Oxygen-Helium Gas Mixture «Heliox» for the Treatment of Respiratory Failure in Patients with New Coronavirus Infection Covid-19 (Randomized Single-Center Controlled Trial)

Introduction. Treatment of respiratory failure in pneumonia caused by coronavirus infection (COVID-19) is still an unsolved problem that requires a comprehensive approach and the development of new methods that expand the range of possibilities of modern therapy. There is evidence that the heated oxygenhelium mixture has a positive effect on gas exchange in the infiltration zone by improving both ventilation and diffusion.AIM of study. To evaluate the effectiveness of the inclusion of a heated oxygen-helium mixture HELIOX (70% Helium/ 30% Oxygen) in the complex intensive care of respiratory failure of pneumonia caused by SARS-CoV-2 infection.Material and methods. The study included 60 patients with confirmed viral pneumonia caused by COVID-19. The patients were randomized into two groups: group 1 (n=30) — patients who were treated with the standard COVID-19 treatment protocol with the heated oxygen-helium mixture HELIOX, and group 2 (control) (n=30) — patients who received standard therapy. Lethality was studied for 28 days, the time in days until a steady increase in SpO2>96% was achieved when breathing atmospheric air; the time until the patient is transferred from the intensive care unit (ICU) to the general department.Results. Inhalation of the HELIOX mixture (70% Helium / 30% Oxygen) resulted in a faster recovery of the hemoglobin oxygen saturation index (SpO2). Starting from day 3, these differences became statistically significant. The time in days from inclusion in the study to a persistent increase in the degree of oxygen saturation of hemoglobin (SpO2>96%) when breathing atmospheric air in the group with inhalation of the HELIOX mixture was less — 8 (7; 10), compared to 10 (8;13) in the control group (p=0.006). In the group with inhaled HELIOX mixture, the median treatment time in the ICU was 8 (7; 9.5) days vs 13 (8; 17) days (p<0.001) in the comparison group.Conclusions. Inhalation of the HELIOX mixture (70% Helium / 30% Oxygen) led to a faster recovery of the hemoglobin oxygen saturation index SpO2, which contributed to reduction in the duration of oxygen therapy and a decrease in mortality.

Multi-parametric characterization of brain-wide hemodynamic and calcium responses to sensory stimulation in mice

Modern optical neuroimaging approaches are expanding our ability to elucidate complex brain function. Diverse imaging contrasts enable direct observation of neural activity with functional sensors along with the induced hemodynamic responses. To date, decoupling the complex interplay of neurovascular coupling and dynamical physiological states has remained challenging when employing single-modality functional neuroimaging tools. We devised a hybrid fluorescence optoacoustic tomography (FLOT) platform combined with a custom data processing pipeline based on statistical parametric mapping, accomplishing the first simultaneous noninvasive observation of both direct and indirect brain-wide activation patterns with optical contrast. Correlated changes in the oxy- and deoxygenated hemoglobin, total hemoglobin, oxygen saturation and rapid GCaMP6f fluorescence signals were observed in response to peripheral sensory stimulation. While the concurrent epifluorescence served to corroborate and complement the functional optoacoustic observations, the latter further aided in decoupling the rapid calcium responses from the slowly varying background in the fluorescence recordings mediated by hemodynamic changes. The hybrid imaging platform expands the capabilities of conventional neuroimaging methods to provide more comprehensive functional readings for studying neurovascular and neurometabolic coupling mechanisms and related diseases.

Determination of the Minimum Infusion Rate of Alfaxalone Combined with Electroacupuncture in Goats

Total intravenous anesthesia (TIVA) is increasingly used in companion animals. The effect of electroacupuncture (EA) on alfaxalone-based TIVA has not been previously reported in goats. Therefore, the objective of this study was to determine the minimum infusion rate (MIR) of alfaxalone required to prevent purposeful movement of the extremities in response to standardized noxious stimulation during its combination with EA in goats. Twelve clinically healthy goats weighing 18.5 ± 2 kg were randomly assigned to two groups (six goats/group). Alfaxalone alone (ALF group) and alfaxalone combined with EA (EA-ALF group). In the EA-ALF, alfaxalone was administered 30 min after EA stimulation. For induction of anesthesia, a bolus of alfaxalone was given at 3 mg/kg IV, and an infusion dose of 9.6 mg/kg/h was initially set for maintenance. The MIR of alfaxalone in both groups was determined by testing for responses to stimulation (clamping on a digit with Vulsellum forceps) at 10-min intervals after induction of anesthesia till the entire period of the experiment. Cardiopulmonary parameters and nociceptive threshold were measured throughout anesthesia. The median alfaxalone MIR was significantly lower in the EA-ALF group than the ALF group [9 (4.8–9.6) and 12 (11.4–18)], respectively; p = 0.0035). In the ALF group, goats anesthetized with MIR showed a significant increase in heart rate and cardiac output (p < 0.0001 and 0.0312, respectively), and decrease in respiratory rate (p < 0.0001), hemoglobin oxygen saturation (p = 0.0081), and rectal temperature (p = 0.0046) compared with those in the EA-ALF. Additionally, goats in the EA-ALF showed a higher nociceptive threshold than those in the ALF group (p < 0.0001). EA provided analgesia, reduced the MIR of alfaxalone-based IV anesthesia and thereby alleviated the adverse cardiorespiratory effects associated with alfaxalone anesthesia in goats.

