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Hypoxaemia

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https://www.readbyqxmd.com/read/29923842/high-flow-nasal-cannula-oxygen-versus-noninvasive-ventilation-in-adult-acute-respiratory-failure-a-systematic-review-of-randomized-controlled-trials
#1
Lim Beng Leong, Ng Wei Ming, Lee Wei Feng
We reviewed the use of noninvasive ventilation (NIV) versus high flow nasal cannula (HFNC) oxygen in adult acute respiratory failure (ARF). We searched major databases and included randomized trials comparing at least NIV with HFNC or NIV+HFNC with NIV in ARF. Primary outcomes included intubation/re-intubation rates. Secondary outcomes were ICU mortality and morbidities. Five trials were included; three compared HFNC with NIV, one compared HFNC, NIV and oxygen whereas one compared HFNC+NIV with NIV. Patients had hypoxaemic ARF (PaO2/FiO2≤300 mmHg)...
June 19, 2018: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/29898904/should-i-stay-or-should-i-go-copd-and-air-travel
#2
REVIEW
Begum Ergan, Metin Akgun, Angela Maria Grazia Pacilli, Stefano Nava
Chronic obstructive pulmonary disease (COPD) is a challenging respiratory problem throughout the world. Although survival is prolonged with new therapies and better management, the magnitude of the burden resulting from moderate-to-severe disease is increasing. One of the major aims of the disease management is to try to break the vicious cycle of patients being homebound and to promote an active lifestyle. A fundamental component of active daily life is, of course, travelling. Today, the world is getting smaller with the option of travelling by air...
June 30, 2018: European Respiratory Review: An Official Journal of the European Respiratory Society
https://www.readbyqxmd.com/read/29850154/novel-method-of-noninvasive-ventilation-supported-therapeutic-lavage-in-pulmonary-alveolar-proteinosis-proves-to-relieve-dyspnea-normalize-pulmonary-function-test-results-and-recover-exercise-capacity-a-short-communication
#3
Szymon Skoczynski, Katarzyna Wyskida, Patrycja Rzepka-Wrona, Magdalena Wyskida, Ewa Uszok-Gawel, Dawid Bartocha, Lukasz Krzych, Wladysław Pierzchala, Adam Barczyk
Whole lung lavage (WLL) under general anesthesia with a double-lumen endobronchial intubation has remained standard treatment option for pulmonary alveolar proteinosis (PAP) for over fifty years now. To the best of our knowledge, this is the first description of noninvasive ventilation (NIV) as an innovative alternative, which enables safe and effective treatment. NIV support enabled cost-effective lavage of the most affected segments and resulted in restoration and long-term maintenance of exercise capacity and diffusion, without WLL related hypoxaemia, volume overload, intubation, or mechanical ventilation related complications...
April 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29804070/-neisseria-meningitidis-sepsis-in-a-patient-with-acute-epiglottitis-and-respiratory-failure
#4
Tobias Zimmermann, Corinne Chmiel
A 78-year-old female patient presented to our emergency department with a 5-day history of throat pain, hoarseness and a progressive and dolorous submandibular swelling. Due to non-conclusive clinical examination and the stable but visibly affected patient, we performed a neck CT scan with intravenous contrast, which showed the thumbprint sign typical for acute epiglottitis. Within minutes, the patient's condition deteriorated and the patient was close to respiratory exhaustion. As intubation was severely complicated by massive swelling of the supraglottic soft tissue, the patient went into hypoxaemia and eventually cardiac arrest...
May 26, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29796067/a-united-kingdom-register-study-of-in-hospital-outcomes-of-patients-receiving-extracorporeal-carbon-dioxide-removal
#5
Carole Cummins, Andrew Bentley, Daniel F McAuley, James J McNamee, Hannah Patrick, Nicholas A Barrett
Introduction: Extracorporeal membrane carbon dioxide removal may have a role in treatment of patients with hypercapnic respiratory failure and refractory hypoxaemia and/or hypercapnia. Methods: We report on the use, outcomes and complications in United Kingdom intensive care units reporting patients on the Extracorporal Life Support Organisation register. Results: Of 60 patients, 42 (70%) had primarily hypoxic respiratory failure and 18 (30%) primarily hypercapnic respiratory failure...
