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End-tidal CO2

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https://www.readbyqxmd.com/read/28419356/arousal-induced-hypocapnia-does-not-reduce-genioglossus-activity-in-obstructive-sleep-apnea-arousal-induced-hypocapnia-in-osa-muscle-effects
#1
Jennifer M Cori, Therese Thornton, Fergal J O'Donoghue, Peter D Rochford, David P White, John Trinder, Amy S Jordan
Study Objectives: To determine whether arousals that terminate obstructive events in obstructive sleep apnea (OSA): 1. Induce hypocapnia and 2. Subsequently reduce genioglossus muscle activity following the return to sleep. Methods: 31 untreated OSA patients slept instrumented with: sleep staging electrodes, nasal mask and pneumotachograph, end-tidal CO2 monitoring and intramuscular genioglossus electrodes. End-tidal CO2 was monitored and respiratory arousals were assigned an end-arousal CO2 change value (PETCO2 on the last arousal breath minus each individual's wakefulness PETCO2)...
April 13, 2017: Sleep
https://www.readbyqxmd.com/read/28413511/application-of-dead-space-fraction-to-titrate-optimal-positive-end-expiratory-pressure-in-an-ards-swine-model
#2
Weishuai Bian, Wei Chen, Yangong Chao, Lan Wang, Liming Li, Jian Guan, Xuefeng Zang, Jie Zhen, Bo Sheng, Xi Zhu
This study aimed to apply the dead space fraction [ratio of dead space to tidal volume (VD/VT)] to titrate the optimal positive end-expiratory pressure (PEEP) in a swine model of acute respiratory distress syndrome (ARDS). Twelve swine models of ARDS were constructed. A lung recruitment maneuver was then conducted and the PEEP was set at 20 cm H2O. The PEEP was reduced by 2 cm H2O every 10 min until 0 cm H2O was reached, and VD/VT was measured after each decrement step. VD/VT was measured using single-breath analysis of CO2, and calculated from arterial CO2 partial pressure (PaCO2) and mixed expired CO2 (PeCO2) using the following formula: VD/VT = (PaCO2 - PeCO2)/PaCO2...
April 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28412161/the-effect-of-the-apneic-period-on-the-respiratory-physiology-of-patients-undergoing-intubation-in-the-emergency-department
#3
Jason R West, Anthony Scoccimarro, Cody Kramer, Nicholas D Caputo
OBJECTIVES: We sought to examine the physiological impact the apneic period has on the respiratory physiology of patients undergoing intubation in the emergency department and whether DAO, the delivery of 15L oxygen by nasal cannula during apnea, can affect the development of respiratory acidosis. METHODS: This was a prospective observational cohort study conducted at an urban academic level 1 trauma center. A convenience sample of 100 patients was taken. Timed data collection forms were completed during the periintubation period...
April 2, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28403972/low-pressure-gynecological-laparoscopy-7mmhg-with-airseal-%C3%A2-system-versus-a-standard-insufflation-15mmhg-a-pilot-study-in-60-patients
#4
J Sroussi, A Elies, A Rigouzzo, N Louvet, M Mezzadri, A Fazel, J-L Benifla
OBJECTIVES: To evaluate feasibility of performing benign gynecologic pathology low pressure (7mmHg) laparoscopy (LPL) with AirSeal(®) system and to study benefits in terms of postoperative pain, when compared to a standard insufflation group (15mmHg). MATERIALS AND METHODS: In this prospective randomized pilot study, 60 patients had laparoscopy for gynecologic benign pathology: 30 with 7mmHg and AirSeal system, and 30 with 15mmHg standard insufflator. The primary endpoint was incidence of shoulder pain...
February 2017: J Gynecol Obstet Hum Reprod
https://www.readbyqxmd.com/read/28403594/the-effect-of-surgical-technique-on-hemodynamics-arterial-oxygenation-and-pulmonary-mechanics-in-radical-prostatectomy-operations
#5
Yucel Yuce, Kutlu Hakan Erkal, Cemal Goktas, Bilal Eryildirim, Kemal Sarica
OBJECTIVE: The effects of surgical technique on respiratory mechanics, arterial oxygenation and hemodynamics in radical prostatectomy operation were investigated. METHODS: The study was planned on ASA II-III, 40-65 years old, fourty patients scheduled for radical prostatectomy under general anesthesia. They were divided into two groups: perineal and suprapubic (Group P, n = 20; Group S, n = 20). Heart rate, mean arterial blood pressure, arterial oxygen saturation (SpO2), partial pressure of end-tidal carbon dioxide (PEtCO2), Peak inspiratory pressure (PIP), plato pressure (Pplato), partial pressure of oxygen in arterial blood (PaO2), partial pressure of carbon dioxide in arterial blood (PaCO2) values were evaluated at 10 minutes after induction...
