scholarly journals Characteristics of Patients With Cardiorespiratory Instability in a Step-down Unit

2012 ◽  
Vol 21 (5) ◽  
pp. 344-350 ◽  
Author(s):  
Khalil Yousef ◽  
Michael R. Pinsky ◽  
Michael A. DeVita ◽  
Susan Sereika ◽  
Marilyn Hravnak
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Oxygen Saturation ◽  
Charlson Comorbidity Index ◽  
Comorbid Condition ◽  
Surgical Trauma ◽  
Trauma Patients ◽  
Comorbidity Index ◽  
Step Down ◽  
Prospective Longitudinal

Background Patients in step-down units are at higher risk for developing cardiorespiratory instability than are patients in general care areas. A triage tool is needed to identify at-risk patients who therefore require increased surveillance. Objectives To determine demographic (age, race, sex) and clinical (Charlson Comorbidity Index at admission, admitting diagnosis, care area of origin, admission service) differences between patients in step-down units who did and did not experience cardiorespiratory instability. Methods In a prospective longitudinal pilot study, 326 surgical-trauma patients had continuous monitoring of heart rate, respirations, and oxygen saturation and intermittent noninvasive measurement of blood pressure. Cardiorespiratory instability was defined as heart rate less than 40/min or greater than 140/min, respirations less than 8/min or greater than 36/min, oxygen saturation less than 85%, or blood pressure less than 80 or greater than 200 mm Hg systolic or greater than 110 mm Hg diastolic. Patients’ status was classified as unstable if their values crossed these thresholds even once during their stay. Results Cardiorespiratory instability occurred in 34% of patients. The Charlson Comorbidity Index was the only variable associated with instability conditions. Compared with patients with no comorbid conditions (50%), more patients with at least 1 comorbid condition (66%) experienced instability (P = .006). Each 1-unit increase in the Charlson Index increased the odds for cardiorespiratory instability by 1.17 (P = .03). Conclusion Although the relationship between Charlson Comorbidity Index and cardiorespiratory instability was weak, adding it to current surveillance systems might improve detection of instability.

The Effects of Passive and Active Smoking on Brachial and radial Blood Pressure and Some Other Physical Factors in Healthy Young Adults

2017 ◽  
Vol 5 (3) ◽  
pp. 259
Author(s):  
Shireen H. Ramadhan ◽  
Shamil K. Talal ◽  
Wasfiya A. Moner
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Oxygen Saturation ◽  
Oxygen Concentration ◽  
Tobacco Smoke ◽  
Blood Pressure Measurement ◽  
Reference Level ◽  
Physical Factors ◽  
New Device ◽  
Active Smoker

Tobacco smoke is enormously harmful to human health, there’s no safe way to smoke. The primary objective of this study is to analyze the role of tobacco smoke compounds and their ability to damage the cardiovascular system and, in particular, to interfere with blood pressure (Brachial and radial pressure), heart rate and partly on the percentage blood Oxygen saturation. A new device has been manufactured which is unique for measuring the level of smoke, to obtained privies readings, the device had fixed to the first reference level آ and starting up from it. The effect of smoking has been studied on (26) male passive (26) active smoker volunteer, (14) female passive and (14) female active smoker participants. The results has been showed that the blood pressure and heart rate has been increased with increasing the number of cigarettes in both genders for passive and active smokers. However, this effect for male was more pronounced comparing with females for passive and active smokers. In the case of oxygen saturation concentration percentage, for males the change of oxygen concentration percentage was not stable. In other words, it was fluctuated with the number of cigarettes. But for females the oxygen concentration was decreased but not too much. This means that this effect was not pronounced. this study found آ that the most pronounced effect has been shown by male’s comparison to females for both passive and active smokers. As well as in nonsmoker’s males, the relation between heart rate and smoke level is inversely proportional. While in male and female smokers and female nonsmokers the relation is proportional. In all cases the relation between the smoke level and time of smoking is inversely proportional. Finally males& females are affected differently by tobacco use; the sensitivities to smoke for males are higher than in females for passive and active smokers in both brachial and radial blood pressure measurement.

