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https://www.readbyqxmd.com/read/29452100/a-new-noninvasive-method-of-measuring-impaired-pulmonary-gas-exchange-in-lung-disease-an-outpatient-study
#1
John B West, Daniel R Crouch, Janelle M Fine, Dipen Makadia, Daniel L Wang, G Kim Prisk
BACKGROUND: It would be valuable to have a noninvasive method of measuring impaired pulmonary gas exchange in patients with lung disease and so reduce the need for repeated arterial punctures. Here we report the results of using a new test in a group of outpatients attending a pulmonary clinic. METHODS: Inspired and expired P O2 and P CO2 are continually measured by small, rapidly responding analyzers. The arterial P O2 is calculated from the oximeter Sp O2 and the oxygen dissociation curve...
February 13, 2018: Chest
https://www.readbyqxmd.com/read/29429821/obstructive-sleep-apnea-screening-among-surgical-patients-a-quality-improvement-project
#2
Linda Lakdawala, Bryce Dickey, Mohammad Alrawashdeh
PURPOSE: Obstructive sleep apnea (OSA) increases the risk of respiratory depression in surgical patients. This project screened patients for OSA and explored its relationship with respiratory complications. DESIGN: Quality improvement project. METHODS: Neurosurgical patients were preoperatively screened using STOP-Bang questionnaire scores of 5 or greater as high risk and less than 5 as low risk for moderate-to-severe OSA. Postoperative respiratory complications were compared between both OSA groups...
February 8, 2018: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
https://www.readbyqxmd.com/read/29423554/performance-of-a-second-generation-pulmonary-capnotracking-system-for-continuous-monitoring-of-cardiac-output
#3
Philip J Peyton, Monique Kozub
Technologies for minimally-invasive cardiac output measurement in patients during surgery remain little used in routine practice. We tested a redeveloped system based on CO 2 elimination (VCO 2 ) by the lungs for use in ventilated patients, which can be seamlessly integrated into a modern anesthesia/monitoring platform, and provides automated, continuous breath-by-breath cardiac output monitoring. A prototype measurement system was constructed to measure VCO 2 and end-tidal CO 2 concentration with each breath...
February 8, 2018: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/29416525/patient-specific-alterations-in-co2-cerebrovascular-responsiveness-in-acute-and-sub-acute-sports-related-concussion
#4
W Alan C Mutch, Michael J Ellis, Lawrence N Ryner, Patrick J McDonald, Marc P Morissette, Philip Pries, Marco Essig, David J Mikulis, James Duffin, Joseph A Fisher
Background: Preliminary studies suggest that sports-related concussion (SRC) is associated with alterations in cerebral blood flow (CBF) regulation. Here, we use advanced magnetic resonance imaging (MRI) techniques to measure CBF and cerebrovascular responsiveness (CVR) in individual SRC patients and healthy control subjects. Methods: 15 SRC patients (mean age = 16.3, range 14-20 years) and 27 healthy control subjects (mean age = 17.6, range 13-21 years) underwent anatomical MRI, pseudo-continuous arterial spin labeling (pCASL) MRI and model-based prospective end-tidal targeting (MPET) of CO2 during blood oxygenation level-dependent (BOLD) MRI...
2018: Frontiers in Neurology
https://www.readbyqxmd.com/read/29416471/a-successful-anesthetic-approach-in-a-patient-with-schwartz-jampel-syndrome
#5
Fernando Calado de Oliveira Camacho, Tânia Marina Lopes Amaral, Joana Irene de Barros Mourão
Schwartz-Jampel syndrome (SJS) is a rare genetic condition that is characterized by several musculoskeletal abnormalities, such as myotonia, joint contractures, and facial dysmorphisms. Patients with this syndrome can present an anesthetic challenge, due to an increased risk of developing malignant hyperthermia (MH) and the possibility of encountering a difficult airway. Several precautions must be taken when general anesthesia is required, such as the avoidance of potential triggers for MH, continuous core temperature, and end-tidal CO2 monitoring, assuring that dantrolene is readily available...