March 31, 2017: Archivio Italiano di Urologia, Andrologia
https://www.readbyqxmd.com/read/28399695/the-effect-of-adenotonsillectomy-on-obstructive-sleep-apnea-in-children-with-down-syndrome
#6
Mosaad Abdel-Aziz, Khaled Azooz, Nader Naguib, Ramez Reda, Ahmed Kamel
OBJECTIVE: Children with Down syndrome (DS) are liable to develop obstructive sleep apnea (OSA) due to many anatomical airway abnormalities. The tonsils and adenoid occupy part of the airway space, and their removal may be helpful in relieving airway obstruction. The aim of this study was to assess the effectiveness of adenotonsillectomy in the treatment of OSA in those children. METHODS: Fifty DS children with difficult breathing were recruited, and they were subjected to polysomnographic examination (PSG)...
April 11, 2017: Acta Oto-laryngologica
https://www.readbyqxmd.com/read/28398947/acidosis-but-not-alkalosis-affects-anaerobic-metabolism-and-performance-in-a-4-km-time-trial
#7
Carlos Rafaell Correia-Oliveira, João Paulo Lopes-Silva, Romulo Bertuzzi, Glenn K McConell, David John Bishop, Adriano Eduardo Lima-Silva, Maria Augusta Peduti Dal'Molin Kiss
PURPOSE: To determine the effect of pre-exercise metabolic acidosis and alkalosis on power output (PO) and aerobic and anaerobic energy expenditure during a 4-km cycling time trial (TT). METHODS: Eleven recreationally trained cyclists (VO2peak 54.1 ± 9.3 mL·kg·min) performed a 4-km TT 100 min after ingesting in a double-blind matter 0.15 g·kg of body mass of ammonium chloride (NH4Cl, acidosis), 0.3 g·kg of sodium bicarbonate (NaHCO3, alkalosis) or 0.15 g·kg of CaCO3 (placebo)...
April 11, 2017: Medicine and Science in Sports and Exercise
https://www.readbyqxmd.com/read/28397574/very-severe-obstructive-sleep-apnea-in-children-outcomes-of-adenotonsillectomy-and-risk-factors-for-persistence
#8
Amal Isaiah, Hisham Hamdan, Romaine F Johnson, Kamal Naqvi, Ron B Mitchell
Objectives (1) To describe the clinical, demographic and polysomnographic (PSG) characteristics of children with very severe obstructive sleep apnea (OSA) without significant comorbidities; (2) to assess the outcomes following tonsillectomy and adenoidectomy (T&A); and (3) to determine predictors of persistence of OSA after T&A. Study Design Case series with chart review. Setting Tertiary-level freestanding children's hospital. Subjects and Methods Seventy-four children aged 2 to 12 years who underwent T&A for very severe OSA (obstructive apnea-hypopnea index [AHI] >30) were included...
April 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28392777/efficacy-of-cerebral-autoregulation-in-early-ischemic-stroke-predicts-smaller-infarcts-and-better-outcome
#9
Pedro Castro, Jorge Manuel Serrador, Isabel Rocha, Farzaneh Sorond, Elsa Azevedo
BACKGROUND AND PURPOSE: Effective cerebral autoregulation (CA) may protect the vulnerable ischemic penumbra from blood pressure fluctuations and minimize neurological injury. We aimed to measure dynamic CA within 6 h of ischemic stroke (IS) symptoms onset and to evaluate the relationship between CA, stroke volume, and neurological outcome. METHODS: We enrolled 30 patients with acute middle cerebral artery IS. Within 6 h of IS, we measured for 10 min arterial blood pressure (Finometer), cerebral blood flow velocity (transcranial Doppler), and end-tidal-CO2...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/28391757/dose-finding-study-comparing-three-treatments-of-remifentanil-in-cats-anesthetized-with-isoflurane-undergoing-ovariohysterectomy
#10
Marcela L Machado, João Henrique N Soares, Maria Alice Kuster de Albuquerque Gress, Douglas Dos Santos E Castro, Kaleizu Teodoro Rosa, Phillipe Bauer de Araujo Doria, Fabio Otero Ascoli
Objectives Three infusion rates of remifentanil were used in isoflurane-anesthetized cats undergoing ovariohysterectomy. The aim of this study was to identify a dosage regimen that would provide optimal anesthetic and surgical conditions, as well as to compare cardiovascular response to surgical stimulation, postoperative analgesia, anesthetic duration and quality of recovery among the tested remifentanil infusion rates. Methods Twenty-seven client-owned, mixed-breed adult healthy female cats were randomized to receive remifentanil 0...
