scholarly journals Observation on the Nursing Effect of Prone Position Ventilation Applied to Children with Respiratory Failure

2021 ◽  
Vol 2 (1) ◽  
Author(s):  
Aili Peng ◽  
Litao Guo ◽  
Jing Xu ◽  
Jingrong Fan
Keyword(s):  
Carbon Dioxide ◽  
Respiratory Failure ◽  
Partial Pressure ◽  
Prone Position ◽  
Pediatric Patients ◽  
Oxygenation Index ◽  
Control Group ◽  
Arterial Partial Pressure ◽  
Arterial Blood ◽  
Experimental Group

Objective — To compare the effects of two prone position ventilation methods on children with respiratory failure, to obtain a safer and more effective way to guide clinical nursing work. Methods — 48 cases of children who were admitted to the intensive care unit of our hospital from February 2018 to August 2019 and applied mechanical ventilation were divided into groups based on a random number table. The odd numbers were included in the experimental group (continuous prone position ventilation group, the duration of continuous prone position exceeded 12 hours, a total of 25 cases). The even numbers were included in the control group (intermittent prone position ventilation group, prone position for 3 hours at a time, alternating with supine position and lateral position, total prone position duration 12 hours, a total of 23 cases). Oxygenation index (OI), PH value, arterial partial pressure of carbon dioxide (PCO2), arterial partial pressure of oxygen (PO2) at 24h, 48h, 72h of the two groups of children, as well as their ventilator use time and ICU hospital stay were compared. Results — Continuous prone position ventilation and intermittent prone position ventilation have no statistical significance on arterial blood carbon dioxide partial pressure (PaCO2), arterial blood oxygen partial pressure (PaO2), ventilator duration, ICU length of stay in children with respiratory failure (P>0.05), but with the increase of the total length of the prone position, when reaching more than 36 hours, the trend of oxygenation index (OI) of the experimental group and the control group can be seen to decline.  Conclusion — In this study, by comparing the effects of two prone position ventilation modes, it was found that intermittent prone position ventilation and continuous prone position ventilation had no difference in the treatment of children with respiratory failure. When children are treated in continuous prone and intermittent prone positions, the total prone position can last up to 36 hours, which can effectively improve the clinical treatment effect. In view of the characteristics of pediatric patients and the difficulty in nursing critically ill patients with tracheal intubation, it is recommended that pediatric patients can use intermittent prone ventilation to complete treatment when the cumulative time in the prone position reaches more than 36 hours.

Effect of cigarette smoke on TNF-a and IL-1b mRNA expression in lung tissues and cells of rats

2015 ◽  
Author(s):  
Mingli Ji ◽  
Yuxia Wang ◽  
Xiaopeng Li ◽  
Zhibi Qian
Keyword(s):  
Carbon Dioxide ◽  
Mrna Expression ◽  
Cigarette Smoke ◽  
Lung Tissue ◽  
Control Group ◽  
Expression Levels ◽  
Arterial Partial Pressure ◽  
Experimental Group ◽  
Mrna Expression Levels ◽  
Pro Inflammatory Cytokines

We investigated lung tissue expression of the pro-inflammatory cytokines TNF-a and IL-1b in response to cigarette smoke exposure and the ensuing effects on arterial oxygen and carbon dioxide as indices of respiratory function. Experimental group rats were exposed to cigarette smoke twice daily (30 min per exposure) for 28 consecutive days. Arterial partial pressure of oxygen (PO2), arterial partial pressure of carbon dioxide (PCO2), and both mRNA and protein expression levels of TNF-a and IL-1b were compared to a control group. Contents of TNF-a and IL-1b in bronchoalveolar lavage fluid (BALF) and lung homogenate were detected by enzyme linked immunosorbent assays while TNF-a mRNA and IL-1b mRNA expression levels in lung tissue were detected by reverse transcription-polymerase chain reaction. Arterial PO2 was significantly lower in the experimental group than the control group, while the arterial PCO2 was significantly higher. BALF levels of TNF-a and IL-1b were significantly higher in the experimental group than the control group, as were TNF-a mRNA and IL-1b mRNA expression levels in lung tissue. Cigarette smoke may activate inflammatory cells in the pulmonary circulation and increase the expression of the pro-inflammatory cytokines TNF-a and IL-1b in lung tissue, leading to lung injury and respiratory dysfunction.

