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Cerebral hypoxemia

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https://www.readbyqxmd.com/read/29344963/refractory-pulmonary-edema-and-upper-body-hypoxemia-during-veno-arterial-extracorporeal-membrane-oxygenation-a-case-for-atrial-septostomy
#1
Amit Prasad, Ali Ghodsizad, Christoph Brehm, Mark Kozak, Michael Körner, Aly El Banayosy, Kai Singbartl
Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) provides mechanical circulatory support for patients with advanced cardiogenic shock, facilitating myocardial recovery and limiting multi-organ failure. In patients with severely limited left ventricular ejection, peripheral VA-ECMO can further increase left ventricular and left atrial pressures (LAP). Failure to decompress the left heart under these circumstances can result in pulmonary edema and upper body hypoxemia, that is, myocardial and cerebral ischemia...
January 18, 2018: Artificial Organs
https://www.readbyqxmd.com/read/29223273/a-79-year-old-woman-with-dyspnea-and-hypoxemia-that-worsened-in-an-upright-position
#2
Tjeerd van der Veer, Johannes C C M In 't Veen, Wijnand K den Dekker, Jelle Miedema
A 79-year-old woman presented to the ED with complaints of gradually worsening exertional dyspnea, dizziness, and chest discomfort. For several weeks she had not been able to perform light household work. The patient's medical history mentioned pulmonary embolism following immobilization (2012), several fractures after trauma, an ischemic cerebral vascular accident (2014), and curative treatment for breast cancer (1995). Her current medication included esomeprazole, clopidogrel, simvastatin, calcium/vitamin D, amitriptyline, and acetaminophen...
December 2017: Chest
https://www.readbyqxmd.com/read/29192867/reduction-of-hyperthermia-in-pediatric-patients-with-severe-traumatic-brain-injury-a-quality-improvement-initiative
#3
Marlina E Lovett, Melissa Moore-Clingenpeel, Onsy Ayad, Nicole O'Brien
OBJECTIVE Severe traumatic brain injury remains a leading cause of morbidity and mortality in the pediatric population. Providers focus on reducing secondary brain injury by avoiding hypoxemia, avoiding hypotension, providing normoventilation, treating intracranial hypertension, and reducing cerebral metabolic demand. Hyperthermia is frequently present in patients with severe traumatic brain injury, contributes to cerebral metabolic demand, and is associated with prolonged hospital admission as well as impaired neurological outcome...
December 1, 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/29191963/competitive-apnea-and-its-effect-on-the-human-brain-focus-on-the-redox-regulation-of-blood-brain-barrier-permeability-and-neuronal-parenchymal-integrity
#4
Anthony R Bain, Philip N Ainslie, Ryan L Hoiland, Otto F Barak, Ivan Drvis, Mike Stembridge, Douglas M MacLeod, Jane McEneny, Benjamin S Stacey, Eduoard Tuaillon, Nicola Marchi, Alexis Fayd'Herbe De Maudave, Zeljko Dujic, David B MacLeod, Damian M Bailey
Static apnea provides a unique model that combines transient hypertension, hypercapnia, and severe hypoxemia. With apnea durations exceeding 5 min, the purpose of the present study was to determine how that affects cerebral free-radical formation and the corresponding implications for brain structure and function. Measurements were obtained before and following a maximal apnea in 14 divers with transcerebral exchange kinetics, measured as the product of global cerebral blood flow (duplex ultrasound) and radial arterial to internal jugular venous concentration differences (a-vD)...
November 30, 2017: FASEB Journal: Official Publication of the Federation of American Societies for Experimental Biology
https://www.readbyqxmd.com/read/29158938/orthodeoxia-without-platypnea-in-hereditary-hemorrhagic-telangiectasia-in-the-presence-of-a-cerebral-abscess-and-multiple-pulmonary-arteriovenous-malformations-unusual-complications-and-transcatheter-endovascular-treatment
#5
Carlos Salazar, Jacky Bruce Blank, Veronica Palmero
Hereditary hemorrhagic telangiectasia is a rare autosomal-dominant condition affecting visceral blood vessel development. Cerebral and most commonly pulmonary arteriovenous malformations are found in the majority of symptomatic patients. The most common complications include embolic strokes and cerebral abscesses, which have been attributed to abnormal vessel communications. Platypnea orthodeoxia is a rare condition that presents dyspnea and oxygen desaturation when adopting an upright position and is relieved on decubitus...
