scholarly journals Factors for Predicting Noninvasive Ventilation Failure in Elderly Patients with Respiratory Failure

2020 ◽  
Vol 9 (7) ◽  
pp. 2116
Author(s):  
Min Jeong Park ◽  
Jae Hwa Cho ◽  
Youjin Chang ◽  
Jae Young Moon ◽  
Sunghoon Park ◽  
...  
Keyword(s):  
Heart Rate ◽  
Elderly Patients ◽  
Noninvasive Ventilation ◽  
High Heart Rate ◽  
Arterial Blood Gas ◽  
Arterial Blood ◽  
Arterial Ph ◽  
Ventilation Failure ◽  
Blood Gas Parameters ◽  
Paco2 Level

Noninvasive ventilation (NIV) is useful when managing critically ill patients. However, it is not easy to apply to elderly patients, particularly those with pneumonia, due to the possibility of NIV failure and the increased mortality caused by delayed intubation. In this prospective observational study, we explored whether NIV was appropriate for elderly patients with pneumonia, defined factors that independently predicted NIV failure, and built an optimal model for prediction of such failure. We evaluated 78 patients with a median age of 77 years. A low PaCO2 level, a high heart rate, and the presence of pneumonia were statistically significant independent predictors of NIV failure. The predictive power for NIV failure of Model III (pneumonia, PaCO2 level, and heart rate) was better than that of Model I (pneumonia alone). Considering the improvement in parameters, patients with successful NIV exhibited significantly improved heart rates, arterial pH and PaCO2 levels, and patients with NIV failure exhibited a significantly improved PaCO2 level only. In conclusion, NIV is reasonable to apply to elderly patients with pneumonia, but should be done with caution. For the early identification of NIV failure, the heart rate and arterial blood gas parameters should be monitored within 2 h after NIV commencement.

scholarly journals Calabadion

2013 ◽  
Vol 119 (2) ◽  
pp. 317-325 ◽  
Author(s):  
Ulrike Hoffmann ◽  
Martina Grosse-Sundrup ◽  
Katharina Eikermann-Haerter ◽  
Sebastina Zaremba ◽  
Cenk Ayata ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Arterial Blood Pressure ◽  
Blocking Agent ◽  
Neuromuscular Blocking ◽  
Arterial Blood Gas ◽  
Arterial Blood ◽  
Train Of Four ◽  
Complete Reversal ◽  
Blood Gas Parameters

Abstract Introduction: To evaluate whether calabadion 1, an acyclic member of the Cucurbit[n]uril family of molecular containers, reverses benzylisoquinoline and steroidal neuromuscular-blocking agent effects. Methods: A total of 60 rats were anesthetized, tracheotomized, and instrumented with IV and arterial catheters. Rocuronium (3.5 mg/kg) or cisatracurium (0.6 mg/kg) was administered and neuromuscular transmission quantified by acceleromyography. Calabadion 1 at 30, 60, and 90 mg/kg (for rocuronium) or 90, 120, and 150 mg/kg (for cisatracurium), or neostigmine/glycopyrrolate at 0.06/0.012 mg/kg were administered at maximum twitch depression, and renal calabadion 1 elimination was determined by using a 1H NMR assay. The authors also measured heart rate, arterial blood gas parameters, and arterial blood pressure. Results: After the administration of rocuronium, resumption of spontaneous breathing and recovery of train-of-four ratio to 0.9 were accelerated from 12.3 ± 1.1 and 16.2 ± 3.3 min with placebo to 4.6 ± 1.8 min with neostigmine/glycopyrrolate to 15 ± 8 and 84 ± 33 s with calabadion 1 (90 mg/kg), respectively. After the administration of cisatracurium, recovery of breathing and train-of-four ratio of 0.9 were accelerated from 8.7 ± 2.8 and 9.9 ± 1.7 min with placebo to 2.8 ± 0.8 and 7.6 ± 2.1 min with neostigmine/glycopyrrolate to 47 ± 13 and 87 ± 16 s with calabadion 1 (150 mg/kg), respectively. Calabadion 1 did not affect heart rate, mean arterial blood pressure, pH, carbon dioxide pressure, and oxygen tension. More than 90% of the IV administered calabadion 1 appeared in the urine within 1 h. Conclusion: Calabadion 1 is a new drug for rapid and complete reversal of the effects of steroidal and benzylisoquinoline neuromuscular-blocking agents.