Chloride Reduction Therapy with Furosemide: Short-Term Effects in Children with Acute Respiratory Failure

2021 ◽  
Author(s):  
Hisataka Nozawa ◽  
Norihiko Tsuboi ◽  
Tadashi Oi ◽  
Yoshiki Takezawa ◽  
Ichiro Osawa ◽  
...  
Keyword(s):  
Respiratory Failure ◽  
Acute Respiratory Failure ◽  
Pediatric Patients ◽  
Pediatric Intensive Care ◽  
Chloride Ion ◽  
Interquartile Range ◽  
Control Group ◽  
Case Group ◽  
Arterial Blood Gas ◽  
Arterial Blood

AbstractFrom the perspective of the Stewart approach, it is known that expansion of the sodium chloride ion difference (SCD) induces alkalosis. We investigated the role of SCD expansion by furosemide-induced chloride reduction in pediatric patients with acute respiratory failure. We included patients admitted to our pediatric intensive care unit intubated for acute respiratory failure without underlying diseases, and excluded patients receiving extracorporeal circulation therapy (extracorporeal membrane oxygenation and/or renal replacement therapy). We classified eligible patients into the following two groups: case—those intubated who received furosemide within 24 hours, and control—those intubated who did not receive furosemide within 48 hours. Primary outcomes included SCD, partial pressure of carbon dioxide (PaCO2), and pH results from arterial blood gas samples obtained over 48 hours following intubation. Multiple regression analysis was also performed to evaluate the effects of SCD and PaCO2 changes on pH. Twenty-six patients were included of which 13 patients were assigned to each of the two groups. A total of 215 gas samples were analyzed. SCD (median [mEq/L] [interquartile range]) 48 hours after intubation significantly increased in the case group compared with the control group (37 [33–38] vs. 31 [30–34]; p = 0.005). Although hypercapnia persisted in the case group, the pH (median [interquartile range]) remained unchanged in both groups (7.454 [7.420–7.467] vs. 7.425 [7.421–7.436]; p = 0.089). SCD and PaCO2 were independently associated with pH (p < 0.001 for each regression coefficient). As a result, we provide evidence that SCD expansion with furosemide may be useful in maintaining pH within the normal range in pediatric patients with acute respiratory failure complicated by concurrent metabolic acidosis.

scholarly journals Progressive Decline of Partial Pressure of Carbon dioxide and Bicarbonate levels in Arterial Blood of Pregnant Women

1970 ◽  
Vol 3 ◽  
pp. 13-16
Author(s):  
Dipok Kumar Sunyal ◽  
Md Ruhul Amin ◽  
MH Molla ◽  
MA Momen Talukder ◽  
Abida Ahmed ◽  
...  
Keyword(s):  
Carbon Dioxide ◽  
Partial Pressure ◽  
Pregnant Women ◽  
First Trimester ◽  
Women Subjects ◽  
Arterial Blood ◽  
Significant Difference ◽  
History Of ◽  
Respiratory Centre ◽  
Experimental Group

 In the present study the partial pressure of carbon dioxide (PaCO2) and bicarbonate ion (HCO3-) in arterial blood was estimated in 32 women in Dhaka city. For this purpose a total 32 women subjects with age ranged from 25 years to 35 years without any recent history of respiratory diseases were selected and divided into 8 healthy non-pregnant women as control and 24 normal pregnant women as experimental group. Experimental group was further divided into 8 first trimester, 8 second trimester & 8 third trimester of pregnant women. The PaCO2 and HCO3- were estimated by using "Easy Blood Gas Auto Analyzer". The PaCO2 and HCO3- were estimated during the 1st, 2nd, 3rd trimesters of pregnant women and non-pregnant women. The mean of measured values of PaCO2 and HCO3-were analyzed statistically in relation to 1st, 2nd, 3rd trimesters of pregnant women & non-pregnant women. The PaCO2 and HCO3- were significantly lower in 1st trimester, 2nd trimester & 3rd trimester of pregnant women than that of non-pregnant women. There were no statistically significant difference of PaCO2 and HCO3- between the 1st trimester and 2nd trimester; between the 1st trimester and 3rd trimester; and between the 2nd trimester and 3rd trimester of pregnant women. It may be concluded that the causes of progressively decreased PaCO2 and HCO3- throughout the pregnancy were most likely to be due to effect of progesterone causing hyperventilation. Hyperventilation in pregnancy is due to hypersensitivity of respiratory centre. Due to hyperventilation, there is expelling out CO2 and HCO3- causing decreases PaCO2 and HCO3- during pregnancy. doi: 10.3329/jbsp.v3i0.1788 J Bangladesh Soc Physiol.2008 Dec;(3):13-16.

