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Cerebral hypoxemia

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https://www.readbyqxmd.com/read/27910802/near-infrared-spectroscopy-evaluated-cerebral-oxygenation-during-anesthesia
#1
Henrik Sørensen
Likely, maintained organ and notably cerebral perfusion, secures rapid recovery following anesthesia. To secure cerebral blood flow (CBF) at least mean arterial pressure (MAP) and the arterial carbon dioxide tension (PaCO2) need to be considered. CBF is "autoregulated", i.e. stays more or less stable within a MAP of 50-150 mmHg, but the lower limit appears to depend on the central blood volume and/or cardiac output, illustrated by a decrease in CBF at a MAP of 80 mmHg with a compromised central blood volume, while CBF remains constant with a MAP < 40 mmHg, if the central blood volume is maintained...
December 2016: Danish Medical Journal
https://www.readbyqxmd.com/read/27907083/effects-of-acute-systemic-hypoxia-and-hypercapnia-on-brain-damage-in-a-rat-model-of-hypoxia-ischemia
#2
Wanchao Yang, Xuezhong Zhang, Nan Wang, Jing Tan, Xianhai Fang, Qi Wang, Tao Tao, Wenzhi Li
Therapeutic hypercapnia has the potential for neuroprotection after global cerebral ischemia. Here we further investigated the effects of different degrees of acute systemic hypoxia in combination with hypercapnia on brain damage in a rat model of hypoxia and ischemia. Adult wistar rats underwent unilateral common carotid artery (CCA) ligation for 60 min followed by ventilation with normoxic or systemic hypoxic gas containing 11%O2,13%O2,15%O2 and 18%O2 (targeted to PaO2 30-39 mmHg, 40-49 mmHg, 50-59 mmHg, and 60-69 mmHg, respectively) or systemic hypoxic gas containing 8% carbon dioxide (targeted to PaCO2 60-80 mmHg) for 180 min...
2016: PloS One
https://www.readbyqxmd.com/read/27811496/a-case-report-of-onyx-pulmonary-arterial-embolism-contributing-to-hypoxemia-during-awake-craniotomy-for-arteriovenous-malformation-resection
#3
Brian T Tolly, Jenna L Kosky, Antoun Koht, Laura B Hemmer
A healthy 26-year-old man with cerebral arteriovenous malformation underwent staged endovascular embolization with Onyx followed by awake craniotomy for resection. The perioperative course was complicated by tachycardia and severe intraoperative hypoxemia requiring significant oxygen supplementation. Postoperative chest computed tomography (CT) revealed hyperattenuating Onyx embolization material within the pulmonary vasculature, and an electrocardiogram indicated possible right heart strain, supporting clinically significant embolism...
November 2, 2016: A & A Case Reports
https://www.readbyqxmd.com/read/27769083/neurochemical-changes-following-combined-hypoxemia-and-hemorrhagic-shock-in-a-rat-model-of-penetrating-ballistic-like-brain-injury-a-microdialysis-study
#4
Lai Yee Leung, Ying Deng-Bryant, Katherine Cardiff, Megan Winter, Frank Tortella, Deborah Shear
BACKGROUND: Energy metabolic dysfunction is a key determinant of cellular damage following traumatic brain injury and may be worsened by additional insults. This study evaluated the acute/subacute effects of combined hypoxemia (HX) and hemorrhagic shock (HS) on cerebral interstitial levels of glucose, lactate, and pyruvate in a rat model of penetrating ballistic-like brain injury (PBBI). METHODS: Rats were randomly assigned into the sham control, PBBI, and combined injury (P + HH) groups...
November 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27729704/esmolol-corrects-severe-hypoxemia-in-patients-with-femoro-femoral-venoarterial-extracorporeal-life-support-for-lung-transplantation
#5
Mohamed Ghalayini, Pierre-Yves Brun, Pascal Augustin, Elise Guivarch, Marie Pierre Dilly, Sophie Provenchere, Pierre Mordant, Yves Castier, Philippe Montravers, Dan Longrois
Competitive flows syndrome result in severe regional hypoxemia when the deoxygenated flow from the native left ventricle (LV) competes with oxygenated flow from extracorporeal life support (ECLS) pump with potentially severe consequences for the cerebral and coronary circulations. Fast correction of hypoxemia could be obtained by decreasing native LV flow by infusion of a short-acting beta-blocker (esmolol). Our purpose was to retrospectively review the efficacy of esmolol in this situation and hypothesize on the potential mechanisms of action and the associated risks...
