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Oxygen saturation targeting

Maria Rachele Ceccarini, Michela Codini, Samuela Cataldi, Samuele Vannini, Andrea Lazzarini, Alessandro Floridi, Massimo Moretti, Milena Villarini, Bernard Fioretti, Tommaso Beccari, Elisabetta Albi
BACKGROUND: Sphingomyelin plays very important roles in cell function under physiological and pathological conditions. Physical and chemical stimuli produce reactive oxygen species that stimulate acid sphingomyelinase to induce apoptosis. Antioxidant plants of the traditional Chinese Pharmacopoeia, such as Lycium Barbarum and Lycium Chinense, have become increasingly popular in Western countries. We investigated the effects of Lycium Chinense on acid sphingomyelinase and sphingomyelin species in relation to gene expression...
October 19, 2016: Lipids in Health and Disease
D J Asby, M G Radigois, D C Wilson, F Cuda, C L L Chai, A Chen, A S Bienemann, M E Light, D C Harrowven, A Tavassoli
Elevation of reactive oxygen species (ROS) is both a consequence and driver of the upregulated metabolism and proliferation of transformed cells. The resulting increase in oxidative stress is postulated to saturate the cellular antioxidant machinery, leaving cancer cells susceptible to agents that further elevate their intracellular oxidative stress. Several small molecules, including the marine natural product cribrostatin 6, have been demonstrated to trigger apoptosis in cancer cells by increasing intracellular ROS...
October 4, 2016: Organic & Biomolecular Chemistry
Ann Hellström, David Ley, Ingrid Hansen-Pupp, Boubou Hallberg, Luca A Ramenghi, Chatarina Löfqvist, Lois E H Smith, Anna-Lena Hård
Retinopathy of prematurity is a potentially blinding disease, which is associated with low neonatal IGF-I serum concentrations and poor growth. In severe cases impaired retinal vessel growth is followed by pathologic neovascularization, which may lead to retinal detachment. IGF-I may promote growth even in catabolic states. Treating preterm infants with recombinant human (rh) IGF-I to concentrations normally found during gestation has been suggested to have a preventative effect on ROP. A recent phase 2 study treating infants (gestational age between 23weeks+0days and 27weeks +6days) with rhIGF-I/IGF binding protein-3 until 30 postmenstrual weeks showed no effect on ROP but a 53% reduction in severe bronchopulmonary dysplasia and 44% reduction in severe intraventricular hemorrhage...
September 28, 2016: Growth Hormone & IGF Research
Abele Donati, Elisa Damiani, Roberta Domizi, Claudia Scorcella, Andrea Carsetti, Stefania Tondi, Valentina Monaldi, Erica Adrario, Rocco Romano, Paolo Pelaia, Mervyn Singer
BACKGROUND: Impaired microcirculatory perfusion and tissue oxygenation during critical illness are associated with adverse outcome. The aim of this study was to detect alterations in tissue oxygenation or microvascular reactivity and their ability to predict outcome in critically ill patients using thenar near-infrared spectroscopy (NIRS) with a vascular occlusion test (VOT). METHODS: Prospective observational study in critically ill adults admitted to a 12-bed intensive care unit (ICU) of a University Hospital...
October 1, 2016: Critical Care: the Official Journal of the Critical Care Forum
Jureerat Khongkaew, Dujdao Sahasthas, Tharrittawadha Potat, Phatchara Thammawirat
BACKGROUND: The transesophageal echocardiograhpy (TEE) has been studied worldwide. However, identifying additional factors on top of operator's experience and patient's cooperation which could influence the success of the procedure in unsedated patients with heart disease  is not well documented. METHODS: Under the cross-sectional descriptive design, 85 target patients were fulfilling the criteria: being Thai national at the age of at least 20-year-old, being performed TEE by the study participant's cardiologists, being able to communicate verbally...
October 5, 2016: Cardiovascular Ultrasound
Thomas Desautels, Jacob Calvert, Jana Hoffman, Melissa Jay, Yaniv Kerem, Lisa Shieh, David Shimabukuro, Uli Chettipally, Mitchell D Feldman, Chris Barton, David J Wales, Ritankar Das
BACKGROUND: Sepsis is one of the leading causes of mortality in hospitalized patients. Despite this fact, a reliable means of predicting sepsis onset remains elusive. Early and accurate sepsis onset predictions could allow more aggressive and targeted therapy while maintaining antimicrobial stewardship. Existing detection methods suffer from low performance and often require time-consuming laboratory test results. OBJECTIVE: To study and validate a sepsis prediction method, InSight, for the new Sepsis-3 definitions in retrospective data, make predictions using a minimal set of variables from within the electronic health record data, compare the performance of this approach with existing scoring systems, and investigate the effects of data sparsity on InSight performance...