One hour effects of salbutamol and formoterol on blood pressure, heart rate and oxygen saturation in asthmatics

2008 ◽  
Vol 14 (3) ◽  
pp. 353-361
Author(s):  
Geraldo Andrade Capuchinho-Júnior ◽  
Ricardo Marques Dias ◽  
Sônia Regina da Silva de Carvalho
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Oxygen Saturation

scholarly journals Autonomic modulation at rest and in response to postural change in adolescents with Duchenne muscular dystrophy: a cross-sectional study

2021 ◽  
Vol 79 (9) ◽  
pp. 766-773
Author(s):  
Mariana Viana Rodrigues ◽  
Mileide Cristina Stoco-Oliveira ◽  
Talita Dias da Silva ◽  
Celso Ferreira ◽  
Heloisa Balotari Valente ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Duchenne Muscular Dystrophy ◽  
Muscular Dystrophy ◽  
Oxygen Saturation ◽  
Cross Sectional Study ◽  
Control Group ◽  
Autonomic Modulation ◽  
Postural Change ◽  
Cross Sectional

ABSTRACT Background: Analysis of autonomic modulation after postural change may inform the prognosis and guide treatment in different populations. However, this has been insufficiently explored among adolescents with Duchenne muscular dystrophy (DMD). Objective: To investigate autonomic modulation at rest and in response to an active sitting test (AST) among adolescents with DMD. Methods: Fifty-nine adolescents were included in the study and divided into two groups: 1) DMD group: adolescents diagnosed with DMD; 2) control group (CG): healthy adolescents. Participants’ weight and height were assessed. Lower limb function, motor limitations and functional abilities of the participants in the DMD group were classified using the Vignos scale, Egen classification and motor function measurement, respectively. The following variables were assessed before, during and after AST: systolic blood pressure (SBP), diastolic blood pressure (DBP), respiratory rate (f), oxygen saturation and heart rate (HR). To analyze the autonomic modulation, the HR was recorded beat-by-beat. Heart rate variability (HRV) indices were calculated in the time and frequency domains. Results: Differences in relation to groups were observed for all HRV indices, except LF/HF, oxygen saturation, HR and f (p < 0.05). Differences in relation to time and the interaction effect between group and time were observed for RMSSD, SD1, SD2, SD1/SD2, LFms2 and LFnu, HFun, SBP and DBP (p < 0.05). Differences in relation to time were also observed for the indice SDNN, FC and f (p < 0.05). Conclusions: Performing the AST promoted reduced autonomic modulation and increased SBP, DBP and HR in adolescents with DMD.

scholarly journals Prognosis of COVID-19 Pneumonia Can Be Early Predicted Combining Age-Adjusted Charlson Comorbidity Index, CRB Score and Baseline Oxygen Saturation.

2021 ◽  
Author(s):  
Pilar Nuevo-Ortega ◽  
Carmen Reina-Artacho ◽  
Francisco Dominguez-Moreno ◽  
Victor Manuel Becerra-Muñoz ◽  
Luis Ruiz-Del-Fresno ◽  
...  
Keyword(s):  
Oxygen Saturation ◽  
Charlson Comorbidity Index ◽  
Severe Disease ◽  
Hospital Environment ◽  
Severe Illness ◽  
Comorbidity Index ◽  
Clinical Tools ◽  
Discharge From Hospital ◽  
Statistical Criteria

