scholarly journals Oxygen Homeostasis and Mitochondrial Function in COVID-19 and ARDS Patients: The Ultimate Vital Signs

2020 ◽  
Keyword(s):  
Blood Flow ◽  
Real Time ◽  
Mitochondrial Function ◽  
Vital Signs ◽  
The Body ◽  
Oxygen Balance ◽  
Tissue Oxygen ◽  
Microcirculatory Blood Flow ◽  
Oxygen Homeostasis ◽  
Hemoglobin Oxygenation

The leading cause of death from the COVID-19 is the development of Pneumonia and Acute Respiratory Distress Syndrome-ARDS. Advanced physiological monitoring of COVID -19 patients in real time is a missing tool that avoid the optimization of better diagnosis and evaluating the efficacy of the treatment given. As of today, the monitoring of the systemic vital signs provides important information regarding the respiratory and cardiovascular systems including the pulse oximetry that provide data on hemoglobin oxygenation in the macro circulation. Our hypothesis is that the pathophysiology of COVID-19 and ARDS patients includes severe changes in the microcirculatory hemodynamics and cellular disturbances in Tissue and cellular Oxygen Homeostasis. Therefore, we postulate that real time monitoring of mitochondrial NADH redox state and microcirculatory blood flow, volume and hemoglobin oxygenation is the missing information that will affect dramatically the outcome of COVID-19 and ARDS patients. During the last 2 decades we studied the mechanism of blood flow redistribution activated in animal models as well as in patients exposed to total body negative oxygen balance. This mechanism is activated by the sympathetic pathway. This effect is not equal in all organs of the body, namely, in the most vital organs - brain, heart, and adrenal glands oxygen supply is preserved while in the less vital organs (visceral and peripheral organs) hypo perfusion and negative oxygen balance is recorded. In order to evaluate the tissue oxygen homeostasis, we developed a new concept named - LifenLight Score (LLS)TM based on the monitoring of four physiological parameters measured in real time from one of the less vital organs in the body. Our developed device is monitoring mitochondrial function by measuring the NADH auto fluorescence and microcirculatory blood flow, tissue reflectance and hemoglobin oxygenation. In animal model we monitored simultaneously the brain and the small intestine. In patients we used a 3-way Foley catheter introduced to the bladder via the urethra. We found that monitoring the less vital organ could serve as an early warning signal to the development of negative oxygen balance in the body as well as indicate of a recovery process in the improvement of the oxygen balance homeostasis. In conclusion, we hypothesize that using our new monitoring system will be able to detect deterioration process related to hypoxia in COVID-19 and ARDS patients, as well as to monitor improvement in tissue oxygen balance due to various treatments such as exposure to hyperoxia.

SHEDDING LIGHT ON LIFE: OPTICAL ASSESSMENT OF MITOCHONDRIAL FUNCTION AND TISSUE VITALITY IN BIOLOGY AND MEDICINE

2008 ◽  
Vol 01 (01) ◽  
pp. 71-83 ◽  
Author(s):  
AVRAHAM MAYEVSKY
Keyword(s):  
Blood Flow ◽  
Real Time ◽  
Mitochondrial Function ◽  
Foley Catheter ◽  
The Body ◽  
Tissue Blood Flow ◽  
Mitochondrial Activity ◽  
New Device ◽  
Urethral Wall

The involvement of mitochondrial dysfunction in various pathophysiological conditions, developed in experimental and clinical situations, is widely documented. Nevertheless, real time monitoring of mitochondrial function In-vivo is very rare. The pressing question is how the mitochondria of intact tissues behave under In-vivo conditions as compared to isolated mitochondria that had been described by Chance and Williams over 50 years ago. This subject has been recently discussed in detail (Mayevsky and Rogatsky 2007). We reviewed the subject of evaluating mitochondrial function by monitoring NADH fluorescence together with microcirculatory blood flow, Hemoglobin oxygenation and tissue reflectance. These 4 parameters represent the vitality of the tissue and could be monitored in vivo, using optical spectroscopy, in animal models as well as in clinical practice. It is a well known physiological hypothesis that, under emergency conditions, the sympathetic nervous system will give preference to the most vital organs in the body, namely the brain, heart and adrenal glands. The less vital organs, such as the skin, GI-tract, and Urethral wall, will become hypoperfused and their mitochondrial activity will be inhibited. The monitoring of the less vital organs may reveal critical tissue conditions that may manifest an early phase of body deterioration. The aim of the current presentation is to review the experimental and preliminary clinical results accumulated using a new integrated medical device – the "CritiView" which enabled, for the first time, monitoring 4 parameters from the tissue using a single optical probe. The CritiView is a computerized optical device that integrates hardware and software in order to provide real time information on tissue vitality. In preliminary clinical testing, we used a 3-way Foley catheter that includes a bundle of optical fibers enabling the monitoring of the 4 parameters, representing the vitality of the urethral wall (a less vital organ).We found that the exposure of patients to metabolic imbalances in the operation room led to changes in tissue blood flow and inhibition of mitochondrial function in the urethral wall. In conclusion, the new device "CritiView" could provide reliable, real time data on mitochondrial function and tissue vitality in experimental animals as well as in patients.

