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Joseph M Blankush, Robbie Freeman, Joy McIlvaine, Trung Tran, Stephen Nassani, I Michael Leitman
Modified Early Warning Scores (MEWS) provide real-time vital sign (VS) trending and reduce ICU admissions in post-operative patients. These early warning calculations classically incorporate oxygen saturation, heart rate, respiratory rate, systolic blood pressure, and temperature but have not previously included end-tidal CO2 (EtCO2), more recently identified as an independent predictor of critical illness. These systems may be subject to failure when physiologic data is incorrectly measured, leading to false alarms and increased workload...
October 20, 2016: Journal of Clinical Monitoring and Computing
Rajasree Omanakutty Amma, Subha Ravindran, Rachel Cherian Koshy, K M Jagathnath Krishna
BACKGROUND AND AIMS: With the availability of modern workstations and heightened awareness on the environmental effects of waste anaesthesia gases, anaesthesiologists worldwide are practicing low flow anaesthesia (LFA). Although LFA is being practiced in India, hard evidence on the current practice of the same from anaesthesiologists practicing in India is lacking and hence, we conducted this survey. METHODS: A questionnaire containing 16 questions was distributed among a subgroup of anaesthesiologists who attended the 2014 National Conference of Indian Society of Anaesthesiologists...
October 2016: Indian Journal of Anaesthesia
Tariq Yousuf, Taylor Brinton, Ghulam Murtaza, Daniel Wozniczka, Khansa Ahmad, Joy Iskandar, Raju Mehta, Hesam Keshmiri, Tabassum Hanif
End-tidal carbon dioxide (ETCO2) monitoring is useful in many situations. However, ETCO2 monitoring is unreliable in patients with acute respiratory distress syndrome (ARDS) due to widespread lung inflammation. In our study, we attempt to establish the gradient between the arterial pressure of carbon dioxide (PaCO2) and ETCO2 in patients with ARDS, which we defined as the PaETCO2 gradient. The main objective of the study was to establish a PaETCO2 gradient in each severity of ARDS. We analyzed 35 patients with ARDS and a total of 88 arterial blood gases were included...
October 14, 2016: Journal of Investigative Medicine: the Official Publication of the American Federation for Clinical Research
Maria Skytioti, Signe Søvik, Maja Elstad
Intact cerebral blood flow (CBF) is essential for cerebral metabolism and function, whereas hypoperfusion in relation to hypovolemia and hypocapnia can lead to severe cerebral damage. This study was designed to assess internal carotid artery blood flow (ICA-BF) during simulated hypovolemia and noninvasive positive pressure ventilation (PPV) in young healthy humans. Beat-by-beat blood velocity (ICA and aorta) were measured by Doppler ultrasound during normovolemia and simulated hypovolemia (lower body negative pressure), with or without PPV in 15 awake subjects...
October 2016: Physiological Reports
Ryota Asahara, Kanji Matsukawa, Kei Ishii, Nan Liang, Kana Endo
When performing exercise arbitrarily, activation of central command should start prior to the onset of exercise, but when exercise is forced to start with cue, activation of central command should be delayed. We examined whether the in advance activation of central command influenced the ventilatory response and reflected in the prefrontal oxygenation, by comparing the responses during exercise with arbitrary and cued start. The breath-by-breath respiratory variables and the prefrontal oxygenated-hemoglobin concentration (Oxy-Hb) were measured during one-legged cycling...
September 29, 2016: Journal of Applied Physiology
T Wesley Templeton, Lauren K Hoke, Jill Yaung, Carol A Aschenbrenner, Danielle M Rose, Leah B Templeton, Yvon F Bryan
STUDY OBJECTIVE: To determine quantitative differences in several routinely measured ventilation parameters using a standardized anesthetic technique and 3 different ventilation modalities in pediatric patients with a ProSeal laryngeal mask airway (PLMA). DESIGN: Randomized prospective study. SETTING: Pediatric hospital of a tertiary care academic medical center. PATIENTS: Thirty-three, American Society of Anesthesiologists classification 1-2, pediatric patients (12 months to 5 years)...
November 2016: Journal of Clinical Anesthesia
Cliff Reid, Ian Ferguson, Brian Burns, Karel Habig, Mohammed Shareef
BACKGROUND: Life-like end-tidal capnography (ETCO2) waveforms have been demonstrated in recently deceased and fresh-frozen cadavers following tracheal intubation, offering potential for high fidelity airway simulation training. As the mechanism for carbon dioxide production is not fully understood, it is possible that oesophageal intubation may also generate a capnograph. Our aim was to measure ETCO2 levels following (1) oesophageal and (2) tracheal intubation in fresh-frozen cadavers, and to observe the size, shape and duration of any capnographic waveform...