January 2018: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/29416329/sex-specific-cardiopulmonary-exercise-testing-indices-to-estimate-the-severity-of-inoperable-chronic-thromboembolic-pulmonary-hypertension
#6
Tian-Xiang Chen, Bigyan Pudasaini, Jian Guo, Su-Gang Gong, Rong Jiang, Lan Wang, Qin-Hua Zhao, Wen-Hui Wu, Ping Yuan, Jin-Ming Liu
Background: Sex differences in chronic thromboembolic pulmonary hypertension (CTEPH) have been revealed in few studies. Although right heart catheterization (RHC) is the gold standard for clinical diagnosis and assessment of prognosis in pulmonary hypertension (PH), cardiopulmonary exercise testing (CPET) has been a more widely used assessment of functional capacity, disease severity, prognosis, and treatment response in PH. We hypothesized that the "sex-specific" CPET indices could estimate the severity of inoperable CTEPH...
2018: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/29411336/central-sleep-apnea-with-cheyne-stokes-breathing-in-heart-failure-from-research-to-clinical-practice-and-beyond
#7
K Terziyski, A Draganova
Characterized by periodic crescendo-decrescendo pattern of breathing alternating with central apneas, Central sleep apnea (CSA) with Cheyne-Stokes Breathing represents a highly prevalent, yet underdiagnosed comorbidity in chronic heart failure (CHF). A diverse body of evidence demonstrates increased morbidity and mortality in the presence of CSB. CSB has been described in both CHF patients with preserved and reduced ejection fraction, regardless of drug treatment. Risk factors for CSB are older age, male gender, high BMI, atrial fibrillation and hypocapnia...
February 7, 2018: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/29408324/vascular-reactivity-in-small-cerebral-perforating-arteries-with-7%C3%A2-t-phase-contrast-mri-a-proof-of-concept-study
#8
Lennart Geurts, Alex Bhogal, Jeroen Siero, Peter Luijten, Geert Jan Biessels, Jaco Zwanenburg
Existing cerebrovascular reactivity (CVR) techniques assess flow reactivity in either the largest cerebral vessels or at the level of the parenchyma. We examined the ability of 2D phase contrast MRI at 7 T to measure CVR in small cerebral perforating arteries. Blood flow velocity in perforators was measured in 10 healthy volunteers (mean age 26 years) using a 7 T MR scanner, using phase contrast acquisitions in the semioval center (CSO), the basal ganglia (BG) and the middle cerebral artery (MCA). Changes in flow velocity in response to a hypercapnic breathing challenge were assessed, and expressed as the percentual increase of flow velocity as a function of the increase in end tidal partial pressure of CO2...
February 2, 2018: NeuroImage
https://www.readbyqxmd.com/read/29395236/randomized-trial-of-low-versus-high-carbon-dioxide-insufflation-pressures-in-posterior-retroperitoneoscopic-adrenalectomy
#9
Sheila Fraser, Olov Norlén, Kyle Bender, Joanne Davidson, Sonya Bajenov, David Fahey, Shawn Li, Stan Sidhu, Mark Sywak
BACKGROUND: Posterior retroperitoneoscopic adrenalectomy has gained widespread acceptance for the removal of benign adrenal tumors. Higher insufflation pressures using carbon dioxide (CO2) are required, although the ideal starting pressure is unclear. This prospective, randomized, single-blinded, study aims to compare physiologic differences with 2 different CO2 insufflation pressures during posterior retroperitoneoscopic adrenalectomy. METHODS: Participants were randomly assigned to a starting insufflation pressure of 20 mm Hg (low pressure) or 25 mm Hg (high pressure)...
January 30, 2018: Surgery
https://www.readbyqxmd.com/read/29383314/controlled-vs-spontaneous-ventilation-for-bronchoscopy-in-children-with-tracheobronchial-foreign-body
#10
Leila Mashhadi, Alireza Sabzevari, Mohammad Gharavi Fard, Reza Shojaeian, Maryam Salehi, Marjan Joodi, Mahdi Fathi, Ali Jafarzadeh Esfehani, Kamran Khazaeni
Introduction: Tracheobronchial foreign body aspiration is a common life-threatening condition in children. There are controversies in the management of this condition, including the type of ventilation during bronchoscopy. This study aims to compare anesthesia with controlled ventilation versus spontaneous ventilation in rigid bronchoscopy in children with foreign body aspiration. Materials and Methods: Patients who were candidates for rigid bronchoscopy due to foreign body aspiration were randomly assigned to either anesthesia with spontaneous ventilation or controlled ventilation...
