keyword
https://read.qxmd.com/read/38654449/the-intricate-physiology-of-veno-venous-extracorporeal-membrane-oxygenation-an-overview-for-clinicians
#1
REVIEW
Emilia Tomarchio, Francesca Momigliano, Lorenzo Giosa, Patrick Duncan Collins, Nicholas A Barrett, Luigi Camporota
During veno-venous extracorporeal membrane oxygenation (V-V ECMO), blood is drained from the central venous circulation to be oxygenated and decarbonated by an artificial lung. It is then reinfused into the right heart and pulmonary circulation where further gas-exchange occurs. Each of these steps is characterized by a peculiar physiology that this manuscript analyses, with the aim of providing bedside tools for clinical care: we begin by describing the factors that affect the efficiency of blood drainage, such as patient and cannulae position, fluid status, cardiac output and ventilatory strategies...
April 2024: Perfusion
https://read.qxmd.com/read/38651573/mechanical-ventilation-during-extracorporeal-membrane-oxygenation-support-new-trends-and-continuing-challenges
#2
JOURNAL ARTICLE
Konstanty Szuldrzynski, Mariusz Kowalewski, Justyna Swol
BACKGROUND: The impact of mechanical ventilation on the survival of patients supported with veno-venous extracorporeal membrane oxygenation (V-V ECMO) due to severe acute respiratory distress syndrome (ARDS) remains still a focus of research. METHODS: Recent guidelines, randomized trials, and registry data underscore the importance of lung-protective ventilation during respiratory and cardiac support on ECMO. RESULTS: This approach includes decreasing mechanical power delivery by reducing tidal volume and driving pressure as much as possible, using low or very low respiratory rate, and a personalized approach to positive-end expiratory pressure (PEEP) setting...
April 2024: Perfusion
https://read.qxmd.com/read/38649817/diagnostic-utility-of-capnography-in-emergency-department-triage-for-screening-acidemia-a-pilot-study
#3
JOURNAL ARTICLE
Paul Peng, Alex F Manini
BACKGROUND: Capnography is a quantitative and reliable method of determining the ventilatory status of patients. We describe the test characteristics of capnography obtained during Emergency Department triage for screening acidemia. RESULTS: We performed an observational, pilot study of adult patients presenting to Emergency Department (ED) triage. The primary outcome was acidemia, as determined by the basic metabolic panel and/or blood gas during the ED visit. Secondary outcomes include comparison of estimated and measured respiratory rates (RR), relationships between end-tidal CO2 (EtCO2 ) and venous partial pressure of CO2 , admission disposition, in-hospital mortality during admission, and capnogram waveform analysis...
April 22, 2024: International Journal of Emergency Medicine
https://read.qxmd.com/read/38643097/the-effects-of-different-positions-on-lower-extremity-hemodynamics-during-robot-assisted-laparoscopic-radical-prostatectomy-for-prostate-cancer
#4
JOURNAL ARTICLE
Zheng Wang, Xinyu Wang, Xiaofen Yu
PURPOSE: This study aimed to investigate the effects of two different positions on lower extremity hemodynamics during robot-assisted laparoscopic radical prostatectomy (RARP) for prostate cancer. METHODS: A total of 196 patients who underwent RARP in our hospital from February 2020 to March 2022 were included in this study. Among them, 98 patients who underwent surgery with the Trendelenburg position and split-leg position with calf reverse arch from March 2021 to March 2022 were assigned to the observation group, while 98 patients who underwent surgery with the Trendelenburg position and low lithotomy position from February 2020 to February 2021 were assigned to the control group...
April 20, 2024: BMC Urology
https://read.qxmd.com/read/38635487/potential-indicators-of-intestinal-necrosis-in-portal-venous-gas-a-case-report-of-an-82-year-old-woman-on-long-term-hemodialysis-with-ascites-and-pneumatosis-coli
#5
JOURNAL ARTICLE
Yoshio Hisata, Naoko E Katsuki, Masaki Tago, Tomoyo Nishi, Tomotaro Nakashima, Yoshimasa Oda, Shu-Ichi Yamashita
BACKGROUND Several factors have been reported as possible predictors of intestinal necrosis in patients with portal venous gas (PVG). We describe potential indicators of intestinal necrosis in PVG identified by contrasting 3 episodes of PVG in a patient on hemodialysis against previously verified factors. CASE REPORT An 82-year-old woman undergoing hemodialysis was admitted to our hospital thrice for acute abdominal pain. On first admission, she was alert, with a body temperature of 36.3°C, blood pressure (BP) of 125/53 mmHg, pulse rate of 60/min, respiratory rate of 18/min, and 100% oxygen saturation on room air...
