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https://www.readbyqxmd.com/read/29351442/measurements-of-pulmonary-gas-exchange-efficiency-using-expired-gas-and-oximetry-results-in-normal-subjects
#1
John B West, Daniel L Wang, Gordon Kim Prisk
We are developing a novel, noninvasive method for measuring the efficiency of pulmonary gas exchange in patients with lung disease. The patient wears an oximeter, and we measure the partial pressures of oxygen and carbon dioxide in inspired and expired gas using miniature analyzers. The arterial PO2 is then calculated from the oximeter reading and the oxygen dissociation curve, using the end-tidal PCO2 to allow for the Bohr effect. This calculation is only accurate when the oxygen saturation is below 94% and therefore these normal subjects breathed 12...
December 20, 2017: American Journal of Physiology. Lung Cellular and Molecular Physiology
https://www.readbyqxmd.com/read/29349687/adjunct-and-rescue-therapies-for-refractory-hypoxemia-prone-position-inhaled-nitric-oxide-high-frequency-oscillation-extra-corporeal-life-support
#2
Niall D Ferguson, Claude Guérin
No abstract text is available yet for this article.
January 18, 2018: Intensive Care Medicine
https://www.readbyqxmd.com/read/29346245/diagnostic-yield-and-safety-of-bronchoscopist-directed-moderate-sedation-with-a-bolus-dose-administration-of-propofol-during-endobronchial-ultrasound-bronchoscopy
#3
Danai Khemasuwan, Krittika Teerapuncharoen, David C Griffin
BACKGROUND: The propofol use for moderate sedation (MS) during endobronchial ultrasound (EBUS) bronchoscopy is primarily restricted for use by an anesthesiologist because of safety concerns. The goals of this study were to demonstrate the safety and the diagnostic yield of the use of propofol by bronchoscopists and trained endoscopy nurses during EBUS bronchoscopy without intubation. METHODS: We tested a bolus propofol administration protocol targeting MS for EBUS bronchoscopy...
January 16, 2018: Journal of Bronchology & Interventional Pulmonology
https://www.readbyqxmd.com/read/29344963/refractory-pulmonary-edema-and-upper-body-hypoxemia-during-veno-arterial-extracorporeal-membrane-oxygenation-a-case-for-atrial-septostomy
#4
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/29343015/-clinical-and-imaging-features-of-pulmonary-veno-occlusive-disease-and-pulmonary-capillary-hemangioma
#5
Q H Zhao, W H Wu, S G Gong, R Jiang, J He, C J Luo, H L Qiu, J L Li, J M Liu, L Wang
Objective: To improve the diagnosis and treatment of the pulmonary veno-occlusive disease (PVOD) and pulmonary capillary hemangioma (PCH). Methods: The clinical features, radiological findings, laboratory testing and treatment in 8 cases of PVOD/PCH which was diagnosed from 2013 to 2017 were described. Results: PVOD/PCH was rare. The clinical symptoms were easily confused with IPAH, but the decrease of hypoxemia, clubbing, D(L)CO were more obvious, and the imaging features of HRCT were helpful for PVOD/PCH diagnosis...
January 12, 2018: Chinese Journal of Tuberculosis and Respiratory Diseases
https://www.readbyqxmd.com/read/29340298/efficacy-and-safety-of-sedation-during-endoscopic-submucosal-dissection-of-gastric-cancers-using-a-comparative-trial-of-propofol-versus-midazolam
#6
Hitomi Kikuchi, Takuto Hikichi, Ko Watanabe, Jun Nakamura, Tadayuki Takagi, Rei Suzuki, Mitsuru Sugimoto, Yuichi Waragai, Naoki Konno, Hiroyuki Asama, Mika Takasumi, Yuki Sato, Katsutoshi Obara, Hiromasa Ohira
Background and study aims : Proper sedation is necessary for the safe and satisfactory completion of endoscopic submucosal dissection (ESD) for early gastric cancer. This study was conducted as a comparative trial of efficacy and safety, comparing propofol-based sedation and midazolam-based sedation during ESD of early gastric cancer patients. Patients and methods : This study examined 64 lesions in 58 patients treated using ESD with midazolam plus pentazocine between July 2013 and January 2014 (group M) and 237 lesions in 216 patients treated by ESD using propofol plus pentazocine between February 2014 and December 2015 (group P)...
