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Hypoxemia

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https://www.readbyqxmd.com/read/27913766/myocardial-cytochrome-oxidase-activity-increases-with-age-and-hypoxemia-in-patients-with-congenital-heart-disease
#1
Michael Onwugbufor, Richard J Levy, David Zurakowski, Richard A Jonas, Pranava Sinha
BACKGROUND: Myocardial tolerance to ischemia is influenced by age and preoperative cyanosis through unknown mechanisms and significantly affects postoperative outcomes. Cytochrome c oxidase (CcOx), the terminal enzyme of the mitochondrial electron transport chain, may play a role in the susceptibility to ischemic-reperfusion (IR) injury. Our study aimed at investigating changes in human myocardial CcOx activity based on age and preoperative oxygen saturation to understand its role in transition from neonatal to mature myocardium and hypoxic conditions...
December 1, 2016: Perfusion
https://www.readbyqxmd.com/read/27913141/acute-lung-injury-and-persistent-small-airway-disease-in-a-rabbit-model-of-chlorine-inhalation
#2
Sadiatu Musah, Connie F Schlueter, David M Humphrey, Karen S Powell, Andrew M Roberts, Gary W Hoyle
Chlorine is a pulmonary toxicant to which humans can be exposed through accidents or intentional releases. Acute effects of chlorine inhalation in humans and animal models have been well characterized, but less is known about persistent effects of acute, high-level chlorine exposures. In particular, animal models that reproduce the long-term effects suggested to occur in humans are lacking. Here, we report the development of a rabbit model in which both acute and persistent effects of chlorine inhalation can be assessed...
November 29, 2016: Toxicology and Applied Pharmacology
https://www.readbyqxmd.com/read/27910802/near-infrared-spectroscopy-evaluated-cerebral-oxygenation-during-anesthesia
#3
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/27909457/the-severity-of-sleep-disordered-breathing-induces-different-decrease-in-the-oxygen-saturation-during-rapid-eye-movement-and-non-rapid-eye-movement-sleep
#4
Eunkyung Choi, Doo-Heum Park, Jae-Hak Yu, Seung-Ho Ryu, Ji-Hyeon Ha
OBJECTIVE: To investigate how differences in oxygen saturation between non-REM (NREM) and REM sleep in patients according to the severity of sleep apnea. METHODS: We studied 396 male patients diagnosed with simple snoring or obstructive sleep apnea syndrome (OSAS) on nocturnal polysomnography. Patients were divided into groups by the OSAS severity. We compared the average oxygen saturation between REM and NREM sleep in each group. RESULTS: In the simple snoring group, average oxygen saturation was significantly greater during REM than during NREM sleep...
November 2016: Psychiatry Investigation
https://www.readbyqxmd.com/read/27907962/critical-care-of-traumatic-cervical-spinal-cord-injuries-preventing-secondary-injury
#5
Gary Schwartzbauer, Deborah Stein
The incidence of traumatic spinal cord injury (SCI) has not changed much over the years due to an aging population suffering falls, yet advances have been made in quality of life and survival time. In addition to initial medical and surgical stabilization, modern intensive care unit (ICU) care throughout the critical early period following SCI is essential to avoid continued secondary injury to the spinal cord. Cervical SCI patients are particularly prone and sensitive to periods of cardiovascular instability and respiratory failure directly resulting from their injuries...
December 2016: Seminars in Neurology
https://www.readbyqxmd.com/read/27907083/effects-of-acute-systemic-hypoxia-and-hypercapnia-on-brain-damage-in-a-rat-model-of-hypoxia-ischemia
#6
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/27906717/spectrum-of-postoperative-complications-in-pulmonary-hypertension-and-obesity-hypoventilation-syndrome
#7
Roop K Kaw
PURPOSE OF REVIEW: The purpose of this review is to identify chronic pulmonary conditions which may often not be recognized preoperatively especially before elective noncardiac surgery and which carry the highest risk of perioperative morbidity and mortality. RECENT FINDINGS: This review discusses some of the most recent studies that highlight the perioperative complications, and their prevention and management strategies. SUMMARY: Pulmonary hypertension is a well recognized risk factor for postoperative complications after cardiac surgery but the literature surrounding noncardiac surgery is sparse...
November 30, 2016: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/27903458/cardiac-arrest-among-patients-with-infections-causes-clinical-practice-and-research-implications
#8
REVIEW
Davide Leoni, Jordi Rello
The incidence of sepsis is increasing, and the condition is now the leading cause of death in general intensive care units (ICUs). Our review failed to identify studies of the causes of cardiac arrest among infected patients, even though non-cardiac causes represent 15% of out-of-hospital cardiac arrests and though one-third of events have positive blood cultures. Sudden cardiac arrest is the result of local damage to the heart and of the impact of systemic and pulmonary conditions on cardiac performance, and its danger is underestimated...
