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Michael S Toce, Michele M Burns, Katherine A O'Donnell
CONTEXT: Exploratory buprenorphine ingestions in young children have been associated with clinically significant toxicity. However, detailed data on the clinical presentation and management of these patients are lacking. In an attempt to obtain more comprehensive data, we sought to examine a single center cohort of patients with report of buprenorphine exposure and provide descriptive analysis of rates of respiratory depression, time to respiratory depression, interventions, disposition, and outcomes...
October 19, 2016: Clinical Toxicology
Jarkko Harju, Antti Vehkaoja, Ville Lindroos, Pekka Kumpulainen, Sasu Liuhanen, Arvi Yli-Hankala, Niku Oksala
Alterations in arterial blood oxygen saturation, heart rate (HR), and respiratory rate (RR) are strongly associated with intra-hospital cardiac arrests and resuscitations. A wireless, easy-to-use, and comfortable method for monitoring these important clinical signs would be highly useful. We investigated whether the Nellcor™ OxiMask MAX-FAST forehead sensor could provide data for vital sign measurements when located at the distal forearm instead of its intended location at the forehead to provide improved comfortability and easy placement...
October 17, 2016: Journal of Clinical Monitoring and Computing
Angel Paternina-Caicedo, Jezid Miranda, Ghada Bourjeily, Andrew Levinson, Carmelo Dueñas, Camilo Bello Muñoz, José A Rojas-Suarez
BACKGROUND: Every day, about 830 women die worldwide from preventable causes related to pregnancy and childbirth. Obstetric early-warning scores have been proposed as a potential tool to reduce maternal morbidity and mortality, based upon the identification of predetermined abnormal values in the vital signs or laboratory parameters, to generate a rapid and effective medical response. Several early-warning scores have been developed for obstetrical patients, but the majority are the result of a clinical consensus rather than statistical analyses of clinical outcome measures (i...
October 14, 2016: American Journal of Obstetrics and Gynecology
Mei-Yun Liaw, Lin-Yi Wang, Ya-Ping Pong, Yu-Chin Tsai, Yu-Chi Huang, Tsung-Hsun Yang, Meng-Chih Lin
The aim of this study was to investigate the relationships between pulmonary function, respiratory muscle strength, perceived dyspnea, degree of fatigue, and activity of daily living with motor function and neurological status in stroke patients with stable congestive heart failure (CHF).This was a cohort study in a tertiary care medical center. Stroke patients with CHF and exertional dyspnea (New York Heart Association class I-III) were recruited. The baseline characteristics included duration of disease, Brunnstrom stage, spirometry, resting heart rate, resting oxyhemoglobin saturation (SpO2), maximal inspiratory pressure (MIP), maximal expiratory pressure (MEP), Borg scale, fatigue scale, and Barthel index...
October 2016: Medicine (Baltimore)
Hai Wang, Jiang-Li Sun, Zheng-Hai Bai, Xiao-Bo Wang, Zheng-Liang Zhang, Hong-Hong Pei
Preoxygenation can rapidly improve oxygenation and enhance the security of endotracheal intubation, so it is very essential before endotracheal intubation. The conventional preoxygenation method self-inflating bag (SIB) is not very effective in case of emergency. So our study aims to find a more effective method of preoxygenation in a critical situation.We retrospectively analyzed data of 105 patients in this study. A total of 49 patients with preoxygenation with invasive ventilator in volume control mode (VCM) and 56 patients with preoxygenation with SIB were included...
October 2016: Medicine (Baltimore)
Toshiyuki Ohya, Ryo Yamanaka, Hayato Ohnuma, Masahiro Hagiwara, Yasuhiro Suzuki
BACKGROUND: Some endurance athletes exhibit exercise-induced arterial hypoxemia during high-intensity exercise. Inhalation of hyperoxic gas during exercise has been shown to counteract this exercise-associated reduction in hemoglobin oxygen saturation (SaO2), but the effects of hyperoxic gas inhalation on performance and SaO2 during high-intensity intermittent exercise remain unclear. This study investigated the effects of hyperoxic gas inhalation on performance and SaO2 during high-intensity intermittent cycling exercise...
December 2016: Sports Medicine—Open
N Pratheeba, G S Ramya, R V Ranjan, R Remadevi
CONTEXT: Laryngeal mask airway (LMA) Classic™ has an inflatable cuff while i-gel™ has a noninflatable cuff made of thermoplastic elastomer. AIMS: To compare ease of insertion, number, and duration of insertion attempts among the two device. Secondary objectives were to evaluate the hemodynamic response and SpO2 during device insertion and during maintenance of general anesthesia. SETTINGS AND DESIGN: This study was conducted as randomized observational study in a teaching hospital...
