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Hypoxaemia

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https://www.readbyqxmd.com/read/29049534/high-frequency-percussive-ventilation-in-cardiac-surgery-patients-failing-mechanical-conventional-ventilation
#1
Ivan Wong, Berhane Worku, Jeremy A Weingarten, Alexander Ivanov, Felix Khusid, Ashwad Afzal, Robert F Tranbaugh, Iosif Gulkarov
OBJECTIVES: Failure of mechanical conventional ventilation (MCV) after cardiac surgery portends a dismal prognosis, with extracorporeal membrane oxygenation frequently utilized as a salvage therapy. We describe our experience with high-frequency percussive ventilation (HFPV) as a rescue therapy for hypoxaemia refractory to MCV after cardiac surgery. METHODS: In a 6-year retrospective analysis from 2009 to 2015, we identified 16 subjects who required HFPV after cardiac surgery...
July 21, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29047088/lung-ischaemia-reperfusion-injury-the-role-of-reactive-oxygen-species
#2
Oleg Pak, Akylbek Sydykov, Djuro Kosanovic, Ralph T Schermuly, Alexander Dietrich, Katrin Schröder, Ralf P Brandes, Thomas Gudermann, Natascha Sommer, Norbert Weissmann
Lung ischaemia-reperfusion injury (LIRI) occurs in many lung diseases and during surgical procedures such as lung transplantation. The re-establishment of blood flow and oxygen delivery into the previously ischaemic lung exacerbates the ischaemic injury and leads to increased microvascular permeability and pulmonary vascular resistance as well as to vigorous activation of the immune response. These events initiate the irreversible damage of the lung with subsequent oedema formation that can result in systemic hypoxaemia and multi-organ failure...
2017: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/29043397/myocardial-fistulisation-and-coronary-arterial-ectasia-in-children-with-univentricular-circulation-an-under-recognised-problem
#3
Daragh Finn, Kevin Walsh, David Roberson, Colin J McMahon
Among 241 children with univentricular circulation who underwent total cavopulmonary connection (Glenn or Fontan) over a 17 years period (January 2000-April 2017), we found two patients who had diffuse coronary fistulisation of their myocardium (0.8%). We also report an additional third case from Oak Lawn, Illinois, USA. One of the children had documented normal coronary arteries and myocardium at catheterisation prior to development of the fistulisation process. The same child also developed extensive veno-venous collaterals...
October 17, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/29040433/low-end-tidal-co2-as-a-real-time-severity-marker-of-intra-anaesthetic-acute-hypersensitivity-reactions
#4
A Gouel-Chéron, L de Chaisemartin, F Jönsson, P Nicaise-Roland, V Granger, A Sabahov, M-T Guinnepain, S Chollet-Martin, P Bruhns, C Neukirch, D Longrois
Background: Prompt diagnosis of intra-anaesthetic acute hypersensitivity reactions (AHR) is challenging because of the possible absence and/or difficulty in detecting the usual clinical signs and because of the higher prevalence of alternative diagnoses. Delayed epinephrine administration during AHR, because of incorrect/delayed diagnosis, can be associated with poor prognosis. Low end-tidal CO2 (etCO2) is known to be linked to low cardiac output. Yet, its clinical utility during suspected intra-anaesthetic AHR is not well documented...
October 10, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29033246/effect-of-choline-chloride-premedication-on-xylazine-induced-hypoxaemia-in-sheep
#5
Preet M Singh, Katherine Reid, Ravindra Gaddam, Madhav Bhatia, Stefan Smith, Antony Jacob, Paul Chambers
OBJECTIVE: To determine the anti-inflammatory efficacy of choline in vivo and in vitro and to investigate the anti-inflammatory mechanisms of choline. STUDY DESIGN: Randomized, controlled studies. ANIMALS: In vivo trials used 16 Romney sheep. In vitro experiments utilized RAW 264.7 mouse macrophage cells. METHODS: Hypoxaemia induced in 16 sheep by intravenous (IV) injection of 50 μg kg(-1) xylazine, an α-2 agonist, was measured in sheep at 0, 1 and 4 minutes using arterial blood gas analysis with and without 50 mg kg(-1) IV choline chloride premedication...