November 26, 2016: Clinical Microbiology and Infection
https://www.readbyqxmd.com/read/27903300/inhaled-nitric-oxide-and-the-risk-of-renal-dysfunction-in-patients-with-acute-respiratory-distress-syndrome-a-propensity-matched-cohort-study
#9
Sheng-Yuan Ruan, Hon-Yen Wu, Hsien-Ho Lin, Huey-Dong Wu, Chong-Jen Yu, Mei-Shu Lai
BACKGROUND: Inhaled nitric oxide (iNO) is a rescue therapy for severe hypoxemia in patients with acute respiratory distress syndrome (ARDS). Pooled data from clinical trials have signaled a renal safety warning for iNO therapy, but the significance of these findings in daily clinical practice is unclear. We used primary data to evaluate the risk of iNO-associated renal dysfunction in patients with ARDS. METHODS: We conducted a cohort study using data from a tertiary teaching hospital to evaluate the risk of incident renal replacement therapy (RRT) in iNO users compared with that of non-users...
November 30, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27903260/clinical-physiologic-and-radiographic-factors-contributing-to-development-of-hypoxemia-in-moderate-to-severe-copd-a-cohort-study
#10
J Michael Wells, Raul San Jose Estepar, Merry-Lynn N McDonald, Surya P Bhatt, Alejandro A Diaz, William C Bailey, Francine L Jacobson, Mark T Dransfield, George R Washko, Barry J Make, Richard Casaburi, Edwin J R van Beek, Eric A Hoffman, Frank C Sciurba, James D Crapo, Edwin K Silverman, Craig P Hersh
BACKGROUND: Hypoxemia is a major complication of COPD and is a strong predictor of mortality. We previously identified independent risk factors for the presence of resting hypoxemia in the COPDGene cohort. However, little is known about characteristics that predict onset of resting hypoxemia in patients who are normoxic at baseline. We hypothesized that a combination of clinical, physiologic, and radiographic characteristics would predict development of resting hypoxemia after 5-years of follow-up in participants with moderate to severe COPD METHODS: We analyzed 678 participants with moderate-to-severe COPD recruited into the COPDGene cohort who completed baseline and 5-year follow-up visits and who were normoxic by pulse oximetry at baseline...
December 1, 2016: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/27898867/angus-calves-born-and-raised-at-high-altitude-adapt-to-hypobaric-hypoxia-by-increasing-alveolar-ventilation-rate-but-not-hematocrit
#11
A K Gulick, F B Garry, T N Holt, K Retallick-Trennepohl, R M Enns, M G Thomas, J M Neary
The objective of this study was to evaluate the effect of altitude on arterial blood-gases and hematocrit in Angus-based calves. It was hypothesized that alveolar ventilation rate, as indicated by arterial pCO, would increase with altitude but hematocrit would not. Five Angus-based herds ( = 30 to 80 per cohort) located at 105 m, 1,470 m, 2,010 m, 2,170 m, and 2,730 m above sea level were enrolled in this prospective cohort study. A portable analyzer measured blood-gas tensions in coccygeal arterial blood. Calves at 1,470 m, 2,170 m, and 2,730 m were sampled twice, at approximately 4 mo and 7 mo of age...
October 2016: Journal of Animal Science
https://www.readbyqxmd.com/read/27898438/rescue-therapies-for-acute-respiratory-distress-syndrome-what-to-try-first
#12
Onnen Moerer, Tommaso Tonetti, Michael Quintel
PURPOSE OF REVIEW: Severe respiratory failure due to the acute respiratory distress syndrome (ARDS) might require rescue therapy measures beyond even extended standard care to ensure adequate oxygenation and survival. This review provides a summary and assessment of treatment options that can be beneficial when the standard approach fails. RECENT FINDINGS: 'Life-threatening' conditions or refractory hypoxemia during mechanical ventilation are more a matter of personal rating than an objective diagnosis based on defined and/or unanimously agreed thresholds that would mandate the use of rescue therapies...
November 24, 2016: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/27898437/how-best-to-set-the-ventilator-on-extracorporeal-membrane-lung-oxygenation
#13
Luciano Gattinoni, Tommaso Tonetti, Michael Quintel
PURPOSE OF REVIEW: Extracorporeal respiratory support in patients with acute respiratory distress syndrome is applied either as rescue maneuver for life-threatening hypoxemia or as a tool to reduce the harm of mechanical ventilation. Depending on the blood and gas flow, extracorporeal support may completely substitute the natural lung as a gas exchanger (high-flow venovenous bypass) or reduce the need for mechanical ventilation, enabling the removal of a fraction of the metabolically produced CO2...
November 24, 2016: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/27894561/apneic-oxygenation-may-not-prevent-severe-hypoxemia-during-rapid-sequence-intubation-a-retrospective-helicopter-emergency-medical-service-study
#14
Sattha Riyapan, Jeffrey Lubin
OBJECTIVE: This study sought to determine the effectiveness of apneic oxygenation in preventing hypoxemia during prehospital rapid sequence intubation (RSI). METHODS: We performed a case-cohort study using a pre-existing database looking at intubation management by a single helicopter emergency medical service between July 2013 and June 2015. Apneic oxygenation using high-flow nasal cannula (15 L/min) was introduced to the standard RSI protocol in July 2014. Severe hypoxemia was defined as an incidence of oxygen saturation less than 90%...
