scholarly journals Prehospital Diagnosis of Shortness of Breath Caused by Profound Metformin-Associated Metabolic Acidosis

Healthcare ◽  
2021 ◽  
Vol 9 (1) ◽  
pp. 74
Author(s):  
Pietro Elias Fubini ◽  
Laurent Suppan
Keyword(s):  
Metabolic Acidosis ◽  
Hospital Setting ◽  
Blood Gases ◽  
Shortness Of Breath ◽  
Potential Harm ◽  
Arterial Blood Gas ◽  
Arterial Blood ◽  
Common Causes ◽  
Prehospital Diagnosis ◽  
Gas Measurement

Shortness of breath is a common complaint among patients in emergency medicine. While most common causes are usually promptly identified, less frequent aetiologies might be challenging to diagnose, especially in the pre-hospital setting. We report a case of prehospital dyspnoea initially ascribed to pulmonary oedema which turned out to be the result of profound metformin-associated metabolic acidosis. This diagnosis was already made during the prehospital phase by virtue of arterial blood gas measurement. Pre-hospital measurement of arterial blood gases is therefore feasible and can improve diagnostic accuracy in the field, thus avoiding unnecessary delay and potential harm to the patient before initiating the appropriate therapeutic actions.

Arterial blood gases

2007 ◽  
pp. 319-326
Keyword(s):  
Decision Making ◽  
Pulse Oximetry ◽  
Respiratory Rate ◽  
Management Strategy ◽  
Blood Gases ◽  
Capillary Blood ◽  
Blood Gas ◽  
Arterial Blood Gas ◽  
Arterial Blood ◽  
Gas Measurements

Arterial blood gas (ABGs) analysis forms the cornerstone of emergency respiratory investigation. In many situations values obtained dictate management strategy and facilitate decision-making. It is an uncomfortable procedure for the patients and if repeated ABGs are required, consider whether less invasive measures, such as respiratory rate, pulse oximetry or capillary blood gas measurements could be used....

Comparison of SVO2, SpO2, and clinical parameters with arterial blood gases during ventilatory weaning after cardiac surgery

1994 ◽  
Vol 3 (5) ◽  
pp. 353-355 ◽  
Author(s):  
ML Noll ◽  
JF Byers
Keyword(s):  
Oxygen Saturation ◽  
Respiratory Rate ◽  
Artery Bypass ◽  
Arterial Oxygen Saturation ◽  
Bypass Graft ◽  
Blood Gases ◽  
Arterial Oxygen ◽  
Arterial Blood Gases ◽  
Arterial Blood Gas ◽  
Arterial Blood

Correlations of mixed venous and arterial oxygen saturation, heart rate, respiratory rate, and mean arterial pressure with arterial blood gas variables were computed for 57 sets of data obtained from 30 postoperative coronary artery bypass graft patients who were being weaned from mechanical ventilation. Arterial oxygen saturation and respiratory rate correlated significantly, although moderately, with blood gases.

Successful Treatment of Experimental Neonatal Respiratory Failure Using Extracorporeal Membrane Lung Assist

1986 ◽  
Vol 9 (6) ◽  
pp. 427-432 ◽  
Author(s):  
R. Fumagalli ◽  
T. Kolobow ◽  
P. Arosio ◽  
V. Chen ◽  
D.K. Buckhold ◽  
...  
Keyword(s):  
Respiratory Failure ◽  
Pulmonary Ventilation ◽  
Blood Gases ◽  
Blood Gas ◽  
Arterial Blood Gases ◽  
Arterial Blood Gas ◽  
Membrane Lung ◽  
Arterial Blood ◽  
Long Term Survivors

A total of 44 preterm fetal lambs at great risk of developing respiratory failure were delivered by Cesarean section, and were then managed on conventional mechanical pulmonary ventilation. Fifteen animals initially fared well, and 14 of these were long term survivors. Twenty-nine other lambs showed a progressive deterioration in arterial blood gases within 30 minutes of delivery, of which 10 lambs were continued on mechanical pulmonary ventilation (20% survival), while the remaining 19 lambs were placed on an extracorporeal membrane lung respiratory assist (79% survival). Extracorporeal membrane lung bypass rapidly corrected arterial blood gas values, and permitted the use of high levels of CPAP instead of the continuation of mechanical pulmonary ventilation at high peak airway pressures. Improvement in lung function was gradual, and predictable. Early institution of extracorporeal respiratory assist using a membrane artificial lung rapidly corrected arterial blood gas values and significantly improved on neonate survival.

