scholarly journals Anaesthesia-Specifi c Oxygen Transport Assessment in Robot-Assisted Pelvic Surgery: a Clinical Trial

2021 ◽  
Vol 11 (4) ◽  
pp. 307-315
Author(s):  
I. I. Lutfarakhmanov ◽  
S. T. Lazarev ◽  
N. A. Zdorik ◽  
A. D. Lifanova ◽  
A. A. Grazhdankin ◽  
...  
Keyword(s):  
Oxygen Consumption ◽  
Adverse Events ◽  
Oxygen Transport ◽  
Oxygen Delivery ◽  
Functional Class ◽  
Adverse Outcomes ◽  
Pelvic Surgery ◽  
Low Oxygen ◽  
Robot Assisted ◽  
Trendelenburg Position

Background. Robot-assisted pelvic surgery rapidly becomes a choice in surgeries for gynaecological oncology and urology. These interventions require special settings (pneumoperitonaeum and Trendelenburg position), which inevitably and systemically impact oxygen transport. Low oxygen delivery during surgery associates with manifold adverse outcomes. A single universal oxygen delivery threshold is impractical, as oxygen consumption must be taken into account. This study examines the effects of pneumoperitonaeum and Trendelenburg position on oxygen transport in patients of ASA functional class I–III (as per American Society of Anaesthesiologists).Materials and methods. Delivery, consumption, oxygen extraction, perioperative adverse events and type of general anaesthesia were prospectively studied in 126 adult patients.Results and discussion. Mean oxygen consumption was 242 mL/min/m2 , mean oxygen delivery — 612 mL/min/m2 . Oxygen delivery was below median 529 mL/min/m2 in 54 (43  %) patients. Perioperative adverse events developed in 36 (29 %) patients. A strong correlation (r > 0.500; p<0.001) between oxygen delivery and consumption was observed in 54 patients. Blood lactate level of 2.7 mmol/L at surgery end was indicative of inadequate oxygen delivery.Conclusion. No relationship was revealed between oxygen delivery and adverse perioperative events, and neither — between oxygen delivery and consumption relative to a particular anaesthetic.

Temperature acclimation influences temperature-related behaviour as well as oxygen-transport physiology and biochemistry in the water flea Daphnia magna

2003 ◽  
Vol 81 (2) ◽  
pp. 237-249 ◽  
Author(s):  
Tobias Lamkemeyer ◽  
Bettina Zeis ◽  
Rüdiger J Paul
Keyword(s):  
Oxygen Consumption ◽  
Daphnia Magna ◽  
Oxygen Concentration ◽  
Oxygen Transport ◽  
Oxygen Affinity ◽  
Low Oxygen ◽  
High Concentration ◽  
Water Flea ◽  
Two Dimensional Gel Electrophoresis ◽  
Physiology And Biochemistry

To evaluate the role of temperature in oxygen transport in the water flea Daphnia magna, temperature-related behaviour as well as oxygen-transport physiology and biochemistry were investigated in animals long-term acclimated to moderate temperatures: 10, 20, or 30°C (normoxia) or 20°C (hypoxia). Study of the behaviour of animal groups within a normoxic thermal gradient showed their preferred temperatures and distribution patterns to be connected with acclimation conditions; for example, cold-acclimated individuals, with their relatively high metabolic rates and low oxygen-transport capacities, crowded at low temperatures where the oxygen concentration was high. One key to explaining these data is to assume a strategy of avoiding oxygen shortage. Both temperature and hypoxia acclimation also modified oxygen-transport variables such as oxygen consumption, ventilation and circulation rates, or the concentration and oxygen affinity of haemoglobin. Characteristic features of cold-acclimated D. magna were relatively high oxygen-consumption and heart rates and a low concentration and oxygen affinity of haemoglobin. Hypoxia-acclimated D. magna showed relatively low convective rates (frequency of thoracic-limb movements, heart rate) but a high concentration and oxygen affinity of haemoglobin. Additional experiments showed that independently of each other, temperature and ambient oxygen concentration modify haemoglobin quantity and quality, the former possibly acting via a temperature-induced hypoxia. The varying oxygen affinity is probably due to alterations of haemoglobin subunit composition, with the particular participation of subunits A, E, and G as revealed by two-dimensional gel electrophoresis.

