at p=0.043; pulmonary embolism event from 0.50 (95% CI 01.0) in the control group to 0.28 (95% CI 01.0) in the study group at p=0.041. There was also a decrease in the duration of intensive care unit length of stay to 6.11.1 days in the study group versus 8.91.3 days in the control group. Conclusion. Compared with standard infusion therapy, the use of meglumine sodium succinate leads to a faster normalization of ventilation-perfusion ratios in patients with severe coronavirus infection.

Hemoglobin Oxygen Saturation Discrepancy Using Various Methods in Patients with Sickle Cell Disease.

Blood ◽  
2004 ◽  
Vol 104 (11) ◽  
pp. 3672-3672
Author(s):  
Shahid Ahmed ◽  
Rabia K. Shahid ◽  
Anita K. Siddiqui ◽  
Cristina P. Sison ◽  
Dilip V. Patel ◽  
...  
Keyword(s):  
Sickle Cell Disease ◽  
Oxygen Saturation ◽  
Pulse Oximetry ◽  
Sickle Cell ◽  
Control Group ◽  
Cell Disease ◽  
Oxyhemoglobin Saturation ◽  
Hemoglobin Oxygen Saturation ◽  
Mcnemar’S Test ◽  
Mcnemar's Test

Abstract Objective: Sickle cell disease (SCD) is characterized by chronic hemolytic anemia and vaso-occlusive painful crises. Recurrent pulmonary microinfarction as well as increased predisposition to lung infection during vaso-occlusive crisis places these patients at high risk for hypoxemia. Furthermore, because hypoxemia is a trigger for sickling and vaso-occlusion, the detection of arterial hypoxemia and its correction are very important during painful episodes. We previously assessed reliability of pulse oximetry in pateints with SCD (Blood2001:98;491 abstr 2049). In present study we evaluated agreement among three available methods for measuring hemoglobin oxygen saturation in a relatively larger group of adult patients with SCD during vaso-occlusive crisis and compared them to a control group. Methods: Eighteen adult hypoxic patients with SCD hospitalized during a painful episode at a tertiary care institution served as the study group, whereas 12 non-SCD hypoxic African-American patients admitted with various cardio-pulmonary diagnoses served the control group. The hemoglobin oxygen saturation was determined simultaneously by pulse oximetry (SpO2), co-oximetry (SO2 [functional oxyhemoglobin saturation] & FO2Hb [oxyhemoglobin fraction]) and by calculation (SaO2) using a normal oxyhemoglobin dissociation curve in the 2 groups.Bland-Altman analysis was carried out to evaluate agreement of various methods in the two groups. Spearman Correlations were calculated for descriptive purposes. As a secondary analysis, McNemar’s Test was used to compare the proportion of ‘critically hypoxic’ patients between two measurement techniques. Results: The two groups were different with respect to age, systolic blood pressure, body temperature, hemoglobin level, serum bilirubin level, blood pH, methemoglobin and carboxyhemoglobin levels. Mean differences between various methods for measuring hemoglobin oxygen saturation in patients with SCD were significantly larger than the control group. Mean bias between SpO2 and SO2, and SpO2 and FO2Hb in patients with SCD were −3.1 ±4.4 (95% CI −11.7 to 5.5) and 2 ±4.1 (95% CI, −6 to 10) respectively compared to −1.4 ±1.4 (95% CI, −4 to 1.4) and 1.2 ±1.5 (95% CI, −1.8 to 4.2) in control group. A bias of −4.5 ±4 (95% CI, −12.3 to 3.8) between SpO2 and SaO2 was noted in patients with SCD compared to −0.08 ±2.1 (95% CI, −4.2 to 4.1) in control. Spearman correlations between various methods in control group were consistently higher (0.82 to 0.99) than patients with SCD (0.59 to 0.89). McNemar’s test for comparing the proportion of "Critically Hypoxic" disposition using a cut-point of 90% oxyhemoglobin saturation showed that there was poor agreement among methods in the sickle cell group whereas acceptable agreement was noted among methods in the control group. Conclusion: Patients with SCD during vaso-occlusive crisis have discrepancies in oxyhemoglobin saturation measurements by various methods. Abnormal pulse oximetry values in these patients should be interpreted cautiously and supplemented by PO2 and co-oximetry.

scholarly journals Oxygen Saturation Index and Severity of Hypoxic Respiratory Failure

Neonatology ◽  
2015 ◽  
Vol 107 (3) ◽  
pp. 161-166 ◽  
Author(s):  
Munmun Rawat ◽  
Praveen K. Chandrasekharan ◽  
Ashley Williams ◽  
Sylvia Gugino ◽  
Carmon Koenigsknecht ◽  
...  
Keyword(s):  
Respiratory Failure ◽  
Oxygen Saturation ◽  
Saturation Index ◽  
Hypoxic Respiratory Failure

scholarly journals Current conception about the pathogenesis and intensive care of severe COVID-19 (review)