Respiratory failure

2018 ◽  
Author(s):  
Matt Wise ◽  
Simon Barry
Keyword(s):  
Carbon Dioxide ◽  
Respiratory Failure ◽  
Partial Pressure ◽  
Acute Onset ◽  
Type I ◽  
Failure Type ◽  
Arterial Blood ◽  
Ventilation Failure

Respiratory failure is a syndrome characterized by defective gas exchange due to inadequate function of the respiratory system. There is a failure to oxygenate blood (hypoxaemia) and/or eliminate carbon dioxide (hypercapnia). Hypoxaemia is defined as an arterial blood partial pressure of oxygen (PaO2) of <8 kPa, and hypercapnia as an arterial blood partial pressure of carbon dioxide (PaCO2) of >6 kPa. Respiratory failure is divided into two different types, conventionally referred to as type 1 and type 2. The distinction between these two is important because it emphasizes not only different their pathophysiological mechanisms and etiologies, but also different treatments. The preferred terminology and definitions are as follows: oxygenation failure (type I respiratory failure), PaO2 of <8 kPa; ventilation failure (type 2 respiratory failure), PaCO2 >6 kPa. Respiratory failure may be acute (onset over hours to days), or chronic (developing over months to years); alternatively, there may be an acute deterioration of a chronic state.

scholarly journals Observations on some cardiopulmonary effects of midazolam, xylazine and a midazolam / ketamine combination in the goat

1999 ◽  
Vol 70 (3) ◽  
Author(s):  
G.F. Stegmann
Keyword(s):  
Carbon Dioxide ◽  
Blood Pressure ◽  
Partial Pressure ◽  
Arterial Blood Pressure ◽  
Mean Arterial Blood Pressure ◽  
Minute Volume ◽  
Partial Pressure Of Oxygen ◽  
Arterial Partial Pressure ◽  
Arterial Blood ◽  
Change In Mean

Xylazine, midazolam and a midazolam / ketamine combination were administered to 6 goats in a randomised 3-way block design. All goats received all treatments with at least a 7-day interval between treatments. Statistically significant (P < 0.05) changes were observed in some of the measured cardiopulmonary variables for xylazine and midazolam/ ketamine. Xylazine administration resulted in statistically significant decreases in minute volume, arterial partial pressure of oxygen, heart rate andmeanarterial blood pressure. The increase in arterial partial pressure of carbon dioxide was not statistically significant. For the midazolam / ketamine combination, the decrease in tidal volume was statistically significant, but not the decrease in minute volume and increase in arterial partial pressure of carbon dioxide. The decrease in the arterial partial pressure of oxygen was also statistically significant. The mean arterial blood pressure for the combination was statistically significantly higher compared to xylazine. The changes in cardiopulmonary variables after midazolam administration were not statistically significant, such as tidal and minute volume, arterial partial pressure of oxygen and carbon dioxide. However, clinically significant effects such as hypoventilation and hypoxia were observed after its administration. The change in mean arterial blood pressure was minimal.

scholarly journals Therapeutic hypercapnia for prevention of secondary ischemia after severe subarachnoid hemorrhage: physiological responses to continuous hypercapnia

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Christian Stetter ◽  
Franziska Weidner ◽  
Nadine Lilla ◽  
Judith Weiland ◽  
Ekkehard Kunze ◽  
...  
Keyword(s):  
Carbon Dioxide ◽  
Cardiac Output ◽  
Subarachnoid Hemorrhage ◽  
Partial Pressure ◽  
Rebound Effect ◽  
Target Range ◽  
Tissue Oxygen Saturation ◽  
Arterial Partial Pressure ◽  
Optimum Duration ◽  
Arterial Blood

AbstractTemporary hypercapnia has been shown to increase cerebral blood flow (CBF) and might be used as a therapeutical tool in patients with severe subarachnoid hemorrhage (SAH). It was the aim of this study was to investigate the optimum duration of hypercapnia. This point is assumed to be the time at which buffer systems become active, cause an adaptation to changes of the arterial partial pressure of carbon dioxide (PaCO2) and annihilate a possible therapeutic effect. In this prospective interventional study in a neurosurgical ICU the arterial partial pressure of carbon dioxide (PaCO2) was increased to a target range of 55 mmHg for 120 min by modification of the respiratory minute volume (RMV) one time a day between day 4 and 14 in 12 mechanically ventilated poor-grade SAH-patients. Arterial blood gases were measured every 15 min. CBF and brain tissue oxygen saturation (StiO2) were the primary and secondary end points. Intracranial pressure (ICP) was controlled by an external ventricular drainage. Under continuous hypercapnia (PaCO2 of 53.17 ± 5.07), CBF was significantly elevated between 15 and 120 min after the start of hypercapnia. During the course of the trial intervention, cardiac output also increased significantly. To assess the direct effect of hypercapnia on brain perfusion, the increase of CBF was corrected by the parallel increase of cardiac output. The maximum direct CBF enhancing effect of hypercapnia of 32% was noted at 45 min after the start of hypercapnia. Thereafter, the CBF enhancing slowly declined. No relevant adverse effects were observed. CBF and StiO2 reproducibly increased by controlled hypercapnia in all patients. After 45 min, the curve of CBF enhancement showed an inflection point when corrected by cardiac output. It is concluded that 45 min might be the optimum duration for a therapeutic use and may provide an optimal balance between the benefits of hypercapnia and risks of a negative rebound effect after return to normal ventilation parameters.Trial registration: The study was approved by the institutional ethics committee (AZ 230/14) and registered at ClinicalTrials.gov (Trial-ID: NCT01799525). Registered 01/01/2015.

