scholarly journals Continuous Noninvasive Haemoglobin Monitoring in Vascular Surgery within the Goal-Directed Therapy Protocol

2019 ◽  
Vol 1 (1) ◽  
pp. 1
Author(s):  
Rosanna Carmela De Rosa ◽  
Antonio Romanelli ◽  
Mariangela Calabria ◽  
Roberta Abbate ◽  
Raffaele Montesano ◽  
...  
Keyword(s):  
High Risk ◽  
Haemoglobin Concentration ◽  
Blood Gas Analysis ◽  
Abdominal Aortic Aneurysm Repair ◽  
Laboratory Method ◽  
Gas Analysis ◽  
Coulter Counter ◽  
P Value ◽  
Four Quadrant ◽  
Therapy Protocol

The optimisation of DO2, within the Goal-Direct Therapy Protocol (GDTP) in high-risk surgical patients, improves their outcome. Haemodynamic and haemoglobin monitoring become crucial to achieve optimal DO2. Our study compared Hb as measured by three methods: Coulter Counter (standard laboratory method) and CO-Oximetry (Masimo rainbow SET Radical 7 Pulse CO-Oximetry (SpHb) and Blood Gas Analysis) to establish the utility of the Hb continuous intraoperative monitoring, within the GDTP, in high-risk bleeding surgery. We studied 72 patients undergoing open abdominal aortic aneurysm repair. We compared the accuracy and the trending ability in measuring the haemoglobin concentration between the three methods (Coulter Counter, BGA and Masimo). We collected three simultaneous haemoglobin measurements: after induction of anaesthesia, pre- and post-aortic cross-clamping and at the end of the surgery. SpHb showed an excellent r-value for all samples (0.952, CI-95% (0.939, 0.961), p-value < 0.0001) compared to laboratory measurements. The results of the linear regression between SpHb and laboratory, for each time considered, demonstrated that SpHb showed excellent r and R2 value. All data were statistically significant, with a p-value <0.0001. A Bland-Altmann analysis for SpHb vs. laboratory showed a bias of −1.45 g/dL (CI-95% −1.51 and −1.39 g/dL, LOA from −2.42 to −0.48 g/dL) with a precision of 0.49 g/dL. Four-quadrant plot trend analyses showed a high concordance rate ≥90%. During elective high-risk surgery, Masimo Pulse CO-Oximetry is not enough sufficiently accurate to assess the current value of haemoglobin but may be useful for the trend value ensuring DO2 within intraoperative GDTP.

scholarly journals Comparison of Blood Gas Analysis between Benchtop and Handheld Device

2020 ◽  
Vol 27 (1) ◽  
Author(s):  
Phey Liana ◽  
Iza Netiasa Haris ◽  
Yan Effendi Hasyim
Keyword(s):  
Clinical Decision Making ◽  
Blood Gas Analysis ◽  
Gas Analysis ◽  
P Value ◽  
Strong Positive Correlation ◽  
Blood Gas ◽  
Cross Sectional ◽  
Handheld Device ◽  
Arterial Blood ◽  
Significant Difference

The use of blood gas analysis is to determine the Acid-base status required to treat patients with emergency conditionssuch as metabolic disorders and respiratory diseases. Benchtop device is commonly used in hospitals to analyze blood gas;however, handheld devices are recently more often used in emergency settings due to its quick and simple process. Thisstudy was performed to compare blood gas analysis results between the i-STAT handheld device and the Nova pHox Ultrabenchtop device that were currently being used in the central laboratory. This cross-sectional study was conducted by using42 arterial blood patients that were measured with i-STAT handheld device dan Nova pHox Ultra benchtop device. The pH,pCO2, and pO2 parameters were then evaluated. The data were analyzed using Spearman's correlation test, Mann-Whitneytest, and Bland-Altman plots. This study showed a very strong positive correlation for all parameters. Mann-Whitneycomparison test showed that there was no significant difference between the result of the two devices (p-value > 0.05). Allparameters showed that 95% of plots were within the acceptable limit. There was no clinical significance on the mean biasesof blood gas results between both devices. The i-STAT and Nova pHox Ultra devices showed a good agreement for bloodgas measurement. Therefore, both devices can be used interchangeably with minimal effect on clinical decision-making.

scholarly journals Analysis of Prolonged Pediatric Intensive Care Stay in Children with Diabetic Ketoacidosis

