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https://www.readbyqxmd.com/read/29049136/comparisons-of-traditional-metabolic-markers-and-compensatory-reserve-as-early-predictors-of-tolerance-to-central-hypovolemia-in-humans
#1
Alicia M Schiller, Jeffrey T Howard, Kristen R Lye, Christian G Magby, Victor A Convertino
Circulatory shock remains a leading cause of death in both military and civilian trauma. Early, accurate and reliable prediction of decompensation is necessary for the most efficient interventions and clinical outcomes. Individual tolerance to reduced central blood volume can serve as a model to assess the sensitivity and specificity of vital sign measurements. The compensatory reserve (CRM) is the measurement of this capacity. Measurements of muscle oxygen saturation (SmO2), blood lactate and end tidal CO2 (EtCO2) have recently gained attention as prognostic tools for early assessment of the status of patients with progressive hemorrhage, but lack the ability to adequately differentiate individual tolerance to hypovolemia...
October 18, 2017: Shock
https://www.readbyqxmd.com/read/29047136/apnoeic-oxygenation-with-high-flow-nasal-oxygen-for-laryngeal-surgery-a-case-series
#2
C Lyons, M Callaghan
Surgery under apnoeic conditions with the use of high-flow nasal oxygen is novel. Between November 2016 and May 2017, 28 patients underwent tubeless laryngeal or tracheal surgery under apnoeic conditions with high-flow nasal oxygen as the sole method of gas exchange. Patients received total intravenous anaesthesia and neuromuscular blocking agents for the duration of their surgery. The median (IQR [range]) apnoea time was 19 (15-24 [9-37]) min. Four patients experienced an episode of oxygen desaturation to a value between 85% and 90%, lasting less than 2 min in each case...
November 2017: Anaesthesia
https://www.readbyqxmd.com/read/29040433/low-end-tidal-co2-as-a-real-time-severity-marker-of-intra-anaesthetic-acute-hypersensitivity-reactions
#3
A Gouel-Chéron, L de Chaisemartin, F Jönsson, P Nicaise-Roland, V Granger, A Sabahov, M-T Guinnepain, S Chollet-Martin, P Bruhns, C Neukirch, D Longrois
Background: Prompt diagnosis of intra-anaesthetic acute hypersensitivity reactions (AHR) is challenging because of the possible absence and/or difficulty in detecting the usual clinical signs and because of the higher prevalence of alternative diagnoses. Delayed epinephrine administration during AHR, because of incorrect/delayed diagnosis, can be associated with poor prognosis. Low end-tidal CO2 (etCO2) is known to be linked to low cardiac output. Yet, its clinical utility during suspected intra-anaesthetic AHR is not well documented...
October 10, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29020995/sedation-with-propofol-during-ercp-is-the-combination-with-esketamine-more-effective-and-safer-than-with-alfentanil-study-protocol-for-a-randomized-controlled-trial
#4
Susanne Eberl, Lena Koers, Jeanin E van Hooft, Edwin de Jong, Thomas Schneider, Markus W Hollmann, Benedikt Preckel
BACKGROUND: Endoscopic retrograde cholangiopancreatography (ERCP) is a gastrointestinal procedure that requires a relatively motionless patient during the intervention. Deep sedation by intravenous propofol combined with an opioid has recently become the preferred sedation technique. However, when high doses of propofol are used, side effects, namely respiratory depression, may occur. Esketamine has hypnotic, analgesic, and sympathomimetic effects. Our assumption is that a combination of propofol with esketamine reduces the dosage of individual drugs, thereby minimizing sedation side effects while keeping the same satisfaction level of patients and endoscopists...
October 11, 2017: Trials
https://www.readbyqxmd.com/read/28975076/comparing-the-effect-of-adaptive-support-ventilation-asv-and-synchronized-intermittent-mandatory-ventilation-simv-on-respiratory-parameters-in-neurosurgical-icu-patients
#5
Mohammadreza Ghodrati, Alireza Pournajafian, Ali Khatibi, Mohammad Niakan, Mohammad Hosein Hemadi, Mohammad Mahdi Zamani
BACKGROUND: Various modes of mechanical ventilation have different effects on respiratory variables. Lack of patients' neuro-ventilatory coordination and increasing the work of breathing are major disadvantages in mechanically ventilated patients. OBJECTIVES: This study is conducted to compare the respiratory parameters differences in Adaptive support ventilation (ASV) and synchronized intermittent mandatory ventilation (SIMV) modes in neurosurgical ICU patients...