May 2018: Journal of the Intensive Care Society
https://www.readbyqxmd.com/read/29765455/ringer-s-lactate-solution-enhances-the-inflammatory-response-during-fluid-resuscitation-of-experimentally-induced-haemorrhagic-shock-in-rats
#6
Krzysztof Kusza, Mariusz Mielniczuk, Lukasz Krokowicz, Jacek B Cywiński, Maria Siemionow
Introduction: Hemorrhagic shock leads to systemic oxygen deficit (hypoxaemia) that results in systemic inflammatory response syndrome (SIRS), a recognised cause of late mortality in this case. The aim of this study was to analyse the impact of fluid resuscitation, using two Ringer solutions, on the microcirculation changes that take place during experimentally induced haemorrhagic shock. Material and methods: A model of the rat cremaster muscle was used to assess microcirculation in vivo ...
April 2018: Archives of Medical Science: AMS
https://www.readbyqxmd.com/read/29756063/the-carrico-index-is-the-parameter-that-guides-the-requirement-of-oxygen-in-the-postoperative-period-in-patients-undergoing-head-and-neck-surgery-under-general-anaesthesia-a-cross-sectional-study
#7
Parnandi Bhaskar Rao, Manaswini Mangaraj, Preetam Mahajan, Swagata Tripathy, Neha Singh, Thenmozhi Mani, Sukdev Nayak
Background & aims: Altered lung function and consequent decrease in oxygenation has been linked to the duration of anaesthesia. This necessitates oxygen monitoring and supplementation in the perioperative period. But, evidence is lacking regarding the parameter that guides best the oxygen supplementation in the postoperative period and the parameter that correlates best with the duration of anaesthesia. Methods: Adult patients scheduled for head & neck surgery under general anaesthesia were recruited...
April 2018: Romanian Journal of Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/29735491/a-case-of-platypnoea-orthodeoxia-following-laproscopic-cholecystectomy
#8
Timothy Riddles, James Brown, Daniel Judge
Platypnoea Orthodeoxia syndrome is defined by dyspnoea and hypoxaemia exacerbated by orthostatic positioning and alleviated in recumbency. This condition has been reported in association with pulmonary, hepatic and cardiac disease. We describe a case herein of a 79 year old female who developed severe hypoxaemia and dyspnoea post laparoscopic cholecystectomy. A difference in arterial blood gas oxygen tension was demonstrated in the supine and erect positions on arterial blood gas analysis. A Patent Foramen Ovale (PFO) with a right to left shunt was evident on echocardiogram employing colour doppler and agitated normal saline studies...
May 7, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29708586/oxygen-supplementation-for-critically-ill-patients-a-protocol-for-a-systematic-review
#9
REVIEW
M Barbateskovic, O L Schjørring, J C Jakobsen, C S Meyhoff, B S Rasmussen, A Perner, J Wetterslev
BACKGROUND: In critically ill patients, hypoxaemia is a common clinical manifestation of inadequate gas exchange in the lungs. Supplemental oxygen is therefore given to all critically ill patients. This can result in hyperoxaemia, and some observational studies have identified harms with hyperoxia. The objective of this systematic review is to critically assess the evidence of randomised clinical trials on the effects of higher versus lower inspiratory oxygen fractions or targets of arterial oxygenation in critically ill adult patients...
April 30, 2018: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/29703920/prevalent-metabolic-derangement-and-severe-thrombocytopenia-in-abo-incompatible-liver-recipients-with-pre-transplant-plasma-exchange
#10
Hye-Mee Kwon, In-Gu Jun, JungBok Lee, Young-Jin Moon, Kyeo-Woon Jung, Hye-Won Jeong, Yong-Seok Park, Jun-Gol Song, Gyu-Sam Hwang
Desensitisation with therapeutic plasma exchange (TPE) is essential for ABO-incompatible (ABO-I) liver transplants (LTs). However, excessive citrate load and coagulation disturbances after TPE have been poorly studied, in particular in cirrhotic patients with hypocapnic alkalosis, metabolic compensation and electrolyte imbalances. We retrospectively evaluated 1123 consecutive LT recipients (923 ABO-compatible [ABO-C], 200 ABO-I) from November 2008 to May 2015. TPE was generally performed a day before LT and blood sampling was performed before anaesthesia induction...