scholarly journals Hypotension during Fluid-restricted Abdominal Surgery

2011 ◽  
Vol 114 (3) ◽  
pp. 557-564 ◽  
Author(s):  
Luzius B. Hiltebrand ◽  
Eliana Koepfli ◽  
Oliver Kimberger ◽  
Gisli H. Sigurdsson ◽  
Sebastian Brandt
Keyword(s):  
Blood Flow ◽  
Abdominal Surgery ◽  
Oxygen Tension ◽  
Intestinal Tract ◽  
Tissue Oxygen Tension ◽  
Control Group ◽  
Tissue Oxygen ◽  
Microcirculatory Blood Flow ◽  
Intestinal Tissue ◽  
Doppler Flowmetry

Background Vasopressors, such as norepinephrine, are frequently used to treat perioperative hypotension. Increasing perfusion pressure with norepinephrine may increase blood flow in regions at risk. However, the resulting vasoconstriction could deteriorate microcirculatory blood flow in the intestinal tract and kidneys. This animal study was designed to investigate the effects of treating perioperative hypotension with norepinephrine during laparotomy with low fluid volume replacement. Methods Twenty anesthetized and ventilated pigs were randomly assigned to a control or treatment (norepinephrine) group. Both groups received 3 ml · kg⁻¹ · h⁻¹ Ringer's lactate solution. In addition, the norepinephrine group received norepinephrine to stepwise increase blood pressure to 65 and 75 mmHg. Regional blood flow was measured in the splanchnic arteries. In the small bowel and colon, microcirculatory blood flow was measured using laser Doppler flowmetry. Intestinal tissue oxygen tension was measured with intramural Clark-type electrodes. Results Hepatosplanchnic and kidney blood flow remained unchanged after reversal of arterial hypotension to a mean arterial pressure of 75 mmHg with norepinephrine. For the norepinephrine group versus the control group, the mean ± SD microcirculatory blood flow in the jejunum (96 ± 41% vs. 93 ± 18%) and colon (98 ± 19% vs. 97 ± 28%) and intestinal tissue oxygen tension (jejunum, 45 ± 13 vs. 43 ± 5 mmHg; colon, 50 ± 10 vs. 45 ± 8 mmHg) were comparable. Conclusions In this model of abdominal surgery in which clinical conditions were imitated as close as possible, treatment of perioperative hypotension with norepinephrine had no adverse effects on microcirculatory blood flow or tissue oxygen tension in the intestinal tract.

Mitochondrial function in vivo evaluated by NADH fluorescence: from animal models to human studies

2007 ◽  
Vol 292 (2) ◽  
pp. C615-C640 ◽  
Author(s):  
Avraham Mayevsky ◽  
Gennady G. Rogatsky
Keyword(s):  
Animal Models ◽  
Real Time ◽  
Mitochondrial Function ◽  
The Body ◽  
Patient Treatment ◽  
Metabolic State ◽  
Experimental Conditions ◽  
Fluorescence Measurements ◽  
Nadh Fluorescence