December 2016: Anesthesiology and Pain Medicine
https://www.readbyqxmd.com/read/28970317/respiratory-adaptation-in-term-infants-following-elective-caesarean-section
#6
Daragh Finn, Julie De Meulemeester, Lisa Dann, Ita Herlihy, Vicki Livingstone, Geraldine B Boylan, C Anthony Ryan, Eugene M Dempsey
OBJECTIVE: To determine respiratory rate (RR), tidal volume (TV) and end-tidal carbon dioxide (EtCO2) values in full-term infants immediately after caesarean section, and to assess whether infants that develop transient tachypnoea of the newborn (TTN) follow the same physiological patterns. DESIGN AND PATIENTS: A Respironics NM3 Monitor (Philips, Netherlands) continuously measured RR, TV and EtCO2 for 7 min in infants >37 weeks' gestation following elective caesarean section (ECS)...
September 29, 2017: Archives of Disease in Childhood. Fetal and Neonatal Edition
https://www.readbyqxmd.com/read/28965646/haemodynamic-response-and-effectiveness-of-tracheal-intubation-with-airtraq%C3%A2-versus-macintosh-laryngoscope-in-paediatric-patient-undergoing-elective-surgery-prospective-randomised-and-blind-clinical-trial
#7
J A Orozco, J L Rojas, A J Medina-Vera
OBJECTIVE: To compare the haemodynamic response and effectiveness of tracheal intubation with Airtraq® device and Macintosh laryngoscope, for airway management of patients between 2 and 8 years undergoing elective surgery. METHODS: A prospective, comparative, randomised and blind clinical trial where the effectiveness of tracheal intubation in 80 paediatric patients undergoing elective surgery was determined. Patients were divided into 2 groups of 40 subjects each: group A, intubated with Airtraq® optical laryngoscope; and group M, intubated with Macintosh laryngoscope...
September 28, 2017: Revista Española de Anestesiología y Reanimación
https://www.readbyqxmd.com/read/28953197/effect-of-impella-during-veno-arterial-extracorporeal-membrane-oxygenation-on-pulmonary-artery-flow-as-assessed-by-end-tidal-carbon-dioxide
#8
Jacob Eliet, Philippe Gaudard, Norddine Zeroual, Philippe Rouvière, Bernard Albat, Marc Mourad, Pascal H Colson
Peripheral veno-arterial extracorporeal membrane oxygenation (VA ECMO) exposes the patient to a pulmonary blood flow bypass and a left ventricle afterload increase. Impella, a catheter-mounted microaxial rotary pump, has been proposed for left ventricle (LV) unloading in combination with VA ECMO. In order to assess the effect of Impella on pulmonary flow and LV preload, we checked Doppler pulmonary artery velocity-time integral (pVTI) and LV diastolic diameter (LVED) by transesophageal echocardiography and end-tidal carbon dioxide (EtCO2) during a step-by-step increase in Impella flow (Impella ramp test)...
September 25, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28942011/end-tidal-carbon-dioxide-and-defibrillation-success-in-out-of-hospital-cardiac-arrest
#9
Simone Savastano, Enrico Baldi, Maurizio Raimondi, Alessandra Palo, Mirko Belliato, Elisa Cacciatore, Valentina Corazza, Simone Molinari, Fabrizio Canevari, Aurora I Danza, Gaetano M De Ferrari, Giorgio Antonio Iotti, Luigi Oltrona Visconti
PURPOSE: Basing on the relationship between the quality of cardiopulmonary resuscitation (CPR) and the responsiveness of VF to the defibrillation we aimed to assess whether the values of ETCO2 in the minute before defibrillation could predict the effectiveness of the shock. MATERIALS AND METHODS: We retrospectively evaluated the reports generated by the manual monitor/defibrillator (Corpuls by GS Elektromedizinische Geräte G. Stemple GmbH, Germany) used for cases of VF cardiac arrest from January 2015 to December 2016...
September 21, 2017: Resuscitation
https://www.readbyqxmd.com/read/28928295/real-time-human-respiration-carbon-dioxide-measurement-device-for-cardiorespiratory-assessment
#10
Om Prakash Singh, Teo Aik Howe, Malarvili Balakrishnan
Development of a human respiration carbon dioxide (CO2) measurement device remains a demanding research to evaluate the cardio-respiratory status of human beings since last decades in and out of hospital. Hence, we report a real time, user operable CO2 measurement device using infrared CO2 sensor, Arduino Mega2560, and thin film transistor (TFT, 3.5"), incorporated with low pass (cut-off frequency,10Hz) and moving average (span,8) filters. The proposed device measures features such as partial end-tidal carbon dioxide (EtCO2), respiratory rate (RR), inspired carbon dioxide (ICO2) and newly proposed feature, Hjorth Activity that annotated with a date and time received from real-time clock and stores into the secure digital (SD) card...