2020 ◽  
Vol 9 (1) ◽  
pp. 46-50
Author(s):  
Sandip Kumar Singh ◽  
Shikha Rijal ◽  
Vijay Kumar Sah ◽  
Babita Khanal ◽  
Arun Giri
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Diabetic Ketoacidosis ◽  
Pediatric Intensive Care ◽  
Blood Gas Analysis ◽  
Gas Analysis ◽  
P Value ◽  
Prolonged Stay ◽  
Medical College ◽  
Intensive Care Stay

Background: Diabetic ketoacidosis is one of most serious complication of diabetes requiring intensive care management. We aim to analyze various factors responsible for prolonged duration of stay in pediatric intensive care unit in a child with Diabetic Ketoacidosis. Materials and Methods: This was a hospital based prospective observational study conducted in Nobel Medical College and Teaching Hospital among children with Diabetic ketoacidosis over the period of one year. A total of 22 cases with Diabetic ketoacidosis aged 1 month to 18 years were included and clinical profile, laboratory reports including blood gas analysis were documented. Results: Among cases of Diabetic ketoacidosis, 4 (18%) cases were of mild Diabetic ketoacidosis, 4 cases (18%) were of moderate Diabetic ketoacidosis and 14 cases (64%) were of severe Diabetic ketoacidosis. Mean duration of Intensive care stay in new cases of Diabetic ketoacidosis was 69.46 hours which was significantly higher compared to old cases (30.66 hours) suggested by p value < 0.0001. In 15 cases (68%), acidosis resolved in less than 48-55 hours, whereas 7 cases (32%) required more than 48-55 hours for resolution of acidosis, hence required longer Intensive care stay. Cases who required prolonged Pediatric Intensive care stay, sepsis was contributing factor in 3 cases (42.85%), one case (14.28%) has associated muscular dystrophy and 3 cases (42.85%) had hyperchloremia at the end of 48 hours. Conclusion: Presence of sepsis and Hyperchloremia are important reasons for prolonged stay in Intensive Care Unit in Diabetic ketoacidosis patients. Other associated chronic illness can also prolong intensive care stay in Diabetic ketoacidosis patients.

A policy of routine umbilical cord blood gas analysis decreased missing samples from high-risk births

2016 ◽  
Vol 106 (1) ◽  
pp. 43-48 ◽  
Author(s):  
M Ahlberg ◽  
C Elvander ◽  
S Johansson ◽  
S Cnattingius ◽  
O Stephansson
Keyword(s):  
High Risk ◽  
Cord Blood ◽  
Umbilical Cord ◽  
Umbilical Cord Blood ◽  
Blood Gas Analysis ◽  
Gas Analysis ◽  
Blood Gas

scholarly journals A Survey to Evaluate the Impact of Ailurophobia on Blood Oxygen Level

2019 ◽  
Vol 4 (2) ◽  
Keyword(s):  
Oxygen Saturation ◽  
Pulse Oximeter ◽  
Blood Gas Analysis ◽  
Gas Analysis ◽  
P Value ◽  
Blood Oxygen ◽  
Oxygen Level ◽  
Blood Oxygen Level ◽  
Peripheral Oxygen Saturation ◽  
The Impact

The blood oxygen level is a measure of amount of oxygen circulation in the blood. The blood oxygen level test also known as ‘blood gas analysis’ estimates the proper working of the lungs and it performs different measurements. Pulse oximeter, a noninvasive device that helps to detect or estimate the level of carbon dioxide and oxygen saturation in the blood. Normal pulse oximeter reading has a range of 95 to 100 percent. 200 individuals were selected and asked about the fear of cats and their peripheral oxygen saturation was estimated using pulse oximeter device. The results calculated from M Stat software and student’s t-test revealed that there is a significant impact of cat phobia on peripheral oxygen saturation. The calculated p-value was significant depicting the correlation between blood oxygen level and ailurophobia.

scholarly journals Can venous blood gas be a reliable substitute for arterial blood gases in modern clinical practice?