April 27, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29660106/safety-effectiveness-and-feasibility-of-outpatient-management-of-children-with-pneumonia-with-chest-indrawing-at-port-moresby-general-hospital-papua-new-guinea
#11
Rose Morre, Kone Sobi, Wendy Pameh, Paulus Ripa, John D Vince, Trevor Duke
Implementing the World Health Organization (WHO) recommendations on home-based management of pneumonia with chest indrawing is challenging in many settings. In Papua New Guinea, 120 children presenting with the WHO definition of pneumonia were screened for danger signs, comorbidities and hypoxaemia using pulse oximetry; 117 were appropriate for home care. We taught mothers about danger signs and when to return, using structured teaching materials and a video. The children were given a single dose of intramuscular benzylpenicillin, then sent home on oral amoxicillin for 5 days, with follow-up at Days 2 and 6...
April 6, 2018: Journal of Tropical Pediatrics
https://www.readbyqxmd.com/read/29628389/effects-of-buprenorphine-butorphanol-or-tramadol-premedication-on-anaesthetic-induction-with-alfaxalone-in-common-marmosets-callithrix-jacchus
#12
Jaco Bakker, Sandra Roubos, Edmond J Remarque, Saskia S Arndt, Peter W Kronen, Jan Am Langermans
OBJECTIVE: To investigate the clinical and physiological effects of intravenous (IV) alfaxalone alone or in combination with buprenorphine, butorphanol or tramadol premedication in marmosets. STUDY DESIGN: Prospective, randomized, blinded, crossover design. ANIMALS: Nine healthy marmosets (391 ± 48 g, 3.7 ± 2.2 years old). METHODS: Meloxicam 0.20 mg kg-1 subcutaneously, atropine 0.05 mg kg-1 intramuscularly (IM) and either buprenorphine 20 μg kg-1 IM (BUP-A), butorphanol 0...
May 2018: Veterinary Anaesthesia and Analgesia
https://www.readbyqxmd.com/read/29622717/scorpion-bite-induced-unilateral-pulmonary-oedema
#13
Nandakishore Bompelli, Rakesh Reddy C, Anirudda Deshpande
A 24-year-old woman came to the emergency room of our hospital, 6 hours after a sting to the pulp of her middle finger of her left upper limb by an Indian red scorpion. On examination, she had tachycardia, tachypnoea, hypotension and low oxygen saturation at room temperature. On auscultation, there was poor air entry in all areas of the right lung along with crackles. The left lung field was normal on auscultation. Chest X-ray showed unilateral haziness of right lung field. Two-dimensional echocardiography showed clinical findings of myocarditis...
April 5, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29604081/the-peripheral-chemoreflex-indefatigable-guardian-of-fetal-physiological-adaptation-to-labour
#14
Christopher A Lear, Guido Wassink, Jenny A Westgate, Jan G Nijhuis, Austin Ugwumadu, Robert Galinsky, Laura Bennet, Alistair J Gunn
The fetus is consistently exposed to repeated periods of impaired oxygen (hypoxaemia) and nutrient supply in labour. This is balanced by the healthy fetus's remarkable anaerobic tolerance and impressive ability to mount protective adaptations to hypoxaemia. The most important mediator of fetal adaptations to brief repeated hypoxaemia is the peripheral chemoreflex, a rapid reflex response to acute falls in arterial oxygen tension. The overwhelming majority of fetuses are able to respond to repeated uterine contractions without developing hypotension or hypoxic-ischaemic injury...
March 31, 2018: Journal of Physiology
https://www.readbyqxmd.com/read/29599530/excessive-activated-t-cell-proliferation-after-anti-cd19-car-t-cell-therapy
#15
Wen-Ying Zhang, Yang Liu, Yao Wang, Jing Nie, Ye-Lei Guo, Chun-Meng Wang, Han-Ren Dai, Qing-Ming Yang, Zhi-Qiang Wu, Wei-Dong Han
Excessive activated T-cell proliferation was observed in vivo in one patient after an anti-CD19-chimeric antigen receptor (CAR) T-cell infusion. The patient, who had chemotherapy refractory and CD19+ diffuse large B-cell lymphoma (DLBCL), received an anti-CD19 CAR T-cell infusion following conditioning chemotherapy (fludarabine/cyclophosphamide). The lymphocyte count in the peripheral blood (PB) increased to 77 × 109 /L on day 13 post infusion, and the proportion of CD8+ actived T cells was 93.06% of the lymphocytes...