April 18, 2024: American Journal of Case Reports
https://read.qxmd.com/read/38628643/pharmacokinetics-of-desflurane-uptake-and-disposition-in-piglets
#6
JOURNAL ARTICLE
Chih-Cherng Lu, Shung-Tai Ho, Oliver Yao-Pu Hu, Cheng-Huei Hsiong, Yuan-Chen Cheng, Che-Hao Hsu, Tso-Chou Lin
INTRODUCTION: Many respiratory but few arterial blood pharmacokinetics of desflurane uptake and disposition have been investigated. We explored the pharmacokinetic parameters in piglets by comparing inspiratory, end-tidal, arterial blood, and mixed venous blood concentrations of desflurane. METHODS: Seven piglets were administered inspiratory 6% desflurane by inhalation over 2 h, followed by a 2-h disposition phase. Inspiratory and end-tidal concentrations were detected using an infrared analyzer...
2024: Frontiers in Pharmacology
https://read.qxmd.com/read/38623600/investigation-of-air-bubble-behaviour-after-gas-embolism-events-induced-in-a-microfluidic-network-mimicking-microvasculature
#7
JOURNAL ARTICLE
Mohammad Mahdi Mardanpour, Ayyappasamy Sudalaiyadum Perumal, Zahra Mahmoodi, Karine Baassiri, Gala Montiel-Rubies, Kenneth M LeDez, Dan V Nicolau
Gas embolism is a medical condition that occurs when gas bubbles are present in veins or arteries, decreasing blood flow and potentially reducing oxygen delivery to vital organs, such as the brain. Although usually reported as rare, gas embolism can lead to severe neurological damage or death. However, presently, only limited understanding exists regarding the microscale processes leading to the formation, persistence, movement, and resolution of gas emboli, as modulated by microvasculature geometrical features and blood properties...
April 16, 2024: Lab on a Chip
https://read.qxmd.com/read/38617591/pulmonary-embolism-with-paradoxical-embolization-to-right-coronary-artery-in-the-presence-of-a-large-patent-foramen-ovale-a-case-report
#8
Erik Boberg, Anders Hedman, Jacob Hollenberg
BACKGROUND: Pulmonary embolism (PE) is the leading cause of in-hospital death and the third most frequent cause of cardiovascular death. The clinical presentation of PE is variable, and choosing the appropriate treatment for individual patients can be challenging. CASE SUMMARY: A 64-year-old man presented to hospital with acute chest pain, shortness of breath, and pulmonary oedema. Electrocardiogram revealed ST-elevation myocardial infarction. D-dimer was 18.8 mg/L fibrinogen equivalent units (FEU) (normal <0...
April 2024: European Heart Journal. Case Reports
https://read.qxmd.com/read/38608954/localized-mammary-gland-changes-in-milk-composition-and-venous-blood-metabolite-concentrations-result-from-sterile-subclinical-mastitis
#9
JOURNAL ARTICLE
C S Gammariello, J Hanson, A E Relling, M X S Oliveira, A S Sipka, K M Enger, B D Enger
Subclinical mastitis reduces milk yield and elicits undesirable changes in milk composition, but the mechanisms resulting in reduced milk production in affected mammary glands are incompletely understood. This study investigated the effects of sterile inflammation on mammary gland metabolism by assessing changes in milk and venous blood composition. Mid-lactation primiparous Holstein cows (n = 4) had udder halves randomly allocated to treatments; quarters of 1 udder half were infused with 2 billion cfu of formalin fixed Staphylococcus aureus (FX-STAPH) and quarters of the opposite udder half infused with saline (SAL)...
April 10, 2024: Journal of Dairy Science
https://read.qxmd.com/read/38586110/effect-of-ultrasound-guided-stellate-ganglion-block-on-cerebral-oxygen-metabolism-and-s100b-protein-during-carotid-endarterectomy
#10
JOURNAL ARTICLE
Fen Yang, Yulong Du, Chen Yuan, Li Han, Yue Zhao, Yang Xie, Wenyong Peng
OBJECTIVE: To investigate the effect of ultrasound-guided stellate ganglion block (SGB) on cerebral oxygen metabolism and serum S100B during carotid endarterectomy (CEA). METHODS: Patients who were prospectively enrolled to receive CEA under elective general anesthesia were randomized into an SGB group and a control group (ChiCTR2000033385). Before anesthesia, the SGB group underwent ipsilateral SGB under ultrasound guidance, while the control group did not. Ultrasound-guided right subclavian internal jugular vein catheterization was performed under general anesthesia...