March 6, 2017: Veterinary Anaesthesia and Analgesia
https://www.readbyqxmd.com/read/29028928/effectiveness-of-tip-rotation-in-fibreoptic-bronchoscopy-under-different-experimental-conditions-an-in-vitro-crossover-study
#6
T Piegeler, N G Clausen, M Weiss
Background: Proper manipulation of fibreoptic bronchoscopes is essential for successful tracheal intubation or diagnostic bronchoscopy. Failure of proper navigation and rotation of the fibrescope may lead to difficulties in advancing the fibrescope and might also be responsible for (unnecessary) difficulties and delays in fibreoptic tracheal intubation, with subsequent hypoxaemia. The present study, therefore, aimed to assess the effectiveness of tip rotation in flexible bronchoscopes in different experimental conditions...
October 4, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29017230/-guidelines-in-practice-the-new-s3-guideline-sleeping-disorders-sleep-related-abnormal-breathing
#7
Martin Gerlach, Bernd Sanner
Sleep related breathing disorders include central sleep apnea (CSA), obstructive sleep apnea (OSA), sleep-related hypoventilation, and sleep-related hypoxia. These disorders are frequent and growing in clinical relevance. The related chapter of the S3 guideline "Non-restorative sleep/Sleep disorders", published by the German Sleep Society (DGSM), has recently been updated in November 2016. Epidemiology, diagnostics, therapeutic procedures, and classification of sleep related disorders have been revised. Concerning epidemiology, a considerably higher mortality rate among pregnant women with OSA has been emphasized...
October 2017: Laryngo- Rhino- Otologie
https://www.readbyqxmd.com/read/28947918/efficacy-study-of-pulmonary-surfactant-combined-with-assisted-ventilation-for-acute-respiratory-distress-syndrome-management-of-term-neonates
#8
Jinfeng Liu, Gang Liu, Hongwei Wu, Zhenguang Li
The clinical efficacy of pulmonary surfactant (PS) combined with assisted ventilation was assessed for acute respiratory distress syndrome (RDS) management of term neonates. The total sample size was of 60 subjects. Group I: Experimental group, 30 cases were treated with standard of care with tracheal intubation, mechanical ventilation and PS (100-200 mg/kg). In case of hypoxaemia present even after 12 h standard of care was administered again, up to 4 times. Group II: Control group, 30 cases treated with conventional tracheal intubation and mechanical ventilation...
September 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28926832/persistent-pulmonary-hypertension-of-the-newborn-in-twin-twin-transfusion-syndrome-a-case-control-study
#9
Manon Gijtenbeek, M C Haak, Derk Jan Ten Harkel, Arjan B Te Pas, Johanna M Middeldorp, Frans J C M Klumper, Nan van Geloven, Dick Oepkes, Enrico Lopriore
BACKGROUND: Persistent pulmonary hypertension of the newborn (PPHN) is associated with severe morbidity and mortality. Twin-twin transfusion syndrome (TTTS) is suggested to increase the risk of PPHN. OBJECTIVES: To describe the incidence of PPHN in TTTS twins and to identify risk factors in TTTS twins for the development of severe PPHN. METHODS: Cases with severe PPHN were extracted from our monochorionic twin database (2002-2016). Severe PPHN was defined as severe hypoxaemia requiring mechanical ventilation and inhaled nitric oxide (iNO) treatment, confirmed by strict echocardiographic criteria...
September 20, 2017: Neonatology
https://www.readbyqxmd.com/read/28912057/apnoeic-oxygenation-during-intubation-in-the-intensive-care-unit-a-systematic-review-and-meta-analysis
#10
REVIEW
Matthew J Binks, Rhys S Holyoak, Thomas M Melhuish, Ruan Vlok, Anthony Hodge, Thomas Ryan, Leigh D White
Hypoxaemia increases the risk of cardiac arrest and mortality during intubation. The reduced physiological reserve and reduced efficacy of pre-oxygenation in intensive care patients makes their intubation particularly dangerous. Apnoeic oxygenation is a promising means of preventing hypoxaemia in this setting. We sought to ascertain whether apnoeic oxygenation reduces the incidence of hypoxaemia when used during endotracheal intubation in the intensive care unit (ICU). A systematic review of five databases for all relevant studies published up to November 2016 was performed...
