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https://www.readbyqxmd.com/read/27906717/spectrum-of-postoperative-complications-in-pulmonary-hypertension-and-obesity-hypoventilation-syndrome
#1
Roop K Kaw
PURPOSE OF REVIEW: The purpose of this review is to identify chronic pulmonary conditions which may often not be recognized preoperatively especially before elective noncardiac surgery and which carry the highest risk of perioperative morbidity and mortality. RECENT FINDINGS: This review discusses some of the most recent studies that highlight the perioperative complications, and their prevention and management strategies. SUMMARY: Pulmonary hypertension is a well recognized risk factor for postoperative complications after cardiac surgery but the literature surrounding noncardiac surgery is sparse...
November 30, 2016: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/27901291/success-rate-of-pneumatic-reduction-of-intussusception-with-and-without-sedation
#2
Oren Feldman, Giora Weiser, Mona Hanna, Ori Devir, Uri Balla, David W Johnson, Eran Kozer, Itai Shavit
BACKGROUND: Pneumatic reduction of ileocolic intussusception is often performed without sedation. The aim of this study was to evaluate the success rate of pneumatic reduction of intussusception with and without sedation. METHODS: We conducted a retrospective cohort study in Israel in two tertiary care centers using a similar protocol for pneumatic reduction of intussusception. In one center, patients had pneumatic reduction of intussusception under propofol-based sedation, while in the other, patients had pneumatic reduction of intussusception without any sedation...
November 30, 2016: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/27898867/angus-calves-born-and-raised-at-high-altitude-adapt-to-hypobaric-hypoxia-by-increasing-alveolar-ventilation-rate-but-not-hematocrit
#3
A K Gulick, F B Garry, T N Holt, K Retallick-Trennepohl, R M Enns, M G Thomas, J M Neary
The objective of this study was to evaluate the effect of altitude on arterial blood-gases and hematocrit in Angus-based calves. It was hypothesized that alveolar ventilation rate, as indicated by arterial pCO, would increase with altitude but hematocrit would not. Five Angus-based herds ( = 30 to 80 per cohort) located at 105 m, 1,470 m, 2,010 m, 2,170 m, and 2,730 m above sea level were enrolled in this prospective cohort study. A portable analyzer measured blood-gas tensions in coccygeal arterial blood. Calves at 1,470 m, 2,170 m, and 2,730 m were sampled twice, at approximately 4 mo and 7 mo of age...
October 2016: Journal of Animal Science
https://www.readbyqxmd.com/read/27894744/-vitamin-d-deficiency-and-morbimortality-in-critically-ill-paediatric-patients
#4
Patricia García-Soler, Antonio Morales-Martínez, Vanessa Rosa-Camacho, Juan Antonio Lillo-Muñoz, Guillermo Milano-Manso
OBJECTIVES: To determine the prevalence and risks factors of vitamin D deficiency, as well as its relationship with morbidity and mortality in a PICU. MATERIAL AND METHODS: An observational prospective study in a tertiary children's University Hospital PICU conducted in two phases: i: cohorts study, and ii: prevalence study. The study included 340 critically ill children with ages comprising 6 months to 16 years old. EXCLUSION CRITERIA: Chronic kidney disease, known parathyroid disorders, and vitamin D supplementation...
November 25, 2016: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría (A.E.P.)
https://www.readbyqxmd.com/read/27893618/early-resuscitation-with-lyophilized-plasma-provides-equal-neuroprotection-compared-with-fresh-frozen-plasma-in-a-large-animal-survival-model-of-traumatic-brain-injury-and-hemorrhagic-shock
#5
Ihab Halaweish, Ted Bambakidis, Vahagn C Nikolian, Patrick Georgoff, Peter Bruhn, Patryk Piascik, Lisa Buckley, Ashok Srinivasan, Baoling Liu, Yongqing Li, Hasan B Alam
BACKGROUND: Combined traumatic brain injury (TBI) and hemorrhagic shock (HS) is highly lethal. In previous models of combined TBI + HS, we showed that early resuscitation with fresh frozen plasma (FFP) improves neurologic outcomes. Delivering FFP, however, in austere environments is difficult. Lyophilized plasma (LP) is a logistically superior alternative to FFP, but data are limited regarding its efficacy for treatment of TBI. We conducted this study to determine the safety and long-term outcomes of early treatment with LP in a large animal model of TBI + HS...