September 2016: Anesthesia, Essays and Researches
Mirthe J Mebius, Michelle E van der Laan, Elise A Verhagen, Marcus Tr Roofthooft, Arend F Bos, Elisabeth Mw Kooi
BACKGROUND: Evidence suggests that hypoxic-ischemic brain injury in infants with congenital heart disease already occurs during early life. The aim of our study was, therefore, to assess the course of regional cerebral oxygen saturation (rcSO2) and fractional tissue oxygen extraction (FTOE) during the first 72h after birth in infants with prenatally diagnosed duct-dependent congenital heart disease. In addition, we identified clinical parameters that were associated with rcSO2. MATERIALS AND METHODS: We included 56 infants with duct-dependent congenital heart disease...
October 11, 2016: Early Human Development
Philippe Jolliet, Lamia Ouanes-Besbes, Fekri Abroug, Jalila Ben Khelil, Mohamed Besbes, Aude Garnero, Jean-Michel Arnal, Fabrice Daviaud, Jean-Daniel Chiche, Benoît Lortat-Jacob, Jean-Luc Diehl, Nicolas Lerolle, Alain Mercat, Keyvan Razazi, Christian Brun-Buisson, Isabelle Durand-Zaleski, Joëlle Texereau, Laurent Brochard
RATIONALE: During non-invasive ventilation (NIV) for COPD exacerbations, Helium/Oxygen (He/O2) reduces work of breathing and hypercapnia more than Air/O2 but impact on clinical outcome remains unknown. OBJECTIVE: To determine whether continuous administration of He/O2 for 72 hours, during and in-between NIV sessions, is superior to Air/O2 in reducing NIV failure (25% to 15%) in severe hypercapnic COPD exacerbations. METHODS: Prospective, randomized, open-label trial (16 intensive care units, 6 countries)...
October 13, 2016: American Journal of Respiratory and Critical Care Medicine
Samir Jaber, Marion Monnin, Mehdi Girard, Matthieu Conseil, Moussa Cisse, Julie Carr, Martin Mahul, Jean Marc Delay, Fouad Belafia, Gérald Chanques, Nicolas Molinari, Audrey De Jong
PURPOSE: High-flow nasal cannula oxygen (HFNC) has the potential to provide apnoeic oxygenation. We decided to assess in a proof-of-concept study whether the addition of HFNC to non-invasive ventilation (NIV) could reduce oxygen desaturation during intubation, compared with NIV alone for preoxygenation, in severely hypoxaemic intensive care unit (ICU) patients with respiratory failure. METHODS: We conducted a randomised, controlled, single-centre trial with assessor-blinded outcome assessment in patients admitted to the ICU...
October 11, 2016: Intensive Care Medicine
Mohamed Ghalayini, Pierre-Yves Brun, Pascal Augustin, Elise Guivarch, Marie Pierre Dilly, Sophie Provenchere, Pierre Mordant, Yves Castier, Philippe Montravers, Dan Longrois
Competitive flows syndrome result in severe regional hypoxemia when the deoxygenated flow from the native left ventricle (LV) competes with oxygenated flow from extracorporeal life support (ECLS) pump with potentially severe consequences for the cerebral and coronary circulations. Fast correction of hypoxemia could be obtained by decreasing native LV flow by infusion of a short-acting beta-blocker (esmolol). Our purpose was to retrospectively review the efficacy of esmolol in this situation and hypothesize on the potential mechanisms of action and the associated risks...
September 2016: Journal of Extra-corporeal Technology
Vibe Maria Laden Nielsen, Jacob Madsen, Anette Aasen, Anne Pernille Toft-Petersen, Kenneth Lübcke, Bodil Steen Rasmussen, Erika Frischknecht Christensen
BACKGROUND: Patients with acute respiratory failure are at risk of deterioration during prehospital transport. Ventilatory support with continuous positive airway pressure (CPAP) can be initiated in the prehospital setting. The objective of the study is to evaluate adherence to treatment and effectiveness of CPAP as an addition to standard care. METHODS: In North Denmark Region, patients with acute respiratory failure, whom paramedics assessed as suffering from acute cardiopulmonary oedema, acute exacerbation of chronic obstructive pulmonary disease or asthma were treated with CPAP using 100 % O2 from 1 March 2014 to 3 May 2015...
October 10, 2016: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
Talha Mahmud, Adnan Shafiq, Abdul Hafeez, Muhammad Saqib, Sidrah Farooq
18-year-old lady was admitted through emergency department after she accidently aspirated a long sewing machine needle into her airways. Upon examination, she was anxious with normal vital signs and without any respiratory distress with SpO2 of 98% on air. Systemic examination was normal except slightly reduced breath sounds intensity on right lower side of chest. Her chest radiograph revealed needle in right lower lobe but it was not visualized on bronchoscopic examination of airways up to sub segmental level...
2016: Respiratory Medicine Case Reports
R Sahni, X Ameer, K Ohira-Kist, J-T Wung
OBJECTIVES: Inhaled nitric oxide (iNO) is effective in conjunction with tracheal intubation (TI) and mechanical ventilation (MV) for treating arterial pulmonary hypertension and hypoxemic respiratory failure (HRF) in near-term and term newborns. Non-invasive respiratory support with nasal continuous positive airway pressure (CPAP) is increasingly used to avoid morbidity associated with TI and MV, yet the effectiveness of iNO delivery via nasal CPAP remains unknown. To evaluate the effectiveness of iNO delivered via the bubble nasal CPAP system in term and preterm newborns with HRF...