September 2016: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/27704200/prominent-cerebral-veins-on-susceptibility-weighted-imaging-swi-in-pulmonary-embolism
#6
Bilge Öztoprak
OBJECTIVES: Clinical applications of susceptibility-weighted imaging (SWI) are increasing steadily. The aim of this study is to investigate the appearance of cerebral veins on SWI, which is very sensitive to the deoxyhaemoglobin level in vessels, in pulmonary embolism (PE). METHODS: The cranial SWI images of 19 patients with PE and 22 controls from September 2013 through March 2016 were retrospectively examined for the presence of prominent cerebral veins. MRI findings were correlated with blood oxygen levels...
October 4, 2016: European Radiology
https://www.readbyqxmd.com/read/27692955/outcome-of-aortic-arch-reconstruction-in-infants-with-coarctation-importance-of-operative-approach
#7
Andreas Tulzer, Rudolf Mair, Michaela Kreuzer, Gerald Tulzer
OBJECTIVES: Coarctation with hypoplastic aortic arch can be treated with resection and extended end-to-end anastomosis (REEEA) as well as end-to-side anastomosis (ESA). The aim of the study was to review our experience with these techniques in newborns and infants and to assess mid-term outcome with regards to morbidity, mortality, and reintervention rate in relation to operative access and technique. PATIENTS AND METHODS: Retrospective review of hospital charts and surgical reports from 183 consecutive newborns and infants with coarctation and hypoplastic aortic arch with or without ventricular septal defect between 1996 and 2013...
August 31, 2016: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/27532507/cerebral-oximetry-in-ugandan-children-with-severe-anemia-clinical-categories-and-response-to-transfusion
#8
Aggrey Dhabangi, Brenda Ainomugisha, Christine Cserti-Gazdewich, Henry Ddungu, Dorothy Kyeyune, Ezra Musisi, Robert Opoka, Christopher P Stowell, Walter H Dzik
Importance: Severe anemia, defined as a hemoglobin level of less than 5.0 g/dL, affects millions of children worldwide. The brain has a high basal demand for oxygen and is especially vulnerable to hypoxemia. Previous studies have documented neurocognitive impairment in children with severe anemia. Data on cerebral tissue oxygenation in children with severe anemia and their response to blood transfusion are limited. Objective: To measure hemoglobin saturation in cerebral tissue (cerebral tissue oxygen saturation [tSo2]) before, during, and after blood transfusion in a cohort of children presenting to hospital with severe anemia...
October 1, 2016: JAMA Pediatrics
https://www.readbyqxmd.com/read/27529318/effects-of-acute-profound-hypoxia-on-healthy-humans-implications-for-safety-of-tests-evaluating-pulse-oximetry-or-tissue-oximetry-performance
#9
Philip E Bickler, John R Feiner, Michael S Lipnick, Paul Batchelder, David B MacLeod, John W Severinghaus
Extended periods of oxygen deprivation can produce acidosis, inflammation, energy failure, cell stress, or cell death. However, brief profound hypoxia (here defined as SaO2 50%-70% for approximately 10 minutes) is not associated with cardiovascular compromise and is tolerated by healthy humans without apparent ill effects. In contrast, chronic hypoxia induces a suite of adaptations and stresses that can result in either increased tolerance of hypoxia or disease, as in adaptation to altitude or in the syndrome of chronic mountain sickness...
August 12, 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27505083/hematological-changes-in-severe-early-onset-growth-restricted-fetuses-with-absent-and-reversed-end-diastolic-flow-in-the-umbilical-artery
#10
Franz Bahlmann, Ammar Al Naimi, Manfred Ossendorf, Monica Schmidt-Fittschen, Arne Willruth
BACKGROUND: Erythropoietin seems to play an important role in the regulation of fetal hypoxemia. The present prospective study was designed to determine if changes in erythropoietin levels can be found in fetuses with severe early-onset growth restriction and hemodynamic compromise. METHODS AND RESULTS: Erythropoietin, hemoglobin, hematocrit, platelet counts, normoblasts, lacate, arterial and venous blood gasses in the umbilical cord were determined in 42 fetuses with fetal growth restriction (IUGR) with absent (zero-flow) and 26 IUGR fetuses with retrograde end-diastolic flow (reverse-flow) in the umbilical artery...