September 20, 2017: Journal of Breath Research
https://www.readbyqxmd.com/read/28899911/correlation-of-end-tidal-carbon-dioxide-amplitude-spectrum-area-and-coronary-perfusion-pressure-in-a-porcine-model-of-cardiac-arrest
#11
Nicolas Segal, Anja K Metzger, Johanna C Moore, Laura India, Michael C Lick, Paul S Berger, Wanchun Tang, David G Benditt, Keith G Lurie
Amplitude Spectrum Area (AMSA) values during ventricular fibrillation (VF) correlate with myocardial energy stores and predict defibrillation success. By contrast, end tidal CO2 (ETCO2) values provide a noninvasive assessment of coronary perfusion pressure and myocardial perfusion during cardiopulmonary resuscitation (CPR). Given the importance of the timing of defibrillation shock delivery on clinical outcome, we tested the hypothesis that AMSA and ETCO2 correlate with each other and can be used interchangably to correlate with myocardial perfusion in an animal laboratory preclinical, randomized, prospective investigation...
September 2017: Physiological Reports
https://www.readbyqxmd.com/read/28893016/comparison-of-intubating-conditions-using-fentanyl-plus-propofol-versus-fentanyl-plus-midazolam-during-fiberoptic-laryngoscopy
#12
Parmod Kumar, Tripat Kaur, Gurpreet Kaur Atwal, Jatinderpaul Singh Bhupal, Ajay Kumar Basra
INTRODUCTION: Awake nasal or oral flexible fiberoptic intubation is the airway management technique of choice in known or anticipated difficult airway, unstable cervical fracture, limited mouth opening (as in temporomandibular joint disease), mandibular-maxillary fixation and severe facial burns. Both optimal intubating condition and patient comfort are important for fiberoptic intubation. Optimal intubating conditions provided by an ideal sedation regimen would ensure haemodynamic stability, patient comfort, attenuation of airway reflexes and amnesia...
July 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28875348/effects-of-dominant-and-non-dominant-passive-arm-manoeuvres-on-the-neurovascular-coupling-response
#13
Osian Llwyd, Ronney B Panerai, Thompson G Robinson
PURPOSE: Models designed to study neurovascular coupling (NVC) describe a possible cerebral hemisphere dominance dependent on task completed and preference in handedness. We investigated whether passive arm manoeuvre performed with dominant (Dom-Arm) or non-dominant arm (ND-Arm) stimulated haemodynamic differences in either contralateral (Cont-H) or ipsilateral (Ipsil-H) cerebral hemisphere. METHODS: Healthy individuals lying in supine position, had measurements of beat-to-beat blood pressure (BP, mmHg), electrocardiogram (HR, bpm), end-tidal CO2 (etCO2, mmHg), and bilateral insonation of the middle cerebral arteries (MCA, cm s(-1))...
November 2017: European Journal of Applied Physiology
https://www.readbyqxmd.com/read/28870163/comparison-of-the-supreme%C3%A2-and-proseal%C3%A2-laryngeal-mask-airways-in-infants-a-prospective-randomised-clinical-study
#14
Sibel Oba, Hacer Sebnem Turk, Canan Tulay Isil, Huseyin Erdogan, Pinar Sayin, Ali Ihsan Dokucu
BACKGROUND: The Supreme™ and ProSeal™ laryngeal mask airways (LMAs) are widely used in paediatric anaesthesia; however, LMA use in infants is limited because many anaesthesiologists prefer to use tracheal intubation in infants. In this study, we compared the Supreme and ProSeal LMAs in infants by measuring their performance characteristics, including insertion features, ventilation parameters, induced changes in haemodynamics and rates of postoperative complications. METHODS: Infants of ASA physical status I scheduled for elective, minor, lower abdominal surgery were divided into two groups: the Supreme LMA group and the ProSeal LMA group...
September 5, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28858101/usefulness-of-end-tidal-carbon-dioxide-as-an-indicator-of-dehydration-in-pediatric-emergency-departments-a-retrospective-observational-study
#15
Hee Won Yang, Woochan Jeon, Young Gi Min, Ji Sook Lee
Physician assessment of hydration status is one of the most important factors in the management of dehydration in the pediatric emergency department (ED). Overestimating dehydration may lead to overtreatment with intravenous fluids or unnecessary hospitalization, whereas underestimation may lead to delayed therapy and aggravation of symptoms. Various methods to estimate hydration status have been proposed, including use of physical findings, body weight, and laboratory results. These methods are subjective, invasive, or inappropriate for application in the ED...