September 11, 2017: Heart & Lung: the Journal of Critical Care
https://www.readbyqxmd.com/read/28883928/cpap-impact-a-protocol-for-a-randomised-trial-of-bubble-continuous-positive-airway-pressure-versus-standard-care-for-high-risk-children-with-severe-pneumonia-using-adaptive-design-methods
#11
Andrew G Smith, Michelle Eckerle, Tisungane Mvalo, Brian Weir, Francis Martinson, Alfred Chalira, Norman Lufesi, Innocent Mofolo, Mina Hosseinipour, Eric D McCollum
INTRODUCTION: Pneumonia is a leading cause of mortality among children in low-resource settings. Mortality is greatest among children with high-risk conditions including HIV infection or exposure, severe malnutrition and/or severe hypoxaemia. WHO treatment recommendations include low-flow oxygen for children with severe pneumonia. Bubble continuous positive airway pressure (bCPAP) is a non-invasive support modality that provides positive end-expiratory pressure and oxygen. bCPAP is effective in the treatment of neonates in low-resource settings; its efficacy is unknown for high-risk children with severe pneumonia in low-resource settings...
2017: BMJ Open Respiratory Research
https://www.readbyqxmd.com/read/28877511/severe-neurotoxicity-requiring-mechanical-ventilation-in-a-dog-envenomed-by-a-red-bellied-black-snake-pseudechis-porphyriacus-and-successful-treatment-with-an-experimental-bivalent-whole-equine-igg-antivenom
#12
A M Padula, E M Leister
Snakebite in dogs from Pseudechis porphyriacus (red-bellied black snake; RBBS) is a common envenomation treated by veterinarians in Australia where this snake occurs. This case report describes the successful treatment of a clinically severe RBBS envenomation in a dog with an experimental bivalent equine whole IgG antivenom and mechanical ventilation, following its presentation in a cyanotic state. The cause of the cyanosis and respiratory distress was considered due to paralysis from neurotoxins in RBBS venom...
November 2017: Toxicon: Official Journal of the International Society on Toxinology
https://www.readbyqxmd.com/read/28874237/-drowning-induced-hyperfibrinolytic-disseminated-intravascular-coagulation
#13
Andreas Lund Hattesen, Henrik Karsten Berg, Lars Folkersen, Anne-Mette Hvas
This article summarizes the current knowledge of drowning-induced hyperfibrinolytic disseminated intravascular coagulation. Drowning induces respiratory failure with ensuing cardiac arrest, hypoxaemia and ischaemia. A coagulopathy is induced by ischaemia, acidosis and hypothermia, and clinically the patient develops uncontrolled bleeding due to hyperfibrinolysis. A rapid diagnostic approach is required to recognize this hyperfibrinolytic state, since initiation of treatment with antifibrinolytics and fibrinogen concentrate may bring this life-threatening condition to cessation...
August 28, 2017: Ugeskrift for Laeger
https://www.readbyqxmd.com/read/28873076/women-awaken-faster-than-men-after-electroencephalogram-monitored-propofol-sedation-for-colonoscopy-a-prospective-observational-study
#14
Andrea Riphaus, Mark Slottje, Jan Bulla, Carolin Keil, Christian Mentzel, Vera Limbach, Barbara Schultz, Christian Unzicker
BACKGROUND: Sedation for colonoscopy using intravenous propofol has become standard in many Western countries. OBJECTIVE: Gender-specific differences have been shown for general anaesthesia in dentistry, but no such data existed for gastrointestinal endoscopy. DESIGN: A prospective observational study. SETTING: An academic teaching hospital of Hannover Medical School. PATIENTS: A total of 219 patients (108 women and 111 men) scheduled for colonoscopy...
October 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/28871590/pulmonary-hypertension-in-diffuse-parenchymal-lung-diseases-is-there-any-benefit-of-pah-specific-therapy
#15
Monika Szturmowicz, Aneta Kacprzak, Jan Kuś
Pulmonary hypertension (PH) is diagnosed in 40-50% of the patients with end-stage diffuse parenchymal lung diseases (DPLD), and it is associated with significant worsening of life expectancy. Latest ERS/ESC guidelines recommend best available treatment of DPLD, and long-term oxygen therapy in the patients with PaO2 less than 60 mm Hg. Pulmonary arterial hypertension (PAH)-targeted drugs are not recommended in PH-DPLD patients, due to the risk of increasing the ventilation-perfusion mismatch, and consequently worsening of hypoxaemia...
