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https://www.readbyqxmd.com/read/28412161/the-effect-of-the-apneic-period-on-the-respiratory-physiology-of-patients-undergoing-intubation-in-the-emergency-department
#1
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/28408467/isolated-mild-sleep-associated-hypoventilation-in-children-with-down-syndrome
#2
Wai Wong, Dennis Rosen
INTRODUCTION: Children with Down syndrome (DS) have a high incidence of obstructive sleep apnea (OSA) that is often associated with hypoventilation. Little is known, however, about the prevalence of sleep-associated hypoventilation independent of OSA in these children. METHODS: Retrospective chart review of all children with DS under 18 years of age undergoing polysomnography at a tertiary care paediatric hospital during a 2-year period. Exclusion criteria were as follow: those requiring oxygen or positive-pressure ventilation; with tracheostomy, baseline hypoxia, unrepaired cyanotic heart disease, pulmonary hypertension, and cerebral palsy; or OSA with >5 obstructions/hour...
April 13, 2017: Archives of Disease in Childhood
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
#3
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/28391261/end-tidal-co2-predicts-reduction-in-mitral-regurgitation-in-patients-undergoing-percutaneous-mitral-valve-edge-to-edge-repair
#4
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/28384963/effect-of-pneumoperitoneum-and-lateral-position-on-oropharyngeal-seal-pressures-of-proseal-lma-in-laparoscopic-urological-procedures
#5
Preeti Rustagi, Geeta A Patkar, Anil Kumar Ourasang, Bharati A Tendolkar
INTRODUCTION: A sustained and effective oropharyngeal sealing with supraglottic airway is required to maintain the ventilation during laparoscopic surgery. Previous studies have observed the Oropharyngeal Seal Pressure (OSP) for Proseal Laryngeal Mask Airway (PLMA) after pneumoperitoneum in supine and trendelenburg position, where PLMA was found to be an effective airway device. This study was conducted with ProSeal LMA, for laparoscopic Urologic procedures done in lateral position. AIM: To measure OSP in supine and lateral position and to observe the effect of pneumoperitoneum in lateral position on OSP...
February 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28368918/evaluating-the-effectiveness-of-end-tidal-carbon-dioxide-monitoring-during-burn-wound-care-in-the-nonintubated-patient-population
#6
Samantha Weimer, Justin Burleson, Mary Mancuso, Cameron Bell, Mary Beth Flynn Makic
Daily burn wound care for nonintubated patients involves administration of intravenous analgesic and sedation agents. Vital signs and oxygen saturation monitoring alone can result in late signs of oversedation and ineffective breathing. End-tidal carbon dioxide (EtCo2) monitoring provides immediate feedback of effective breathing during procedural sedation. The purpose of this study was to describe the nurse's sedation and analgesic therapy management of nonintubated patients during burn wound care when EtCo2 was used...
March 31, 2017: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/28356297/nitric-oxide-sensitive-guanylyl-cyclase-signaling-affects-co2-dependent-but-not-pressure-dependent-regulation-of-cerebral-blood-flow
#7
Shadi Jahshan, Lior Dayan, Giris Jacob
Cerebrovascular CO2 reactivity is affected by nitric oxide (NO). We tested the hypothesis that sildenafil selectively potentiates NO-cGMP signaling affects CO2 reactivity. Fourteen healthy males (34±2 years) were enrolled in the study. BP, ECG, velocity of cerebral blood flow (CBF, measured by TCD), end tidal CO2 (EtCO2) were assessed at baseline (CO2 ~ 39 mm Hg), during hyperventilation (CO2 ~ 24 mm Hg), hypercapnia (CO2 ~ 46 mm Hg), boluses of phenylephrine (25-200 µg) and during graded head-up tilting (HUT)...
March 29, 2017: American Journal of Physiology. Regulatory, Integrative and Comparative Physiology
https://www.readbyqxmd.com/read/28345964/end-tidal-carbon-dioxide-as-a-prognostic-feature-in-pulmonary-arterial-hypertension
#8
Caitlin E Welch, Evan L Brittain, Alexander L Newman, Ivan M Robbins, Meredith E Pugh, John H Newman, Anna R Hemnes
RATIONALE: Pulmonary arterial hypertension (PAH) is characterized in part by increased dead space ventilation, which can be estimated noninvasively at the bedside by measurement of end-tidal CO2 (ETCO2). OBJECTIVES: Prior work has demonstrated that ETCO2 is lower in PAH than control patients, but whether ETCO2 has prognostic value is unknown. We hypothesized that lower measurements of ETCO2 in patients with PAH correlate with worse long-term outcomes. METHODS: Patients with PAH seen in our referral clinic were prospectively recruited for ETCO2 measurement between September 2009 and February 2010...
March 27, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28341350/deadly-business-the-usefulness-of-etco2
#9
EDITORIAL
Jozien Versteeg, Gerrit Jan Noordergraaf
No abstract text is available yet for this article.