January 2018: Endoscopy International Open
https://www.readbyqxmd.com/read/29336036/the-incidence-and-significance-of-periictal-apnea-in-epileptic-seizures
#7
Nuria Lacuey, Bilal Zonjy, Johnson P Hampson, M R Sandhya Rani, Anita Zaremba, Rup K Sainju, Brian K Gehlbach, Stephan Schuele, Daniel Friedman, Orrin Devinsky, Maromi Nei, Ronald M Harper, Luke Allen, Beate Diehl, John J Millichap, Lisa Bateman, Mark A Granner, Deidre N Dragon, George B Richerson, Samden D Lhatoo
OBJECTIVE: The aim of this study was to investigate periictal central apnea as a seizure semiological feature, its localizing value, and possible relationship with sudden unexpected death in epilepsy (SUDEP) pathomechanisms. METHODS: We prospectively studied polygraphic physiological responses, including inductance plethysmography, peripheral capillary oxygen saturation (SpO2 ), electrocardiography, and video electroencephalography (VEEG) in 473 patients in a multicenter study of SUDEP...
January 16, 2018: Epilepsia
https://www.readbyqxmd.com/read/29334496/oxygen-in-the-critically-ill-friend-or-foe
#8
Elisa Damiani, Abele Donati, Massimo Girardis
PURPOSE OF REVIEW: To examine the potential harmful effects of hyperoxia and summarize the results of most recent clinical studies evaluating oxygen therapy in critically ill patients. RECENT FINDINGS: Excessive oxygen supplementation may have detrimental pulmonary and systemic effects because of enhanced oxidative stress and inflammation. Hyperoxia-induced lung injury includes altered surfactant protein composition, reduced mucociliary clearance and histological damage, resulting in atelectasis, reduced lung compliance and increased risk of infections...
January 12, 2018: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29331494/a-novel-difficult-airway-prediction-tool-for-emergency-airway-management-validation-of-the-heaven-criteria-in-a-large-air-medical-cohort
#9
Edward Kuzmack, Travis Inglis, David Olvera, Allen Wolfe, Kona Seng, Daniel Davis
BACKGROUND: Difficult-airway prediction tools help identify optimal airway techniques, but were derived in elective surgery patients and may not be applicable to emergency rapid sequence intubation (RSI). The HEAVEN criteria (Hypoxemia, Extremes of size, Anatomic abnormalities, Vomit/blood/fluid, Exsanguination, Neck mobility issues) may be more relevant to emergency RSI patients. OBJECTIVE: To validate the HEAVEN criteria for difficult-airway prediction in emergency RSI using a large air medical cohort...
January 10, 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29330690/extracorporeal-membrane-oxygenation-for-severe-middle-east-respiratory-syndrome-coronavirus
#10
Mohammed S Alshahrani, Anees Sindi, Fayez Alshamsi, Awad Al-Omari, Mohamed El Tahan, Bayan Alahmadi, Ahmed Zein, Naif Khatani, Fahad Al-Hameed, Sultan Alamri, Mohammed Abdelzaher, Amenah Alghamdi, Faisal Alfousan, Adel Tash, Wail Tashkandi, Rajaa Alraddadi, Kim Lewis, Mohammed Badawee, Yaseen M Arabi, Eddy Fan, Waleed Alhazzani
BACKGROUND: Middle East respiratory syndrome (MERS) is caused by a coronavirus (MERS-CoV) and is characterized by hypoxemic respiratory failure. The objective of this study is to compare the outcomes of MERS-CoV patients before and after the availability of extracorporeal membrane oxygenation (ECMO) as a rescue therapy in severely hypoxemic patients who failed conventional strategies. METHODS: We collected data retrospectively on MERS-CoV patients with refractory respiratory failure from April 2014 to December 2015 in 5 intensive care units (ICUs) in Saudi Arabia...