Normal mitochondrial function is a critical factor in maintaining cellular homeostasis in various organs of the body. Due to the involvement of mitochondrial dysfunction in many pathological states, the real-time in vivo monitoring of the mitochondrial metabolic state is crucially important. This type of monitoring in animal models as well as in patients provides real-time data that can help interpret experimental results or optimize patient treatment. The goals of the present review are the following: 1) to provide an historical overview of NADH fluorescence monitoring and its physiological significance; 2) to present the solid scientific ground underlying NADH fluorescence measurements based on published materials; 3) to provide the reader with basic information on the methodologies used in the past and the current state of the art fluorometers; and 4) to clarify the various factors affecting monitored signals, including artifacts. The large numbers of publications by different groups testify to the valuable information gathered in various experimental conditions. The monitoring of NADH levels in the tissue provides the most important information on the metabolic state of the mitochondria in terms of energy production and intracellular oxygen levels. Although NADH signals are not calibrated in absolute units, their trend monitoring is important for the interpretation of physiological or pathological situations. To understand tissue function better, the multiparametric approach has been developed where NADH serves as the key parameter. The development of new light sources in UV and visible spectra has led to the development of small compact units applicable in clinical conditions for better diagnosis of patients.

scholarly journals MOBILE APPLICATION SISTEM MONITORING KONDISI PASIEN SERANGAN JANTUNG BERBASIS GOOGLE MAPS DAN ANDROID

2017 ◽  
Vol 4 (2) ◽  
pp. 146
Author(s):  
Musfirah Putri Lukman ◽  
Hendra Surasa
Keyword(s):  
Web Service ◽  
Real Time ◽  
Vital Signs ◽  
Heart Association ◽  
The Body ◽  
Google Maps ◽  
Recurrent Attack ◽  
Heart Attacks ◽  
Phone Calls ◽  
The Right

<p><em>Many people with heart disease who do not detect recurrent heart attacks because they do not feel chest pain, shortness of breath and cold sweat. Recorded 45% of cases in the journal Circulation America Heart Association published heart attacks that did not start with symptoms to make deaths due to heart triples. Therefore, continuous monitoring of vital signs of the body such as heart rate, breathing frequency and body temperature, especially for fast, slow and unnecessary activity functions need to reduce the risk of paralysis, coma, and even death.</em></p><p><em>The method used in mobile applications based on Google Maps and android uses a waterfall model. This application is designed with the purpose of protecting patients, especially with elderly risk factors from sudden death at the location of recurrent heart attacks by identifying the functional abnormalities of the body's vital activity in real-time that alarm the family against the alarm signals that occur in patients. A monitoring system using a microcontroller and sensors mounted on the patient will send the location of a recurrent attack of the patient with the help of google maps technology and the value of the body's vital tool will be displayed on the smartphone screen without limitation of location, distance, and time. Applications built with java programming language, and using web service and MySQL for database.</em></p><p><em>The results of this study the application has been able to display the parameter values measured by the right and can display the location of the occurrence of recurrent attacks of the heart. Techno-biomedical devices with GPS technology can also provide a quick response to the initial rescue handling of patients who suddenly experience recurrent attacks by sending alarm alerts as alarms in the form of phone calls.</em></p><p><strong><em>Keywords:</em></strong> <em>Application, Monitoring, Heart, breath and temperature</em></p><p><em>Banyak penderita penyakit jantung yang tidak mendeteksi terjadinya serangan jantung berulang sebab tidak merasakan nyeri dada, napas yang pendek dan keringat dingin. Tercatat 45% kasus dalam jurnal Circulation terbitan America Heart Association serangan jantung yang tidak diawali dengan gejala membuat kematian akibat jantung meningkat tiga kali lipat. Oleh sebab itu perlu pemantauan berkelanjutan terhadap tanda vital tubuh seperti detak jantung, frekuensi nafas dan suhu tubuh penderita khususnya untuk fungsi aktivitas yang telalu cepat, terlalu lambat dan tidak ada perlu untuk mengurangi resiko kelumpuhan, pasien koma, bahkan kematian.</em></p><p><em>Metode yang digunakan pada </em><em>aplikasi mobile berbasis Google Maps dan android ini </em><em>menggunakan model waterfall. </em><em>Aplikasi ini dirancang dengan tujuan melindungi penderita terutama dengan faktor resiko lansia dari kematian mendadak pada lokasi serangan jantung berulang dengan mengidentifikasi kelainan fungsi aktivitas vital tubuh secara real-time yang menjadi alarm bagi keluarga terhadap tanda bahaya yang terjadi pada penderita. Sebuah sistem monitoring menggunakan mikrokontroller dan sensor yang dipasang pada penderita akan mengirimkan lokasi serangan berulang penderita dengan bantuan teknologi google maps dan nilai alat vital tubuh akan ditampilkan pada layar smartphone </em><em>tanpa batasan lokasi, jarak, dan waktu</em><em>. Aplikasi </em><em>dibangun dengan bahasa pemrograman java, dan menggunakan web service serta MySQL untuk basis data.</em><em></em></p><p><em>Hasil dari penelitian ini aplikasi telah mampu menampilkan nilai parameter yang diukur oleh dengan tepat dan dapat menampilkan lokasi terjadinya serangan berulang jantung. </em><em> Perangkat tekno-biomedik dengan teknologi GPS juga dapat memberikan respon cepat terhadap penanganan penyelamatan awal terhadap penderita yang tiba-tiba mengalami serangan berulang dengan mengirimkan tanda bahaya sebagai alarm</em><em> dalam bentuk panggilan telepon</em><em>.</em></p><p><em><em><strong>Keywords</strong></em><em>: Aplikasi, Monitoring, Jantung, Nafas dan Suhu</em><br /></em></p>