Oxygen transport in the critically ill

2016 ◽  
Author(s):  
Stephan M. Jakob ◽  
Jukka Takala
Keyword(s):  
Oxygen Consumption ◽  
Oxygen Saturation ◽  
Oxygen Transport ◽  
Oxygen Delivery ◽  
Arterial Oxygen Saturation ◽  
Lactate Concentration ◽  
Mixed Venous Oxygen Saturation ◽  
Arterial Oxygen ◽  
Venous Oxygen Saturation ◽  
Mixed Venous

Adequate oxygen delivery is crucial for organ survival. The main determinants of oxygen delivery are cardiac output, haemoglobin concentration, and arterial oxygen saturation. The adequacy of oxygen delivery also depends on oxygen consumption, which may vary widely. Mixed venous oxygen saturation reflects the amount of oxygen not extracted by the tissues, and therefore provides useful information on the relationship between oxygen delivery and oxygen needs. If not in balance, tissue hypoxia may ensue and arterial lactate concentration increases. This occurs at higher oxygen delivery rates in acute compared with chronic diseases where metabolic adaptions often occur. Arterial and mixed venous oxygen saturation are related to each other. The influence of mixed venous saturation on arterial saturation increases with an increasing intrapulmonary shunt. This chapter discusses interactions between the components of oxygen transport and how they can be evaluated. Various methods for measuring tissue oxygenation and oxygen consumption are also presented, together with their limitations.

Low oxygen extraction despite high oxygen delivery causes low oxygen consumption in patients with burns recovering slowly from operative hypothermia

Surgery ◽  
1995 ◽  
Vol 118 (1) ◽  
pp. 44-48 ◽  
Author(s):  
T SHIOZAKI ◽  
M OHNISHI ◽  
O TASAKI ◽  
A HIRAIDE ◽  
T SHIMAZU ◽  
...  
Keyword(s):  
Oxygen Consumption ◽  
Oxygen Delivery ◽  
High Oxygen ◽  
Oxygen Extraction ◽  
Low Oxygen

Safety and Effectiveness of SAF-R, a Novel Patient Positioning Device for Robot-Assisted Pelvic Surgery in Trendelenburg Position

2016 ◽  
Vol 30 (3) ◽  
pp. 286-292
Author(s):  
Saman S. Talab ◽  
Azadeh Elmi ◽  
Jaydev Sarma ◽  
Glen W. Barrisford ◽  
Shahin Tabatabaei
Keyword(s):  
Patient Positioning ◽  
Pelvic Surgery ◽  
Robot Assisted ◽  
Trendelenburg Position ◽  
Positioning Device

scholarly journals CENTRAL HEMODYNAMICS AND OXYGEN TRANSPORT IN PATIENTS WITH ACUTE RESPIRATORY DISTRESS SYNDROME CAUSED BY COVID-19 AND THEIR IMPACT ON THE COURSE AND OUTCOMES OF THE DISEASE

2021 ◽  
pp. 3-11
Author(s):  
Volodymyr Korsunov ◽  
Marine Georgiyants ◽  
Vita Skoryk
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Cardiac Index ◽  
Adverse Events ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Oxygen Transport ◽  
Oxygen Delivery ◽  
Distress Syndrome ◽  
Infusion Therapy ◽  
Hemodynamic Status

The aim. Determine hemodynamic status and its impact on oxygen transport, frequency of adverse events and outcomes in patients with severe SARS-CoV-2 associated with acute respiratory distress syndrome (ARDS). Materials and methods. A single-center prospective comparative study was conducted with 29 patients enrolled over the period of July—October 2020 who suffered a severe course of coronavirus disease and bilateral pneumonia associated with ARDS. Based on the estimated cardiac index (CI), patients were allocated to two groups: Group 1 included 14 patients with severe ARDS and CI 1.9 [1.5–2.5] L/min/m2, whereas Group 2 included 15 patients with CI 4.2 [3.2–8.1] L/min/m2 (p=0.001). Patient`s intensive care was regulated by the relevant orders of the Ministry of Health of Ukraine. Statistical analysis of the results was carried out using Statistica 10 software. Statistical significance of parameters was assessed using the non-parametric Wilcoxon criterion. Results were considered significant at p values <0.05. Data are presented as M [25–75]. Relative risk (RR) and odds ratio (OR) of adverse events were calculated. Results. The severe course of coronavirus disease is associated with significant oxygen transport disorders that increase with hypovolemia. Despite the increase in oxygen delivery in the group with normal CI its high tissue extraction remained, which may be a sign of development mitochondrial distress. Conclusions. Patients admitted to the ICU with severe COVID-19 may be in a state of hypovolemia and require individual assessment of hemodynamic status and the appointment of infusion therapy. Increased oxygen delivery in patients with normal cardiac index was associated with decreased adverse events rate and statistically significant decrease of mortality rate

Characterisation of production of organic rich topsoil from sludge

2000 ◽  
Vol 42 (9) ◽  
pp. 195-201 ◽  
Author(s):  
P. Andreasen ◽  
P. B. Mortensen ◽  
A. Stubsgaard ◽  
B. Langdahl
Keyword(s):  
Organic Matter ◽  
Oxygen Consumption ◽  
Oxygen Transport ◽  
Mineral Soil ◽  
Climatic Conditions ◽  
Growth Media ◽  
Soil Mixture ◽  
Water Suspension ◽  
Aerobic Process ◽  
Stable Product

The stabilisation of a sludge-mineral soil mixture and a method to evaluate the state of stabilisation were investigated. The organic matter and nitrogen content are reduced up to 50% during a stabilisation process of three months under Danish climatic conditions. The stabilisation was shown to be an aerobic process limited by oxygen transport within the mixture. The degree of stabilisation was evaluated by oxygen consumption in a water suspension and the results showed that a stable product was achieved when oxygen consumption was stable and in the level of natural occurring aerobic soils (0.1 mgO2/(g DS*hr). The study thereby demonstrates that a stability of a growth media can be controlled by the oxygen consumption method tested.