September 30, 2016: JMIR Medical Informatics
Timo Sturm, Julia Leiblein, Verena Schneider-Lindner, Thomas Kirschning, Manfred Thiel
PURPOSE: Clinically unapparent microcirculatory impairment is common and has a negative impact on septic shock, but specific therapy is not established so far. This prospective observational study aimed at identifying candidate parameters for microcirculatory-guided hemodynamic therapy. CLINICALTRIALSGOV: NCT01530932. MATERIALS AND METHODS: Microcirculatory flow and postcapillary venous oxygen saturation were detected during vaso-occlusive testing (VOT) on days 1 (T0), 2 (T24), and 4 (T72) in 20 patients with septic shock at a surgical intensive care unit using a laser Doppler spectrophotometry system (O2C)...
September 29, 2016: Journal of Intensive Care Medicine
Margaret J Trost, Melissa Cowell, Jennifer Cannon, Kendra Mitchell, Kevin Waloff, Humberto Avila, Sanjay Chand, Christopher J Russell
PURPOSE: Children with sleep apnea may be at increased risk for overnight respiratory events (ORE) following anesthesia. We sought to identify ORE risk factors in sleep apnea patients sedated for magnetic resonance imaging (MRI). METHODS: One thousand four hundred seven hospitalizations for children with sleep apnea (by ICD-9 code) occurred at our institution from 5/1/2011 to 2/1/2015. One hundred twenty-seven (9 %) encounters were solely for post-MRI observation representing 96 unique patients...
September 28, 2016: Sleep & Breathing, Schlaf & Atmung
R A Chemtob, T G Eskesen, H Moeller-Soerensen, A Perner, H B Ravn
BACKGROUND: Adequate tissue oxygenation is necessary to maintain organ function. Low venous oxygen saturation may reflect impaired tissue oxygenation, and may be used as a predictive tool and a therapeutic target to improve the care of critically ill patients. We therefore conducted a systematic review of the existing literature reflecting these aspects. METHODS: We searched electronic databases in January 2016 for relevant studies on venous oxygen saturation for treatment guidance and patient outcome...
November 2016: Acta Anaesthesiologica Scandinavica
R P E Boezeman, B P Becx, D A F van den Heuvel, Ç Ünlü, J A Vos, J P P M de Vries
OBJECTIVE: Near-infrared spectroscopy (NIRS) non-invasively determines tissue oxygen saturation (Sto2) in muscle tissue. Its application to monitor real time hemodynamic changes during percutaneous transluminal angioplasty (PTA) and Sto2 changes in feet 4 weeks after PTA was evaluated. METHODS: This study included 14 patients with critical limb ischemia (CLI, six patients Rutherford classification Stage IV, two patients Stage V, and six patients Stage VI). In patients with arterial ulcers, NIRS optodes were placed near the ulcer of the diseased foot (Optode 1), and at the same spot at the contralateral foot (Optode 2)...
September 7, 2016: European Journal of Vascular and Endovascular Surgery
P Madhan Mohan, V Nagarajan, J C Vignesh
Due to increasing health consciousness among people, it is imperative to have low-cost health care devices to measure the vital parameters like heart rate and arterial oxygen saturation (SpO2). In this paper, an efficient heart rate monitoring algorithm based on the morphology of photoplethysmography (PPG) signals to measure the spot heart rate (HR) and its real-time implementation is proposed. The algorithm does pre-processing and detects the onsets and systolic peaks of the PPG signal to estimate the heart rate of the subject...
September 9, 2016: Journal of Medical Engineering & Technology
Esther Oder, Martin K Safo, Osheiza Abdulmalik, Gregory J Kato
The hallmark of sickle cell disease is the polymerization of sickle haemoglobin due to a point mutation in the β-globin gene (HBB). Under low oxygen saturation, sickle haemoglobin assumes the tense (T-state) deoxygenated conformation that can form polymers, leading to rigid erythrocytes with impaired blood vessel transit, compounded or initiated by adhesion of erythrocytes to endothelium, neutrophils and platelets. This process results in vessel occlusion and ischaemia, with consequent acute pain, chronic organ damage, morbidity and mortality...
October 2016: British Journal of Haematology
François Lellouche, Pierre-Alexandre Bouchard, Maude Roberge, Serge Simard, Erwan L'Her, François Maltais, Yves Lacasse
INTRODUCTION: We developed a device (FreeO2) that automatically adjusts the oxygen flow rates based on patients' needs, in order to limit hyperoxia and hypoxemia and to automatically wean them from oxygen. OBJECTIVE: The aim of this study was to evaluate the feasibility of using FreeO2 in patients hospitalized in the respiratory ward for an acute exacerbation of COPD. METHODS: We conducted a randomized controlled trial comparing FreeO2 vs manual oxygen titration in the respiratory ward of a university hospital...
