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Alveolar-arterial oxygen gradient

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https://www.readbyqxmd.com/read/29131002/low-tidal-volume-positive-end-expiratory-pressure-versus-high-tidal-volume-zero-positive-end-expiratory-pressure-and-postoperative-pulmonary-functions-in-robot-assisted-laparoscopic-radical-prostatectomy
#1
Murat Haliloglu, Beliz Bilgili, Mehtap Ozdemir, Tumay Umuroglu, Nurten Bakan
OBJECTIVE: The aim was to compare the effects of low tidal volume (VT) and moderate positive end-expiratory pressure(PEEP) with high tidal volume (VT) and zero end-expiratory pressure(ZEEP), on postoperative pulmonary functions and oxygenation in patients undergoing robot-assisted laparoscopic radical prostatectomy. SUBJECTS AND METHODS: Forty-four (44) patients were randomized into low VT-PEEP and high VT-ZEEP groups. The patients were ventilated with VT of 6 ml/kg and 8 cmH2O PEEP in low VT-PEEP group and VT of 10 ml/kg and 0 cmH2O PEEP in high VT-ZEEP group...
October 31, 2017: Medical Principles and Practice: International Journal of the Kuwait University, Health Science Centre
https://www.readbyqxmd.com/read/29125632/median-sternotomy-versus-intercostal-thoracotomy-for-lung-lobectomy-a-comparison-of-short-term-outcome-in-134-dogs
#2
Seth Bleakley, Kevin Phipps, Brian Petrovsky, Eric Monnet
OBJECTIVE: To compare short-term outcomes between dogs undergoing lung lobectomy via median sternotomy (MS) or intercostal thoracotomy (ICT). STUDY DESIGN: Retrospective case control study. METHODS: Medical records of dogs that underwent lung lobectomy via MS or ICT at a single institution were reviewed for demographics, intraoperative findings, and postoperative management and outcomes. Dogs with pleural effusion, pneumonia, migrating foreign body, lung abscess, spontaneous pneumothorax, or lung lobe torsion were excluded...
November 10, 2017: Veterinary Surgery: VS
https://www.readbyqxmd.com/read/29118307/prevention-of-pulmonary-edema-after-minimally-invasive-cardiac-surgery-with-mini-thoracotomy-using-neutrophil-elastase-inhibitor
#3
Satoshi Yamashiro, Ryoko Arakaki, Yuya Kise, Yukio Kuniyoshi
PURPOSE: Unilateral re-expansion pulmonary edema (RPE) is a rare but one of the most critical complications that may occur after re-expansion of a collapsed lung after minimally invasive cardiac surgery (MICS) with mini-thoracotomy. METHODS: We performed a total of 40 consecutive patients with MICS by right mini-thoracotomy with single-lung ventilation between January 2013 and June 2016. We divided the patients into control group (n = 13) and neutrophil elastase inhibitor group (n = 27)...
November 8, 2017: Annals of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29043980/a-support-to-biological-validation-of-oxygenation-parameters
#4
Maud Godignon, Frédéric Costes, Vincent Sapin, Damien Bouvier
Blood gas analyzers are able to provide information on a wide range of oxygenation parameters. Some of these data are complex. Their biological significance or clinical consistency are not always well known. This article aims to define these parameters, their reference values according to the type of sample; and to outline the possible errors during their interpretation. Thus, these reliable results can be integrated into the diagnostic procedure. We will see that the information provided by physicians plays an important role in their interpretation (temperature, patient ventilation condition, type of sample…)...
October 18, 2017: Annales de Biologie Clinique
https://www.readbyqxmd.com/read/28987478/clinical-impact-of-intrapulmonary-vascular-dilatation-in-liver-transplant-candidates
#5
Hilary M DuBrock, Michael J Krowka, Kimberly A Forde, Karen Krok, Mamta Patel, Tiffany Sharkoski, Michael Sprys, Grace Lin, Jae K Oh, Carl D Mottram, Paul D Scanlon, Michael B Fallon, Steven M Kawut
BACKGROUND: Intrapulmonary vascular dilatations (IPVD) are frequently detected in patients with liver disease by the delayed appearance of microbubbles on contrast-enhanced echocardiography. IPVD with an elevated alveolar-arterial (A-a) gradient define hepatopulmonary syndrome, however the importance of IPVD in the absence of abnormal gas exchange is unknown. We aimed to determine the clinical impact of IPVD in patients with liver disease. METHODS: We performed a cross-sectional study within the Pulmonary Vascular Complications of Liver Disease (PVCLD2) Study, a multicenter prospective cohort study of patients being evaluated for liver transplantation...