January 10, 2018: Annals of Intensive Care
https://www.readbyqxmd.com/read/29329111/severe-peri-ictal-respiratory-dysfunction-is-common-in-dravet-syndrome
#11
YuJaung Kim, Eduardo Bravo, Caitlin K Thirnbeck, Lori A Smith-Mellecker, Se Hee Kim, Brian K Gehlbach, Linda C Laux, Douglas R Nordli Jr, George B Richerson
Dravet syndrome (DS) is a severe childhood-onset epilepsy commonly due to mutations of the sodium channel gene SCN1A. DS patients have a high risk of sudden unexplained death in epilepsy (SUDEP), believed to be due to cardiac mechanisms. Here we show that DS patients have peri-ictal respiratory dysfunction. One patient who had severe and prolonged postictal hypoventilation later died of SUDEP. Mice with an Scn1aR1407X/+ loss of function mutation died after spontaneous and heat-induced seizures due to central apnea followed by progressive bradycardia...
January 11, 2018: Journal of Clinical Investigation
https://www.readbyqxmd.com/read/29327119/nocturnal-hypoxemic-burden-is-associated-with-epicardial-fat-volume-in-patients-with-acute-myocardial-infarction
#12
Dominik Linz, Stefan Colling, Wolfgang Nußstein, Kurt Debl, Mathias Hohl, Claudia Fellner, Michael Böhm, Lars S Maier, Okka W Hamer, Stefan Buchner, Michael Arzt
BACKGROUND: Increased epicardial fat volume (EFV) is a common feature of patients with sleep-disordered breathing (SDB), is considered as an established marker of cardiovascular risk, and is associated with adverse cardiovascular events after myocardial infarction (MI). METHODS: To investigate the association between different measures of SDB severity and EFV after acute MI, we enrolled 105 patients with acute MI in this study. Unattended in-hospital polysomnography was performed to determine the number of apneas and hypopneas per hour during sleep (apnea-hypopnea index, AHI)...
January 11, 2018: Sleep & Breathing, Schlaf & Atmung
https://www.readbyqxmd.com/read/29324515/acute-cor-pulmonale-in-veno-venous-extracorporeal-membrane-oxygenation-three-case-reports
#13
Erik R Dong, David G Ng, Danny Ramzy, Joshua S Chung, Oren Friedman, Alain Combes, Francisco A Arabia, Michael Nurok
A retrospective review of three patients with acute respiratory distress syndrome (ARDS) and normal baseline right ventricular function admitted to the Cardiac Surgery Intensive Care Unit whom developed acute cor pulmonale while on veno-venous extracorporeal membrane oxygenation. These patients were diagnosed with ARDS using Berlin Criteria definitions and cannulated with a dual lumen (Avalon) cannula. Despite variations in history, presentation, and course, findings of acute cor pulmonale were encountered 4 to 6 weeks after extracorporeal membrane oxygenation cannulation...
January 10, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/29323459/reliability-and-safety-of-transnasal-compared-to-conventional-endoscopy-for-detecting-esophageal-varices-in-cirrhotic-patients
#14
Elio C Castro Filho, Hugo Perazzo, Raquel Al-Cici P Guimaraes, Lilian Machado, Flavia F Fernandes, Renata M Perez
BACKGROUND & AIMS: Unsedated transnasal endoscopy may be used for detecting esophageal varices. However, few studies evaluated feasibility and accuracy of this technique. We aimed to evaluate accuracy, interobserver agreement and safety of the transnasal ultrathin compared to conventional endoscopy in patients with cirrhosis. METHODS: This cross-sectional study included consecutive patients referred for screening or surveillance of esophageal varices. Patients underwent unsedated transnasal and sedated conventional endoscopies at the same day, which were recorded in a digital video file and randomly analyzed by two double-blinded endoscopists...
January 11, 2018: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/29321702/carpal-tunnel-syndrome-in-obstructive-sleep-apnea-patients
#15
Özgür Bilgin Topçuoğlu, Özlem Oruç, Sema Saraç, Gülgün Çetintaş Afşar, Kayıhan Uluç
Introduction: Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy of the upper extremity. It is usually associated with the compression of the median nerve in the median groove. Because the main symptoms of CTS pain and numbness worsen at night, sleep disorders in CTS patients and the impact of preferred sleeping position on CTS development have been formerly studied. However, to the best of our knowledge, this is the first study assessing the frequency of CTS in obstructive sleep apnea (OSA) patients...