Effect of temperature on arterial blood gas tensions and pH during exercise

1964 ◽  
Vol 19 (2) ◽  
pp. 243-245 ◽  
Author(s):  
Alf Holmgren ◽  
Malcolm B. McIlroy
Keyword(s):  
Metabolic Acidosis ◽  
Normal Subjects ◽  
Bicycle Ergometer ◽  
Effect Of Temperature ◽  
Membrane Diffusion ◽  
Arterial Blood Gas ◽  
Arterial Blood ◽  
Capillary Membrane ◽  
Severe Exercise ◽  
Alveolar Capillary

We measured arterial blood Po2, Pco2 and pH at rest and during a standard exercise test on a bicycle ergometer in ten normal subjects. In five we measured esophageal and five arterial blood temperature during the exercise and corrected the arterial blood values to the temperature at the time the samples were collected. We found an average rise in temperature of 1 C (range 0.2–1.6 C) during exercise lasting about 30 min at loads up to an average of 1,200 kg-m/min. At the highest load the average correction for PaOO2 was 5.6 mm Hg, for PaCOCO2 1.6 mm Hg and for pH 0.014 units. Our corrected values showed a fall in PaCOCO2 and pH and a rise in PaOO2 during severe exercise. These findings are compatible with the development of a metabolic acidosis during severe exercise and indicate that our subjects were not limited by diffusion across the alveolar-capillary membrane. metabolic acidosis; alveolar capillary membrane diffusion; hyperventilation; PaOO2 and PaCOCO2 in severe exercise Submitted on June 17, 1963

Ventilation of a rat with a large-animal respirator

1986 ◽  
Vol 61 (3) ◽  
pp. 1192-1194 ◽  
Author(s):  
J. D. Wood ◽  
N. L. Herman ◽  
D. R. Kostreva
Keyword(s):  
Ventilation System ◽  
Blood Gases ◽  
Large Animal ◽  
Arterial Blood Gases ◽  
Sprague Dawley ◽  
Arterial Blood Gas ◽  
Normal Limits ◽  
Arterial Blood ◽  
Gas Measurements ◽  
Catheter Tubing

Rats were effectively ventilated with 100% O2 mixed with room air utilizing a modified tracheostomy tube and a Bird Mark 7 respirator to maintain arterial blood gases within normal limits. A 3-cm segment of rubber pilot tubing was attached to a 15-mm respiratory connector and a 3-cm piece of polyethylene catheter tubing was fitted snugly into the other end. The catheter was inserted and secured into the trachea of 250- to 500-g Sprague-Dawley rats with the adaptor hose of the respirator fitted onto the 15-mm connector following tracheostomy. Manometer and inspiratory flow rate controls of the respirator were set to their minimum operating position. Appropriate rate control adjustments were made when necessary as determined by arterial blood gas measurements. By use of the above ventilation system, adequate arterial blood gases of anesthesized rats can be maintained for greater than 3 h.

scholarly journals Sampling Errors in pH and Blood Gas Analysis—An Evaluation of Three New Arterial Blood Samplers

1986 ◽  
Vol 23 (3) ◽  
pp. 329-333 ◽  
Author(s):  
A S Hutchison ◽  
F J Dryburgh ◽  
S H Ralston
Keyword(s):  
Blood Gas Analysis ◽  
Gas Analysis ◽  
Blood Gas ◽  
Sampling Errors ◽  
Venous Sampling ◽  
Arterial Blood Gas ◽  
Arterial Blood ◽  
Increased Risk ◽  
Gas Measurement ◽  
Heparin Solution