Abstract Background: In potentially severe diseases in general and COVID-19 in particular, it is vital to early identify those patients who are going to develop complications. The last update of a recent living systematic review dedicated to predictive models in COVID-19,[1] critically appraises 145 models, 8 of them focused on prediction of severe disease and 23 on mortality. Unfortunately, in all 145 models, they found a risk of bias significant enough to finally "not recommend any for clinical use". Authors suggest concentrating on avoiding biases in sampling and prioritising the study of already identified predictive factors, rather than the identification of new ones that are often dependent on the database. Our objective is to develop a model to predict which patients with COVID-19 pneumonia are at high risk of developing severe illness or dying, using basic and validated clinical tools.Methods: prospective cohort of consecutive patients admitted in a teaching hospital during the “first wave” of the COVID-19 pandemic. Follow-up to discharge from hospital. Multiple logistic regression selecting variables according to clinical and statistical criteria. Results: 404 consecutive patients were evaluated, 392 (97%) completed follow-up. Mean age was 61 years; 59% were men. The median burden of comorbidity was 2 points in the Age-adjusted Charlson Comorbidity Index, CRB was abnormal in 18% of patients and basal oxygen saturation on admission lower than 90% in 18%. A model composed of Age-adjusted Charlson Comorbidity Index, CRB score and basal oxygen saturation can predict unfavorable evolution or death with an area under the ROC curve of 0.85 (95% CI: 0.80-0.89), and 0.90 (95% CI: 0.86 to 0.94), respectively.Conclusion: prognosis of COVID-19 pneumonia can be predicted in the out-of-hospital environment using two classic prognostic scales and a pocket pulse oximeter.

Instillation of normal saline before suctioning in patients with pulmonary infections: a prospective randomized controlled trial

1998 ◽  
Vol 7 (4) ◽  
pp. 261-266 ◽  
Author(s):  
MH Ackerman ◽  
DJ Mick
Keyword(s):  
Blood Pressure ◽  
Adverse Effect ◽  
Heart Rate ◽  
Oxygen Saturation ◽  
Normal Saline ◽  
Pulmonary Infection ◽  
Controlled Trial ◽  
Pulmonary Infections ◽  
Randomized Controlled ◽  
Prospective Randomized Controlled Trial

OBJECTIVE: To determine the effect of instillation of normal saline before suctioning on oxygen saturation, heart rate, and blood pressure in patients with pulmonary infections. METHODS: A prospective randomized controlled trial was conducted in the surgical, medical, and burn/trauma ICUs of an academic medical center. Eighteen men and 11 women (mean age = 60 years) receiving mechanical ventilation who met the criteria for pulmonary infection were randomly assigned to 2 groups. One group had instillation of a 5-mL bolus of normal saline before suctioning; the other did not. Suctioning was done as needed during an 8-to 12-hour period. Oxygen saturation, heart rate, and blood pressure were measured noninvasively immediately before and after suctioning, at 1-minute intervals for 5 minutes after suctioning, and at 10 minutes after suctioning. RESULTS: Instillation of normal saline had an adverse effect on oxygen saturation, which worsened over time. Differences in saturation between the 2 groups were significant at 4, 5, and 10 minutes after suctioning. Differences in heart rate and blood pressure were not significant. CONCLUSION: Instillation of normal saline before suctioning has an adverse effect on oxygen saturation and should not be used routinely in patients receiving mechanical ventilation who have pulmonary infection.

scholarly journals The Effect of Live Spontaneous Harp Music on Patients in the Intensive Care Unit

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Ann Marie Chiasson ◽  
Ann Linda Baldwin ◽  
Carrol Mclaughlin ◽  
Paula Cook ◽  
Gulshan Sethi
Keyword(s):  
Blood Pressure ◽  
Intensive Care Unit ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Intensive Care ◽  
Oxygen Saturation ◽  
Respiratory Rate ◽  
Rest Period ◽  
Underlying Mechanism ◽  
To Receive

This study was performed to investigate the effect of live, spontaneous harp music on individual patients in an intensive care unit (ICU), either pre- or postoperatively. The purpose was to determine whether this intervention would serve as a relaxation or healing modality, as evidenced by the effect on patient’s pain, heart rate, respiratory rate, blood pressure, oxygen saturation, and heart rate variability. Each consenting patient was randomly assigned to receive either a live 10-minute concert of spontaneous music played by an expert harpist or a 10-minute rest period. Spontaneous harp music significantly decreased patient perception of pain by 27% but did not significantly affect heart rate, respiratory rate, oxygen saturation, blood pressure, or heart rate variability. Trends emerged, although being not statistically significant, that systolic blood pressure increased while heart rate variability decreased. These findings may invoke patient engagement, as opposed to relaxation, as the underlying mechanism of the decrease in the patients’ pain and of the healing benefit that arises from the relationship between healer, healing modality, and patient.

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