September 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28841360/prehospital-end-tidal-carbon-dioxide-predicts-mortality-in-trauma-patients
#16
Kelsey Childress, Kelly Arnold, Christopher Hunter, George Ralls, Linda Papa, Salvatore Silvestri
BACKGROUND: End-tidal carbon dioxide (EtCO2) measurement has been shown to have prognostic value in acute trauma. OBJECTIVE: Evaluate the association of prehospital EtCO2 and in-hospital mortality in trauma patients and to assess its prognostic value when compared to traditional vital signs. METHODS: Retrospective, cross-sectional study of patients transported by a single EMS agency to a level one trauma center. We evaluated initial out-of-hospital vital signs documented by EMS personnel including EtCO2, respiratory rate (RR), systolic BP (SBP), diastolic BP (DBP), pulse (P), and oxygen saturation (O2) and hospital data...
August 25, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28828555/efficacy-of-co2-insufflation-during-thoracoscopic-esophagectomy-in-the-left-lateral-position
#17
Itasu Ninomiya, Koichi Okamoto, Sachio Fushida, Katsunobu Oyama, Jun Kinoshita, Hiroyuki Takamura, Hidehiro Tajima, Isamu Makino, Tomoharu Miyashita, Tetsuo Ohta
OBJECTIVE: Thoracoscopic esophagectomy (TE) is widely performed as a minimally invasive technique in the management of esophageal cancer. The aim of this study was to estimate the efficacy of intrathoracic carbon dioxide (CO2) insufflation during TE in the left lateral position. METHODS: From January 2010 to April 2016, 58 patients with esophageal cancer underwent TE without intrathoracic CO2 insufflation (Group N) and 37 patients with esophageal cancer underwent TE with intrathoracic CO2 insufflation (Group C)...
August 21, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28827165/reproducibility-of-task-activation-using-the-addenbrooke-s-cognitive-examination-in-healthy-controls-a-functional-transcranial-doppler-ultrasonography-study
#18
L Beishon, C A L Williams, R B Panerai, T G Robinson, V J Haunton
INTRODUCTION: Cerebral blood flow velocity (CBFv) changes occurring with cognitive stimulation can be measured by Transcranial Doppler ultrasonography (TCD). The aim of this study was to assess the reproducibility of CBFv changes to the Addenbrooke's cognitive examination (ACE-III). NEW METHOD: 13 volunteers underwent bilateral TCD (middle cerebral artery), continuous heart rate (HR, 3-lead ECG, Finometer), beat-to-beat mean arterial pressure (MAP, Finometer), and end-tidal CO2 (ETCO2, capnography)...
November 1, 2017: Journal of Neuroscience Methods
https://www.readbyqxmd.com/read/28802098/response-time-of-indirectly-accessed-gas-exchange-depends-on-measurement-method
#19
Jakub Rafl, Filip Kulhanek, Petr Kudrna, Vaclav Ort, Karel Roubik
Noninvasive techniques are routinely used for assessment of tissue effects of lung ventilation. However, comprehensive studies of the response time of the methods are scarce. The aim of this study was to compare the response time of noninvasive methods for monitoring of gas exchange to sudden changes in the composition of the inspired gas. A prospective experimental study with 16 healthy volunteers was conducted. A ventilation circuit was designed that enabled a fast change in the composition of the inspiratory gas mixture while allowing spontaneous breathing...
August 12, 2017: Biomedizinische Technik. Biomedical Engineering
https://www.readbyqxmd.com/read/28793002/laryngeal-tube-suction-for-airway-management-during-in-hospital-emergencies
#20
Haitham Mutlak, Christian Friedrich Weber, Dirk Meininger, Colleen Cuca, Kai Zacharowski, Christian Byhahn, Richard Schalk
OBJECTIVE: The role of supraglottic airway devices in emergency airway management is highlighted in international airway management guidelines. We evaluated the application of the new generation laryngeal tube suction (LTS-II/LTS-D) in the management of in-hospital unexpected difficult airway and cardiopulmonary resuscitation. METHODS: During a seven-year period, patients treated with a laryngeal tube who received routine anesthesia and had an unexpected difficult airway (Cormack Lehane Grade 3-4), who underwent cardiopulmonary resuscitation, or who underwent cardiopulmonary resuscitation outside the operating room and had a difficult airway were evaluated...
July 2017: Clinics
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