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Hypoxaemia

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https://www.readbyqxmd.com/read/29208583/challenging-anaesthetic-management-of-captive-reindeer-rangifer-tarandus-report-of-4-cases
#1
P Monticelli, A McSloy, U Morath, C Adami
Four captive reindeer underwent anaesthesia to allow dehorning or drainage of lymph nodes abscessation. Premedication was based on xylazine (dose range: 0.075- 0.5 mg/kg, IM or IV), with or without ketamine (dose range: 1-2 mg/kg, IM or IV), all of which failed to produce effective sedation without side effects. During anaesthesia, 2 reindeer experienced severe hypoxaemia and hypoventilation. Recovery was smooth in 3 out 4 animals, but delayed in one reindeer sedated with 0.5 mg/kg of xylazine IV; this patient required repeated atipamezole administrations (0...
December 2017: Schweizer Archiv Für Tierheilkunde
https://www.readbyqxmd.com/read/29171661/a-randomised-controlled-trial-comparing-high-flow-nasal-oxygen-with-standard-management-for-conscious-sedation-during-bronchoscopy
#2
N Douglas, I Ng, F Nazeem, K Lee, P Mezzavia, R Krieser, D Steinfort, L Irving, R Segal
Traditional conscious sedation for endobronchial ultrasound procedures places patients at risk of desaturation, and high-flow nasal oxygen may reduce the risk. We designed a parallel-group randomised controlled trial of high-flow nasal oxygen at a flow rate of 30-70 l.min(-1) via nasal cannulae, compared with standard oxygen therapy at 10 l.min(-1) via a bite block in adults planned for conscious sedation for endobronchial ultrasound. The primary outcome was the proportion of patients experiencing desaturation (defined as SpO2 < 90%)...
November 24, 2017: Anaesthesia
https://www.readbyqxmd.com/read/29169839/cardiopulmonary-effects-of-anaesthesia-maintained-by-propofol-infusion-versus-isoflurane-inhalation-in-cheetahs-acinonyx-jubatus
#3
Roxanne K Buck, Adrian Sw Tordiffe, Gareth E Zeiler
OBJECTIVE: To compare the cardiopulmonary effects of propofol total intravenous anaesthesia (TIVA) with isoflurane in cheetahs (Acinonyx jubatus) to evaluate feasibility for field use. STUDY DESIGN: Prospective clinical study. ANIMALS: A group of 24 adult cheetahs, 12 per group. METHODS: Cheetahs were immobilized with zolazepam/tiletamine (1.2 mg kg(-1)) and medetomidine [40 μg kg(-1), both intramuscular (IM)] by darting...
June 23, 2017: Veterinary Anaesthesia and Analgesia
https://www.readbyqxmd.com/read/29168911/pre-operative-parameters-do-not-reliably-identify-post-operative-respiratory-risk-in-children-undergoing-adenotonsillectomy
#4
Surendran Thavagnanam, Saou Y Cheong, Karuthan Chinna, Anna M Nathan, Jessie A de Bruyne
AIM: Adenotonsillectomy is performed in children with recurrent tonsillitis or obstructive sleep apnoea. Children at risk of post-operative respiratory complications are recommended to be monitored in paediatric intensive care unit (PICU). The aim of the study is to review the risk factors for post-operative complications and admissions to PICU. METHODS: A review of medical records of children who underwent adenotonsillectomy between January 2011 and December 2014 was performed...
November 23, 2017: Journal of Paediatrics and Child Health
https://www.readbyqxmd.com/read/29161401/the-evolution-of-airway-management-new-concepts-and-conflicts-with-traditional-practice
#5
A F McNarry, A Patel
In the last 25 yr, there have been several advances in the safe management of the airway. Videolaryngoscopes and supraglottic airways, now in routine use by new trainees in anaesthesia, have had their genesis in the recent past. The 4th National Audit Project of the Royal College of Anaesthetists and the Difficult Airway Society published in 2011 a seminal report that has influenced airway management worldwide . Understanding how the report's recommendations were constructed and how clinical guidelines compliment rather than contradict them is important in understanding the tenets of safe airway management...
December 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29138266/postoperative-hypoxaemia-telebrix-aspiration
#6
Ina Dubin, Amichai Schattner
No abstract text is available yet for this article.
November 14, 2017: Postgraduate Medical Journal
https://www.readbyqxmd.com/read/29122894/dyspnoea-in-lupus
#7
Jeremy Fleri Soler, Andrew Borg, Cecilia Mercieca
A 32-year-old woman suffering from systemic lupus erythematosus presented with a 6-week history of progressive dyspnoea and pleuritic chest pain. Examination was normal apart from reduced air entry at the lung bases.Arterial blood gases showed hypoxaemia and chest X-ray revealed raised hemidiaphragms without any pleural effusions. Lung function showed a restrictive pathology while high-resolution chest CT and CT pulmonary angiogram were negative. Echocardiography showed normal ventricular diameters and no pericardial effusion...
November 8, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29105576/clinical-signs-of-hypoxaemia-in-children-aged-2%C3%A2-months-to-5%C3%A2-years-with-acute-respiratory-distress-in-switzerland-and-senegal
#8
Lucie von der Weid, Mario Gehri, Boubacar Camara, Aliou Thiongane, Andrès Pascual, Jean-Yves Pauchard
BACKGROUND: Hypoxaemia is a predictor of pneumonia-related mortality. WHO published recommendations for oxygen therapy based on clinical signs which state that, when oxygen is plentiful, it should be given to children with central cyanosis, inability to drink, severe chest indrawing, RR >70 breaths/min, grunting with every breath (in young infants) or those who display head nodding. These guidelines, however, are based on a few studies only. AIM: To assess the accuracy of combinations of clinical signs which predict hypoxaemia in pre-school children aged 2 months to 5 years with acute respiratory distress in hospitals in Switzerland and Senegal...
