scholarly journals Asymptomatic Hypoxemia as a Characteristic Symptom of Coronavirus Disease: A Narrative Review of Its Pathophysiology

COVID ◽  
2022 ◽  
Vol 2 (1) ◽  
pp. 47-61
Author(s):  
Kiichi Hirota ◽  
Taku Mayahara ◽  
Yosuke Fujii ◽  
Kenichiro Nishi

Coronavirus disease (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has become a pandemic and caused a huge burden to healthcare systems worldwide. One of the characteristic symptoms of COVID-19 is asymptomatic hypoxemia, also called happy hypoxia, silent hypoxemia, or asymptomatic hypoxemia. Patients with asymptomatic hypoxemia often have no subjective symptoms, such as dyspnea, even though hypoxemia is judged by objective tests, such as blood gas analysis and pulse oximetry. Asymptomatic hypoxemia can lead to acute respiratory distress syndrome, and the delay in making a diagnosis and providing initial treatment can have fatal outcomes, especially during the COVID-19 pandemic. Thus far, not many studies have covered asymptomatic hypoxemia. We present a review on the human response to hypoxemia, focusing on the respiratory response to hypoxemia rather than the pathophysiology of lung injury arising from SARS-CoV-2 infection. We have also discussed whether asymptomatic hypoxemia is specific to SARS-CoV-2 infection or a common phenomenon in lung-targeted viral infections.

2021 ◽  
Author(s):  
Yi-Rong Zheng ◽  
Yu-Qing Lei ◽  
Jian-Feng Liu ◽  
Hong-Lin Wu ◽  
Ning Xu ◽  
...  

Abstract Objective: This study aimed to evaluate the effects of pulmonary surfactant (PS) combined with high-frequency oscillatory ventilation (HFOV) or conventional mechanical ventilation (CMV) in infants with acute respiratory distress syndrome (ARDS) after congenital cardiac surgery.Method: A total of 61 infants with ARDS were eligible and were randomized to the CMV + PS group (n= 30) or the HFOV + PS group (n= 31) between January 2020 and December 2020. The primary outcomes were the improvement of the arterial blood gas analysis. The incidence of mechanical ventilation duration, length of hospitalization, and the incidence of complications were considered as secondary outcomes.Results: A total of 61 infants completed the study. In HFOV + PS group, the blood gas analysis results were significantly improved (P<0.05), while, duration of mechanical ventilation and length of hospitalization were shorter than CMV + PS group (P<0.05). But the incidences of complications had no statistical significance between the two groups (P>0.05).Conclusions: Compared with the CMV + PS group, HFOV + PS significantly improved the ABG variables and shortened the length of hospitalization and mechanical ventilation in infants with ARDS after cardiac surgery.


2020 ◽  
Vol 46 (1) ◽  
Author(s):  
Giuseppe De Bernardo ◽  
Rita De Santis ◽  
Maurizio Giordano ◽  
Desiree Sordino ◽  
Giuseppe Buonocore ◽  
...  

Author(s):  
G.G. Khubulava ◽  
A.B. Naumov ◽  
S.P. Marchenko ◽  
O.Yu. Chupaeva ◽  
A.A. Seliverstova ◽  
...  

Author(s):  
Elisabetta Colciago ◽  
Simona Fumagalli ◽  
Elena Ciarmoli ◽  
Laura Antolini ◽  
Antonella Nespoli ◽  
...  

Abstract Purpose Delayed cord clamping for at least 60 s is recommended to improve neonatal outcomes. The aim of this study is to evaluate whether there are differences in cord BGA between samples collected after double clamping the cord or without clamping the cord, when blood collection occurs within 60 s from birth in both groups. Methods A cross-sectional study was carried out, collecting data from 6884 high-risk women who were divided into two groups based on the method of cord sampling (clamped vs unclamped). Results There were significant decrease in pH and BE values into unclamped group compared with the clamped group. This difference remained significant when considering pathological blood gas analysis parameters, with a higher percentage of pathological pH or BE values in the unclamped group. Conclusion Samples from the unclamped cord alter the acid–base parameters compared to collection from the clamped cord; however, this difference does not appear to be of clinical relevance. Findings could be due to the large sample size, which allowed to achieve a high power and to investigate very small numerical changes between groups, leading to a statistically significant difference in pH and BE between samples even when we could not appreciate any clinical relevant difference of pH or BE between groups. When blood gas analysis is indicated, the priority should be given to the timing of blood collection to allow reliable results, to assess newborns status at birth and intervene when needed.


1934 ◽  
Vol 104 (1) ◽  
pp. 29-31
Author(s):  
Friedrich Rappaport ◽  
Klara Köck-Molnar

2021 ◽  
pp. 039139882098785
Author(s):  
Lawrence Garrison ◽  
Jeffrey B Riley ◽  
Steve Wysocki ◽  
Jennifer Souai ◽  
Hali Julick

Measurements of transcutaneous carbon dioxide (tcCO2) have been used in multiple venues, such as during procedures utilizing jet ventilation, hyperbaric oxygen therapy, as well as both the adult and neo-natal ICUs. However, tcCO2 measurements have not been validated under conditions which utilize an artificial lung, such cardiopulmonary bypass (CPB). The purpose of this study was to (1) validate the use of tcCO2 using an artificial lung during CPB and (2) identify a location for the sensor that would optimize estimation of PaCO2 when compared to the gold standard of blood gas analysis. tcCO2 measurements ( N = 185) were collected every 30 min during 54 pulsatile CPB procedures. The agreement/differences between the tcCO2 and the PaCO2 were compared by three sensor locations. Compared to the earlobe or the forehead, the submandibular PtcCO2 values agreed best with the PaCO2 and with a median difference of –.03 mmHg (IQR = 5.4, p < 0.001). The small median difference and acceptable IQR support the validity of the tcCO2 measurement. The multiple linear regression model for predicting the agreement between the submandibular tcCO2 and PaCO2 included the SvO2, the oxygenator gas to blood flow ratio, and the native perfusion index ( R2 = 0.699, df = 1, 60; F = 19.1, p < 0.001). Our experience in utilizing tcCO2 during CPB has demonstrated accuracy in estimating PaCO2 when compared to the gold standard arterial blood gas analysis, even during CO2 flooding of the surgical field.


Sign in / Sign up

Export Citation Format

Share Document