scholarly journals Sedative and cardiopulmonary effects of acepromazine, midazolam, butorphanol, acepromazine-butorphanol and midazolam-butorphanol on propofol anaesthesia in goats

2009 ◽  
Vol 80 (1) ◽  
Author(s):  
T.B. Dzikitia ◽  
G.F. Stegmanna ◽  
L.J. Hellebrekers ◽  
R.E.J. Auer ◽  
L.N. Dzikiti
Keyword(s):  
Saline Group ◽  
Control Group ◽  
Blood Gas ◽  
Arterial Blood Gas ◽  
Induction Dose ◽  
Normal Limits ◽  
Arterial Blood ◽  
Blood Gas Parameters ◽  
Induction Of Anaesthesia

The sedative, propofol-sparing and cardiopulmonary effects of acepromazine, midazolam, butorphanol and combinations of butorphanol with acepromazine or midazolam in goats were evaluated. Six healthy Boer - Indigenous African crossbreed goats were by randomised cross-over designated to 6 groups: Group SAL that received saline, Group ACE that received acepromazine, Group MID that received midazolam, Group BUT that received butorphanol, Group ACEBUT that received acepromazine and butorphanol and Group MIDBUT that received midazolam and butorphanol as premedication agents intramuscularly on different occasions at least 3 weeks apart. The degree of sedation was assessed 20 minutes after administration of the premedication agents. Thirty minutes after premedication, the dose of propofol required for induction of anaesthesia adequate to allow placement of an endotracheal tube was determined. Cardiovascular, respiratory and arterial blood-gas parameters were assessed up to 30 minutes after induction of general anaesthesia. Acepromazine and midazolam produced significant sedation when administered alone, but premedication regimens incorporating butorphanol produced inconsistent results. The dose of propofol required for induction of anaesthesia was significantly reduced in goats that received midazolam alone, or midazolam combined with either acepromazine or butorphanol. The quality of induction of anaesthesia was good in all groups, including the control group. Cardiovascular, respiratory and blood-gas parameters were within normal limits in all groups and not significantly different between or within all groups. In conclusion: sedation with midazolam alone, or midazolam combined with either acepromazine or butorphanol significantly reduces the induction dose of propofol with minimal cardiopulmonary effects in goats.

An update report on the harmonization of adult reference intervals in Australasia

2018 ◽  
Vol 0 (0) ◽  
Author(s):  
Gus Koerbin ◽  
Ken Sikaris ◽  
Graham R.D. Jones ◽  
Robert Flatman ◽  
Jillian R. Tate
Keyword(s):  
Royal College ◽  
Clinical Chemistry ◽  
Metrological Traceability ◽  
Reference Intervals ◽  
Evidence Based ◽  
Blood Gas ◽  
Arterial Blood Gas ◽  
The Past ◽  
Arterial Blood ◽  
Blood Gas Parameters

Abstract The Australasian Association of Clinical Biochemists (AACB) has over the past 5 years been actively working to achieve harmonized reference intervals (RIs) for common clinical chemistry analytes using an evidence-based checklist approach where there is sound calibration and metrological traceability. It has now recommended harmonized RIs for 18 common clinical chemistry analytes which are performed in most routine laboratories and these have been endorsed by the Royal College of Pathologists of Australasia (RCPA). In 2017 another group of analytes including urea, albumin and arterial blood gas parameters were considered and suggested harmonized RIs proposed. This report provides an update of those harmonization efforts.

scholarly journals The effects of lung volume reduction treatment on diffusing capacity and gas exchange

2020 ◽  
Vol 29 (158) ◽  
pp. 190171
Author(s):  
Marlies van Dijk ◽  
Karin Klooster ◽  
Nick H.T. Ten Hacken ◽  
Frank Sciurba ◽  
Huib. A.M. Kerstjens ◽  
...  
Keyword(s):  
Gas Exchange ◽  
Lung Volume ◽  
Diagnostic Techniques ◽  
Volume Reduction ◽  
Diffusing Capacity ◽  
Blood Gas ◽  
Lung Volume Reduction ◽  
Arterial Blood Gas ◽  
Arterial Blood ◽  
Blood Gas Parameters