Intraoperative Control of Hemoglobin Oxygen Saturation in the Intestinal Wall during Anastomosis Surgery

During surgery for colon cancer, monitoring of the oxygen saturation of hemoglobin in the tissues under study makes it possible to assess the degree of blood supply to the anastomosis areas of the colon. Adequate blood supply in this area is decisive in terms of the consistency of the anastomosis and can significantly reduce the risk leakage of anastomosis. In this work, we propose a new approach to assessing the hemoglobin oxygen saturation based on measuring both the diffuse reflectance and transmittance spectra of the colon wall tissues. The proposed method is based on the use of two fiber-optic tools for irradiation from both sides—the intestinal lumen and the outside of the intestinal wall. The spectra are recorded from the external side. To determine the degree of hemoglobin saturation, two algorithms, both based on the Taylor series expansion of the coefficient of light attenuation by tissues, are proposed. The results of a clinical study of the proposed approach on volunteers were obtained, allowing to draw a conclusion about the applicability of the approach in a clinical setting.

Efficacy of hyperbaric oxygenation in the complex treatment of new coronavirus infection COVID-19

Purpose of the study: evaluation of the therapeutic effectiveness of hyperbaric oxygenation in the complex treatment of a new coronavirus infection – COVID-19. Materials and Methods: we studied 190 patients with COVID-19-induced pneumonia (mean age 52.2 ± 2.3 years), the study group (95 patients; 41 women, 54 men) received against the background of complex treatment courses of hyperbaric oxygenation № 3-5; at pressure 1.3-1.4 ATA for 40-60 minutes; comparison group (n = 95; 42 women; 53 men) received standard complex treatment. The concomitant diseases in most patients were: arterial hypertension (stage I-II), obesity (stage II-IV) and type 2 diabetes mellitus. Results: a more pronounced therapeutic effect was noted in the main group of patients: only 3 patients were admitted to the intensive care unit, while in the comparison group – 10 patients, 2 of whom died. The presented data suggest that the use of HBO can quickly achieve correction of hypoxia in patients with new coronavirus infection, improve lung function, as well as improve the course of related diseases, including symptoms related to gastrointestinal pathology, cardiovascular disease, mental conditions, etc., affecting the body as a biostimulant. Conclusion: hyperbaric oxygenation in patients with new coronavirus infection caused by SARS-CoV-2 virus is an effective method and has a multifactorial effect leading both to improvement of subjective state parameters of the examined patients and to increase of hemoglobin oxygen saturation, decrease of lipid peroxidation processes intensity, activation of antioxidant system of the body, restoration of pro- and antioxidants balance, normalization of apoptosis processes.

Lipid Emulsion And Isoflurane: The Quality Assessment of Anesthesia Parameters In Pigeons

An objective was to evaluate the efficacy of intravenous (IV) emulsified isoflurane formulation for maintenance of general anesthesia and to compare with IV lipid emulsion infusion with inhalation isoflurane in pigeons. The animals was total of 21 healthy, mature pigeons (Columba livia domestica), weighing 318 ± 13 g. Pigeons were anesthetized by emulsified isoflurane (treatment IΙΙ), inhalation isoflurane with IV lipid emulsion (treatment ΙΙ ), and inhalation isoflurane (treatment Ι) alone. Over 50 minutes, wing tone, toe pinch (pedal), and feather pluck reflex were tested every 10 minutes. Data was recorded at 10, 20 and 30 minutes for temperature (T), peripheral hemoglobin oxygen saturation (SpO2) heart rate (HR), and respiratory rate (fR). A scoring system was used to assess parameters related to anesthesia duration and depth. There were no significant differences in hemodynamic variables between the treatment Ι and treatments ΙΙ and IΙΙ, in treatments associated with fat emulsion have shown faster induction, longer anesthesia, more immobilization, and longer recovery time. Furthermore, in anesthesia depth percentages evaluation it was observed that emulsified isoflurane entered the anesthesia deep stage earlier and was removed immediately after discontinuation of administration.Administration of 8% v/v emulsified isoflurane IV was effective in anesthesia rapid induction, stability in depth of anesthesia, rapid withdrawal from anesthesia depth by discontinuation of the infusion, delayed recovery, cardiorespiratory and (T) stability.