August 9, 2016: Journal of Perinatal Medicine
https://www.readbyqxmd.com/read/27486311/simultaneous-surgery-in-patients-with-both-cardiac-and-noncardiac-diseases
#11
Yang Yang, Feng Xiao, Jin Wang, Bo Song, Xi-Hui Li, Jian Li, Zhi-Song He, Huan Zhang, Ling Yin
BACKGROUND: To investigate the possibility and feasibility of simultaneous cardiac and noncardiac surgery. METHODS: From August 2000 to March 2015, 64 patients suffering from cardiac and noncardiac diseases have been treated by simultaneous surgeries. RESULTS: Two patients died after operations in hospital; thus, the hospital mortality rate was 3.1%. One patient with coronary heart disease, acute myocardial infarction, and a recurrence of bladder cancer accepted emergency simultaneous coronary artery bypass grafting (CABG), bladder cystectomy, and ureterostomy...
2016: Patient Preference and Adherence
https://www.readbyqxmd.com/read/27484964/fetal-cerebral-and-umbilical-doppler-in-pregnancies-complicated-by-late-onset-placental-abruption
#12
José Morales-Roselló, Asma Khalil, Farida Akhoundova, Silvia Salvi, Maddalena Morlando, Janani Sivanathan, José Alberola-Rubio, David Hervas-Marín, Victoria Fornés-Ferrer, Alfredo Perales-Marín, Basky Thilaganathan
OBJECTIVE: To evaluate whether changes in the cerebroplacental Doppler and birth weight (BW) suggestive of chronic fetal hypoxemia, precede the development of late-onset placental abruption (PA) after 32 weeks. METHODS: In a multicenter retrospective study, the Doppler examinations of the fetal umbilical artery (UA) and middle cerebral artery (MCA) recorded after 32 weeks were collected in pregnancies subsequently developing PA. The BW centiles were calculated and the MCA pulsatility indices (PI), and UA PI were converted into multiples of the median (MoM)...
August 2, 2016: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/27457403/air-embolism-following-removal-of-hemodialysis-catheter
#13
Tuncay Sahutoglu, Tamer Sakaci, Nuri Baris Hasbal, Ekrem Kara, Elbis Ahbap, Mustafa Sevinc, Yener Koc, Taner Basturk, Elif Sahutoglu, Abdulkadir Unsal
Introduction Air embolism (AE) is a rare, but serious complication that can occur in the practice of hemodialysis. In contrast to careful techniques and meticulous care during insertions and manipulations of the central catheters, awareness of the risk of AE following catheter removal is less. We aimed to analyze the clinical characteristics of the all case reports with AE after catheter removal and summarize the mechanisms, clinical consequences, treatment and prevention of AE. Methods In addition to our case, MEDLINE database was searched for all case reports with AE following catheter removal, and the clinical, diagnostic and outcome data were analyzed...
July 25, 2016: Hemodialysis International
https://www.readbyqxmd.com/read/27383062/the-association-between-arterial-oxygen-tension-and-neurological-outcome-after-cardiac-arrest
#14
Nicholas J Johnson, Kalani Dodampahala, Babette Rosselot, Sarah M Perman, Mark E Mikkelsen, Munish Goyal, David F Gaieski, Anne V Grossestreuer
A number of observational studies have evaluated the association between arterial oxygen tensions and outcome after cardiac arrest with variable results. The objective of this study is to determine the association between arterial oxygen tension and neurological outcome after cardiac arrest. A retrospective cohort analysis was performed using the Penn Alliance for Therapeutic Hypothermia registry. Adult patients who experienced return of spontaneous circulation after in-hospital or out-of-hospital cardiac arrest (OHCA) and had a partial pressure of arterial oxygen (PaO2) recorded within 48 hours were included...
July 6, 2016: Therapeutic Hypothermia and Temperature Management
https://www.readbyqxmd.com/read/27376233/an-unusual-presentation-of-opioid-induced-cerebral-infarction
#15
Mujeeb-Ur-Rehman Abid Butt, Reeja Nadir
Opioid induced cerebral infarction is one of the most dreadful complications encountered in clinical practice. A30-year known hypertensive male presented to the emergency department of Shalamar Hospital, Lahore, Pakistan, with altered state of consciousness. He had been in his usual state of health a day before the presentation. On examination he was afebrile, his GCS was 3/15 having pinpoint pupils with absent doll's eye movements. His blood pressure was 90/60 mmHg, pulse rate was 62/minute, and respiratory rate was 10/minute...