2024: American Journal of Translational Research
https://read.qxmd.com/read/38585150/evaluating-the-efficacy-of-a-standardized-4%C3%A2-ml-kg-fluid-bolus-technique-in-critically-ill-patients-with-elevated-p-va-co-2-secondary-analysis-of-two-prospective-studies
#11
JOURNAL ARTICLE
Rachid Attou, Thierry Du, Dimitrios Velissaris, Sebastien Redant, Mircea T Talpoș, Charalampos Pierrakos
BACKGROUND: Limiting the fluid bolus (FB) volume may attenuate side effects, including hemodilution and increased filling pressures, but it may also reduce hemodynamic responsiveness. The minimum volume to create hemodynamic effects is considered to be 4 mL/kg. In critically ill patients, the hemodynamic effects of FB with this volume have not been adequately investigated and compared to higher quantities. We hypothesized that a standardized FB approach using 4 mL/kg has comparable hemodynamic and metabolic effects to the common practice of physician-determined FB in critically ill patients...
2024: Frontiers in Medicine
https://read.qxmd.com/read/38575401/consensus-of-the-brazilian-association-of-hematology-hemotherapy-and-cellular-therapy-on-patient-blood-management
#12
JOURNAL ARTICLE
Roseny Dos Reis Rodrigues, Denise Menezes Brunetta, Lorena Costa, Bruno Deltreggia Benites, Mariana Munari Magnus, Susankerle de Oliveira Costa Alves, Gil Cunha De Santis, Silvia Renata Cornélio Parolin Rizzo, Guilherme Rabello, Dante Mario Langhi Junior
Understanding the physiological concepts of oxygen delivery is essential to discern the mechanisms that influence its increase, reduction or maintenance in the body. This text explores the different mechanisms that help maintain oxygen delivery even in the face of reduced hemoglobin levels. Adequate oxygen delivery ensures tissue and metabolic balance, which is crucial to avoid harmful consequences such as metabolic acidosis and cellular dysoxia. The complex interaction between variables such as cardiac output, hemoglobin and heart rate (HR) plays a fundamental role in maintaining oxygen delivery, allowing the body to temporarily adjust to situations of anemia or high metabolic demand...
March 19, 2024: Hematology, Transfusion and Cell Therapy
https://read.qxmd.com/read/38569861/-veno-venous-extracorporeal-membrane-oxygenation-for-capillary-leak-syndrome-during-induction-chemotherapy-in-acute-myeloid-leukemia
#13
JOURNAL ARTICLE
Tadashi Okamura, Shogo Murata, Kyohei Miyamoto, Misato Tane, Yuka Okabe, Satomi Takeda, Shotaro Tabata, Hideki Kosako, Yoshikazu Hori, Yusuke Yamashita, Toshiki Mushino, Hiroki Hosoi, Takashi Sonoki
A 44-year-old woman was diagnosed with acute myeloid leukemia (RUNX1::RUNX1T1 translocation) and received induction chemotherapy with idarubicin hydrochloride and cytosine arabinoside. The pneumonia that had been present since admission worsened, and a drug-induced skin rash appeared. On day 17, she presented with respiratory failure and shock, complicated by hemoconcentration and hypoalbuminemia. This was considered capillary leak syndrome due to pneumonia and drug allergy, so she was started on pulse steroid therapy and IVIG, and was intubated on the same day...
2024: [Rinshō Ketsueki] the Japanese Journal of Clinical Hematology
https://read.qxmd.com/read/38566545/venous-blood-gas-and-lactate-values-in-adult-giraffe-trained-for-voluntary-jugular-phlebotomy
#14
JOURNAL ARTICLE
Jordan Elias Cole, Liza Dadone, Sangeeta Rao, Priya Bapodra-Villaverde, Amy Schilz, Matthew Johnston
Blood gas analyses have previously been performed for giraffe under anesthesia and with physical restraint in a chute; however, reference values for giraffe that are trained to participate in venipuncture without chemical or physical restraint have not previously been described. Using a point-of-care blood gas and lactate analyzer and 20 giraffe trained for voluntary phlebotomy, values were determined for venous blood gasses and plasma lactate concentration. Ninety-five percent confidence in the mean values for venous pH (7...
April 2, 2024: Zoo Biology
https://read.qxmd.com/read/38557821/a-nomogram-for-predicting-surgical-risk-in-neonates-with-necrotizing-enterocolitis-a-retrospective-cohort-study
#15
JOURNAL ARTICLE
Lulu Chen, Wenxian Zhi, Shungen Huang, Jian Wang
OBJECTIVES: To construct a nomogram that predicts the risk of surgery in patients with necrotizing enterocolitis (NEC). METHODS: This retrospective cohort study recruited patients diagnosed with NEC at the Children's Hospital of Soochow University from 2013 to 2023. The neonates were divided into conservative and surgical-treatment groups. Univariate and multivariate logistic regressions were performed to identify factors influencing surgical risk, and a predictive model was constructed...