March 21, 2017: Resuscitation
https://www.readbyqxmd.com/read/28235531/effects-of-the-concurrent-use-of-a-reduced-dose-of-propofol-with-divided-supplemental-remifentanil-and-moderate-hyperventilation-on-duration-and-morphology-of-electroconvulsive-therapy-induced-electroencephalographic-seizure-activity-a-randomized-controlled
#10
Kohki Nishikawa, Michiaki Yamakage
STUDY OBJECTIVE: The clinical adequacy of electroconvulsive therapy (ECT) depends on not only seizure duration but also seizure amplitude and postictal suppression. The objective of this study was to evaluate the effects of combination of a reduced dose of propofol and moderate hyperventilation on seizure duration and electrical stimulus requirement for adequate ictal amplitude and postictal suppression. DESIGN: Prospective, randomized, controlled trial. SETTING: Operating room at a municipal hospital...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28202896/effect-of-mild-hypercapnia-on-lung-oxygenation-in-sitting-position-during-shoulder-arthroscopy-under-general-anesthesia
#11
Hyun Jeong Kwak, Ji Yeon Lee, Jong Wha Lee, Hong Soon Kim, Ho Jin Hur, Ji Young Kim
BACKGROUND Mild hypercapnia is permitted during surgeries in sitting position under general anesthesia to maintain cerebral regional oxygen saturation (rSO2). However, since hypoventilation may cause gas exchange impairment, we evaluated effects of mild hypercapnia on lung oxygenation during shoulder arthroscopy in sitting position. MATERIAL AND METHODS Forty patients were randomly allocated to a normocapnia group (ETCO2 35 mmHg, n=20) or a hypercapnia group (45 mmHg, n=20). The mean arterial pressure (MAP), heart rate (HR), and rSO2 were measured 5 min after intubation in supine position (T0), and at 2, 4, 6, 8, 10, 20, 30, 40, 50, and 60 min of remaining in sitting position (T1-10)...
February 16, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/28202085/should-capnography-be-used-as-a-guide-for-choosing-a-ventilation-strategy-in-circulatory-shock-caused-by-severe-hypothermia-observational-case-series-study
#12
Tomasz Darocha, Sylweriusz Kosiński, Anna Jarosz, Paweł Podsiadło, Mirosław Ziętkiewicz, Tomasz Sanak, Robert Gałązkowski, Jacek Piątek, Janusz Konstanty-Kalandyk, Rafał Drwiła
BACKGROUND: Severe accidental hypothermia can cause circulatory disturbances ranging from cardiac arrhythmias through circulatory shock to cardiac arrest. Severity of shock, pulmonary hypoperfusion and ventilation-perfusion mismatch are reflected by a discrepancy between measurements of CO2 levels in end-tidal air (EtCO2) and partial CO2 pressure in arterial blood (PaCO2). This disparity can pose a problem in the choice of an optimal ventilation strategy for accidental hypothermia victims, particularly in the prehospital period...
February 15, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28183549/hypocapnia-measured-by-end-tidal-carbon-dioxide-tension-during-anesthesia-is-associated-with-increased-30-day-mortality-rate
#13
Philippe Dony, Michele Dramaix, Jean G Boogaerts
STUDY OBJECTIVE: To evaluate the relationship between intraoperative end-tidal carbon dioxide (etco2) values and clinical outcomes with special attention on 30-day postoperative mortality and secondarily on hospital length of stay (LOS). DESIGN: Retrospective, observational study. SETTING: Surgical theaters of the University Hospital Center of Charleroi. PATIENTS: Five thousand three hundred seventeen patients ASA I-IV undergoing various surgical procedures (except pediatric and cardiac surgery) under general anesthesia...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28180117/effect-of-neck-collar-fixation-on-ventilation-in-multiple-trauma-patients
#14
Farzad Rahmani, Mahboob Pouraghaei, Payman Moharamzadeh, Ebrahim Mashhadi
BACKGROUND: According to the guidelines for treatment of multiple trauma patients, immobilization of the neck and neck collar fixation are essential. However, following neck collar fixation patients usually experience dyspnea. Some studies have found that neck collar fixation can lead to decreased pulmonary volumes, yet there have been no studies on the effect of neck collar fixation on patient ventilation. OBJECTIVES: The purpose of this study was to determine the effect of neck collar fixation on ventilation in multiple trauma patients...
September 2016: Trauma Monthly
https://www.readbyqxmd.com/read/28177206/propofol-sedation-reduces-diaphragm-activity-in-spontaneously-breathing-patients-ultrasound-assessment
#15
Monica Rocco, Luigi Maggi, Giorgio Ranieri, Giovanni Ferrari, Cesare Gregoretti, Giorgio Conti, Roberto A DE Blasi
BACKGROUND: The diaphragm is the most important respiratory muscle in humans, and the close relationship between inspired volume and diaphragmatic movement in normal subjects has led to investigations into diaphragmatic activity using ultrasound, during spontaneous breathing and sedative drug infusion. METHODS: A total of 36 consecutive patients undergoing diagnostic procedures under deep propofol sedation were studied. Ultrasound measurements included the following: diaphragmatic thickening end-inspiration (TEI) and end-expiration (TEE)...
