scholarly journals Physiological and Clinical Impact of Repeated Inhaled Oxygen Variation on Erythropoietin Levels in Patients After Surgery

2021 ◽  
Vol 12 ◽  
Author(s):  
Maher Khalife ◽  
Mohammed Ben Aziz ◽  
Costantino Balestra ◽  
Joseph Valsamis ◽  
Maurice Sosnowski
Keyword(s):  
Reticulocyte Count ◽  
Clinical Impact ◽  
Control Group ◽  
Normobaric Oxygen ◽  
Endogenous Erythropoietin ◽  
Oxygen Paradox ◽  
Oxygen Fraction ◽  
Physiologic Mechanism ◽  
Significant Difference ◽  
Inspired Oxygen

The “Normobaric Oxygen Paradox” (NOP) is a physiologic mechanism that induces an increase of endogenous erythropoietin (EPO) production by creating a state of relative hypoxia in subjects previously exposed to hyperoxia, followed by a rapid return to normoxia. Oxygen exposure duration and inspired oxygen fraction required to observe a significant increase in EPO or hemoglobin are not clearly defined. Consequently, we here study the effect of one model of relative hypoxia on EPO, reticulocytes and hemoglobin stimulation in patients after surgery. Patients were prospectively randomized in two groups. The O2 group (n = 10) received 100% oxygen for 1 h per day for eight consecutive days, via a non-rebreathing mask. The control group (n = 12) received no oxygen variation. Serum EPO, hemoglobin and reticulocyte count were measured on admission and postoperatively on days seven and nine. Percentage EPO at day nine with respect to the baseline value was significantly elevated within the groups [O2 group: 323.7 (SD ± 139.0); control group: 365.6 (SD± 162.0)] but not between them. No significant difference was found between the groups in terms of reticulocytes count and hemoglobin. Our NOP model showed no difference on EPO increase between the two groups. However, both groups expressed separately significant EPO elevation.

scholarly journals Hematologic changes in propofol-anesthetized dogs with or without tramadol administration

2013 ◽  
Vol 65 (5) ◽  
pp. 1306-1312 ◽  
Author(s):  
P.F. Costa ◽  
N. Nunes ◽  
E.A. Belmonte ◽  
J.V. Moro ◽  
P.C.F. Lopes
Keyword(s):  
Blood Cells ◽  
Early Postoperative Period ◽  
Control Group ◽  
Anesthesia Induction ◽  
Monocyte Count ◽  
Mechanically Ventilated ◽  
Oxygen Fraction ◽  
Anesthetized Dogs ◽  
Inspired Oxygen ◽  
Rate Infusion

Drugs commonly used in anesthesia practice may significantly alter the oxidative state of blood cells. This mechanism could contribute to the immune suppression that occurs transiently in the early postoperative period. Thus, we assessed the effects of continuous rate infusion (CRI) of propofol associated or not with tramadol on hematologic parameters in dogs. Eight adult mongrel dogs were anesthetized on 2 occasions, 15 d apart. Two groups were formed: control group (CG) and tramadol group (GT). Propofol was used for induction (10mg kg-1) followed by a CRI (0.7mg kg-1minute-1). The animals were positioned in lateral recumbency and mechanically ventilated with inspired oxygen fraction of 0.6. In TG, tramadol (2mg kg-1) followed by a CRI (0.5mg kg-1minute-1) was administered in dogs. In the CG the sodium chloride (NaCl) solution at 0.9% was administered followed by its CRI, in the same volume that was used in TG. The measurement was taken before anesthesia induction (Tbasal), 30 minutes after induction (T0) and then at 30-minute intervals (T30 to T60). Red blood cells, hematocrit, hemoblogin concentration and total leukocytes count decreased from T0 in both groups. In TG, lymphocytes count at Tbasal [1.86 (0.82) x103µl-1] was greater than at T0, T30 and T60 [0.96(0.50), 0.92(0.48) and 0.95(0.48) x103µl-1, respectively]. No significant differences were observed for platelets neutrophil, eosinophil, basophil and monocyte count. In dogs, propofol-anesthesia associated or not with tramadol promoted decrease in blood cell count and should be used with caution in immunossupressed patients.