October 5, 2017: Chest
https://www.readbyqxmd.com/read/28972388/hepatopulmonary-syndrome-which-blood-gas-analysis-criteria-and-position-should-we-use-for-diagnosis
#6
Israel Grilo, Juan Manuel Pascasio, Francisco-Jesús López-Pardo, Francisco Ortega-Ruiz, Juan Luis Tirado, José Manuel Sousa, María José Rodríguez-Puras, María Teresa Ferrer, Miguel Ángel Gómez-Bravo, Antonio Grilo
INTRODUCTION: Different blood gas criteria have been used in the diagnosis of hepatopulmonary syndrome (HPS). PATIENTS AND METHODS: Arterial blood gases were prospectively evaluated in 194 cirrhotic candidates for liver transplantation (LT) in the supine and seated position. Three blood gas criteria were analyzed: classic (partial pressure of oxygen [PaO2] < 70 mmHg and/or alveolar-arterial gradient of oxygen [A-a PO2] ≥ 20 mmHg), modern (A-a PO2 ≥ 15 mmHg or ≥ 20 mmHg in patients over 64) and the A-a PO2 ≥ threshold value adjusted for age...
October 3, 2017: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/28969989/the-effects-of-pioglitazone-in-cirrhotic-rats-with-hepatopulmonary-syndrome
#7
Tsung-Yi Cheng, Wen-Shin Lee, Hui-Chun Huang, Fa-Yauh Lee, Ching-Chih Chang, Han-Chieh Lin, Shou-Dong Lee
BACKGROUND: Hepatopulmonary syndrome (HPS) is characterized by oxygen desaturation and increased intrapulmonary shunting formation in cirrhosis. Due to an unclarified mechanism, there is still no effective therapy except liver transplantation. Recent studies revealed that pulmonary angiogenesis may participate in pathogenesis, in which nitric oxide (NO) and vascular endothelial growth factor (VEGF) play roles. Pioglitazone, a peroxisome proliferator-activated receptor gamma agonist, exerts anti-angiogenesis effect...
November 2017: Journal of the Chinese Medical Association: JCMA
https://www.readbyqxmd.com/read/28924136/a-case-of-tracheobronchomalacia-mimicking-acute-pulmonary-embolism
#8
Stefani M Schwartz, Katherine J Greco, Venugopal Reddy
BACKGROUND Pulmonary embolism is a common acute postoperative complication and is associated with 100,000 deaths per year in the USA. Tracheobronchomalacia is an uncommon condition, which presents with similar symptoms to pulmonary embolism, including hypoxemia, tachycardia, and shortness of breath. We describe a case of a patient who presented with postoperative pulmonary symptoms that were initially thought to be due to pulmonary embolism. However, following imaging investigations these symptoms were found to be due to tracheobronchomalacia...
September 19, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28904478/how-useful-is-extravascular-lung-water-measurement-in-managing-lung-injury-in-intensive-care-unit
#9
Anirban Bhattacharjee, Debasis Pradhan, Prithwis Bhattacharyya, Samarjit Dey, Daniala Chhunthang, Akash Handique, Angkita Barman, Mohd Yunus
CONTEXT: The primary goal of septic shock management is optimization of organ perfusion, often at the risk of overloading the interstitium and causing pulmonary edema. The conventionally used end points of resuscitation do not generally include volumetric parameters such as extravascular lung water index (EVLWI) and pulmonary vascular permeability index (PVPI). AIMS: This study aimed to assess the prognostic value of EVLWI and PVPI by calculating their correlation with the severity of lung injury...
August 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28882651/in-cystic-fibrosis-lung-clearance-index-is-sensitive-to-detecting-abnormalities-appearing-at-exercise-in-children-with-normal-spirometry
#10
Riyadh Chelabi, Thibaud Soumagne, Alicia Guillien, Marc Puyraveau, Bruno Degano
Symptom-limited incremental cardiopulmonary exercise test was performed in school-age children with clinically stable cystic fibrosis (CF), all with normal spirometry. Physiological parameters were compared between patients with normal lung clearance index (LCI; n=6) and patients with elevated LCI (n=6). Dyspnoea ratings during exercise were similar in both groups. Although no patient had significant dynamic hyperinflation, end-expiratory lung volumes were higher throughout exercise in patients with elevated LCI...