2017: Advances in Respiratory Medicine
https://www.readbyqxmd.com/read/28869823/evidence-of-perceptive-impairment-in-osa-patients-investigated-by-means-of-a-visual-search-task
#16
Enrico Giora, Andrea Galbiati, Sara Marelli, Marco Zucconi, Luigi Ferini-Strambi
Obstructive Sleep Apnoea (OSA) is a common sleep disorder characterized by episodes of complete or partial obstruction of respiratory airways during sleep that leads to hypoxaemia and sleep fragmentation. One relevant daytime consequence of OSA is a negative impact on neurocognitive domain, ranging from psychomotor performance to executive function. In spite of a huge amount of evidence regarding cognitive impairment, little is known about perceptual processing in these patients. The aim of this research is to investigate the effects of OSA on visual mechanisms by employing a visual search paradigm...
August 9, 2017: Cortex; a Journal Devoted to the Study of the Nervous System and Behavior
https://www.readbyqxmd.com/read/28847875/evaluation-of-three-intravenous-injectable-anaesthesia-protocols-in-healthy-adult-male-alpacas
#17
RANDOMIZED CONTROLLED TRIAL
Sandra D Taylor, Aubrey N Baird, Ann B Weil, Audrey Ruple
Few studies have investigated the effects of intravenous injectable anaesthesia in alpacas. The objective of this study was to evaluate three intravenous injectable anaesthesia protocols in healthy adult alpacas exposed to noxious stimulation. A prospective randomised crossover study was done using six healthy adult male alpacas. Cardiopulmonary variables including heart rate, respiratory rate, mean arterial pressure, end-tidal pCO2 and haemoglobin oxygen saturation were collected immediately after and every two minutes following induction of each of three anaesthesia protocols in six male castrated alpacas...
September 21, 2017: Veterinary Record
https://www.readbyqxmd.com/read/28828865/comparison-of-thiafentanil-medetomidine-to-etorphine-medetomidine-immobilisation-of-impalas-i-aepyceros-melampus-i
#18
Gareth E Zeiler, Leith C R Meyer
Impalas (Aepyceros melampus) are increasingly valuable in the South African wildlife industry, and there is a greater need to chemically immobilise them, ideally with minimal risk. This study aimed to compare the times to recumbency and physiological effects of thiafentanilmedetomidine versus etorphine-medetomidine immobilisation. A combination of thiafentanil (2 mg) + medetomidine (2.2 mg) and etorphine (2 mg) + medetomidine (2.2 mg) was administered (to nine impalas; crossover design) via a dart. After darting, a stopwatch was started to record times to recumbency (time from darting until recumbent without attempts to stand)...
August 4, 2017: Journal of the South African Veterinary Association
https://www.readbyqxmd.com/read/28814557/when-technology-creates-uncertainty-pulse-oximetry-and-overdiagnosis-of-hypoxaemia-in-bronchiolitis
#19
Ricardo A Quinonez, Eric R Coon, Alan R Schroeder, Virginia A Moyer
No abstract text is available yet for this article.
August 16, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/28805234/prognostic-factors-for-mortality-due-to-pneumonia-among-adults-from-different-age-groups-in-singapore-and-mortality-predictions-based-on-psi-and-curb-65
#20
Zoe Xz Zhang, Yang Yong, Wan C Tan, Liang Shen, Han Seong Ng, Kok Yong Fong
INTRODUCTION: Pneumonia is associated with considerable mortality. However, the information on age-specific prognostic factors for death from pneumonia is limited. METHODS: Patients hospitalised with a diagnosis of pneumonia through the emergency department were stratified into three age groups: 18-64 years; 65-84 years; and ≥ 85 years. Multivariate logistic regression and receiver operating characteristic (ROC) curve analyses were conducted to evaluate prognostic factors for mortality and the performance of pneumonia severity scoring tools for mortality prediction...
August 14, 2017: Singapore Medical Journal
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