Use of a Vital Capacity Maneuver to Prevent Atelectasis after Cardiopulmonary Bypass 

1998 ◽  
Vol 88 (1) ◽  
pp. 134-142 ◽  
Author(s):  
Lennart Magnusson ◽  
Vitas Zemgulis ◽  
Arne Tenling ◽  
Johan Wernlund ◽  
Hans Tyden ◽  
...  
Keyword(s):  
Cardiopulmonary Bypass ◽  
Vital Capacity ◽  
Major Complication ◽  
Control Group ◽  
Intrapulmonary Shunt ◽  
Computed Tomographic ◽  
The Third ◽  
Oxygen Fraction ◽  
Lung Area ◽  
Inspired Oxygen

Background Respiratory failure secondary to cardiopulmonary bypass (CPB) remains a major complication after cardiac surgery. The authors previously found that the increase in intrapulmonary shunt was well correlated with the amount of atelectasis. They tested the hypothesis that post-CPB atelectasis can be prevented by a vital capacity maneuver (VCM) performed before termination of the bypass. Methods Eighteen pigs received standard hypothermic CPB (no ventilation during bypass). The VCM was performed in two groups and consisted of inflating the lungs during 15 s to 40 cmH2O at the end of the bypass. In one group, the inspired oxygen fraction (FIO2) was then increased to 1.0. In the second group, the FIO2 was left at 0.4. In the third group, no VCM was performed (control group). Ventilation-perfusion distribution was measured with the inert gas technique and atelectasis by computed tomographic scanning. Results Intrapulmonary shunt increased after bypass in the control group (from 4.9 +/- 4% to 20.8 +/- 11.7%; P < 0.05) and was also increased in the vital capacity group ventilated with 100% oxygen (from 2.2 +/- 1.3% to 6.9 +/- 2.9%; P < 0.01) but was unaffected in the vital capacity group ventilated with 40% oxygen. The control pigs showed extensive atelectasis (21.3 +/- 15.8% of total lung area), which was significantly larger (P < 0.01) than the proportion of atelectasis found in the two vital capacity groups (5.7 +/- 5.7% for the vital capacity group ventilated with 100% oxygen and 2.3 +/- 2.1% for the vital capacity group ventilated with 40% oxygen. Conclusion In this pig model, postcardiopulmonary bypass atelectasis was effectively prevented by a VCM.

Can the normobaric oxygen paradox (NOP) increase reticulocyte count after traumatic hip surgery?

2013 ◽  
Vol 25 (2) ◽  
pp. 129-134 ◽  
Author(s):  
Pierre Lafère ◽  
Thomas Schubert ◽  
David De Bels ◽  
Peter Germonpré ◽  
Costantino Balestra
Keyword(s):  
Reticulocyte Count ◽  
Hip Surgery ◽  
Normobaric Oxygen ◽  
Oxygen Paradox

Inspired Oxygen Fraction of 0.8 Does Not Attenuate Postoperative Nausea and Vomiting after Strabismus Surgery

2005 ◽  
Vol 103 (1) ◽  
pp. 6-10 ◽  
Author(s):  
Tanja A. Treschan ◽  
Christian Zimmer ◽  
Christoph Nass ◽  
Bernd Stegen ◽  
Joachim Esser ◽  
...  
Keyword(s):  
General Anesthesia ◽  
Intravenous Administration ◽  
Postoperative Nausea ◽  
Postoperative Nausea And Vomiting ◽  
Strabismus Surgery ◽  
Nausea And Vomiting ◽  
Controlled Study ◽  
Oxygen Fraction ◽  
Significant Difference ◽  
Inspired Oxygen