March 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28157836/continuous-capnography-monitoring-during-resuscitation-in-a-transitional-large-mammalian-model-of-asphyxial-cardiac-arrest
#16
Praveen Chandrasekharan, Payam Vali, Munmun Rawat, Bobby Mathew, Sylvia F Gugino, Carmon Koenigschnekt, Justin Helman, Jayasree Nair, Sara Berkelhamer, Satyan Lakshminrusimha
BACKGROUND: In neonates requiring chest compression (CC) during resuscitation, neonatal resuscitation program (NRP) recommends against relying on a single feedback device such as end-tidal carbon dioxide (ETCO2) or SpO2 to determine return of spontaneous circulation (ROSC) until more evidence becomes available. METHODS: We evaluated the role of monitoring ETCO2 during resuscitation in a lamb model of cardiac arrest induced by umbilical cord occlusion (n=21). Lambs were resuscitated as per NRP guidelines...
February 3, 2017: Pediatric Research
https://www.readbyqxmd.com/read/28123650/post-operative-capnostream-monitoring-in-patients-with-obstructive-sleep-apnoea-symptoms-case-series
#17
Vasanth Rao Kadam, Mazyar Danesh
Obstructive sleep apnoea (OSA) patients on opioid analgesic have an increased incidence of postoperative respiratory complications; prevention of these may be possible with appropriate post-operative monitoring. We recruited 4 OSA patients who had general anaesthesia for orthopaedic and septoplasty surgery. They required Patient Controlled Analgesia (PCA) or oral opioids in the post-operative period, hence continuous Saturation of Oxygen (Spo2), End Tidal Carbon dioxide (EtCo2) monitoring on Capnostream monitor with Integrated Pulmonary Index (IPI) was organized in high dependency unit...
July 2016: Sleep Science
https://www.readbyqxmd.com/read/28116675/anesthetic-considerations-for-patients-with-esophageal-achalasia-undergoing-peroral-endoscopic-myotomy-a-retrospective-case-series-review
#18
Benjamin Löser, Yuki B Werner, Mark A Punke, Bernd Saugel, Sebastian Haas, Daniel A Reuter, Oliver Mann, Anna Duprée, Guido Schachschal, Thomas Rösch, Martin Petzoldt
PURPOSE: Peroral endoscopic myotomy (POEM) is a novel technique for treating esophageal achalasia. During POEM, carbon dioxide (CO2) is insufflated to aid surgical dissection, but it may inadvertently track into surrounding tissues, causing systemic CO2 uptake and tension capnoperitoneum. This in turn may affect cardiorespiratory function. This study quantified these cardiorespiratory effects and treatment by hyperventilation and percutaneous abdominal needle decompression (PND). METHODS: One hundred and seventy-three consecutive patients who underwent POEM were included in this four-year retrospective study...
May 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/28114921/prevention-of-hypothermia-in-patients-undergoing-orthotopic-liver-transplantation-using-the-humigard%C3%A2-open-surgery-humidification-system-a-prospective-randomized-pilot-and-feasibility-clinical-trial
#19
RANDOMIZED CONTROLLED TRIAL
Laurence Weinberg, Andrew Huang, Daniel Alban, Robert Jones, David Story, Larry McNicol, Brett Pearce
BACKGROUND: Perioperative thermal disturbances during orthotopic liver transplantation (OLT) are common. We hypothesized that in patients undergoing OLT the use of a humidified high flow CO2 warming system maintains higher intraoperative temperatures when compared to standardized multimodal strategies to maintain thermoregulatory homeostasis. METHODS: We performed a randomized pilot study in adult patients undergoing primary OLT. Participants were randomized to receive either open wound humidification with a high flow CO2 warming system in addition to standard care (Humidification group) or to standard care alone (Control group)...
January 23, 2017: BMC Surgery
https://www.readbyqxmd.com/read/28111195/endotracheal-tube-placement-confirmation-100-sensitivity-and-specificity-with-sustained-four-phase-capnographic-waveforms-in-a-cadaveric-experimental-model
#20
Salvatore Silvestri, Jay G Ladde, James F Brown, Jesus V Roa, Christopher Hunter, George A Ralls, Linda Papa
BACKGROUND: Waveform capnography is considered the gold standard for verification of proper endotracheal tube placement, but current guidelines caution that it is unreliable in low-perfusion states such as cardiac arrest. Recent case reports found that long-deceased cadavers can produce capnographic waveforms. The purpose of this study was to determine the predictive value of waveform capnography for endotracheal tube placement verification and detection of misplacement using a cadaveric experimental model...
January 19, 2017: Resuscitation
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