April 1, 2017: Journal of Feline Medicine and Surgery
https://www.readbyqxmd.com/read/28391261/end-tidal-co2-predicts-reduction-in-mitral-regurgitation-in-patients-undergoing-percutaneous-mitral-valve-edge-to-edge-repair
#11
Michael Huntgeburth, Robert Schier, Roman Pfister, Henrik Ten Freyhaus, Kristina Dahlem, Kai Friedrichs, Stephan Baldus, Volker Rudolph
OBJECTIVES: We evaluated end-tidal CO2 (etCO2), which has been proposed to assess acute hemodynamic changes, to guide percutaneous edge-to-edge mitral valve repair (PMVR) with the MitraClip system. METHODS: Thirty-nine patients (aged 78 ± 14 years) undergoing PMVR for moderate-to-severe mitral regurgitation (MR) of primary and secondary etiology were included. General anesthesia was maintained with sevoflurane and constant ventilation parameters to ensure stable etCO2 tension...
April 8, 2017: Cardiology
https://www.readbyqxmd.com/read/28389799/effects-of-hypercapnia-on-postoperative-nausea-and-vomiting-after-laparoscopic-surgery-a-double-blind-randomized-controlled-study
#12
Ji-Seon Son, Ji-Yun Oh, Seonghoon Ko
BACKGROUND: Laparoscopic surgery is associated with a high incidence of postoperative nausea and vomiting (PONV). The use of CO2 pneumoperitoneum has been proposed as a potential cause of high PONV incidence. However, intraoperative hypercarbia may be related to enhanced perfusion to the main effector sites for PONV, including the brain and gastrointestinal tract. In this study, we investigated whether an increase in intraoperative CO2 partial pressure in arterial blood (PaCO2) reduces the incidence of PONV...
April 7, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28389602/shear-mediated-dilation-of-the-internal-carotid-artery-occurs-independent-of-hypercapnia
#13
Ryan L Hoiland, Kurt Jason Smith, Howard H Carter, Nia C S Lewis, Michael M Tymko, Kevin W Wildfong, Anthony R Bain, Daniel J Green, Philip N Ainslie
Evidence for shear stress as a regulator of carotid artery dilation in response to increased arterial carbon dioxide was recently demonstrated in humans during sustained elevations in CO2 (hypercapnia); however, the relative contributions of CO2 and shear stress to this response remains unclear. We examined the hypothesis that, following a 30-second transient increase in arterial CO2 tension and consequent increase in internal carotid artery shear stress, internal carotid artery diameter would increase, indicating shear-mediated dilation, in the absence of concurrent hypercapnia...
April 7, 2017: American Journal of Physiology. Heart and Circulatory Physiology
https://www.readbyqxmd.com/read/28389601/anterior-cerebral-blood-velocity-and-end-tidal-co2-responses-to-exercise-differ-in-children-and-adults
#14
Lindsay A Ellis, Philip N Ainslie, Victoria A Armstrong, Laura Emily Morris, Ryan Gerard Simair, Nathan R Sletten, Christine M Tallon, Ali Mary McManus
Little is known about the response of the cerebrovasculature to acute exercise in children and how these responses might differ with adults. Therefore, we compared changes in middle cerebral artery blood velocity (MCAVmean), partial pressure of end-tidal carbon dioxide (PETCO2), blood pressure and ventilation (VE) in response to incremental exercise between children and adults. Thirteen children [aged 9±1 (SD) y] and 13 sex-matched adults [aged 25±4 y] completed a maximal exercise test during which MCAVmean, PETCO2 and VE were measured continuously...