2017: Case Reports in Pulmonology
https://www.readbyqxmd.com/read/29089437/transient-hypoxemia-chronically-disrupts-maturation-of-preterm-fetal-ovine-subplate-neuron-arborization-and-activity
#6
Evelyn McClendon, Daniel C Shaver, Kiera Degener-O'Brien, Xi Gong, Thuan Nguyen, Anna Hoerder-Suabedissen, Zoltán Molnár, Claudia Mohr, Ben D Richardson, David J Rossi, Stephen A Back
Preterm infants are at risk for a broad spectrum of neurobehavioral disabilities associated with diffuse disturbances in cortical growth and development. During brain development, subplate neurons (SPNs) are a largely transient population that serves a critical role to establish functional cortical circuits. By dynamically integrating into developing cortical circuits, they assist in consolidation of intracortical and extracortical circuits. Although SPNs reside in close proximity to cerebral white matter, which is particularly vulnerable to oxidative stress, the susceptibility of SPNs remains controversial...
December 6, 2017: Journal of Neuroscience: the Official Journal of the Society for Neuroscience
https://www.readbyqxmd.com/read/29074711/enhanced-cerebral-perfusion-during-brief-exposures-to-cyclic-intermittent-hypoxemia
#7
Xiaoli Liu, Diqun Xu, James R Hall, Sarah Ross, Shande Chen, Howe Liu, Robert T Mallet, Xiangrong Shi
Cerebral vasodilation and increased cerebral oxygen extraction help maintain cerebral oxygen uptake in the face of hypoxemia. This study examined cerebrovascular responses to intermittent hypoxemia in eight healthy men breathing 10% O2 for 5 cycles, each 6 min, interspersed with 4 min of room air breathing. Hypoxia exposures raised heart rate (P<0.01) without altering arterial pressure, and increased ventilation (P<0.01) by expanding tidal volume. Arterial oxygen saturation (SaO2) and cerebral tissue oxygenation (ScO2) fell (P<0...
October 26, 2017: Journal of Applied Physiology
https://www.readbyqxmd.com/read/28987197/neuropathology-of-cerebrovascular-diseases
#8
Isidro Ferrer, Noemi Vidal
The chapter describes the epidemiology of cerebrovascular diseases, anatomy of the cerebral blood vessels, pathophysiology of ischemia, hypoxia, hypoxemia, anemic hypoxia, histotoxic hypoxia, carbon monoxide damage, hyperoxid brain damage and decompression sickness, and selective cell and regional vulnerability; diseases of the blood vessels including atherosclerosis, hypertensive angiopathy, small vessel disease, inflammatory vascular diseases, cerebral amyloid angiopathies, CADASIL, CARASIL and other diseases that can lead to cerebrovascular occlusion; intracranial and intraspinal aneurysms and vascular malformations; hematologic disorders that can cause cerebral infarct or hemorrhage; brain ischemic damage; and spontaneous intracranial bleeding...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/28923474/beyond-the-inhaled-nitric-oxide-in-persistent-pulmonary-hypertension-of-the-newborn
#9
REVIEW
Mei-Yin Lai, Shih-Ming Chu, Satyan Lakshminrusimha, Hung-Chih Lin
Persistent pulmonary hypertension (PPHN) is a consequence of failed pulmonary vascular transition at birth and leads to pulmonary hypertension with shunting of deoxygenated blood across the ductus arteriosus (DA) and foramen ovale (FO) resulting in severe hypoxemia, and it may eventually lead to life-threatening circulatory failure. PPHN is a serious event affecting both term and preterm infants in the neonatal intensive care unit. It is often associated with diseases such as congenital diaphragmatic hernia, meconium aspiration, sepsis, congenital pneumonia, birth asphyxia and respiratory distress syndrome...
August 10, 2017: Pediatrics and Neonatology
https://www.readbyqxmd.com/read/28854512/cerebral-oxygenation-and-desaturations-in-preterm-infants-a-longitudinal-data-analysis
#10
Benjamin Mayer, Moritz Pohl, Helmut D Hummler, Manuel B Schmid
OBJECTIVE: Hypoxemic episodes commonly occur in very preterm infants and may be associated with several adverse effects. Cerebral tissue oxygen saturation (StO2) as measured by near infrared spectroscopy (NIRS) may be a useful measure to assess brain oxygenation. However, knowledge on variability of StO2 is limited in preterm infants at this time, so StO2 dependency on arterial oxygenation (SpO2) and heart rate (HR) was assessed in preterm infants using statistical methods of time series analysis...