September 4, 2017: Respiratory Physiology & Neurobiology
https://www.readbyqxmd.com/read/28656646/parenteral-irons-versus-transfused-red-blood-cells-for-treatment-of-anemia-during-canine-experimental-bacterial-pneumonia
#11
COMPARATIVE STUDY
Dante A Suffredini, Wanying Xu, Junfeng Sun, Jesús Barea-Mendoza, Steven B Solomon, Samuel L Brashears, Andreas Perlegas, Daniel B Kim-Shapiro, Harvey G Klein, Charles Natanson, Irene Cortés-Puch
BACKGROUND: No studies have been performed comparing intravenous (IV) iron with transfused red blood cells (RBCs) for treating anemia during infection. In a previous report, transfused older RBCs increased free iron release and mortality in infected animals when compared to fresher cells. We hypothesized that treating anemia during infection with transfused fresh RBCs, with minimal free iron release, would prove superior to IV iron therapy. STUDY DESIGN AND METHODS: Purpose-bred beagles (n = 42) with experimental Staphylococcus aureus pneumonia rendered anemic were randomized to be transfused RBCs stored for 7 days or one of two IV iron preparations (7 mg/kg), iron sucrose, a widely used preparation, or ferumoxytol, a newer formulation that blunts circulating iron levels...
October 2017: Transfusion
https://www.readbyqxmd.com/read/28611257/isolated-intrapulmonary-vascular-dilatations-and-the-risk-of-developing-hepatopulmonary-syndrome-in-liver-transplant-candidates
#12
Manuel Mendizabal, David Goldberg, Federico Piñero, Diego Arufe, María José de la Fuente, Pablo Testa, Matías Coronel, Sergio Baratta, Luis Podestá, Michael Fallon, Marcelo Silva
BACKGROUND: The natural history of intrapulmonary vascular dilations (IPVD) and their impact on patient outcomes in the setting of portal hypertension has only been described in small series. AIMS: To assess the development of hepatopulmonary síndrome (HPS) in patients with isolated IPVD and to evaluate outcomes of IPVD and HPS among patients evaluated for liver transplantation (LT). MATERIAL AND METHODS: Data from a prospective cohort of patients evaluated for LT with standardized screening for HPS were analyzed...
July 2017: Annals of Hepatology
https://www.readbyqxmd.com/read/28539140/hemoglobin-oxygen-saturation-with-mild-hypoxia-and-microgravity
#13
Johnny Conkin, James H Wessel, Jason R Norcross, Omar S Bekdash, Andrew F J Abercromby, Matthew D Koslovsky, Michael L Gernhardt
INTRODUCTION: Microgravity (μG) exposure and even early recovery from μG in combination with mild hypoxia may increase the alveolar-arterial oxygen (O2) partial pressure gradient. METHODS: Four male astronauts on STS-69 (1995) and four on STS-72 (1996) were exposed on Earth to an acute sequential hypoxic challenge by breathing for 4 min 18.0%, 14.9%, 13.5%, 12.9%, and 12.2% oxygen-balance nitrogen. The 18.0% O2 mixture at sea level resulted in an inspired O2 partial pressure (PIo2) of 127 mmHg...
June 1, 2017: Aerospace Medicine and Human Performance
https://www.readbyqxmd.com/read/28490218/evaluation-of-clinical-prognostic-factors-for-interstitial-pneumonia-in-anti-mda5-antibody-positive-dermatomyositis-patients
#14
Youhei Fujiki, Takuya Kotani, Kentaro Isoda, Takaaki Ishida, Takeshi Shoda, Shuzo Yoshida, Tohru Takeuchi, Shigeki Makino
OBJECTIVES: We retrospectively investigated clinical prognostic factors for interstitial pneumonia (IP) in anti-melanoma differentiation-associated gene 5 (MDA5) antibody (Ab)-positive dermatomyositis (DM) patients. METHODS: Subjects comprised 18 patients with anti-MDA5 Ab-positive DM-IP (9 survivors; 9 deaths). RESULTS: Initial serum albumin levels, ferritin levels, and ground-glass opacity (GGO) scores in the right middle lobes were significantly higher in the death group than in the survivor group (p = ...
May 11, 2017: Modern Rheumatology
https://www.readbyqxmd.com/read/28460544/pulmonary-vascular-resistance-index-during-coronary-artery-bypass-surgery-with-aprotinin
#15
Vesa Toikkanen, Timo Rinne, Jari Laurikka, Helena Porkkala, Matti Tarkka, Ari Mennander
Low pulmonary vascular resistance index (PVRI) reflects favorable redundant pulmonary circulation following coronary artery bypass grafting with cardiopulmonary bypass surgery (CPB). This randomized study investigated whether aprotinin given in different modalities impacts PVRI after coronary artery bypass grafting. A total of 40 patients undergoing coronary artery bypass grafting were randomized to four groups according to aprotinin dose: (1) high dose, (2) early low dose, (3) late low dose, and (4) without aprotinin...