2021 ◽  
pp. 4-9
Author(s):  
Marine Georgiyants ◽  
Volodymyr Korsunov ◽  
Sergii Dubrov ◽  
Oleg Loskutov ◽  
Nataliia Bohuslavska ◽  
...  
Keyword(s):  
Intensive Care ◽  
Respiratory Failure ◽  
Multiple Organ ◽  
Hospitalized Patients ◽  
Invasive Ventilation ◽  
Hypoxemic Respiratory Failure ◽  
Nasal Catheter ◽  
Therapeutic Anticoagulation ◽  
Coronavirus Infection

The aim of the research. The aim of this work was to summarize the scientific literature data on the pathogenesis and intensive care of the severe course of coronavirus infection. Materials and methods. Databases such as PubMed, Google Scholar, Scopus and Web Of Science 2020-2021 were used for literary searches. Results. An intense inflammatory response against the SARS-CoV-2 virus in COVID-19 patients causes a cytokine storm and hypercoagulability with the development of acute respiratory distress syndrome (ARDS) and multiple organ failure. Approximately 17 % to 35 % of hospitalized patients with COVID-19 are treated in the intensive care unit, most often due to hypoxemic respiratory failure and the development of ARDS, and between 29 % and 91 % of patients in intensive care units require invasive ventilation. In addition to acute respiratory failure, hospitalized patients may have acute renal failure (9 %), liver dysfunction (19 %), coagulation disorders (10 %–25 %), and septic shock (6 %). More than 75 % of hospitalized patients require additional oxygen therapy. Respiratory support could vary from the need for oxygen supplementation through a nasal catheter to invasive ventilation or extracorporeal membrane oxygenation in patients with the most severe ARDS. The uncontrolled inflammation and coagulation seen in COVID-19 patients is similar to multifactorial ARDS, where a plethora of evidence has demonstrated the ability of long-term corticosteroid therapy (CST) to reduce inflammation-coagulation-fibroproliferation and accelerate recovery. With regard to the assessment of the benefits of therapeutic anticoagulation in patients with elevated D-dimer, the question has not yet been finally resolved, and research devoted to this is still ongoing. Conclusions. The approaches to respiratory, anticoagulant, anti-inflammatory therapy in critically ill patients with COVID-19 require further research to determine the optimal treatment tactics

scholarly journals Correlation of Oxygen Saturation Index and Oxygenation Index in Hypoxaemic Respiratory Failure among Neonates

2021 ◽  
Author(s):  
B Sunil ◽  
E Nithya
Keyword(s):  
Respiratory Failure ◽  
Oxygen Saturation ◽  
Neonatal Intensive Care ◽  
Saturation Index ◽  
Oxygenation Index ◽  
Blood Gases ◽  
Supplemental Oxygen ◽  
P Value ◽  
Arterial Blood ◽  
Extremely Preterm

Introduction: Hypoxaemic Respiratory Failure (HRF) is severe arterial hypoxaemia that is refractory to supplemental oxygen. Oxygen Saturation Index (OSI) can be an alternate method of diagnosing and assessing the severity of HRF as it uses Oxygen Saturation (SpO2) in place of Partial Pressure of Oxygen (PaO2) and may be utilised with reasonable sensitivity and specificity. Aim: To evaluate the correlation between OSI and Oxygenation Index (OI) in HRF in neonates. Materials and Methods: The prospective observational study was conducted in Kempegowda Institute of Medical Sciences and Hospital, Bengaluru, Karnataka, India, from December 2016 to July 2018. Fifty neonates who were admitted to Neonatal Intensive Care Unit (NICU) and conventionally ventilated in view of HRF were included. Arterial blood gases in the first 24 hours of life and corresponding oxygen saturations and ventilator settings were recorded. OI and OSI was calculated using the standard formula and their correlation was analysed. Results: The neonates were all on first day of life at admission to NICU and were invasively ventilated due to HRF. The mean birth weight was 1.89±0.84 kg. Of the 50 neonates, 22 (44%) were preterm babies (<34 weeks), 17 (34%) belonged to late preterm group (34 weeks to 36 weeks +6 days), 9 (18%) were term babies (>37 weeks), two neonates were extremely preterm (less than 28 weeks). In this study, OSI and OI significantly associated and correlated (p-value <0.01) with a correlation coefficient r=0.727. Area under the Receiver Operating Characteristic (ROC) curve for OSI was 0.912 which indicates that OSI is an excellent test to assess the severity of HRF. Conclusion: That OSI can be used to diagnose and assess the severity of lung disease in neonates having HRF.

Sign in / Sign up

Export Citation Format

Share Document