November 6, 2017: Paediatrics and International Child Health
https://www.readbyqxmd.com/read/29104014/continuous-positive-airway-pressure-an-early-intervention-to-prevent-phosgene-induced-acute-lung-injury
#9
Stuart Graham, Sarah Fairhall, Steve Rutter, Philippa Auton, Rachel Rendell, Adam Smith, Rosi Perrott, Tim Nicholson Roberts, Bronwen Jugg
Exposure to toxic industrial chemicals such as phosgene may occur through accidental or deliberate release. Inhalation may result in an acute lung injury which manifests as hypoxaemia with insufficient oxygen being delivered to the tissues resulting in hypoxia, respiratory failure and death. No effective pharmacological therapy currently exists and treatment remains supportive, often requiring intensive care facilities. In a mass casualty scenario the logistical burden of managing exposed individuals would rapidly overwhelm healthcare systems...
November 2, 2017: Toxicology Letters
https://www.readbyqxmd.com/read/29094472/serum-mast-cell-tryptase-measurements-sensitivity-and-specificity-for-a-diagnosis-of-anaphylaxis-in-emergency-department-patients-with-shock-or-hypoxaemia
#10
Abbie Francis, Daniel M Fatovich, Glenn Arendts, Stephen Pj Macdonald, Erika Bosio, Yusuf Nagree, Hugh Ma Mitenko, Simon Ga Brown
OBJECTIVE: Clinical diagnosis of anaphylaxis is principally based on symptoms and signs. However, particularly for patients with atypical symptoms, laboratory confirmation of anaphylaxis would be useful. This study investigated the utility of mast cell tryptase, an available clinical biomarker, for differentiating anaphylaxis from other causes of critical illness, which can also involve mast cell activation. METHODS: Tryptase was measured (ImmunoCAP) in serum from patients with anaphylaxis and non-anaphylactic critical illness (controls) at ED arrival, and after 1-2, 3-4 and 12-24 h...
November 2, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/29092970/extracorporeal-membrane-oxygenation-for-post-transplant-hypoxaemia-following-very-severe-hepatopulmonary-syndrome
#11
Lakshmi Kumar, Dinesh Balakrishnan, Rekha Varghese, Sudhindran Surendran
Hepatopulmonary syndrome (HPS) associated with end-stage liver disease has a high morbidity when room air PaO2 is less than 50 mm Hg. Safe levels of oxygenation to facilitate transplantation have not been defined despite advancement in care. Postoperatively, hypoxaemia worsens due to ventilation perfusion mismatch contributed by postoperative pulmonary vasoconstriction and due to decrease in endogenous nitric oxide. A 16-year-old boy with cirrhosis presented with HPS and a PaO2 of 37 mm Hg on room air and underwent living donor liver transplant...
November 1, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29080284/pulse-oximetry-values-of-neonates-admitted-for-care-and-receiving-routine-oxygen-therapy-at-a-resource-limited-hospital-in-kenya
#12
Melissa C Morgan, Beth Maina, Mary Waiyego, Catherine Mutinda, Jalemba Aluvaala, Michuki Maina, Mike English
AIM: There are 2.7 million neonatal deaths annually, 75% of which occur in sub-Saharan Africa and South Asia. Effective treatment of hypoxaemia through tailored oxygen therapy could reduce neonatal mortality and prevent oxygen toxicity. METHODS: We undertook a two-part prospective study of neonates admitted to a neonatal unit in Nairobi, Kenya, between January and December 2015. We determined the prevalence of hypoxaemia and explored associations of clinical risk factors and signs of respiratory distress with hypoxaemia and mortality...
October 27, 2017: Journal of Paediatrics and Child Health
https://www.readbyqxmd.com/read/29071074/long-term-outcomes-of-patients-with-pulmonary-arteriovenous-malformations-considered-for-lung-transplantation-compared-with-similarly-hypoxaemic-cohorts
#13
Claire L Shovlin, Elisabetta Buscarini, J Michael B Hughes, David J Allison, James E Jackson
INTRODUCTION: Pulmonary arteriovenous malformations (PAVMs) may not be amenable to treatment by embolisation or surgical resection, and many patients are left with significant hypoxaemia. Lung transplantation has been undertaken. There is no guidance on selection criteria. METHODS: To guide transplantation listing assessments, the outcomes of the six patients who had been considered for transplantation were compared with a similarly hypoxaemic patient group recruited prospectively between 2005 and 2016 at the same UK institution...
2017: BMJ Open Respiratory Research
https://www.readbyqxmd.com/read/29049534/high-frequency-percussive-ventilation-in-cardiac-surgery-patients-failing-mechanical-conventional-ventilation
#14
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
#15
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
#16
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
#17
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...
November 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29033246/effect-of-choline-chloride-premedication-on-xylazine-induced-hypoxaemia-in-sheep
#18
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
#19
T Piegeler, N G Clausen, M Weiss, Takashi Asai
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...
December 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29017230/-guidelines-in-practice-the-new-s3-guideline-sleeping-disorders-sleep-related-abnormal-breathing
#20
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
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