June 2016: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/27375400/a-case-of-bronchiectasis-needing-lung-isolation-for-cerebello-pontine-angle-tumor-excision-anesthetic-challenges
#16
C Srinivasan, G P Kurian, R Mariappan
The main goals of neuroanesthesia are the maintenance of adequate cerebral perfusion pressure, avoidance of hypercarbia, hypoxemia, and to provide better brain relaxation. Providing anesthesia for a patient with bronchiectasis needing lung isolation for craniotomy can be challenging. A 56-year-old male patient, case of right lung bronchiectasis with a right cerebello pontine angle tumor underwent excision in the left lateral position. Since he had severe bronchiectasis of the right lung, we had isolated the right lung using right-sided double lumen tube to avoid spillage...
July 2016: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/27256521/cerebral-oxidative-metabolism-is-decreased-with-extreme-apnoea-in-humans-impact-of-hypercapnia
#17
Anthony R Bain, Philip N Ainslie, Ryan L Hoiland, Otto F Barak, Marija Cavar, Ivan Drvis, Mike Stembridge, Douglas M MacLeod, Damian M Bailey, Zeljko Dujic, David B MacLeod
KEY POINTS: The present study describes the cerebral oxidative and non-oxidative metabolism in man during a prolonged apnoea (ranging from 3 min 36 s to 7 min 26 s) that generates extremely low levels of blood oxygen and high levels of carbon dioxide. The cerebral oxidative metabolism, measured from the product of cerebral blood flow and the radial artery-jugular venous oxygen content difference, was reduced by ∼29% at the termination of apnoea, although there was no change in the non-oxidative metabolism...
September 15, 2016: Journal of Physiology
https://www.readbyqxmd.com/read/27139243/obstructive-sleep-apnea-is-linked-to-depression-and-cognitive-impairment-evidence-and-potential-mechanisms
#18
Nancy A Kerner, Steven P Roose
Obstructive sleep apnea (OSA) is highly prevalent but very frequently undiagnosed. OSA is an independent risk factor for depression and cognitive impairment/dementia. Herein the authors review studies in the literature pertinent to the effects of OSA on the cerebral microvascular and neurovascular systems and present a model to describe the key pathophysiologic mechanisms that may underlie the associations, including hypoperfusion, endothelial dysfunction, and neuroinflammation. Intermittent hypoxia plays a critical role in initiating and amplifying these pathologic processes...
June 2016: American Journal of Geriatric Psychiatry
https://www.readbyqxmd.com/read/27116331/reported-cardiac-phenotypes-in-hereditary-hemorrhagic-telangiectasia-emphasize-burdens-from-arrhythmias-anemia-and-its-treatments-but-suggest-reduced-rates-of-myocardial-infarction
#19
C L Shovlin, I Awan, Z Cahilog, F N Abdulla, A E Guttmacher
INTRODUCTION: Cardiac phenotypes should be pronounced in hereditary hemorrhagic telangiectasia (HHT) due to frequent systemic arteriovenous malformations (AVMs), iron deficiency anemia, hypoxemia, hyperdynamic circulations, venous thromboemboli, and paradoxical emboli through pulmonary AVMs. METHODS/RESULTS: In an international survey, 1025 respondents (median age 55years) met HHT diagnostic criteria: 942 (91.9%) reported nosebleeds, 452 (44.1%) at least daily. AVMs were commonly reported in pulmonary (544, 53%), hepatic (194, 18...
July 15, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27108833/severe-fat-embolism-in-perioperative-abdominal-liposuction-and-fat-grafting
#20
Rodrigo de Lima E Souza, Bruno Tavares Apgaua, João Daniel Milhomens, Francisco Tadeu Motta Albuquerque, Luiz Antônio Carneiro, Márcio Henrique Mendes, Tiago Carvalho Garcia, Clerisson Paiva, Felipe Ladeia, Deiler Célio Jeunon
BACKGROUND AND OBJECTIVES: Fat embolism syndrome may occur in patients suffering from multiple trauma (long bone fractures) or plastic surgery (liposuction), compromising the circulatory, respiratory and/or central nervous systems. This report shows the evolution of severe fat embolism syndrome after liposuction and fat grafting. CASE REPORT: SSS, 42 years old, ASA 1, no risk factors for thrombosis, candidate for abdominal liposuction and breast implant prosthesis...
May 2016: Brazilian Journal of Anesthesiology
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