scholarly journals The Effect of the Duration of Pre-Oxygenation before Endotracheal Suction on Hemodynamic Symptoms

2016 ◽  
Vol 9 (2) ◽  
pp. 127
Author(s):  
Hossein Tavangar ◽  
Mostafa Javadi ◽  
Saeed Sobhanian ◽  
Fatemeh Forozan Jahromi
Keyword(s):  
Heart Rate ◽  
Oxygen Saturation ◽  
Arterial Oxygen Saturation ◽  
Repeated Measure ◽  
Arterial Oxygen ◽  
Endotracheal Suctioning ◽  
Endotracheal Suction ◽  
The Mean ◽  
The One ◽  
Clinical Conditions

<p><strong>BACKGROUND:</strong> Hypoxia and hypoxemia are among the most common complications of endotracheal suctioning. These complications are often mitigated by the administration of oxygen 100% prior to endotracheal suction. Although several studies have supported the application of this method, none have yet specified the exact duration of pre-oxygenation required to be performed before endotracheal suction. The present study was therefore conducted to determine the effect of the duration of pre-oxygenation before endotracheal suction on heart rate and arterial oxygen saturation in patients in intensive care units.</p><p><strong>OBJECTIVES:</strong> This prospective clinical trial conducted on 63 eligible ICU patients under mechanical ventilator. Subjects randomly divided into three groups. Pre-oxygenation was carried out for 30 seconds in the first group, for one minute in the second group and for two minutes in the third group. All three groups were then hyper-oxygenated for one minute. Arterial oxygen saturation and heart rate were recorded on different occasions in the three groups. The data obtained were analyzed using the ANOVA, the one-way ANOVA, the post-hoc test and the repeated measure ANOVA.</p><p><strong>RESULTS:</strong> The results obtained showed a greater reduction in the mean O2sat during the suctioning episodes in the 30-second pre-oxygenation group compared to in the one-minute (P=0.046) and two-minute (P=0.001) pre-oxygenation groups. This mean reduction was also observed immediately after suctioning (P=0.001). The mean O2sat was lower in the 30-second pre-oxygenation group than in the one-minute pre-oxygenation group in minutes 5 (P=0.002) and 20 (P=0.001) of the suctioning. Similarly, the mean O2sat was lower in the 30-second pre-oxygenation group than in the two-minute pre-oxygenation group in minutes 5 (P=0.001) and 20 (P=0.001) of the suctioning. The results obtained through the ANOVA showed the lack of significant differences between the three groups in the mean variation in heart rate in the different stages of suctioning.</p><p><strong>CONCLUSIONS:</strong> According to the results obtained, one-minute and two-minute pre-oxygenations cause less disruption in arterial oxygen saturation compared to a 30-second pre-oxygenation. To achieve stability in arterial oxygen saturation and avoid hypoxemia caused by endotracheal suctioning, one-minute or two-minute pre-oxygenation is recommended in ICUs depending on the patient’s clinical conditions.</p>

Psychophysiological Responses of Pilots in Hypoxia Training at 7000 and 7500 m

2020 ◽  
Vol 91 (10) ◽  
pp. 785-789
Author(s):  
Dongqing Wen ◽  
Lei Tu ◽  
Guiyou Wang ◽  
Zhao Gu ◽  
Weiru Shi ◽  
...  
Keyword(s):  
Heart Rate ◽  
Psychomotor Performance ◽  
Physiological Responses ◽  
Arterial Oxygen Saturation ◽  
Arterial Oxygen ◽  
Awareness Training ◽  
Similar Frequency ◽  
Psychophysiological Responses ◽  
The Mean ◽  
Training Protocol