2019 ◽  
Vol 6 (4) ◽  
pp. 1016
Author(s):  
Sabiha Naz ◽  
Kiran Chugh ◽  
Isha Malik
Keyword(s):  
Venous Blood ◽  
Blood Gases ◽  
Blood Gas Analysis ◽  
Gas Analysis ◽  
P Value ◽  
Emergency Setting ◽  
Blood Gas ◽  
Arterial Blood Gases ◽  
Arterial Blood ◽  
Venous Blood Gas

Background: It is clearly mentioned in the medicine books that blood gas analysis from arterial puncture is the gold standard. But in the past few years it is commonly seen that clinicians have started trusting on venous blood gas analysis as well as started advising VBG (Venous blood gas) in the initial diagnosis of critical patients in emergency setting. Keeping this fact in mind, we designed a study to determine whether VBG could be a better replacement of ABG (Arterial blood gases) in the emergency where diverse pathological conditions are encountered.Methods: This prospective cross-sectional study comprised of 50 patients of 20-60 yrs age with a variety of diagnoses admitted in the emergency department. 50 paired samples (ABG+VBG) were obtained from them under strict aseptic precautions after obtaining their verbal consent. With a minimum delay of less than 2 min blood gas analysis was performed on blood gas analyzer. Parameters (pH, PCO2, PO2, HCO3, Base Excess and O2 saturation) from ABG and VBG were recorded and compared using Student’s Unpaired ‘t’ test.Results: pH and HCO3 showed statistical significant (p value <0.05) differences between ABG and VBG, while BE showed statistical non-significant (p value >0.05) difference between them. Contrary to this, PCO2, PO2 and O2 saturation from ABG and VBG showed statistical highly significant (p value <0.0001) differences.Conclusions: VBG should not be interchangeably considered in place of ABG with regard to pH, HCO3, PCO2, PO2 and O2 saturation in conditions where actual oxygenation status of patient is required (e.g.; hypovolemic shock, respiratory disorders, mechanically ventilated patients, etc.)

Letter to the Editor

PEDIATRICS ◽  
1994 ◽  
Vol 93 (5) ◽  
pp. 873-873
Author(s):  
Ronald B. Turner
Keyword(s):  
Respiratory Syncytial Virus ◽  
High Risk ◽  
Severe Disease ◽  
Blood Gas Analysis ◽  
Underlying Disease ◽  
Gas Analysis ◽  
Blood Gas ◽  
American Academy Of Pediatrics ◽  
Rsv Infection ◽  
Syncytial Virus

The American Academy of Pediatrics Committee on Infectious Diseases recently published a revised statement regarding the use of ribavirin for treatment of respiratory syncytial virus (RSV) infections.1 The new statement specifically recommends that patients at high risk for complications of their RSV infection by virtue of underlying disease or with severe disease as indicated by blood gas analysis be treated with ribavirin. This is a change from the previous statement that acknowledged the lack of consensus and did not explicitly recommend ribavirin in these situations.

scholarly journals Rare Case of Methemoglobinemia Complicating Pregnancy

2016 ◽  
Vol 2016 ◽  
pp. 1-3
Author(s):  
S. Verma ◽  
P. Sachdeva ◽  
G. Gandhi
Keyword(s):  
High Risk ◽  
Oxygen Saturation ◽  
Blood Gas Analysis ◽  
Gas Analysis ◽  
Operation Theatre ◽  
Arterial Blood Gas ◽  
Arterial Blood ◽  
Emergency Cesarean ◽  
Arterial Blood Gas Analysis ◽  
High Risk Case

A patient at 38 weeks of gestation when taken for emergency cesarean section had her oxygen saturation of 66 to 70% (by saturation probe on monitor) in operation theatre. She was otherwise asymptomatic but her oxygen saturation was persistently low on the monitors. Her arterial blood gas analysis showed all parameters to be normal. Her electrocardiography was normal. Her surgery was imperative but due to her reduced oxygen saturation she became a high-risk case. In presence of senior consultants of anesthesia and gynecology and under high-risk consent she had an uneventful cesarean delivery. Physician and cardiologist opinions were sought thereafter. The outcomes and the results of our efforts to find the etiology of her reduced saturation on monitors despite being clinically asymptomatic lead to the disclosure of this rare hemoglobinopathy. Mother and baby had uneventful course after delivery and were discharged well.

scholarly journals IMMEDIATE EFFECT OF INCENTIVE SPIROMETRY ON ARTERIAL BLOOD GASES ANALYSIS AFTER CORONARY BYPASS GRAFT SURGERY PATIENTS

2018 ◽  
Vol 4 (4) ◽  
pp. 23-25
Author(s):  
Shagufta Khan ◽  
Abhijeet Diwate ◽  
Arijit Kumar Das
Keyword(s):  
Artery Bypass ◽  
Bypass Graft ◽  
Blood Gas Analysis ◽  
Gas Analysis ◽  
P Value ◽  
Arterial Line ◽  
Arterial Blood Gas ◽  
Arterial Blood ◽  
Arterial Blood Gas Analysis ◽  
Incentive Spirometry