We have tested the accuracy, acceptability and general performance of three recently-marketed samplers for arterial blood gas measurement (the Corning Arterial Blood Sampler, the Concord ‘Pulsator’ and the Sarstedt ‘Monovette’™). All three greatly reduce or eliminate the error of venous sampling, and the Corning and Sarstedt samplers eliminate the risk of dilution of the sample by excess heparin solution. A positive bias in pO2 measurement, more marked at higher levels, was demonstrated with the Concord and Sarstedt samplers, and the latter carry a slightly increased risk of cross-infection. None of the samplers completely overcame potential sampling errors.

scholarly journals Postoperative Arterial Blood Gas Measurement in Obese Patients

1975 ◽  
Vol 182 (6) ◽  
pp. 705-709 ◽  
Author(s):  
ROBERT W. VAUGHAN ◽  
LESLIE WISE
Keyword(s):  
Obese Patients ◽  
Blood Gas ◽  
Arterial Blood Gas ◽  
Arterial Blood ◽  
Gas Measurement

scholarly journals P-Chloroaniline Poisoning Causing Methemoglobinemia: A Case Report and Review of the Literature

2015 ◽  
Vol 2015 ◽  
pp. 1-4
Author(s):  
Anna Sarah Messmer ◽  
Christian Hans Nickel ◽  
Dirk Bareiss
Keyword(s):  
Case Report ◽  
Blood Gas Analysis ◽  
Gas Analysis ◽  
Peripheral Oxygen Saturation ◽  
Arterial Blood Gas ◽  
Oxygen Administration ◽  
Arterial Blood ◽  
Arterial Blood Gas Analysis ◽  
Common Causes ◽  
Treatable Condition

Background. Methemoglobin (MetHb) most commonly results from exposure to an oxidizing chemical but may also arise from genetic, dietary, or even idiopathic etiologies.P-chloroaniline (PCA) was one of the first substances described in the context of acquired methemoglobinemia.Case Report. We report the case of a cyanotic chemistry worker who presented to our emergency department (ED) after working with PCA. His peripheral oxygen saturation (SpO2) measured by pulse oximetry was at 81% and remained on that level despite oxygen administration (100% oxygenation via nonrebreather mask). His MetHb level was measured at 42.8% in arterial blood gas analysis. After treatment with intravenous methylene blue cyanosis resolved and the patient was discharged after 36 hours of observation.Conclusion. Acquired methemoglobinemia is a treatable condition, which may cause significant morbidity and mortality. The knowledge about the most common causes, fast diagnostic, and proper treatment is crucial.

scholarly journals Open and Closed Endotracheal Suctioning and Arterial Blood Gas Values: A Single-Blind Crossover Randomized Clinical Trial

2015 ◽  
Vol 2015 ◽  
pp. 1-7
Author(s):  
Azam Faraji ◽  
Alireza Khatony ◽  
Gholamreza Moradi ◽  
Alireza Abdi ◽  
Mansour Rezaei
Keyword(s):  
Clinical Trial ◽  
Heart Surgery ◽  
Open Heart Surgery ◽  
Blood Gases ◽  
Open Heart ◽  
Blood Gas ◽  
Open Technique ◽  
Endotracheal Suctioning ◽  
Arterial Blood Gas ◽  
Arterial Blood

Aim. This study was aimed at comparing the effects of the open and closed suctioning techniques on the arterial blood gas values in patients undergoing open-heart surgery.Methods. In a clinical trial, we recruited 42 patients after open-heart surgery in an educational hospital. Each patient randomly underwent both open and closed suctioning. ABGs, PaO2, SaO2, PaCO2, were analyzed before and one, five, and fifteen minutes after each suctioning episode.Results. At first the pressure of oxygen in arterial blood increased; however, this increase in the open technique was greater than that of the closed system(P<0.001). The pressure of oxygen decreased five and fifteen minutes after both suctioning techniques(P<0.05). The trends of carbon dioxide variations after the open and closed techniques were upward and downward, respectively. Moreover, the decrease in the level of oxygen saturation five and fifteen minutes after the open suctioning was greater than that of the closed suctioning technique(P<0.05).  Conclusion. Arterial blood gas disturbances in the closed suctioning technique were less than those of the open technique. Therefore, to eliminate the unwanted effects of endotracheal suctioning on the arterial blood gases, the closed suctioning technique is recommended.

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