March 29, 2018: Gene Therapy
https://www.readbyqxmd.com/read/29599378/effects-of-supplemental-oxygen-therapy-in-patients-with-suspected-acute-myocardial-infarction-a-meta-analysis-of-randomised-clinical-trials
#16
Nariman Sepehrvand, Stefan K James, Dion Stub, Ardavan Khoshnood, Justin A Ezekowitz, Robin Hofmann
BACKGROUND: Although oxygen therapy has been used for over a century in the management of patients with suspected acute myocardial infarction (AMI), recent studies have raised concerns around the efficacy and safety of supplemental oxygen in normoxaemic patients. OBJECTIVE: To synthesise the evidence from randomised controlled trials (RCTs) that investigated the effects of supplemental oxygen therapy compared with room air in patients with suspected or confirmed AMI...
March 29, 2018: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/29591780/a-comparison-of-the-effects-of-carbon-dioxide-and-medical-air-for-abdominal-insufflation-on-respiratory-parameters-in-xylazine-sedated-sheep-undergoing-laparoscopic-artificial-insemination
#17
J D Haan, B L Hay Kraus, S R Sathe
AIMS: To determine if abdominal insufflation with medical air will improve oxygenation and ventilation parameters when compared to insufflation with CO2 in xylazine-sedated sheep undergoing laparoscopic artificial insemination (AI). METHODS: Forty-seven sheep underwent oestrus synchronisation and were fasted for 24 hours prior to laparoscopic AI. Each animal was randomised to receive either CO2 or medical air for abdominal insufflation. An auricular arterial catheter was placed and utilised for serial blood sampling...
July 2018: New Zealand Veterinary Journal
https://www.readbyqxmd.com/read/29582497/emergency-department-risk-factors-for-serious-clinical-deterioration-in-a-paediatric-hospital-in-peru
#18
Katie R Nielsen, Rubén Aronés Rojas, José Tantaleán da Fieno, Luis Huicho, Joan S Roberts, Joseph Zunt
AIM: Identification of critically ill children upon presentation to the emergency department (ED) is challenging, especially when resources are limited. The objective of this study was to identify ED risk factors associated with serious clinical deterioration (SCD) during hospitalisation in a resource-limited setting. METHODS: A retrospective case-control study of children less than 18 years of age presenting to the ED in a large, freestanding children's hospital in Peru was performed...
March 26, 2018: Journal of Paediatrics and Child Health
https://www.readbyqxmd.com/read/29577091/early-administration-of-venovenous-extracorporeal-life-support-for-status-asthmaticus-during-anaesthetic-induction-case-report-and-literature-review
#19
Won Ho Chang
Here we report a case of a 40-year-old man who visited the emergency room with severe chest pain. He showed a Stanford type B aortic dissection on chest-computed tomography. Despite medical treatment and malperfusion of lower extremities, acute renal failure developed; hence thoracic endovascular aortic repair (TEVAR) was considered under general anaesthesia. After endotracheal intubation, ventilation with low tidal volume required high inspiratory airway pressure. An arterial blood gas analysis showed PaCO2 of 61...
2018: Open Medicine (Warsaw, Poland)
https://www.readbyqxmd.com/read/29558860/pregnant-sheep-develop-hypoxaemia-during-short-term-anaesthesia-for-caesarean-delivery
#20
Gabrielle C Musk, Matthew W Kemp
Short-term anaesthesia of the pregnant ewe may be required for caesarean delivery of a preterm foetus within a research protocol. The aim of this study was to evaluate and compare the acid-base and haematological status of the ewe and foetus at the time of surgical delivery by collecting maternal and foetal arterial blood samples. Fifteen date-mated singleton-pregnant merino cross ewes at 122.0 (±0.5) days of gestation were anaesthetised with a combination of midazolam (0.5 mg/kg) and ketamine (10 mg/kg) by intravenous injection...
January 1, 2018: Laboratory Animals
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