April 1, 2024: Indian Journal of Pediatrics
https://read.qxmd.com/read/38537300/decompression-illness-a-comprehensive-overview
#16
JOURNAL ARTICLE
Simon J Mitchell
Decompression illness is a collective term for two maladies (decompression sickness [DCS] and arterial gas embolism [AGE]) that may arise during or after surfacing from compressed gas diving. Bubbles are the presumed primary vector of injury in both disorders, but the respective sources of bubbles are distinct. In DCS bubbles form primarily from inert gas that becomes dissolved in tissues over the course of a compressed gas dive. During and after ascent ('decompression'), if the pressure of this dissolved gas exceeds ambient pressure small bubbles may form in the extravascular space or in tissue blood vessels, thereafter passing into the venous circulation...
March 31, 2024: Diving and Hyperbaric Medicine: the Journal of the South Pacific Underwater Medicine Society
https://read.qxmd.com/read/38525926/venous-blood-gases-in-the-assessment-of-respiratory-failure-in-patients-undergoing-sleep-studies-a-randomized-study
#17
JOURNAL ARTICLE
Steven James Lindstrom, Christine Faye McDonald, Mark Erskine Howard, Fergal James O'Donoghue, Marcus Anthony McMahon, Linda Rautela, Thomas Churchward, Peter Biesenbach, Peter Douglas Rochford
STUDY OBJECTIVES: Venous blood gases (VBGs) are not consistently considered suitable surrogates for arterial blood gases (ABGs) in assessing acute respiratory failure due to variable measurement error. The physiological stability of patients with chronic ventilatory failure may lead to improved agreement in this setting. METHODS: Adults requiring ABGs for sleep or ventilation titration studies had VBGs drawn before or after each ABG, in a randomized order. Veno-arterial correlation and agreement were examined for carbon dioxide tension (PCO2 ), pH, oxygen tension (PO2 ) and oxygen saturation (SO2 )...
October 25, 2023: Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine
https://read.qxmd.com/read/38513795/presumptive-spontaneous-hemothorax-associated-to-thymic-involution-in-a-dog-with-steroid-responsive-meningitis-arteritis-srma
#18
B Alcocer, P Bou, L Bosch, C Torrente
OBJECTIVE: To describe an unusual case of spontaneous hemothorax resulting from thymic involution in a dog with suspected acquired bleeding dyscrasia associated with steroid-responsive meningitis-arteritis (SRMA). CASE DESCRIPTION: A 6-month-old spayed female Golden Retriever was referred due to the sudden onset of lethargy, fever (pyrexia), loss of appetite (anorexia), and moderate neck pain. These symptoms emerged six days after an ovariohysterectomy performed by the primary veterinarian...
March 19, 2024: Topics in Companion Animal Medicine
https://read.qxmd.com/read/38504475/blood-gases-acid-base-and-metabolic-alterations-in-calves-with-bronchopneumonia-diagnosed-via-clinical-signs-and-thoracic-ultrasonography-a-cross-sectional-study
#19
JOURNAL ARTICLE
Antonio Boccardo, Vincenzo Ferrulli, Giulia Sala, Donatella Scavone, Saverio Paltrinieri, Laura Filippone Pavesi, Davide Pravettoni
BACKGROUND: Bronchopneumonia (BP) in calves potentially causes systemic changes. OBJECTIVES: To describe metabolic, arterial blood gas, and acid-base disorders in calves with BP diagnosed by thoracic ultrasound (TUS), Wisconsin score (WISC), and combinations of WISC and TUS. ANIMALS: Two hundred thirty-one dairy preweaned dairy calves from 13 dairy farms. METHODS: Cross-sectional study. Each calf sequentially underwent arterial blood gas evaluation, WISC score, venous sampling, and TUS...
March 19, 2024: Journal of Veterinary Internal Medicine
https://read.qxmd.com/read/38502268/flow-controlled-ventilation-decreases-mechanical-power-in-postoperative-icu-patients
#20
JOURNAL ARTICLE
Julien P Van Oosten, Juliette E Francovich, Peter Somhorst, Philip van der Zee, Henrik Endeman, Diederik A M P J Gommers, Annemijn H Jonkman
BACKGROUND: Mechanical power (MP) is the energy delivered by the ventilator to the respiratory system and combines factors related to the development of ventilator-induced lung injury (VILI). Flow-controlled ventilation (FCV) is a new ventilation mode using a constant low flow during both inspiration and expiration, which is hypothesized to lower the MP and to improve ventilation homogeneity. Data demonstrating these effects are scarce, since previous studies comparing FCV with conventional controlled ventilation modes in ICU patients suffer from important methodological concerns...
March 19, 2024: Intensive Care Medicine Experimental
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