December 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27869558/polynitroxylated-pegylated-hemoglobin-a-novel-small-volume-therapeutic-for-traumatic-brain-injury-resuscitation-comparison-to-whole-blood-and-dose-response-evaluation
#6
Erik C Brockman, Travis C Jackson, C Edward Dixon, Hulya Bayir, Robert Clark, Vincent A Vagni, Keri L Janesko, Catherine Byrd, Li Ma, Carleton J C Hsia, Patrick M Kochanek
: Resuscitation with polynitroxylated pegylated hemoglobin (PNPH), a PEGylated bovine hemoglobin decorated with nitroxides, eliminated the need for fluid administration, reduced ICP and brain edema, and produced neuroprotection in vitro and in vivo vs. lactated Ringer's (LR) in experimental traumatic brain injury (TBI) plus hemorrhagic shock (HS). HYPOTHESIS: Resuscitation with PNPH will improve acute physiology vs. whole blood after TBI+HS and will be safe and effective across a wide dosage range...
November 21, 2016: Journal of Neurotrauma
https://www.readbyqxmd.com/read/27867566/effectiveness-of-temporary-positive-expiratory-pressure-t-pep-at-home-and-at-hospital-in-patients-with-severe-chronic-obstructive-pulmonary-disease
#7
Valentina Mascardi, Bruna Grecchi, Cornelius Barlascini, Paolo Banfi, Antonello Nicolini
BACKGROUND: Temporary positive airway pressure (T-PEP) is a tool recently introduced in the treatment of chronic obstructive pulmonary disease (COPD) or bronchiectasis. It demonstrated encouraging results also in severe COPD patients. The aim of this study is verify if adding T-PEP to best bronchodilator therapy both in clinic and home administering could reduce disease exacerbations and improve lung function in patients with severe COPD. METHODS: A total of 142 patients with severe COPD (FEV1 <50%) were enrolled; 120 were randomized in three groups: a group treated with T-PEP at home, a group with T-PEP at hospital and a group with medical therapy only (control group)...
October 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/27857961/physiologic-and-performance-effects-of-sago-supplementation-before-and-during-cycling-in-a-warm-humid-environment
#8
Mohd Rahimi Che Jusoh, Stephen R Stannard, Toby Mündel
The present study determined whether 0.8g/kg bodyweight sago ingested before (Pre-Sago) or during (Dur-Sago) exercise under warm-humid conditions (30 ± 2°C, 78 ± 3 % RH; 20 km·h(-1) frontal airflow) conferred a performance and/or physiological benefit compared to a control (Control) condition. Eight trained, male cyclists/triathletes (45 ± 4 y, VO2peak: 65 ± 10 ml·kg(-1)·min(-1), peak aerobic power: 397 ± 71 W) completed 3 15-min time-trials (∼75% VO2peak) pre-loaded with 45 min of steady-state (∼55% VO2peak) cycling following > 24 h standardization of training and diet...
April 2016: Temperature: Multidisciplinary Biomedical Journal
https://www.readbyqxmd.com/read/27842708/-effects-of-different-levels-of-end-expiratory-pressure-on-hemodynamic-respiratory-mechanics-and-systemic-stress-response-during-laparoscopic-cholecystectomy
#9
Oznur Sen, Yasemin Erdogan Doventas
OBJECTIVE: General anesthesia causes reduction of functional residual capacity. And this decrease can lead to atelectasis and intrapulmonary shunting in the lung. In this study we want to evaluate the effects of 5 and 10cmH2O PEEP levels on gas exchange, hemodynamic, respiratory mechanics and systemic stress response in laparoscopic cholecystectomy. METHODS: American Society of Anesthesiologist I-II physical status 43 patients scheduled for laparoscopic cholecystectomy were randomly selected to receive external PEEP of 5cmH2O (PEEP 5 group) or 10cmH2O PEEP (PEEP 10 group) during pneumoperitoneum...
November 11, 2016: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/27818327/an-educational-intervention-optimizes-the-utilization-of-arterial-blood-gases-across-intensive-care-units-from-different-specialties-a-quality-improvement-study
#10
Carlos D Martínez-Balzano, Paulo Oliveira, Michelle O'Rourke, Luanne Hills, Andrés F Sosa
BACKGROUND: Arterial blood gas (ABG) overutilization leads to increased costs, inefficient use of staff work-hours, patient discomfort and blood loss. We developed guidelines to optimize ABG utilization in the intensive care unit (ICU). METHODS: ABG utilization guidelines were implemented on all adult ICUs in our institution: three medical, two trauma-surgery, one cardiovascular and one neurosurgical ICU. While relying on pulse oximetry, we encouraged the utilization of ABGs after an acute respiratory event or for a rational clinical concern, and discouraged obtaining ABGs for routine surveillance, after planned changes of PEEP or FiO2 on the mechanical ventilator, for spontaneous breathing trials, or when a disorder was not suspected...