INTRODUCTION: We compared the physiological responses, psychomotor performances, and hypoxia symptoms between 7000 m and 7500 m (23,000 and 24,600 ft) exposure to develop a safer hypoxia training protocol.METHODS: In altitude chamber, 66 male pilots were exposed to 7000 and 7500 m. Heart rate and arterial oxygen saturation were continuously monitored. Psychomotor performance was assessed using the computational task. The hypoxic symptoms were investigated by a questionnaire.RESULTS: The mean duration time of hypoxia was 323.0 56.5 s at 7000 m and 218.2 63.3 s at 7500 m. The 6-min hypoxia training was completed by 57.6% of the pilots and 6.1% of the pilots at 7000 m and at 7500 m, respectively. There were no significant differences in pilots heart rates and psychomotor performance between the two exposures. The Spo2 response at 7500 m was slightly severer than that at 7000 m. During the 7000 m exposure, pilots experienced almost the same symptoms and similar frequency order as those during the 7500 m exposure.CONCLUSIONS: There were concordant symptoms, psychomotor performance, and very similar physiological responses between 7000 m and 7500 m during hypoxia training. The results indicated that 7000-m hypoxia awareness training might be an alternative to 7500-m hypoxia training with lower DCS risk and longer experience time.Wen D, Tu L, Wang G, Gu Z, Shi W, Liu X. Psychophysiological responses of pilots in hypoxia training at 7000 and 7500 m. Aerosp Med Hum Perform. 2020; 91(10):785789.

Two patterns of daily hypoxic exposure and their effects on measures of chemosensitivity in humans

2007 ◽  
Vol 103 (6) ◽  
pp. 1973-1978 ◽  
Author(s):  
Michael S. Koehle ◽  
A. William Sheel ◽  
William K. Milsom ◽  
Donald C. McKenzie
Keyword(s):  
Oxygen Saturation ◽  
Intermittent Hypoxia ◽  
Ventilatory Response ◽  
Arterial Oxygen Saturation ◽  
Arterial Oxygen ◽  
Hypoxic Exposure ◽  
Hypoxic Ventilatory Response ◽  
The Third ◽  
Long Duration ◽  
The Mean

The purpose of this study was to compare chemoresponses following two different intermittent hypoxia (IH) protocols in humans. Ten men underwent two 7-day courses of poikilocapnic IH. The long-duration IH (LDIH) protocol consisted of daily 60-min exposures to normobaric 12% O2. The short-duration IH (SDIH) protocol comprised twelve 5-min bouts of 12% O2, separated by 5-min bouts of room air, daily. Isocapnic hypoxic ventilatory response (HVR) was measured daily during the protocol and 1 and 7 days following. Hypercapnic ventilatory response (HCVR) and CO2 threshold and sensitivity (by the modified Read rebreathing technique) were measured on days 1, 8, and 14. Following 7 days of IH, the mean HVR was significantly increased from 0.47 ± 0.07 and 0.47 ± 0.08 to 0.70 ± 0.06 and 0.79 ± 0.06 l·min−1·%SaO2−1 (LDIH and SDIH, respectively), where %SaO2 is percent arterial oxygen saturation. The increase in HVR reached a plateau after the third day. One week post-IH, HVR values were unchanged from baseline. HCVR increased from 3.0 ± 0.4 to 4.0 ± 0.5 l·min−1·mmHg−1. In both the hyperoxic and hypoxic modified Read rebreathing tests, the slope of the CO2/ventilation plot was unchanged by either intervention, but the CO2/ventilation curve shifted to the left following IH. There were no correlations between the changes in response to hypoxia and hypercapnia. There were no significant differences between the two IH protocols for any measures, indicating that comparable changes in chemoreflex control occur with either protocol. These results also suggest that the two methods of measuring CO2 response are not completely concordant and that the changes in CO2 control do not correlate with the increase in the HVR.