September 23, 2016: Emergency Medicine Journal: EMJ
Llewellyn C Padayachy, Vaishali Padayachy, Ushma Galal, Rebecca Gray, A Graham Fieggen
PURPOSE: The aim of this study was to investigate the relationship between optic nerve sheath diameter (ONSD) measurement and invasively measured intracranial pressure (ICP) in children. METHODS: ONSD measurement was performed prior to invasive measurement of ICP. The mean binocular ONSD measurement was compared to the ICP reading. Physiological variables including systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), pulse rate, temperature, respiratory rate and end tidal carbon dioxide (ETCO2) level were recorded at the time of ONSD measurement...
October 2016: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
Gidugu Himashree, Latika Mohan, Yogesh Singh
UNLABELLED: Context • High altitude (HA) is a psychophysiological stressor for natives of lower altitudes. Reducing the morbidity and optimizing the performance of individuals deployed in an HA region has been attempted and reported with varied results. Objective • The present study intended to explore the effects of comprehensive yogic practices on the health and performance of Indian soldiers deployed at HAs. Design • The research team designed a prospective, randomized, case-control study...
September 2016: Alternative Therapies in Health and Medicine
Xiaojun Du, Songsong Mao, Jianxiu Cui, Jue Ma, Guangyan Zhang, Yong Zheng, Haiyu Zhou, Liang Xie, Dongkun Zhang, Ruiqing Shi, Gang Chen
BACKGROUND: The aim of the present study was to determine the safety and feasibility of the use of laryngeal mask airway (LMA) for non-endotracheal intubated anesthesia for patients with pectus excavatum (PE) undergoing thoracoscopic Nuss procedure. METHODS: Between July 2015 and December 2015, 30 selected patients with PE were planned to undergo a thoracoscopic Nuss procedure using LMA for non-endotracheal intubated anesthesia in the Guangdong General Hospital...
August 2016: Journal of Thoracic Disease
Frank Rasulo, Nicola Zugni, Simone Piva, Nazzareno Fagoni, Federico Pe, Arturo Toninelli, Stefano Calza, Nicola Latronico
BACKGROUND: Supraglottic airway devices (SGDs) are of current use in anesthesia practice and in emergency conditions. It has been suggested that cerebral blood flow (CBF) can decrease after SGD insertion or cuff inflation; however, it is uncertain if this reduction is caused by the SGD or the anesthetic drugs utilized for the anesthetic procedure. During minor surgery we separated CBF measurements by an adequate time interval in order to measure the distinctive changes in cerebral hemodynamics associated with anesthesia induction, SGD insertion and cuff inflation...
August 2016: Minerva Anestesiologica
Chia-Man Chou, Chou-Ming Yeh, Sheng-Yang Huang, Hou-Chuan Chen
BACKGROUND: The field of laparoscopic surgery in neonates or younger infants has benefitted from recent progress. This study aimed to determine the correlation between patient characteristics and perioperative parameters, and to explore the feasibility of laparoscopic surgery in neonates and infants. METHODS: We retrospectively collected and analyzed data on neonates and infants who received laparoscopic surgery at our institute between January 2007 and August 2015...
October 2016: Journal of the Chinese Medical Association: JCMA
Deborah J Williams, Faheem W Guirgis, Thomas K Morrissey, Jennifer Wilkerson, Robert L Wears, Colleen Kalynych, Andrew J Kerwin, Steven A Godwin
OBJECTIVE: To determine if early measurement of end-tidal carbon dioxide (ETCO2) in nonintubated patients triaged to a level 1 trauma center has utility in ruling out severe injury. METHODS: We performed a prospective cohort study of adult patients triaged to our urban, academic, level 1 trauma center. Included patients had ETCO2 measured within 30 minutes of arrival. Chart review was performed on enrolled patients to identify severe injury defined by: admission to an intensive care unit, need for an invasive procedure, blood product transfusion, acute blood loss anemia, and acute clinically significant finding on computed tomographic scan...
August 6, 2016: American Journal of Emergency Medicine
Cathríona R Monnard, Jean-Pierre Montani, Erik K Grasser
BACKGROUND AND PURPOSE: Energy drinks (EDs) are suspected to induce potential adverse cardiovascular effects and have recently been shown to reduce cerebral blood flow velocity (CBFV) in young, healthy subjects. Gender differences in CBFV in response to EDs have not previously been investigated, despite the fact that women are more prone to cardiovascular disturbances such as neurocardiogenic syncope than men. Therefore, the aim of this study was to explore gender differences in cerebrovascular and cardiovascular responses to EDs...