scholarly journals QOLP-17. GROUP MEDICAL PLAY EFFECTIVELY IMPROVES HOSPITALIZATIONADAPTABILITY OF PEDIATRIC PATIENTS WITH NEUROTUMOR

2020 ◽  
Vol 22 (Supplement_2) ◽  
pp. ii178-ii178
Author(s):  
Xing Zhang ◽  
Fuqiang Zhang ◽  
Mingyao Lai ◽  
Juan Li ◽  
Yangqiong Zhang ◽  
...  
Keyword(s):  
Social Status ◽  
Pediatric Patients ◽  
Picture Book ◽  
Family Satisfaction ◽  
Control Group ◽  
Play Intervention ◽  
Significant Difference ◽  
The Difference ◽  
Therapeutic Play ◽  
Experimental Group

Abstract OBJECTIVE To explore the effect of group medical games on the hospitalization adaptability of pediatric patients with neuro tumor. METHODS pediatric patients with neuro tumor (age:6 to 13 years) who were treated in hospital from June to December 2019 and were hospitalized for 1 month to 2 months. 29 pediatric patients(mean age:9y) were selected as the control group and treated as usual; 26 pediatric patients(meanage:8y) were selected as the experimental group for group therapeutic play intervention. Interventions last Monday, Wednesday and Friday of each week, with an average duration of one hour. Group medical play include: medical picture book education, medical preview game, emotional games, social table games. Two groups completed self-made questionnaires at the time of admission and two weeks after admission, including: diet, sleep, compliance, and social status, hospital adaptation and other related issues, two groups completed a satisfaction questionnaire after two weeks of admission, recorded analysis and compared the difference of questionnaire data and satisfaction of the two groups of pediatric patients. RESULTS There was no statistical difference in age and sex between the two groups, and there was no significant difference in baseline RESULTS: The re-test results showed that the experimental group was significantly better than the control group in terms of social status, hospital adaptation, compliance and family satisfaction(p＜0.05). CONCLUSION Group medical games can effectively improve the adaptability, compliance and family satisfaction of pediatric with neuro tumor.

scholarly journals Effect of deep breathing exercises and incentive spirometry on respiratory distress scoring in second degree inhalational burn patients.

2019 ◽  
Vol 2 (1) ◽  
pp. 13-16
Author(s):  
Summiya Siddique Malik ◽  
Sadaf Saeed ◽  
Sumaira Kanwal
Keyword(s):  
Respiratory Distress ◽  
Vital Signs ◽  
Blood Gases ◽  
Sampling Technique ◽  
Control Group ◽  
Deep Breathing ◽  
Breathing Exercises ◽  
Arterial Blood ◽  
Experimental Group ◽  
Second Degree

Objective: Study was conducted for 6 months in PIMS Hospital Islamabad. Data was collected on self-structured Questionnaire, Respiratory distress scoring, Objective tools of Arterial blood gases and vital signs with signed consent. Methodology: The subjects were randomly allocated in experimental and control groups. Baseline data was collected and re-collected on Day 0 and Day 7 respectively and assessed using non-probability convenient sampling technique. Both groups were given standard medical and nursing care. Results: The experimental group was given single treatment regimen i.e. Deep breathing exercises (with 5-10 repetitions of each DBE being possible onto patient for 15-30 minutes twice daily). The control group was given 10-15 cycles of ISM with prior steam inhalation and nebulization with salbutamol for a period of 15-20 minutes for 35-45 minutes twice daily for a period of 07 days. Conclusion: The experimental group results show that deep breathing exercises are significantly effective in improving post burn complications like pneumonia in patients suffering from second degree inhalation burns.

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