Effect of Oxygen Treatment on Heart Rate after Abdominal Surgery 

1999 ◽  
Vol 90 (2) ◽  
pp. 380-384 ◽  
Author(s):  
Susan Rosenberg-Adamsen ◽  
Claus Lie ◽  
Anne Bernhard ◽  
Henrik Kehlet ◽  
Jacob Rosenberg
Keyword(s):  
Heart Rate ◽  
Abdominal Surgery ◽  
Oxygen Saturation ◽  
Oxygen Therapy ◽  
Arterial Oxygen Saturation ◽  
Arterial Oxygen ◽  
Cardiac Complications ◽  
Oxygen Supplementation ◽  
Unselected Group ◽  
Effect Of Oxygen

Background Cardiac complications are common during the postoperative period and may be associated with hypoxemia and tachycardia. Preliminary studies in high-risk patients after operation have shown a possible beneficial effect of oxygen therapy on arterial oxygen saturation and heart rate. Methods The authors studied the effect of oxygen therapy on arterial oxygen saturation and heart rate in 100 consecutive unselected patients randomly and double blindly allocated to receive air or oxygen therapy between the first and fourth day after major abdominal surgery. Results The median arterial oxygen saturation rate increased significantly from 96% to 99% (P &lt; 0.0001) and the heart rate decreased significantly from 85 beats/min to 81 beats/min (P &lt; 0.0001) during oxygen supplementation compared with air administered by a binasal catheter. The greatest decrease in heart rate occurred in patients with the lowest oxygen saturation or the highest heart rate values before oxygen supplementation. Overall, 73% of this unselected group of patients responded with decreased heart rate during supplemental oxygen therapy. No significant differences in changes in heart rate after oxygen supplementation were found between patients with or without an epidural catheter or between the postoperative day studied. Conclusion Postoperative oxygen therapy increased arterial oxygen saturation and decreased heart rate after uncomplicated abdominal surgery in a consecutive unselected group of patients who received routine postoperative care.

scholarly journals Comparison the Sedation Effect and Satisfaction of Two Combinations, Dexmedetomidine and Fentanyl with Midazolam and Fentanyl, in Patients Undergoing Bronchoscopy

2021 ◽  
Vol 6 (6) ◽  
Author(s):  
Alireza Kamali ◽  
Sepideh Sarkhosh ◽  
Hosein Kazemizadeh
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Oxygen Saturation ◽  
Statistical Tests ◽  
Arterial Oxygen Saturation ◽  
Mean Blood Pressure ◽  
Arterial Oxygen ◽  
P Value ◽  
Double Blind ◽  
Significant Difference

Objectives: The aim of this study was to compare sedative effects of dexmedetomidine and fentanyl with midazolam and fentanyl in patients undergoing bronchoscopy. Methods: This study was a double-blind randomized clinical trial that was performed on 92 patients who referred to Amir al Momenin Hospital in Arak for bronchoscopy and underwent ASA 1 or 2 underlying grading procedure. Patients were randomly divided into two groups of dexmedetomidine and fentanyl (D) midazolam and fentanyl (M). Primary vital signs including hypertension and arterial oxygen saturation were monitored and recorded. Then all patients were injected with 2 μg / kg fentanyl as a painkiller and after 3 minutes 30 μg dexmedetomidine in syringe with code A and midazolam 3 mg in syringe with code B were injected to patients by an anesthesiologist. Then the two groups were compared in terms of pain at injection, conscious relaxation, satisfaction of operation, recovery time, hypotension and arterial oxygen saturation and drug side effects and data were analyzed by using statistical tests. Results: There was no significant difference between the two groups in terms of mean age and sex distribution. According to the results of this study, there was no significant difference between the two groups in mean blood pressure (P-value = 0.6) and mean heart rate (P-value = 0.4) at the time of bronchoscopy, but at 5 and 10 minutes after bronchoscopy there was a significant difference, mean blood pressure and heart rate were significantly lower in dexmedetomidine group. Conclusion: Both dexmedetomidine and midazolam drug groups contributed to the development of stable and sedative hemodynamics and satisfaction in patients undergoing bronchoscopy, however, the dexmedetomidine and fentanyl group showed a significant decrease in blood pressure and heart rate compared to midazolam and fentanyl and a weaker decrease in arterial oxygen saturation, and patients with bronchoscopy were more satisfied in the dexmedetomidine group.

scholarly journals Is pulse oximeter a reliable tool for non-critically ill patients with COVID-19?