2016: Frontiers in Physiology
Baruch S Krauss, Gary Andolfatto, Benjamin A Krauss, Rebecca J Mieloszyk, Michael C Monuteaux
STUDY OBJECTIVE: We describe the characteristics of and predictors for apnea and clinical interventions during emergency department (ED) procedural sedation. METHODS: High-resolution data were collected prospectively, using a convenience sample of ED patients undergoing propofol or ketofol sedation. End tidal CO2 (etco2), respiratory rate, pulse rate, and SpO2 were electronically recorded in 1-second intervals. Procedure times, drug delivery, and interventions were electronically annotated...
August 20, 2016: Annals of Emergency Medicine
Ali Ahiskalioglu, İlker İnce, Elif Oral Ahiskalioglu, Akgun Oral, Mehmet Aksoy, Murat Yiğiter, Mehmet Emin Celikkaya, Ahmet Bedii Salman
Purpose The aim of this study is to evaluate operating conditions during general anesthesia with or without neuromuscular blocker (NMB) in patients undergoing percutaneous internal ring suturing (PIRS). Materials and Methods In this study, 40 patients, with American Society of Anesthesiologists I and II between the ages of 1 and 12 years, were randomly assigned to two groups to receive muscle relaxant with endotracheal tube (ETT) (ETT group) or without muscle relaxant with supreme laryngeal mask airway (sLMA) (LMA group)...
August 22, 2016: European Journal of Pediatric Surgery
Matthew J Bradley, Brandon W Bonds, Luke Chang, Shiming Yang, Peter Hu, Hsiao-Chi Li, Megan L Brenner, Thomas M Scalea, Deborah M Stein
BACKGROUND: Open chest cardiac massage (OCCM) is a commonly performed procedure after traumatic cardiac arrest (TCA). OCCM has been reported to be superior to closed chest compressions (CCC) in animal models and in non-TCA. The purpose of this study is to prospectively compare OCCM versus CCC in TCA using end-tidal carbon dioxide (ETCO2), the criterion standard for determining the effectiveness of chest compressions and detection of return of spontaneous circulation (ROSC), as the surrogate for cardiac output and marker for adequacy of resuscitation...
November 2016: Journal of Trauma and Acute Care Surgery
Aymen N Naguib, Peter D Winch, Roby Sebastian, Daniel Gomez, Luisa Guzman, Julie Rice, Dmitry Tumin, Mark Galantowicz, Joseph D Tobias
BACKGROUND: Near-infrared spectroscopy (NIRS) is a noninvasive monitoring technique that measures regional cerebral oxygen saturation (rSO2). OBJECTIVES: The primary aim was to compare the output of 2 NIRS-based cerebral oximetry devices, FORESIGHT (CAS Medical Systems Inc, Branford, Connecticut) and INVOS (Covidien, Boulder, Colorado), to venous oxygen saturations from the jugular venous bulb at cannulation and decannulation of the superior vena cava (SVC). Secondary objectives included evaluating correlations of cerebral saturation, as measured by the NIRS devices, with mean arterial blood pressure (MAP), measured by an invasive arterial line, and end-tidal CO2 (ETCO2)...
August 15, 2016: Journal of Intensive Care Medicine
Edward H Hurley, Martin Keszler
OBJECTIVE: The ability to ventilate babies with tidal volumes (VTs) below dead space has been demonstrated both in vivo and in vitro, though it appears to violate classical respiratory physiology. We hypothesised that this phenomenon is made possible by rapid flow of gas that penetrates the dead space allowing fresh gas to reach the lungs and that the magnitude of this phenomenon is affected by flow rate or how rapidly air flows through the endotracheal tube. METHODS: We conducted two bench experiments...
August 11, 2016: Archives of Disease in Childhood. Fetal and Neonatal Edition
Melih Yüksel, Murat Pekdemir, Serkan Yilmaz, Elif Yaka, Aslı Gülfer Kartal
BACKGROUND/AIM: Pulmonary embolism (PE) is a frequent health problem representing a diagnostic challenge with high mortality and morbidity rates. The aim of this study was to investigate the value of end-tidal carbon dioxide (ETCO2) and alveolar dead space fraction (ADSF) in the diagnosis of PE. MATERIALS AND METHODS: ETCO2 levels of patients with suspected PE were measured with a noninvasive mainstream sensor. ADSF of patients was calculated and PaCO2 levels were also obtained...
2016: Turkish Journal of Medical Sciences
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