December 2017: Noro Psikiyatri Arsivi
https://www.readbyqxmd.com/read/29320657/case-1-2018
#16
Kathryn A Hibbert, Jo-Anne O Shepard, Rebekah J Lane, Marwan M Azar
Presentation of Case. Dr. Raghu R. Chivukula (Medicine): A 39-year-old woman with a history of leukemia and double-unit cord-blood transplantation was admitted to this hospital because of dyspnea, hypoxemia, and the presence of infiltrates in both lungs. Thirty months before this admission, the..
January 11, 2018: New England Journal of Medicine
https://www.readbyqxmd.com/read/29319542/supplemental-oxygen-in-patients-with-stable-chronic-obstructive-pulmonary-disease-evidence-from-nocturnal-oxygen-treatment-trial-to-long-term-oxygen-treatment-trial
#17
Umur Hatipoğlu, James K Stoller
PURPOSE OF REVIEW: Oxygen therapy was the first treatment shown to prolong life in patients with chronic obstructive pulmonary disease (COPD) and has been joined by lung volume reduction surgery in selected patients with emphysema, smoking cessation, and potentially noninvasive ventilation in chronic hypercapneic respiratory failure. Although there is consensus around the survival-enhancing effect of supplemental oxygen (SupplO2) for patients with chronic severe hypoxemia at rest, the impact of SupplO2 for COPD patients with moderate hypoxemia and exertional desaturation had been less clear...
January 9, 2018: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/29317806/profile-of-sugammadex-for-reversal-of-neuromuscular-blockade-in-the-elderly-current-perspectives
#18
REVIEW
Michele Carron, Francesco Bertoncello, Giovanna Ieppariello
The number of elderly patients is increasing worldwide. This will have a significant impact on the practice of anesthesia in future decades. Anesthesiologists must provide care for an increasing number of elderly patients, who have an elevated risk of perioperative morbidity and mortality. Complications related to postoperative residual neuromuscular blockade, such as muscle weakness, airway obstruction, hypoxemia, atelectasis, pneumonia, and acute respiratory failure, are more frequent in older than in younger patients...
2018: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/29316749/-effects-of-baicalin-on-the-changes-in-hemorheology-of-acute-respiratory-distress-syndrome-in-rats
#19
Z M Zhao, Y M Zheng, Y L Zhang, S Q Li
Objective: To investigate the effect of baicalin on the changes in hemorheology and its mechanism during the development of Acute Respiratory Distress Syndrome(ARDS) induced by oleic acid (OA) in rats. Methods: Rats were randomized into 3 groups: control, ARDS (OA induction, 0.12 mg/kg) and ba-icalin-treated group (300 mg/kg). The blood samples were collected at 30 min, 1, 2, 3, 6, 12 and 6 h after OA injection. The whole blood viscosity, plasma viscosity, Maximum erythrocyte deformability index (DImax) were detected...
November 20, 2017: Chinese Journal of Industrial Hygiene and Occupational Diseases
https://www.readbyqxmd.com/read/29314868/bronchiolitis-obliterans-and-pulmonary-fibrosis-after-sulfur-mustard-inhalation-in-rats
#20
Matthew D McGraw, Marilyn M Dysart, Tara B Hendry-Hofer, Paul R Houin, Jacqueline S Rioux, Rhonda B Garlick, Joan E Loader, Russell Smith, Danielle C Paradiso, Wesley W Holmes, Dana R Anderson, Carl W White, Livia A Veress
RATIONALE: Inhalation of powerful chemical agents, such as sulfur mustard (SM), can have debilitating pulmonary consequences, such as bronchiolitis obliterans (BO) and parenchymal fibrosis (PF). The underlying pathogenesis of disorders after SM inhalation is not clearly understood, resulting in a paucity of effective therapies. OBJECTIVE: To evaluate the role of pro-fibrotic pathways involving TGF-β and PDGF in the development of BO and PF after inhalation injury sustained by SM, using a rat model...
January 9, 2018: American Journal of Respiratory Cell and Molecular Biology
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