November 2017: Iranian Journal of Otorhinolaryngology
https://www.readbyqxmd.com/read/29381603/the-impact-of-velopharyngeal-surgery-on-the-polysomnographic-parameters-after-cleft-palate-repair
#11
Mosaad Abdel-Aziz, Ayman Hussien, Ahmed Kamel, Khaled Azooz, Mohamed Fawaz
Velopharyngeal surgical procedures may have adverse effect on the airway of the patients with velopharyngeal insufficiency (VPI). The aim of this study was to evaluate the polysomnographic parameters (PSG) in patients who underwent corrective surgery for treatment of VPI. The study included 39 patients who underwent 1 of 3 velopharyngeal surgical techniques; Furlow palatoplasty (12 patients), pharyngeal flap (18 patients), and sphincter pharyngoplasty (9 patients). The patients were subjected to PSG, and they were considered to have obstructive sleep apnea (OSA) with apnea-hypoapnea index (AHI) >1...
January 29, 2018: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/29374847/volumetric-and-reflective-device-dead-space-of-anaesthetic-reflectors-under-different-conditions
#12
Hagen Bomberg, Max Veddeler, Thomas Volk, Heinrich V Groesdonk, Andreas Meiser
Inhalation sedation is increasingly performed in intensive care units. For this purpose, two anaesthetic reflectors, AnaConDa™ and Mirus™ are commercially available. However, their internal volume (100 ml) and possible carbon dioxide reflection raised concerns. Therefore, we compared carbon dioxide elimination of both with a heat moisture exchanger (HME, 35 ml) in a test lung model. A constant flow of carbon dioxide was insufflated into the test lung, ventilated with 500 ml, 10 breaths per minute. HME, MIRUS and AnaConDa were connected successively...
January 27, 2018: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/29367357/seesawing-end-tidal-carbon-dioxide-portent-of-critical-carbon-dioxide-embolism-in-retroperitoneoscopy
#13
Melvin Alex Abraham, Riya Jose, Mazhuvanchary Jacob Paul
An abrupt increase in end-tidal CO2 (EtCO2; from 35 to 58 mm Hg) followed by a sudden fall (to 18 mm Hg) was noted during retroperitoneoscopic adrenalectomy under general anaesthesia in a 23-year-old patient with adrenal hyperplasia. This was accompanied by hypotension (systolic blood pressure of 60 mm Hg), desaturation (88% SpO2) and ST depression (3.5 mm). The patient was resuscitated with fluids and vasopressor drugs and about 4 mL of air was aspirated through the central venous catheter, confirming the diagnosis of an intraoperative gas embolism...
January 23, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29362042/implementing-microstream-end-tidal-co2-in-the-pacu
#14
Kimberly Latham, Tamera Bird, Joyce Burke
Managing patients with undiagnosed Obstructive Sleep Apnea (OSA) can be a challenge in the postoperative phase. OSA is a chronic disease defined by pauses in breathing that are repetitive during sleep that can last for one minute or longer. This can occur more than five times in an hour. As many as 80-90% of patients undergoing elective surgery have undiagnosed sleep apnea and an increased risk of respiratory complications postoperatively. Capnography is a monitoring tool that can detect increases in end-tidal carbon dioxide levels, which is a sign of respiratory decline...
February 2018: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
https://www.readbyqxmd.com/read/29359072/efficacy-and-safety-of-using-high-flow-nasal-oxygenation-in-patients-undergoing-rapid-sequence-intubation
#15
Santi Maurizio Raineri, Andrea Cortegiani, Giuseppe Accurso, Claudia Procaccianti, Filippo Vitale, Sabrina Caruso, Antonino Giarratano, Cesare Gregoretti
Objective: To assess the efficacy and safety of high-flow nasal oxygen (HFNO) therapy in patients undergoing rapid sequence intubation (RSI) for emergency abdominal surgery. Methods: HFNO of 60 L.min-1 at an inspiratory oxygen fraction of 1 was delivered 4 min before laryngoscopy and maintained until the patient was intubated, and correct intubation was verified by the appearance of the end-tidal CO2 (EtCO2) waveform. Transcutaneous oxygenation (SpO2), heart rate and non-invasive mean arterial pressure were monitored at baseline (T0), after 4 min on HFNO (T1) and at the time of laryngoscopy (T2) and endotracheal intubation (ETI) (T3)...