2021 ◽  
Author(s):  
Aslıhan Gürün Kaya ◽  
Miraç Öz ◽  
İREM AKDEMİR KALKAN ◽  
Ezgi Gülten ◽  
güle AYDIN ◽  
...  
Keyword(s):  
Oxygen Saturation ◽  
Pulse Oximeter ◽  
Lymphocyte Count ◽  
Arterial Oxygen Saturation ◽  
Arterial Oxygen ◽  
Arterial Blood Gas ◽  
Reactive Protein ◽  
Arterial Blood ◽  
The Difference ◽  
Clinical Conditions

Introduction: Guidelines recommend using a pulse oximeter rather than arterial blood gas (ABG) for COVID-19 patients. However, significant differences can be observed between oxygen saturation measured by pulse oximetry (SpO2) and arterial oxygen saturation (SaO2) in some clinical conditions. We aimed to assess the reliability of pulse oximeter in patients with COVID-19 Methods: We retrospectively reviewed ABG analyses and SpO2 levels measured simultaneously with ABG in patients hospitalized in COVID-19 wards. Results: We categorized total 117 patients into two groups; in whom the difference between SpO2 and SaO2 was 4% (acceptable difference) and >4% (large difference). Large difference group exhibited higher neutrophil count, C-reactive protein, ferritin, fibrinogen, D-dimer and lower lymphocyte count. Multivariate analyses revealed that increased fibrinogen, increased ferritin and decreased lymphocyte count were independent risk factors for large difference between SpO2 and SaO2. The total study group demonstrated the negative bias of 4.02% with the limits of agreement of −9.22% to 1.17%. The bias became significantly higher in patients with higher ferritin, fibrinogen levels and lower lymphocyte count. Conclusion: Pulse oximeters may not be sufficient to assess actual oxygen saturation especially in COVID-19 patients with high ferritin and fibrinogen levels and low lymphocyte count low SpO2 measurements.

Effects of a closed tracheal suction system on ventilatory and cardiovascular parameters

1992 ◽  
Vol 1 (3) ◽  
pp. 57-61 ◽  
Author(s):  
SA Harshbarger ◽  
LA Hoffman ◽  
TG Zullo ◽  
MR Pinsky
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Oxygen Saturation ◽  
Respiratory Rate ◽  
Arterial Oxygen Saturation ◽  
Control Mode ◽  
Arterial Oxygen ◽  
Acid Base ◽  
Suction System ◽  
Repeated Measures Design

OBJECTIVE: To determine whether patients ventilated in the assist-control mode experienced a change in oxygenation, respiratory rate, inspiratory:expiratory ratio, heart rate, blood pressure or acid-base balance when suctioned with a closed tracheal suction system. DESIGN: A quasi-experimental, within-subject, repeated-measures design was used. SUBJECTS: 18 patients ventilated on a fraction of inspired oxygen of 0.47 +/- 0.17 and 2.3 +/- 5.0 cm H2O positive end-expiratory pressure. INTERVENTIONS: Two suction passes were performed, with measurements at baseline, immediately after the first suction pass, immediately before the second suction pass, immediately after the second suction pass, 2 minutes after the second suction pass and 5 minutes after the second suction pass. No hyperoxygenation was used. RESULTS: Significant differences were seen over time for arterial oxygen saturation, respiratory rate and inspiratory:expiratory ratio. Arterial oxygen saturation decreased to less than 90% in four subjects (range 88% to 89%), with a maximum fall of 9%. No significant differences were seen for heart rate, blood pressure, partial pressure of carbon dioxide, bicarbonate, time to nadir (lowest arterial oxygen saturation) or recovery time. CONCLUSIONS: Subjects ventilated in the assist-control mode and suctioned with a closed tracheal suction system did not experience significant changes in cardiovascular or acid-base parameters when suctioned without hyperoxygenation. Although most subjects did not become desaturated, four subjects experienced desaturation at one or more intervals. To prevent desaturation, hyperoxygenation should be used before and after suctioning with a closed tracheal suction system.

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