April 7, 2017: American Journal of Physiology. Heart and Circulatory Physiology
https://www.readbyqxmd.com/read/28388225/effects-of-pressure-support-ventilation-may-be-lost-at-high-exercise-intensities-in-people-with-copd
#15
David Anekwe, Michel de Marchie, Jadranka Spahija
Pressure support ventilation (PSV) may be used for exercise training in chronic obstructive pulmonary disease (COPD), but its acute effect on maximum exercise capacity is not fully known. The objective of this study was to evaluate the effect of 10 cm H2O PSV and a fixed PSV level titrated to patient comfort at rest on maximum exercise workload (WLmax), breathing pattern and metabolic parameters during a symptom-limited incremental bicycle test in individuals with COPD. Eleven individuals with COPD (forced expiratory volume in one second: 49 ± 16%; age: 64 ± 7 years) performed three exercise tests: without a ventilator, with 10 cm H2O of PSV and with a fixed level titrated to comfort at rest, using a SERVO-i ventilator...
April 7, 2017: COPD
https://www.readbyqxmd.com/read/28383434/low-pressure-capnoperitoneum-reduces-stress-responses-during-pediatric-laparoscopic-high-ligation-of-indirect-inguinal-hernia-sac-a-randomized-controlled-study
#16
Xiaoguang Niu, Xubin Song, Aiping Su, Shanshan Zhao, Qinghao Li
BACKGROUND: We aimed to evaluate the effect of different capnoperitoneum pressures on stress responses in pediatric laparoscopic inguinal hernia repair. METHODS: In this prospective randomized controlled study, 68 children with indirect inguinal hernia who underwent high ligation of hernia sac were randomly divided into 3 groups: high-pressure group (12 mm Hg, HP group, n = 26); low-pressure group (8 mm Hg, LP group, n = 20); open operation group (OP group, n = 22)...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28379019/-irregular-breathing-during-the-cardiopulmonary-exercise-test-from-mildly-irregular-breathing-pattern-to-periodic-breathing-of-oscillatory-ventilation-type
#17
František Várnay, Leona Mífková, Pavel Homolka, Petr Dobšák
The fluctuating course of tidal volume (VT), breathing frequency (DF) and minute ventilation (VE) during the cardio-pulmonary exercise test using a ramp incremental protocol occurs not only in patients, but relatively frequently also in healthy individuals. It can account for a number of irregularities in the course of the curves VO2, VCO2 and in particular of those of ventilatory equivalents for O2 and CO2 (EQO2, EQCO2) as well as curves of partial pressure of end-tidal oxygen and partial pressure of end-tidal carbon dioxide (PETO2, PETCO2), which are also used, inter alia, to establish ventilatory thresholds...
2017: Vnitr̆ní Lékar̆ství
https://www.readbyqxmd.com/read/28373858/enhanced-cholinergic-activity-improves-cerebral-blood-flow-during-orthostatic-stress
#18
Jorge M Serrador, Roy Freeman
Cerebral blood flow (CBF) and consequently orthostatic tolerance when upright depends on dilation of the cerebral vasculature in the face of reduced perfusion pressure associated with the hydrostatic gradient. However, it is still unclear if cholinergic activation plays a role in this dilation. To determine if enhancing central cholinergic activity with the centrally acting acetylcholinesterase inhibitor, physostigmine would increase CBF when upright compared to the peripherally acting acetylcholinesterase inhibitor, neostigmine, or saline...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/28371672/determinants-of-pulmonary-dead-space-in-ventilated-newborn-infants
#19
Theodore Dassios, Ourania Kaltsogianni, Anne Greenough
BACKGROUND: Pulmonary dead space (VD) is an index of ventilation inhomogeneity and one of the determinants of the magnitude of tidal volume to maintain optimal blood gases. AIMS: To identify the determinants of VD in ventilated newborns and to investigate differences in VD between prematurely born and term infants and those prematurely born infants who did or did not develop bronchopulmonary dysplasia (BPD). METHODS: Sixty-one mechanically ventilated infants (15 term, 46 preterm) were studied at a median age of 8 (IQR 2-31) days; 32 of the preterm infants developed BPD...
March 31, 2017: Early Human Development
https://www.readbyqxmd.com/read/28367294/decrease-in-spectral-entropy-by-low-tidal-volume-ventilation-associated-severe-hypercapnia-a-case-report
#20
Junggun Ann, Sung Mee Jung, Sang-Jin Park
Severe hypercapnia can be predicted by a decrease in cerebral electrical activity. The authors describe a sudden decrease in spectral entropy due to severe hypercapnia-induced respiratory acidosis in a patient with chronic pulmonary obstructive disease during lung resection. After two and a half hours of low tidal volume ventilation in the lateral position, the state entropy suddenly dropped from 45 to 7, without any changes in the effect-site concentration of propofol, end-tidal carbon dioxide (CO2) tension, oxygen saturation, or arterial pressure...
April 2017: Korean Journal of Anesthesiology
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