December 2017: Turkish Journal of Anaesthesiology and Reanimation
https://www.readbyqxmd.com/read/29340500/respiratory-evaluation-through-volumetric-capnography-among-grade-iii-obese-and-eutrophic-individuals-a-comparative-study
#16
Débora Aparecida Oliveira Modena, Marcos Mello Moreira, Ilma Aparecida Paschoal, Mônica Corso Pereira, Luiz Cláudio Martins, Everton Cazzo, Elinton Adami Chaim
BACKGROUND: Excess trunk body fat in obese individuals influences respiratory physiological function. The aims of this study were to compare volumetric capnography findings (VCap) between severely obese patients and normal-weight subjects and to assess whether there is any association between neck circumference (NC), waist-hip ratio (WHR) and VCap among grade III obese individuals. DESIGN AND SETTING: Analytical observational case-matched cross-sectional study, University of Campinas...
January 15, 2018: São Paulo Medical Journal, Revista Paulista de Medicina
https://www.readbyqxmd.com/read/29320309/isocapnic-buffering-phase-a-useful-indicator-of-exercise-endurance-and-prognosis-in-patients-with-coronary-artery-disease
#17
Yun-Shan Yen, Daniel Chiung Jui Su, Kuo-Shu Yuan, Po-Wei Chen, Julie Chi Chow, Willy Chou
OBJECTIVES: The significance of the isocapnic buffering (IB) phase - the period between the first ventilatory threshold (1stVT) and respiratory compensation point (RCP) - has not been adequately established in patients. This study aimed to determine the clinical significance of the IB phase in coronary artery disease (CAD) patients. METHODS: This retrospective study included data of sixty-two CAD patients after coronary artery bypass graft (CABG) or percutaneous coronary intervention (PCI) performed in a single medical center between 2010-2014...
January 10, 2018: Physician and Sportsmedicine
https://www.readbyqxmd.com/read/29261563/pediatric-in-hospital-cardiac-arrest-secondary-to-acute-pulmonary-embolism
#18
Ryan W Morgan, Hannah R Stinson, Heather Wolfe, Robert B Lindell, Alexis A Topjian, Vinay M Nadkarni, Robert M Sutton, Robert A Berg, Todd J Kilbaugh
OBJECTIVES: Pulmonary embolism is a rarely reported and potentially treatable cause of cardiac arrest in children and adolescents. The objective of this case series is to describe the course of five adolescent patients with in-hospital cardiac arrest secondary to pulmonary embolism. DESIGN: Case series. SETTING: Single, large academic children's hospital. PATIENTS: All patients under the age of 18 years (n = 5) who experienced an in-hospital cardiac arrest due to apparent pulmonary embolism from August 1, 2013, to July 31, 2017...
December 19, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/29239696/compression-garments-and-cerebral-blood-flow-influence-on-cognitive-and-exercise-performance
#19
Brittany A Smale, Joseph M Northey, Disa J Smee, Nathan G Versey, Ben Rattray
This study aimed to describe the effect of compression garments on middle cerebral artery blood flow velocity (MCAv) in relation to cognitive and exercise performance whilst cycling. In a randomised-controlled-cross-over design, 15 well-trained male cyclists were recruited to participate in three identical trials wearing loose fitting shorts (control), low-grade, or medium-grade compression garments. The protocol involved four 8 min increments of cycling at 30%, 50%, 70%, and 85% maximal power output and a 4 km time-trial...
December 14, 2017: European Journal of Sport Science
https://www.readbyqxmd.com/read/29210902/insufflation-with-carbon-dioxide-during-pediatric-colonoscopy-for-control-of-postprocedure-pain
#20
Chad Thornhill, Fernando Navarro, Baraa Alabd Alrazzak, S Shahrukh Hashmi, Ashish N DebRoy, Jon M Rhoads, Essam Imseis
GOALS: To determine if carbon dioxide (CO2) insufflation in children would improve postprocedure pain following colonoscopy in children. BACKGROUND: CO2 insufflation during colonoscopy has been found to reduce postcolonoscopy pain in the adult population, but limited data exist in pediatrics. MATERIALS AND METHODS: We conducted a prospective study with 40 pediatric patients scheduled for outpatient colonoscopy. Patients were enrolled continuously and were randomized to receive CO2 or air insufflation...
November 28, 2017: Journal of Clinical Gastroenterology
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