November 3, 2016: Chest
https://www.readbyqxmd.com/read/27816133/anesthesia-for-patients-with-concomitant-sepsis-and-cardiac-dysfunction
#11
REVIEW
Abed Abubaih, Charles Weissman
Anesthesiologists faced with a patient with sepsis and concurrent cardiac dysfunction must be cognizant of the patient's cardiac status and cause of the cardiac problem to appropriately adapt physiologic and metabolic monitoring and anesthetic management. Anesthesia in such patients is challenging because the interaction of sepsis and cardiac dysfunction greatly complicates management. Intraoperative anesthesia management requires careful induction and maintenance of anesthesia; optimizing intravascular volume status; avoiding lung injury during mechanical ventilation; and close monitoring of arterial blood gases, serum lactate concentrations, and hematology renal and electrolyte parameters...
December 2016: Anesthesiology Clinics
https://www.readbyqxmd.com/read/27812638/is-there-a-rationale-for-pulmonary-rehabilitation-following-successful-chemotherapy-for-tuberculosis
#12
Marcela Muñoz-Torrico, Adrian Rendon, Rosella Centis, Lia D'Ambrosio, Zhenia Fuentes, Carlos Torres-Duque, Fernanda Mello, Margareth Dalcolmo, Rogelio Pérez-Padilla, Antonio Spanevello, Giovanni Battista Migliori
The role of tuberculosis as a public health care priority and the availability of diagnostic tools to evaluate functional status (spirometry, plethysmography, and DLCO determination), arterial blood gases, capacity to perform exercise, lesions (chest X-ray and CT), and quality of life justify the effort to consider what needs to be done when patients have completed their treatment. To our knowledge, no review has ever evaluated this topic in a comprehensive manner. Our objective was to review the available evidence on this topic and draw conclusions regarding the future role of the "post-tuberculosis treatment" phase, which will potentially affect several million cases every year...
September 2016: Jornal Brasileiro de Pneumologia: Publicaça̋o Oficial da Sociedade Brasileira de Pneumologia e Tisilogia
https://www.readbyqxmd.com/read/27812301/blood-gas-testing-and-related-measurements-national-recommendations-on-behalf-of-the-croatian-society-of-medical-biochemistry-and-laboratory-medicine
#13
REVIEW
Lora Dukić, Lara Milevoj Kopčinović, Adrijana Dorotić, Ivana Baršić
Blood gas analysis (BGA) is exposed to risks of errors caused by improper sampling, transport and storage conditions. The Clinical and Laboratory Standards Institute (CLSI) generated documents with recommendations for avoidance of potential errors caused by sample mishandling. Two main documents related to BGA issued by the CLSI are GP43-A4 (former H11-A4) Procedures for the collection of arterial blood specimens; approved standard - fourth edition, and C46-A2 Blood gas and pH analysis and related measurements; approved guideline - second edition...
October 15, 2016: Biochemia Medica: časopis Hrvatskoga Društva Medicinskih Biokemičara
https://www.readbyqxmd.com/read/27811445/a-retrospective-analysis-of-blood-gases-with-two-different-insulin-infusion-protocols-in-patients-undergoing-cardiovascular-surgery
#14
S M Kuskonmaz, Ö Kurtipek, M E Aydın, M E Erbatur, M Alkan, Y Ünal, M Arslan
AIM: Intraoperative blood glucose concentration is known to be an independent risk factor for morbidity and mortality in patients undergoing cardiovascular surgery. Arterial blood gas analysis is an important investigation to monitor the acid-base balance and gas exchange in these patients. Hyperglycemia leads to a series of metabolic changes which affect acid-base balance and serum electrolytes. In this study, we aimed to look into the effect of glycemic control on arterial blood gas parameters, serum electrolytes, and hemoglobin (Hb)...
November 2016: Nigerian Journal of Clinical Practice
https://www.readbyqxmd.com/read/27802696/features-of-the-non-contact-carotid-pressure-waveform-cardiac-and-vascular-dynamics-during-rebreathing
#15
S Casaccia, E J Sirevaag, E J Richter, J A O'Sullivan, L Scalise, J W Rohrbaugh
This report amplifies and extends prior descriptions of the use of laser Doppler vibrometry (LDV) as a method for assessing cardiovascular activity, on a non-contact basis. A rebreathing task (n = 35 healthy individuals) was used to elicit multiple effects associated with changes in autonomic drive as well as blood gases including hypercapnia. The LDV pulse was obtained from two sites overlying the carotid artery, separated by 40 mm. A robust pulse signal was obtained from both sites, in accord with the well-described changes in carotid diameter over the blood pressure cycle...