The cost of intraoperative adverse events in abdominal and pelvic surgery: A systematic review

2018 ◽  
Vol 215 (1) ◽  
pp. 163-170 ◽  
Author(s):  
A. Garbens ◽  
M. Goldenberg ◽  
C.J.D. Wallis ◽  
A. Tricco ◽  
T.P. Grantcharov
Keyword(s):  
Systematic Review ◽  
Adverse Events ◽  
Pelvic Surgery ◽  
The Cost

scholarly journals Prognostic value of D-dimer for adverse outcomes in patients with infective endocarditis: an observational study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ying-Wen Lin ◽  
Mei Jiang ◽  
Xue-biao Wei ◽  
Jie-leng Huang ◽  
Zedazhong Su ◽  
...  
Keyword(s):  
Regression Analysis ◽  
Infective Endocarditis ◽  
Adverse Events ◽  
Prognostic Value ◽  
Multivariable Analysis ◽  
Adverse Outcomes ◽  
Hospital Death ◽  
Large Sample Size ◽  
Cox Regression Analysis ◽  
D Dimer

Abstract Background Increased D-dimer levels have been shown to correlate with adverse outcomes in various clinical conditions. However, few studies with a large sample size have been performed thus far to evaluate the prognostic value of D-dimer in patients with infective endocarditis (IE). Methods 613 patients with IE were included in the study and categorized into two groups according to the cut-off of D-dimer determined by receiver operating characteristic (ROC) curve analysis for in-hospital death: > 3.5 mg/L (n = 89) and ≤ 3.5 mg/L (n = 524). Multivariable regression analysis was used to determine the association of D-dimer with in-hospital adverse events and six-month death. Results In-hospital death (22.5% vs. 7.3%), embolism (33.7% vs 18.2%), and stroke (29.2% vs 15.8%) were significantly higher in patients with D-dimer > 3.5 mg/L than in those with D-dimer ≤ 3.5 mg/L. Multivariable analysis showed that D-dimer was an independent risk factor for in-hospital adverse events (odds ratio = 1.11, 95% CI 1.03–1.19, P = 0.005). In addition, the Kaplan–Meier curve showed that the cumulative 6-month mortality was significantly higher in patients with D-dimer > 3.5 mg/L than in those with D-dimer ≤ 3.5 mg/L (log-rank test = 39.19, P < 0.0001). Multivariable Cox regression analysis showed that D-dimer remained a significant predictor for six-month death (HR 1.11, 95% CI 1.05–1.18, P < 0.001). Conclusions D-dimer is a reliable prognostic biomarker that independently associated with in-hospital adverse events and six-month mortality in patients with IE.

scholarly journals Cerebral oxygenation in 45-degree trendelenburg position for robot-assisted radical prostatectomy: a single-center, open, controlled pilot study

BMC Urology ◽  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Clemens Wiesinger ◽  
Dominik Stefan Schoeb ◽  
Mathias Stockhammer ◽  
Emir Mirtezani ◽  
Lukas Mitterschiffthaler ◽  
...  
Keyword(s):  
Pilot Study ◽  
Cerebral Oxygenation ◽  
Preoperative Assessment ◽  
Patient Characteristics ◽  
Rank Test ◽  
Control Group ◽  
Robot Assisted ◽  
Clinical Trial Registry ◽  
Trendelenburg Position ◽  
Signed Rank Test

Abstract Background Within the last decade, robotically-assisted laparoscopic prostatectomy (RALP) has become the standard for treating localized prostate cancer, causing a revival of the 45° Trendelenburg position. In this pilot study we investigated effects of Trendelenburg position on hemodynamics and cerebral oxygenation in patients undergoing RALP. Methods We enrolled 58 patients undergoing RALP and 22 patients undergoing robot-assisted partial nephrectomy (RAPN) (control group) in our study. Demographic patient data and intraoperative parameters including cerebral oxygenation and cerebral hemodynamics were recorded for all patients. Cerebral function was also assessed pre- and postoperatively via the Mini Mental Status (MMS) exam. Changes in parameters during surgery were modelled by a mixed effects model; changes in the MMS result were evaluated using the Wilcoxon signed rank test. Results Preoperative assessment of patient characteristics, standard blood values and vital parameters revealed no difference between the two groups. Conclusions Applying a 45° Trendelenburg position causes no difference in postoperative brain function, and does not alter cerebral oxygenation during a surgical procedure lasting up to 5 h. Further studies in larger patient cohorts will have to confirm these findings. Trial registration German Clinical Trial Registry; DRKS00005094; Registered 12th December 2013—Retrospectively registered; https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00005094.

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