October 6, 2016: Journal of Perinatology: Official Journal of the California Perinatal Association
Leonard A Temme, Paul St Onge, Joseph Bleiberg
INTRODUCTION: Physiological and emotional stressors increase symptoms of concussion in recently injured individuals and both forms of stress-induced symptoms in people recovering from mild traumatic brain injury (mTBI), but who are asymptomatic when not stressed or are at rest. METHODS: Healthy asymptomatic adults (25.0 ± 5.1 years) with a history of mTBI (n = 36) and matched healthy controls (HC) (n = 36) with no mTBI history were exposed to three levels of normobaric hypoxic stress generated with the Reduced Oxygen Breathing Device (ROBD) (Environics, Inc...
2016: Frontiers in Neurology
Massimo Girardis, Stefano Busani, Elisa Damiani, Abele Donati, Laura Rinaldi, Andrea Marudi, Andrea Morelli, Massimo Antonelli, Mervyn Singer
Importance: Despite suggestions of potential harm from unnecessary oxygen therapy, critically ill patients spend substantial periods in a hyperoxemic state. A strategy of controlled arterial oxygenation is thus rational but has not been validated in clinical practice. Objective: To assess whether a conservative protocol for oxygen supplementation could improve outcomes in patients admitted to intensive care units (ICUs). Design, Setting, and Patients: Oxygen-ICU was a single-center, open-label, randomized clinical trial conducted from March 2010 to October 2012 that included all adults admitted with an expected length of stay of 72 hours or longer to the medical-surgical ICU of Modena University Hospital, Italy...
October 5, 2016: JAMA: the Journal of the American Medical Association
Yingjun Qian, Huajun Xu, Yuyu Wang, Hongliang Yi, Jian Guan, Shankai Yin
INTRODUCTION: Obstructive sleep apnea (OSA) has been suggested to be associated with a high risk of metabolic syndrome (MS). However, results on whether the association between OSA and risk of MS is independent of obesity, and the effect of nocturnal intermittent hypoxia (IH) on MS, are conflicting. Our purpose was to estimate the magnitude of the independent association between OSA and risk of MS and further explore whether nocturnal IH in OSA plays a role in MS risk. MATERIAL AND METHODS: The PubMed and EMBASE databases were systematically searched (until January 21, 2015) for available observational evidence...
October 1, 2016: Archives of Medical Science: AMS
Cemil Kavalci, Muhittin Serkan Yilmaz, Afsin Emre Kayipmaz, Bahattin Isık, Elif Celikel, Gulsum Kavalci, Fevzi Yilmaz, Miray Ozlem, Bedriye Muge Sonmez, Selman Celebi
INTRODUCTION: Chronic obstructive pulmonary disease (COPD) leads to physical activity limitation and a significant reduction in quality of life. This study aimed to investigate the correlation between The COPD Assessment Test (CAT) score and peak expiratory flow (PEF), and the factors effecting hospital admission rates of patients with COPD. METHODS: This observational study was conducted prospectively. CAT score was calculated and PEF measured at the time of emergency department admission...
2016: Journal of the National Medical Association
Vasileios Andrianopoulos, Bartolome R Celli, Frits M E Franssen, Victor M Pinto-Plata, Peter M A Calverley, Lowie E G W Vanfleteren, Ioannis Vogiatzis, Jørgen Vestbo, Alvar Agusti, Per S Bakke, Stephen I Rennard, William MacNee, Ruth Tal-Singer, Julie C Yates, Emiel F M Wouters, Martijn A Spruit
Exercise-induced oxygen desaturation (EID) is related to mortality in patients with chronic obstructive pulmonary disease (COPD). We investigated: (1) the prevalence of EID; (2) the relative-weight of several physiological determinants of EID including pulmonary emphysema, and (3) the relationship of EID with certain patients' clinical characteristics. Data from 2050 COPD patients (age: 63.3 ± 7.1years; FEV1: 48.7 ± 15.7%pred.) were analyzed. The occurrence of EID (SpO2post ≤88%) at the six-minute walking test (6MWT) was investigated in association with emphysema quantified by computed-tomography (QCT), and several clinical characteristics...
October 2016: Respiratory Medicine
Fabiola Stollar, Alain Gervaix, Constance Barazzone Argiroffo
Recent publications have established the pulse oxygen saturation (SpO2) threshold of 90% for the hospitalization and discharge of infant patients with bronchiolitis. However, there is no clear recommendation regarding the Emergency Department (ED) observation period necessary before allowing safe home discharge for patients with SpO2 above 90%-92%. Our primary aims were to evaluate the risk factors associated with delayed desaturation in infants with SpO2 ≥ 92% on arrival at the ED as well as the ED observation period necessary before allowing safe home discharge...
2016: PloS One
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