2017: Journal of Neonatal-perinatal Medicine
https://www.readbyqxmd.com/read/28839003/acute-hypoxia-in-a-simulated-high-altitude-airdrop-scenario-due-to-oxygen-system-failure
#11
William Ottestad, Tor Are Hansen, Gaurav N Pradhan, Jan Stepanek, Lars Øivind Høiseth, Jan Ivar Kåsin
High Altitude High Opening (HAHO) is a military operational procedure in which parachute jumps are performed at high altitude requiring supplemental oxygen, putting personnel at risk of acute hypoxia in the event of oxygen equipment failure. This study was initiated by the Norwegian Army in order to evaluate potential outcomes during failure of oxygen supply, and to explore physiology during acute severe hypobaric hypoxia. A simulated HAHO without supplemental oxygen was carried out in a hypobaric chamber with decompression to 30 000 ft (9144 m) and then recompression to ground level with a descent rate of 1000 ft/min (305 m/min)...
August 24, 2017: Journal of Applied Physiology
https://www.readbyqxmd.com/read/28782146/cerebroplacental-ratio-in-reduced-fetal-movements-evidence-for-worsening-fetal-hypoxemia
#12
Julia Binder, Caitriona Monaghan, Baskaran Thilaganathan, José Morales-Roselló, Asma Khalil
OBJECTIVE: To investigate the fetal cerebroplacental ratio (CPR) in women presenting with reduced fetal movements (RFM). METHODS: This is a retrospective cohort study conducted over a 7-year period at a Fetal Medicine Unit at a tertiary referral centre. 4500 singleton pregnancies presenting with RFM after 36 weeks' gestation and 1527 control pregnancies at a similar gestation without RFM were analysed. Fetal biometry and Doppler parameters were recorded and converted into centiles and multiples of the median (MoM)...
August 7, 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28764949/neurological-outcomes-of-patients-with-history-of-obstructive-sleep-apnea-after-a-cardiac-arrest
#13
David Alejos, Emir Festic, Pramod Guru, John E Moss
BACKGROUND: Cardiac arrest survivors may have disabilities due to hypoxic brain injury. Patients with obstructive sleep apnea are exposed to intermittent hypoxemia that may lead to ischemic preconditioning. We have hypothesized that patients with obstructive sleep apnea have better neurological outcomes following a cardiac arrest due to preconditioning of the brain. METHODS: We retrospectively analyzed all the survivors of in-hospital cardiac arrest from January 2006 to September 2016...
October 2017: Resuscitation
https://www.readbyqxmd.com/read/28514318/cerebral-oxygen-saturation-in-children-with-congenital-heart-disease-and-chronic-hypoxemia
#14
Barry D Kussman, Peter C Laussen, Paul B Benni, Francis X McGowan, Doff B McElhinney
BACKGROUND: Increased hemoglobin (Hb) concentration accompanying hypoxemia is a compensatory response to maintain tissue oxygen delivery. Near infrared spectroscopy (NIRS) is used clinically to detect abnormalities in the balance of cerebral tissue oxygen delivery and consumption, including in children with congenital heart disease (CHD). Although NIRS-measured cerebral tissue O2 saturation (ScO2) correlates with arterial oxygen saturation (SaO2), jugular bulb O2 saturation (SjbO2), and Hb, little data exist on the interplay between these factors and cerebral O2 extraction (COE)...
July 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28481626/retinal-hemorrhage-in-a-high-altitude-aid-post-volunteer-doctor-a-case-report
#15
Sanjeeb Sudarshan Bhandari, Pranawa Koirala, Nirajan Regmi, Sushil Pant
Bhandari, Sanjeeb Sudarshan, Pranawa Koirala, Nirajan Regmi, and Sushil Pant. Retinal hemorrhage in a high-altitude aid post volunteer doctor: a case report. High Alt Med Biol. 18: 285-287, 2017.-High-altitude retinal hemorrhages (HARHs) are seen at altitudes more than 3000 m, are usually multiple, flame shaped, and adjacent to blood vessels. Development near the macula causes blurring of vision, otherwise, they are symptomless and self-limiting. They often develop during the first few days after ascent to high altitude and subjects often suffer from acute mountain sickness (AMS) or high-altitude cerebral edema (HACE)...