scholarly journals Goal-directed Colloid Administration Improves the Microcirculation of Healthy and Perianastomotic Colon

2009 ◽  
Vol 110 (3) ◽  
pp. 496-504 ◽  
Author(s):  
Oliver Kimberger ◽  
Michael Arnberger ◽  
Sebastian Brandt ◽  
Jan Plock ◽  
Gisli H. Sigurdsson ◽  
...  
Keyword(s):  
Blood Flow ◽  
Oxygen Tension ◽  
Fluid Therapy ◽  
Group Versus ◽  
Tissue Oxygen Tension ◽  
Colon Anastomosis ◽  
Tissue Oxygen ◽  
Microcirculatory Blood Flow ◽  
Crystalloid Fluid ◽  
Group 3

Background The aim of this study was to compare the effects of goal-directed colloid fluid therapy with goal-directed crystalloid and restricted crystalloid fluid therapy on healthy and perianastomotic colon tissue in a pig model of colon anastomosis surgery. Methods Pigs (n = 27, 9 per group) were anesthetized and mechanically ventilated. A hand-sewn colon anastomosis was performed. The animals were subsequently randomized to one of the following treatments: R-RL group, 3 ml x kg(-1) x h(-1) Ringer lactate (RL); GD-RL group, 3 ml x kg(-1) x h(-1) RL + bolus 250 ml of RL; GD-C group, 3 ml x kg(-1) x h(-1) RL + bolus 250 ml of hydroxyethyl starch (HES 6%, 130/0.4). A fluid bolus was administered when mixed venous oxygen saturation dropped below 60%. Intestinal tissue oxygen tension and microcirculatory blood flow were measured continuously. Results After 4 h of treatment, tissue oxygen tension in healthy colon increased to 150 +/- 31% in group GD-C versus 123 +/- 40% in group GD-RL versus 94 +/- 23% in group R-RL (percent of postoperative baseline values, mean +/- SD; P &lt; 0.01). Similarly perianastomotic tissue oxygen tension increased to 245 +/- 93% in the GD-C group versus 147 +/- 58% in the GD-RL group and 116 +/- 22% in the R-RL group (P &lt; 0.01). Microcirculatory flow was higher in group GD-C in healthy colon. Conclusions Goal-directed colloid fluid therapy significantly increased microcirculatory blood flow and tissue oxygen tension in healthy and injured colon compared to goal-directed or restricted crystalloid fluid therapy.

Real-Time Data Acquisition System for Remote Vital Sign

2013 ◽  
Vol 333-335 ◽  
pp. 442-446
Author(s):  
Ru Xue ◽  
Zong Sheng Wu ◽  
Mei Yun Shao
Keyword(s):  
Data Acquisition ◽  
Real Time ◽  
Remote Monitoring ◽  
Vital Sign ◽  
Vital Signs ◽  
Data Acquisition System ◽  
The Body ◽  
Acquisition System ◽  
Time Data ◽  
Monitoring Center

A data acquisition system for remote vital sign is designed. The system detect humans vital signs through the body temperature, blood pressure and pulse sensors ,and transmit them to the microprocessor after processing, then the microprocessor send the data to remote monitoring center on receiving the instruction .The monitoring center analysis the data and decide what and how to do. The monitoring centers can response various change of data rapidly and implement real-time rescue guide according to different situations.

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