Background Postoperative nausea and vomiting (PONV) is a distressing problem after strabismus surgery. An inspired oxygen fraction has been reported to decrease PONV in patients after colon resection and to be more effective than ondansetron after gynecologic laparoscopy. Therefore, in a randomized, prospective, placebo-controlled study, the authors tested whether an inspired oxygen fraction of 0.8 decreases PONV in patients undergoing strabismus surgery and whether oxygen is more effective than ondansetron. Methods With approval of the authors' institutional review board, 210 patients were randomly assigned to receive one of three treatments: (1) 30% inspired oxygen in air plus intravenous administration of saline, (2) 80% inspired oxygen in air plus intravenous administration of saline, or (3) 30% inspired oxygen in air plus 75 microg/kg ondansetron intravenously during induction. General anesthesia was standardized and included etomidate, alfentanil, and mivacurium for induction and sevoflurane for maintenance. PONV was evaluated 6 and 24 h postoperatively by an investigator unaware of treatment assignment. Results Overall postoperative incidence of nausea and vomiting was 41% for inspired oxygen fraction of 0.3 plus placebo, 38% for inspired oxygen fraction of 0.8 plus placebo, and 28% for inspired oxygen fraction of 0.3 plus ondansetron, respectively (P = 0.279). Therefore, there was no statistically significant difference of PONV incidence among groups. Conclusions An inspired oxygen fraction of 0.8 during general anesthesia with sevoflurane does not decrease PONV in patients undergoing strabismus repair. Ondansetron also did not significantly decrease PONV in our study setting.

scholarly journals Increase in endogenous erythropoietin synthesis through the normobaric oxygen paradox in cardiac surgery patients

2011 ◽  
Vol 106 (5) ◽  
pp. 752-753 ◽  
Author(s):  
Y. Ciccarella ◽  
C. Balestra ◽  
J. Valsamis ◽  
P. Van der Linden
Keyword(s):  
Cardiac Surgery ◽  
Normobaric Oxygen ◽  
Endogenous Erythropoietin ◽  
Oxygen Paradox

S-100 Protein and Neurohistopathologic Changes in a Porcine Model of Acute Lung Injury

2005 ◽  
Vol 102 (4) ◽  
pp. 761-767 ◽  
Author(s):  
Michael Fries ◽  
Johannes Bickenbach ◽  
Dietrich Henzler ◽  
Stefan Beckers ◽  
Rolf Dembinski ◽  
...  
Keyword(s):  
Acute Lung Injury ◽  
Lung Injury ◽  
Blood Gases ◽  
Control Group ◽  
Hippocampal Damage ◽  
Hemodynamic Variables ◽  
Oxygen Fraction ◽  
Injury Group ◽  
S 100 ◽  
Inspired Oxygen

Background Survivors of acute respiratory distress syndrome exhibit neuropsychological sequelae that might be attributable to hippocampal damage. The authors sought to determine the effects of hypoxemia in a pig model of acute lung injury on the hippocampal region and the release of S-100 protein in comparison to a control group in which hypoxemia was induced by reducing the inspired oxygen fraction. Methods Hypoxemia was induced in 14 female pigs by repeated lung lavages (lung injury group; n = 7) or by reducing the inspired oxygen fraction (hypoxia-only group; n = 7). Hemodynamic variables, gas exchange, and serum concentrations of S-100 protein were measured at baseline, after induction of acute lung injury, and subsequently for 12 h. Animals were euthanized, and the brains were removed for histopathologic examination. Results Comparable blood gases were seen in both groups. Serum S-100 protein concentrations were comparable for both groups at baseline. At all other time points, S-100 concentrations were significantly higher in the lung injury group. Neuropathologic examination showed basophilic and shrunken neurons of the pyramidal cell layer in the hippocampal CA1 subregion of all pigs in the lung injury group. Few abnormalities were seen in the hypoxia-only group. Conclusions The same degree of hypoxemia induced in a lavage model of acute lung injury results in greater brain damage assessed by S-100 protein and histopathologic findings when compared to a group in which hypoxemia at the same degree was induced by reducing the inspired oxygen fraction. This suggests that acute lung injury leads to neuropathologic changes independent of hypoxemia.

scholarly journals Normobaric oxygen treatment for mild-to-moderate depression: a randomized, double-blind, proof-of-concept trial

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Yehudit Bloch ◽  
R. H. Belmaker ◽  
Pesach Shvartzman ◽  
Pnina Romem ◽  
Arkady Bolotin ◽  
...  
Keyword(s):  
Rating Scale ◽  
Treated Group ◽  
World Health ◽  
Control Group ◽  
Double Blind ◽  
Normobaric Oxygen ◽  
Moderate Depression ◽  
Oxygen Treatment ◽  
Fraction Of Inspired Oxygen ◽  
Inspired Oxygen