Background: The patients who have done CABG are prone to pulmonary complications. Various physiotherapy management is present for prevention of lung complication. Literature shows lots of technique as treatment of choice, incentive spirometry is one of them. AIM: To asses immediate effect of incentive spirometry on arterial blood gas analysis in patient recently underwent coronary artery bypass surgery. Method: There was 30 patients. Blood was drawn from arterial line for pre-treatment ABG. Incentive spirometry was given 10 reps and 3 sets. Patient was prop up 30-40 degree. Romsons tri colour volume spirometry is used. Mouthpiece was placed in patient’s mouth and made a good seal over the mouthpiece with lips. Exhaled through nose normally then breathe in slowly through mouth. Ball in the incentive spirometer will go up. The patient to hold or rise the ball as high as possible and hold it for 3 or 5 seconds the slowly exhale. This was done for 10 to 15 times. Blood was drawn from arterial line for post treatment ABG. Result: There was statistically extremely significant change in value of PaO2 (112.54 ±39.46 vs133.01 ±42.13) p value <0.0001, PaCO2 (38.75 ±4.2 vs 36.9 ±3.7) p value 0.0003 and SaO2 (96.8 ±1.84 vs 98.93 ±1.11) p value <0.0001 Conclusion: This study shows that there is immediate effect of Incentive Spirometry on ABG analysis in CABG surgery patient by significant improvement of PaO2 and SaO2 and decrease in PaCO2 Keywords:  Incentive spirometry; Arterial blood gas analysis; coronary artery bypass graft surgery.

Efficacy of Near-Infrared Spectrometry for Monitoring the Cerebral Effects of Severe Dilutional Anemia

2014 ◽  
Vol 17 (3) ◽  
pp. 154 ◽  
Author(s):  
Arıtürk Cem ◽  
Ustalar Serpil ◽  
Toraman Fevzi ◽  
Ökten Murat ◽  
Güllü Ümit ◽  
...  
Keyword(s):  
Blood Flow ◽  
Cardiac Surgery ◽  
Blood Lactate ◽  
Near Infrared ◽  
Bypass Graft ◽  
Blood Gas Analysis ◽  
Gas Analysis ◽  
Infrared Spectrometry ◽  
Control Group ◽  
Near Infrared Spectrometry

<p><strong>Introduction:</strong> Clear guidelines for red cell transfusion during cardiac surgery have not yet been established. The current focus on blood conservation during cardiac surgery has increased the urgency to determine the minimum safe hematocrit for these patients. The aim of this study was to determine whether monitoring of cerebral regional oxygen saturation (rSO<sub>2</sub>) via near-infrared spectrometry (NIRS) is effective for assessing the cerebral effects of severe dilutional anemia during elective coronary arterial bypass graft surgery (CABG).</p><p><strong>Methods:</strong> The prospective observational study involved patients who underwent cerebral rSO<sub>2</sub> monitoring by NIRS during elective isolated first-time CABG: an anemic group (<em>N</em>=15) (minimum Hemoglobin (Hb) N=15) (Hb &gt;8 g/dL during CPB). Mean arterial pressure (MAP), pump blood flow, blood lactate level, pCO<sub>2</sub>, pO<sub>2</sub> at five time points and cross-clamp time, extracorporeal circulation time were recorded for each patient. Group results statistically were compared.</p><p><strong>Results:</strong> The anemic group had significantly lower mean preoperative Hb than the control group (10.3 mg/dL versus 14.2 mg/dL; <em>P</em> = .001). The lowest Hb levels were observed in the hypothermic period of CPB in the anemic group. None of the controls exhibited a &gt;20% decrease in cerebral rSO<sub>2</sub>. Eleven (73.3%) of the anemic patients required an increase in pump blood flow to raise their cerebral rSO<sub>2</sub>.</p><p><strong>Conclusions:</strong> In this study, the changes in cerebral rSO<sub>2</sub> in the patients with low Hb were within acceptable limits, and this was in concordance with the blood lactate levels and blood-gas analysis. It can be suggested that NIRS monitoring of cerebral rSO<sub>2</sub> can assist in decision making related to blood transfusion and dilutional anemia during CPB.</p>

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