Surgical component of lateral and central breast cancer treatment

Aim. To improve the results of the surgical component in the treatment of a nodular form of breast cancer with lateral and central localization by analyzing hemoglobin oxygen saturation of arterial blood in the foci of breast cancer, regional lymph nodes and resection line of the breast. Methods. The study involved 175 patients with a nodular form of breast cancer with lateral and central localization (T23N12M0), including 86 in the main group and 89 in the comparison group. In the main group, hemoglobin oxygen saturation in arterial blood of the foci of breast cancer, parenchyma, pectoral muscles and regional lymph nodes was examined for spread of cancer during surgery for nodular breast cancer by using a device developed by us (patent RU 2581266). This examination was not performed in the comparison group. Histopathological examination of resection specimens revealed confirmation of the main foci of breast cancer and the presence of metastases in the regional lymph nodes and pectoral muscles of the breast. Statistical analysis of the data was performed by using the Statistica 10 software. The arithmetic mean, the standard error of the mean and the standard deviation were calculated for the quantitative indicators. Results. In the main group, 86 patients had no recurrence and metastases in the follow-up, while in the comparison group, cancer recurrence was identified in 89 patients and metastases was found during cytological and histological studies in 9 patients. Conclusion. Determination of hemoglobin oxygen saturation of arterial blood during surgery in the subclavian, axillary and subscapular lymph nodes as well as in the pectoralis major and minor muscles allows clarifying the distribution of breast cancer, specifying the scope of the operation and improving the results of the surgical component of breast cancer treatment (T23N12M0).

Acute normobaric hypoxia does not increase blood or plasma viscosity

BACKGROUND: It has previously been reported that chronic hypoxia increases blood viscosity. The increase is usually attributed to polycythemia-induced increases in hematocrit. However, the effect of acute hypoxia in humans on blood viscosity is unknown. OBJECTIVE: Therefore, the purpose of this study was to determine the effect of acute hypoxia, independent of changes in hematocrit, on blood and plasma viscosity. METHODS: Nine healthy volunteers breathed room air for 30 min, followed by 30 min of breathing 15% oxygen. Blood samples were collected at the end of both the normoxic and hypoxic conditions. Blood viscosity, plasma viscosity, and hematocrit were measured in each sample. RESULTS: The mean±SD hemoglobin oxygen saturation significantly (P < 0.05) decreased from 98±1% during normoxia to 87±2% during hypoxia. Hematocrit was essentially identical for the two conditions (42.1% vs. 42.0%). Blood viscosity was not significantly different for the two conditions with a mean of 2.89±0.17 cP during normoxia and 2.83±0.19 cP during hypoxia. Likewise, plasma viscosity was not significantly different for the two conditions with a mean of 1.19±0.04 cP during normoxia and 1.19±0.05 cP during hypoxia. CONCLUSION: Such results suggest that acute normobaric hypoxia, independent of changes in hematocrit, does not increase blood or plasma viscosity.

The Effect of Xylazine Premedication on the Dose and Quality of Anesthesia Induction with Alfaxalone in Goats

Goats have been used as animal models in research and are increasingly kept as companion animals. However, information about effective anesthetic drugs is scarce in this species. The objective of this study was to evaluate the effect of xylazine premedication on alfaxalone induction. Twelve clinically healthy goats weighing 18.5 ± 2 kg were randomly assigned to two groups. Induction was performed with alfaxalone alone intravenously (ALF group) or with xylazine premedication before alfaxalone administration (XYL-ALF group). The quality of induction was scored, induction doses of alfaxalone were determined, and cardiorespiratory parameters and nociceptive thresholds were measured before any treatment(s) (baseline) and at 5, 15, 25 and 35 min after alfaxalone administration. The mean dose of alfaxalone required for induction in the ALF group was greater than that in the XYL-ALF group (p < 0.001). There were no significant changes in diastolic arterial pressure (DAP), mean arterial pressure (MAP) or systolic arterial pressure (SAP) compared to baseline in either group, while hemoglobin oxygen saturation (SpO2) was lower from 5 to 25 min (p < 0.5) in the XYL-ALF group. The nociceptive threshold was significantly higher at 5 min in the XYL-ALF group than in the ALF group (p = 0.0417). Xylazine premedication reduced the required dose of alfaxalone for anesthetic induction and produced better antinociception than alfaxalone alone. In addition, the combination of xylazine and alfaxalone allowed for successful induction; however, oxygen supplementation is necessary to counteract xylazine-associated hypoxemia.