October 2016: Review of Scientific Instruments
https://www.readbyqxmd.com/read/27799777/high-frequency-oscillatory-ventilation-is-an-effective-treatment-for-severe-pediatric-acute-respiratory-distress-syndrome-with-refractory-hypoxemia
#16
Yu-Xiong Guo, Zhao-Ni Wang, Ya-Ting Li, Li Pan, Li-Fen Yang, Yan Hu, Yue-Yu Sun, Liang-Ming Cai, Zhuang-Gui Chen
BACKGROUND AND PURPOSE: Early or primary application of high-frequency oscillatory ventilation (HFOV) has been recently suggested not to offer benefit to patients with acute respiratory distress syndrome (ARDS). However, the rescue effects of HFOV on severe pediatric acute respiratory distress syndrome (PARDS) with hypoxemia refractory to conventional mechanical ventilation (CMV) remain unclear. This study aimed to determine whether severe PARDS children would benefit from HFOV when oxygenation deteriorated on CMV and to identify any potential risk factors related to mortality...
2016: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/27796886/presence-of-telocytes-in-a-non-innervated-organ-the-placenta
#17
Cleofina Bosco, Eugenia Díaz
This chapter discusses the relationship between failure in placentation and the subsequent alterations in the normal structure of the placenta. Interstitial Cajal-like cells (ICLC) were observed for the first time in the human placenta in 2007 and later were named telocytes. Strong evidence confirms that in the placental chorionic villi, TC are located strategically between the smooth muscle cells (SMC) of the fetal blood vessel wall and the stromal myofibroblasts. As the placenta is a non-innervated organ and considering the strategic position of telocytes in chorionic villi, it has been postulated that their function would be related to signal transduction mechanisms involved in the regulation of the blood flow in the fetal vessels, as well as in the shortening/lengthening of the chorionic villi providing the necessary rhythmicity to the process of maternal/fetal metabolic exchange...
2016: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/27795903/effects-of-pressure-controlled-and-volume-controlled-ventilation-on-respiratory-mechanics-and-systemic-stress-response-during-prone-position
#18
Oznur Sen, Mefkur Bakan, Tarik Umutoglu, Nurdan Aydın, Mehmet Toptas, Ibrahim Akkoc
BACKGROUND: Prone position during general anesthesia for special surgical operations may be related with increased airway pressure, decreased pulmonary and thoracic compliance that may be explained by restriction of chest expansion and compression of abdomen. The optimum ventilation mode for anesthetized patients on prone position was not described and studies comparing volume-controlled ventilation (VCV) and pressure-controlled ventilation (PCV) during prone position are limited. We hypothesized that PCV instead of VCV during prone position could achieve lower airway pressures and reduce the systemic stress response...
2016: SpringerPlus
https://www.readbyqxmd.com/read/27794584/heliox-driven-nebulization-has-a-positive-effect-on-the-lung-function-in-lipopolysaccharide-induced-chronic-obstructive-pulmonary-disease-rat-model
#19
Wenwen Wu, Xi Chen, Xiaohan Liu, Chengyuan Liu, Gendi Lu
BACKGROUND Chronic obstructive pulmonary disease (COPD) is a serious lung disease that severely threatens people's health. This study aimed to investigate the effects of heliox-driven nebulization (HDN) on lung function and arterial blood gases in a COPD rat model. MATERIAL AND METHODS Twelve healthy male Wistar rats were selected as controls and 34 rats were used to establish a COPD model induced by lipopolysaccharide. Then 6 rats each from the control and model groups were selected for their symptoms to be observed...
October 30, 2016: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/27792046/ivabradine-attenuates-the-microcirculatory-derangements-evoked-by-experimental-sepsis
#20
Marcos L Miranda, Michelle M Balarini, Daniela S Balthazar, Lorena S Paes, Maria-Carolina S Santos, Eliete Bouskela
BACKGROUND: Experimental data suggest that ivabradine, an inhibitor of the pacemaker current in sinoatrial node, exerts beneficial effects on endothelial cell function, but it is unclear if this drug could prevent microcirculatory dysfunction in septic subjects, improving tissue perfusion and reducing organ failure. Therefore, this study was designed to characterize the microcirculatory effects of ivabradine on a murine model of abdominal sepsis using intravital videomicroscopy. METHODS: Twenty-eight golden Syrian hamsters were allocated in four groups: sham-operated animals, nontreated septic animals, septic animals treated with saline, and septic animals treated with ivabradine (2...
October 28, 2016: Anesthesiology
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