May 2, 2017: Scandinavian Journal of Clinical and Laboratory Investigation
https://www.readbyqxmd.com/read/28439386/usefulness-of-clinical-prediction-rules-d-dimer-and-arterial-blood-gas-analysis-to-predict-pulmonary-embolism-in-cancer-patients
#16
Asifa Karamat, Shazia Awan, Muhammad Ghazanfar Hussain, Fahad Al Hameed, Faheem Butt, Ali Saeed Wahla
OBJECTIVES: Pulmonary embolism (PE) is seven times more common in cancer patients than non-cancer patients. Since the existing clinical prediction rules (CPRs) were validated predominantly in a non-cancer population, we decided to look at the utility of arterial blood gas (ABG) analysis and D-dimer in predicting PE in cancer patients. METHODS: Electronic medical records were reviewed between December 2005 and November 2010. A total of 177 computed tomography pulmonary angiograms (CTPAs) were performed...
March 2017: Oman Medical Journal
https://www.readbyqxmd.com/read/28435094/diammonium-glycyrrhizinate-alleviates-hepatopulmonary-syndrome-via-restoring-superoxide-dismutase-3-activity-in-rats
#17
Xin Zhao, Jinyu Liu, Shijun Yang, Chen Chen, He Yin, Ting Li, Qiuting Wang, Xiaoya Li, Yulin Lin, Dayong Cai
Hepatopulmonary syndrome (HPS) has a fatal hypoxemia from pulmonary shunts. Superoxide dismutase 3 (SOD3) deficiency involves in this pathogenesis. The purpose of this study was to investigate the underlying mechanisms of diammonium glycyrrhizinate (DG) on HPS via SOD3. Carbon tetrachloride induced HPS rats were treated with captopril or DG for 56 days. Blood gas, pulmonary artery pressures, and histological changes were measured. Molecule dynamics of inducible (iNOS), endothelial (eNOS), neuronal nitric oxide synthase (nNOS) and SOD3 were assessed by immunohistochemistry, quantitative RT-PCR and western blot...
July 15, 2017: European Journal of Pharmacology
https://www.readbyqxmd.com/read/28403594/the-effect-of-surgical-technique-on-hemodynamics-arterial-oxygenation-and-pulmonary-mechanics-in-radical-prostatectomy-operations
#18
Yucel Yuce, Kutlu Hakan Erkal, Cemal Goktas, Bilal Eryildirim, Kemal Sarica
OBJECTIVE: The effects of surgical technique on respiratory mechanics, arterial oxygenation and hemodynamics in radical prostatectomy operation were investigated. METHODS: The study was planned on ASA II-III, 40-65 years old, fourty patients scheduled for radical prostatectomy under general anesthesia. They were divided into two groups: perineal and suprapubic (Group P, n = 20; Group S, n = 20). Heart rate, mean arterial blood pressure, arterial oxygen saturation (SpO2), partial pressure of end-tidal carbon dioxide (PEtCO2), Peak inspiratory pressure (PIP), plato pressure (Pplato), partial pressure of oxygen in arterial blood (PaO2), partial pressure of carbon dioxide in arterial blood (PaCO2) values were evaluated at 10 minutes after induction...
March 31, 2017: Archivio Italiano di Urologia, Andrologia
https://www.readbyqxmd.com/read/28301945/the-utility-of-the-macro-aggregated-albumin-lung-perfusion-scan-in-the-diagnosis-and-prognosis-of-hepatopulmonary-syndrome-in-cirrhotic-patients-candidates-for-liver-transplantation
#19
Israel Grilo, Juan Manuel Pascasio, Juan Luis Tirado, Francisco-Jesús López-Pardo, Francisco Ortega-Ruiz, José Manuel Sousa, María José Rodríguez-Puras, María Teresa Ferrer, Miguel Ángel Gómez-Bravo, Antonio Grilo Reina
BACKGROUND: The macro-aggregated albumin lung perfusion scan (99mTc-MAA) is a diagnostic method for hepatopulmonary syndrome (HPS). GOAL: To determine the sensitivity of 99mTc-MAA in diagnosing HPS, to establish the utility of 99mTc-MAA in determining the influence of HPS on hypoxemia in patients with concomitant pulmonary disease and to determine the correlation between 99mTc-MAA values and other respiratory parameters. METHODS: Data from 115 cirrhotic patients who were eligible for liver transplantation (LT) were prospectively analyzed...
May 2017: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/28169983/effect-of-preoperative-inspiratory-muscle-training-on-alveolar-arterial-oxygen-gradients-after-coronary-artery-bypass-surgery
#20
Khalid Turky, Amera M Abdelaziz Afify
PURPOSE: Gas exchange abnormalities and inspiratory muscle dysfunction are common postoperative pulmonary complications after cardiac surgery. The aim of this study was to investigate the changes in the alveolar arterial oxygen gradients and inspiratory muscle power after preoperative inspiratory muscle training (IMT) followed by postoperative IMT and early mobilization after coronary artery bypass graft surgery. METHODS: Patients were randomly assigned to the intervention group (n = 20) or the usual care group (n = 20)...
February 6, 2017: Journal of Cardiopulmonary Rehabilitation and Prevention
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