September 2017: High Altitude Medicine & Biology
https://www.readbyqxmd.com/read/28430880/cerebral-abscess-associated-with-odontogenic-bacteremias-hypoxemia-and-iron-loading-in-immunocompetent-patients-with-right-to-left-shunting-through-pulmonary-arteriovenous-malformations
#16
Emily J Boother, Sheila Brownlow, Hannah C Tighe, Kathleen B Bamford, James E Jackson, Claire L Shovlin
Background: Cerebral abscess is a recognized complication of pulmonary arteriovenous malformations (PAVMs) that allow systemic venous blood to bypass the pulmonary capillary bed through anatomic right-to-left shunts. Broader implications and mechanisms remain poorly explored. Methods: Between June 2005 and December 2016, at a single institution, 445 consecutive adult patients with computed tomography-confirmed PAVMs (including 403 [90.5%] with hereditary hemorrhagic telangiectasia) were recruited to a prospective series...
August 15, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28424613/the-relationship-between-cerebral-small-vessel-disease-hippocampal-volume-and-cognitive-functioning-in-patients-with-copd-an-mri-study
#17
Fiona A H M Cleutjens, Rudolf W H M Ponds, Martijn A Spruit, Saartje Burgmans, Heidi I L Jacobs, Ed H B M Gronenschild, Julie Staals, Frits M E Franssen, Jeanette B Dijkstra, Lowie E G W Vanfleteren, Paul A Hofman, Emiel F M Wouters, Daisy J A Janssen
The neural correlates of cognitive impairment in chronic obstructive pulmonary disease (COPD) are not yet understood. Structural brain abnormalities could possibly be associated with the presence of cognitive impairment through cigarette smoke, inflammation, vascular disease, or hypoxemia in these patients. This study aimed to investigate whether macrostructural brain magnetic resonance imaging (MRI) features of cerebral small vessel disease (SVD) and hippocampal volume (HCV) are related to cognitive performance in patients with COPD...
2017: Frontiers in Aging Neuroscience
https://www.readbyqxmd.com/read/28403909/clinical-pathophysiology-of-hypoxic-ischemic-brain-injury-after-cardiac-arrest-a-two-hit-model
#18
REVIEW
Mypinder S Sekhon, Philip N Ainslie, Donald E Griesdale
Hypoxic ischemic brain injury (HIBI) after cardiac arrest (CA) is a leading cause of mortality and long-term neurologic disability in survivors. The pathophysiology of HIBI encompasses a heterogeneous cascade that culminates in secondary brain injury and neuronal cell death. This begins with primary injury to the brain caused by the immediate cessation of cerebral blood flow following CA. Thereafter, the secondary injury of HIBI takes place in the hours and days following the initial CA and reperfusion. Among factors that may be implicated in this secondary injury include reperfusion injury, microcirculatory dysfunction, impaired cerebral autoregulation, hypoxemia, hyperoxia, hyperthermia, fluctuations in arterial carbon dioxide, and concomitant anemia...
April 13, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28374233/neurological-deficits-in-obstructive-sleep-apnea
#19
REVIEW
Luigi Ferini-Strambi, Giulia Elisabetta Lombardi, Sara Marelli, Andrea Galbiati
Obstructive sleep apnea (OSA) is the most common sleep-related breathing disorder characterized by repetitive episodes of complete or partial obstruction of the upper airway. The prevalence of this disorder is strictly dependent on its gravity. At ≥15 events/h apnea-hypopnea index (AHI), it ranges from 6 to 17% in the general population, with higher rates in men and increasing with age. The hypoxia induced by OSA severely affects the structure and function of blood vessels, culminating in mortality and morbidity...
April 2017: Current Treatment Options in Neurology
https://www.readbyqxmd.com/read/28366323/effect-of-continuous-positive-airway-pressure-on-regional-cerebral-blood-flow-in-patients-with-severe-obstructive-sleep-apnea-syndrome
#20
Jeong Sik Kim, Ji Hye Seo, Mi-Ri Kang, Min Jae Seong, Won Gu Lee, Eun Yeon Joo, Seung Bong Hong
OBJECTIVES: Obstructive sleep apnea (OSA) is commonly associated with neural and cognitive deficits induced by recurrent hypoxemia and sleep fragment. The aims of this study were to use statistical parametric mapping (SPM) to analyze changes in regional cerebral blood flow (rCBF) in untreated patients with severe OSA before and after nasal continuous positive airway pressure (CPAP) treatment, examine the impact of OSA-related variables on rCBF, and assess the therapeutic effect of nasal CPAP treatment...
April 2017: Sleep Medicine
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