2016: International Journal of Chronic Obstructive Pulmonary Disease
Barbara Schmidt, Robin K Whyte, Prakesh S Shah, Soraya Abbasi, Aida Bairam, JoAnn Harrold, Robin S Roberts
Subgroup analysis of the Canadian Oxygen Trial to compare outcomes of extremely preterm infants in centers with more versus less separation between median arterial oxygen saturations in the two target ranges. Centers with more separation observed lower rates of death or disability in the 85%-89% range than in the 91%-95% target range.
September 2, 2016: Journal of Pediatrics
Richard Beasley, Jimmy Chien, James Douglas, Leonie Eastlake, Claude Farah, Gregory King, Rosemary Moore, Janine Pilcher, Michael Richards, Sheree Smith, Haydn Walters
This scientific letter considers the rationale for the target oxygen saturation measured by pulse oximetry (SpO2 ) range of 92-96% for oxygen therapy in adult patients without COPD or other conditions associated with chronic respiratory failure, recommended by the Thoracic Society of Australia and New Zealand, in contrast to the 94-98% target range recommended by the British Thoracic Society. We conclude from the available evidence that the SpO2 target of 92-96% may be preferable to 94-98%.
September 1, 2016: Respirology: Official Journal of the Asian Pacific Society of Respirology
Gemma K Plottier, Kevin I Wheeler, Sanoj K M Ali, Omid Sadeghi Fathabadi, Rohan Jayakar, Timothy J Gale, Peter A Dargaville
OBJECTIVE: To evaluate the performance of a novel rapidly responsive proportional-integral-derivative (PID) algorithm for automated oxygen control in preterm infants with respiratory insufficiency. DESIGN: Interventional study of a 4-hour period of automated oxygen control compared with combined data from two flanking periods of manual control (4 hours each). SETTING: Neonatal intensive care unit. PARTICIPANTS: Preterm infants (n=20) on non-invasive respiratory support and supplemental oxygen, with oxygen saturation (SpO2) target range 90%-94% (manual control) and 91%-95% (automated control)...
August 29, 2016: Archives of Disease in Childhood. Fetal and Neonatal Edition
Z A Vesoulis, C E Lust, S M Liao, S B Trivedi, A M Mathur
OBJECTIVE: Fractional tissue oxygen extraction (FTOE) is a measure derived from cerebral near-infrared spectroscopy (NIRS) and simultaneous pulse oximetry (SpO2), capturing the proportion of oxygen delivered in arterial blood that is used by the target tissue. FTOE may provide a better proxy measurement of retinal hyperoxia than pulse oximetry alone and could provide insight into the risk for retinopathy of prematurity (ROP). In this study, we directly compared hyperoxia burden calculated from FTOE with hyperoxia burden calculated from SpO2 alone in order to assess the strength of association between hyperoxia and severe ROP...
August 25, 2016: Journal of Perinatology: Official Journal of the California Perinatal Association
Lucy Wheeler, Janet James, Sarah Byrne, Julian Forton
AIM: To audit oxygen prescribing in a children's hospital following the introduction of a new paediatric medication chart, which incorporates an oxygen prescription section. METHOD: In June 2015 a 1-day snapshot audit was carried out across all wards in the children's hospital. All patients receiving oxygen on that day were included:▸ The audit was repeated in July 2015.▸ The standards for the audit were set at 100% in accordance with our local guidelines...
September 2016: Archives of Disease in Childhood
Keitaro Kubo
It has been suggested that blood circulation within the tendons contributes to repair of the tendon after the exercises. Recently, blood circulation of human tendons could be measured using red laser lights (Kubo et al. 2008b). Using this technique, we were able to measure changes in blood volume and oxygen saturation of human tendons by various treatments. During a 60-min heating, the blood volume and oxygen saturation of the tendon increased significantly from the resting level, and continued to increase by 35 min...
2016: Advances in Experimental Medicine and Biology
Anna Lavizzari, Mariarosa Colnaghi, Francesca Ciuffini, Chiara Veneroni, Stefano Musumeci, Ivan Cortinovis, Fabio Mosca
Importance: Heated, humidified high-flow nasal cannula (HHHFNC) has gained increasing popularity as respiratory support for newborn infants thanks to ease of use and improved patient comfort. However, its role as primary therapy for respiratory distress syndrome (RDS) of prematurity needs to be further elucidated by large, randomized clinical trials. Objective: To determine whether HHHFNC provides respiratory support noninferior to nasal continuous positive airway pressure (nCPAP) or bilevel nCPAP (BiPAP) as a primary approach to RDS in infants older than 28 weeks' gestational age (GA)...
August 8, 2016: JAMA Pediatrics
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