November 2016: Air Medical Journal
https://www.readbyqxmd.com/read/27891739/acardiac-twin-pregnancies-part-iv-acardiac-onset-from-unequal-embryonic-splitting-simulated-by-a-fetoplacental-resistance-model
#15
Martin J C van Gemert, Jeroen P H M van den Wijngaard, K Marieke Paarlberg, Helena M Gardiner, Peter G J Nikkels
BACKGROUND: Benirschke postulated that acardiac twinning occurs when markedly unequal embryonic splitting combines with arterioarterial (AA) and venovenous placental anastomoses. We tested this hypothesis by model simulations and by comparison of outcomes with 18 "pseudo-" (twin fetus with beating heart but otherwise with clear signs of an acardiac) and 3 "normal" acardiac cases. METHODS: The smaller/larger cell volume ratio at embryonic splitting becomes the smaller/larger embryonic/fetal blood volume ratio (a)...
November 28, 2016: Birth Defects Research. Part A, Clinical and Molecular Teratology
https://www.readbyqxmd.com/read/27891282/a-teenage-girl-with-acute-dyspnea-and-hypoxemia-during-red-blood-cell-transfusion
#16
U Pandee, P Tanpowpong, P Thongpo
Transfusion-related acute lung injury (TRALI) can cause morbidity and mortality. We present the case of teenager who developed dyspnea and hypoxemia few hours after red cell transfusion. After being admitted for close monitoring and oxygen therapy, her symptoms spontaneously resolved. Message: dyspnea during red cell transfusion should raise the suspicion of TRALI.
2016: Case Reports in Pediatrics
https://www.readbyqxmd.com/read/27888562/parainfluenza-3-infections-early-after-kidney-or-simultaneous-pancreas-kidney-transplantation
#17
Ilkka Helanterä, Veli-Jukka Anttila, Raisa Loginov, Marko Lempinen
Parainfluenza (PIV) can cause serious infections after hematopoietic stem cell or lung transplantation. Limited data exist about PIV infections after kidney transplantation. We describe an outbreak of PIV-3 in a transplant unit. During the outbreak 45 patients were treated on the ward for postoperative care after kidney or simultaneous pancreas-kidney (SPK) transplantation. Altogether 29 patients were tested for respiratory viruses (12 patients with respiratory symptoms, 17 asymptomatic exposed patients) from nasopharyngeal swabs with PCR...
November 26, 2016: American Journal of Transplantation
https://www.readbyqxmd.com/read/27886864/an-autopsy-case-of-refractory-pulmonary-hypertension-with-sarcoidosis
#18
Hiroki Ota, Keishi Sugino, Toshimasa Uekusa, Tamiko Takemura, Sakae Homma
A 63-year-old man with sarcoidosis-associated pulmonary hypertension (SAPH) died suddenly of decompensated right heart failure. At autopsy, microscopy showed subpleural and interlobular fibrosis in both upper lobes, with marked broncho-bronchiolectasis, as well as bronchovascular bundle fibrosis and fibrotic organization in alveolar lumens, which are consistent with pulmonary sarcoidosis. Intimal fibrosis and medial hypertrophy were noted in the proximal elastic to distal muscular pulmonary arteries (Heath-Edwards, grades II-III) within intensive fibrotic lesions...
November 2016: Respiratory Investigation
https://www.readbyqxmd.com/read/27881161/lower-hypoxic-ventilatory-response-in-smokers-compared-to-non-smokers-during-abstinence-from-cigarettes
#19
Wulf Hildebrandt, Roland Sauer, Ulrich Koehler, Peter Bärtsch, Ralf Kinscherf
BACKGROUND: Carotid body O2-chemosensitivity determines the hypoxic ventilatory response (HVR) as part of crucial regulatory reflex within oxygen homeostasis. Nicotine has been suggested to attenuate HVR in neonates of smoking mothers. However, whether smoking affects HVR in adulthood has remained unclear and probably blurred by acute ventilatory stimulation through cigarette smoke. We hypothesized that HVR is substantially reduced in smokers when studied after an overnight abstinence from cigarettes i...
November 24, 2016: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/27875775/bronchoscopic-intubation-is-an-effective-airway-strategy-in-critically-ill-patients
#20
Kevin C Ma, Augustine Chung, Kerri I Aronson, Jamuna K Krishnan, Igor Z Barjaktarevic, David A Berlin, Edward J Schenck
PURPOSE: American Society of Anesthesiologists guidelines recommend the use of bronchoscopic intubation as a rescue technique in critically ill patients. We sought to assess the safety and efficacy of bronchoscopic intubation as an initial approach in critically ill patients. METHODS: We performed a retrospective cohort study of patients who underwent endotracheal intubation in the medical intensive care unit of a tertiary urban referral center over 1 academic year...
November 4, 2016: Journal of Critical Care
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