Lung volume reduction (LVR) treatment in patients with severe emphysema has been shown to have a positive effect on hyperinflation, expiratory flow, exercise capacity and quality of life. However, the effects on diffusing capacity of the lungs and gas exchange are less clear. In this review, the possible mechanisms by which LVR treatment can affect diffusing capacity of the lung for carbon monoxide (DLCO) and arterial gas parameters are discussed, the use of DLCO in LVR treatment is evaluated and other diagnostic techniques reflecting diffusing capacity and regional ventilation (V′)/perfusion (Q′) mismatch are considered.A systematic review of the literature was performed for studies reporting on DLCO and arterial blood gas parameters before and after LVR surgery or endoscopic LVR with endobronchial valves (EBV). DLCO after these LVR treatments improved (40 studies, n=1855) and the mean absolute change from baseline in % predicted DLCO was +5.7% (range −4.6% to +29%), with no real change in blood gas parameters. Improvement in V′ inhomogeneity and V′/Q′ mismatch are plausible explanations for the improvement in DLCO after LVR treatment.

Arterial blood gas parameters of normal foals born at 1500 metres elevation

2009 ◽  
Vol 42 (1) ◽  
pp. 59-62 ◽  
Author(s):  
E. S. HACKETT ◽  
J. L. TRAUB-DARGATZ ◽  
J. E. KNOWLES Jr. ◽  
S. F. TARR ◽  
D. A. DARGATZ
Keyword(s):  
Blood Gas ◽  
Arterial Blood Gas ◽  
Arterial Blood ◽  
Blood Gas Parameters

scholarly journals Twenty-Four Hour Noninvasive Ventilation in Duchenne Muscular Dystrophy: A Safe Alternative to Tracheostomy

2013 ◽  
Vol 20 (1) ◽  
pp. e5-e9 ◽  
Author(s):  
Douglas A McKim ◽  
Nadia Griller ◽  
Carole LeBlanc ◽  
Andrew Woolnough ◽  
Judy King
Keyword(s):  
Respiratory Failure ◽  
Duchenne Muscular Dystrophy ◽  
Muscular Dystrophy ◽  
Noninvasive Ventilation ◽  
Gas Analysis ◽  
Blood Gas ◽  
Safe Alternative ◽  
Arterial Blood Gas ◽  
Arterial Blood ◽  
The Mean

BACKGROUND: Almost all patients with Duchenne muscular dystrophy (DMD) eventually develop respiratory failure. Once 24 h ventilation is required, either due to incomplete effectiveness of nocturnal noninvasive ventilation (NIV) or bulbar weakness, it is common practice to recommend invasive tracheostomy ventilation; however, noninvasive daytime mouthpiece ventilation (MPV) as an addition to nocturnal mask ventilation is also an alternative.METHODS: The authors’ experience with 12 DMD patients who used 24 h NIV with mask NIV at night and MPV during daytime hours is reported.RESULTS: The mean (± SD) age and vital capacity (VC) at initiation of nocturnal (only) NIV subjects were 17.8±3.5 years and 0.90±0.40 L (21% predicted), respectively; and, at the time of MPV, 19.8±3.4 years and 0.57 L (13.2% predicted), respectively. In clinical practice, carbon dioxide (CO2) levels were measured using different methods: arterial blood gas analysis, transcutaneous partial pressure of CO2and, predominantly, by end-tidal CO2. While the results suggested improved CO2levels, these were not frequently confirmed by arterial blood gas measurement. The mean survival on 24 h NIV has been 5.7 years (range 0.17 to 12 years). Of the 12 patients, two deaths occurred after 3.75 and four years, respectively, on MPV; the remaining patients continue on 24 h NIV (range two months to 12 years; mean 5.3 years; median 3.5 years).CONCLUSIONS: Twenty-four hour NIV should be considered a safe alternative for patients with DMD because its use may obviate the need for tracheostomy in patients with chronic respiratory failure requiring more than nocturnal ventilation alone.

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