AbstractOxygen enriched air may increase oxygen pressure in brain tissue and have biochemical effects even in subjects without lung disease. Consistently, several studies demonstrated that normobaric oxygen treatment has clinical benefits in some neurological conditions. This study examined the efficacy of normobaric oxygen treatment in subjects with depression. In a randomized, double-blind trial, 55 participants aged 18–65 years with mild to moderate depression (had a Hamilton Rating Scale for Depression [HRSD] score of ≥ 8) were recruited to the study from the Southern district in Israel. Participants underwent a psychiatric inclusion assessment at baseline and then were randomly assigned to either normobaric oxygen treatment of 35% fraction of inspired oxygen or 21% fraction of inspired oxygen (room air) through a nasal tube, for 4 weeks, during the night. Evaluations were performed at baseline, 2 and 4 weeks after commencement of study interventions, using the following tools: HRSD; Clinical Global Impression (CGI) questionnaire; World Health Organization-5 questionnaire for the estimation of Quality of Life (WHO-5-QOL); Sense of Coherence (SOC) 13-item questionnaire; and, Sheehan Disability Scale (SDS). A multivariate regression analysis showed that the mean ± standard deviation [SD] changes in the HRSD scores from baseline to week four were − 4.2 ± 0.3 points in the oxygen-treated group and − 0.7 ± 0.6 in the control group, for a between-group difference of 3.5 points (95% confidence interval [CI] − 5.95 to − 1.0; P = 0.007). Similarly, at week four there was a between-group difference of 0.71 points in the CGI score (95% CI − 1.00 to − 0.29; P = 0.001). On the other hand, the analysis revealed that there were no significant differences in WHO-5-QOL, SOC-13 or SDS scores between the groups. This study showed a significant beneficial effect of oxygen treatment on some symptoms of depression.Trial registration: NCT02149563 (29/05/2014).

Normobaric oxygen therapy strategies in the treatment of postcraniotomy pneumocephalus

2008 ◽  
Vol 108 (5) ◽  
pp. 926-929 ◽  
Author(s):  
Pankaj A. Gore ◽  
Harvinder Maan ◽  
Steve Chang ◽  
Alan M. Pitt ◽  
Robert F. Spetzler ◽  
...  
Keyword(s):  
Study Participant ◽  
Neurological Deficits ◽  
Ct Scans ◽  
Control Group ◽  
Time Interval ◽  
Control Groups ◽  
Normobaric Oxygen ◽  
Significant Difference ◽  
The Mean ◽  
And Control

Object Postsurgical pneumocephalus is an unavoidable sequela of craniotomy. Sufficiently large volumes of intracranial air can cause headaches, lethargy, and neurological deficits. Supplemental O2 to increase the rate of absorption of intracranial air is a common but unsubstantiated neurosurgical practice. To the authors' knowledge, this is the first prospective study to examine the efficacy of this therapy and its effect on the rate of pneumocephalus absorption. Methods Thirteen patients with postoperative pneumocephalus that was estimated to be ≥ 30 ml were alternately assigned to breathe 100% O2 using a nonrebreather mask (treatment group) or to breathe room air (control group) for 24 hours. Head computed tomography (CT) scans without contrast enhancement were obtained at the beginning and end of treatment or control therapy. A neuroradiologist blinded to the type of treatment used software to calculate the 3D volume of the pneumocephalus from the CT scans. The percentage of pneumocephalus absorption was calculated for each study participant. Results There was no statistically significant difference between the treatment and control groups regarding the mean initial pneumocephalus volume or time interval between CT scans. There was a significant difference (p = 0.009) between the mean rate of pneumocephalus volume reduction in the treatment (65%) and control groups (31%) per 24 hours. No patient suffered adverse effects related to treatment. Conclusions Administration of postsurgical supplemental O2 through a nonrebreather mask significantly increases the absorption rate of postcraniotomy pneumocephalus as compared with breathing room air.

Sign in / Sign up

Export Citation Format

Share Document