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Oxygen saturation targeting

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https://www.readbyqxmd.com/read/29679696/effect-of-neuromonitor-guided-titrated-care-on-brain-tissue-hypoxia-after-opioid-overdose-cardiac-arrest
#1
Jonathan Elmer, Katharyn L Flickinger, Maighdlin W Anderson, Allison Koller, Matthew Sundermann, Cameron Dezfulian, David O Okonkwo, Lori A Shutter, David Salcido, Clifton W Callaway, James J Menegazzi
INTRODUCTION: Brain tissue hypoxia may contribute to preventable secondary brain injury after cardiac arrest. We developed a porcine model of opioid overdose cardiac arrest and post-arrest care including invasive, multimodal neurological monitoring of regional brain physiology. We hypothesized brain tissue hypoxia is common with usual post-arrest care and can be prevented by modifying mean arterial pressure (MAP) and arterial oxygen concentration (PaO2 ). METHODS: We induced opioid overdose and cardiac arrest in sixteen swine, attempted resuscitation after 9 minutes of apnea, and randomized resuscitated animals to three alternating 6-hour blocks of standard or titrated care...
April 18, 2018: Resuscitation
https://www.readbyqxmd.com/read/29674770/incidence-of-pulmonary-complications-with-the-prophylactic-use-of-high-flow-nasal-cannula-after-pediatric-cardiac-surgery-prophylactic-hfnc-study-protocol
#2
Naohiro Shioji, Tomoyuki Kanazawa, Tatsuo Iwasaki, Kazuyoshi Shimizu, Tomohiko Suemori, Hirokazu Kawase, Satoshi Kimura, Yasutoshi Kuroe, Hiroshi Morimatsu
We will investigate the incidence of postoperative pulmonary complications (PPCs) with the prophylactic use of a high-flow nasal cannula (HFNC) after pediatric cardiac surgery. Children < 48 months old with congenital heart disease for whom cardiac surgery is planned will be included. The HFNC procedure will be commenced just after extubation, at a flow rate of 2 L/kg/min with adequate oxygen concentration to achieve target oxygen saturation ≥ 94%. This study will reveal the prevalence of PPCs after pediatric cardiac surgery with the prophylactic use of HFNC...
April 2018: Acta Medica Okayama
https://www.readbyqxmd.com/read/29669357/oxygenation-of-the-immature-infant-a-commentary-and-recommendations-for-oxygen-saturation-targets-and-alarm-limits
#3
Ola Didrik Saugstad
BACKGROUND: For 70 years, there has been a search for the optimal oxygenation of premature infants. In spite of the lack of evidence, guidelines have successively reduced oxygenation targets during these years. OBJECTIVES: (1) To present a summary of previously published meta-analyses of 5 randomized studies (NeOProM) which tested a low (85-89%) versus a high (91-95%) oxygen saturation target the first weeks after birth on outcome of immature newborn infants. (2) To present international recommendations for oxygenation the first weeks after birth...
April 18, 2018: Neonatology
https://www.readbyqxmd.com/read/29623766/a-retrospective-analysis-of-the-mixed-venous-oxygen-saturation-as-the-target-for-systemic-blood-flow-control-during-cardiopulmonary-bypass
#4
Staffan Svenmarker, Matias Hannuksela, Michael Haney
OBJECTIVES: The patient's body surface area serves as the traditional reference for the determination of systemic blood flow during cardiopulmonary bypass (CPB). New strategies refer to different algorithms of oxygen delivery. This study reports on the mixed venous oxygen saturation (Sv O2 ) as the target for systemic blood flow control. We hypothesise that an Sv O2 >75% (Sv O2 75) is associated with better preservation of renal function and improved short-term survival. METHODS: This retrospective, 10-year, observational study analysed 6945 consecutive cardiac surgical cases requiring CPB...
April 1, 2018: Perfusion
https://www.readbyqxmd.com/read/29596071/an-observational-cohort-study-examining-the-effect-of-the-duration-of-skin-to-skin-contact-on-the-physiological-parameters-of-the-neonate-in-a-neonatal-intensive-special-care-unit
#5
Hannah Jones, Nick Santamaria
BACKGROUND: Focus on skin-to-skin contact (SSC) as a family-centered care intervention in Neonatal Intensive Special Care (NISC) Units continues to increase. Previously, SSC has been shown to improve neonatal physiological stability, support brain development, and promote bonding and attachment. Limited research exists investigating SSC duration and neonatal physiological responses. PURPOSE: This study examined the relationship between SSC duration and the neonate's oxygen saturation, heart rate (HR), respiratory rate (RR), and temperature...
March 28, 2018: Advances in Neonatal Care: Official Journal of the National Association of Neonatal Nurses
https://www.readbyqxmd.com/read/29568744/fermentation-conditions-and-media-optimization-for-isocitric-acid-production-from-ethanol-by-yarrowia-lipolytica
#6
Svetlana V Kamzolova, Roman V Shamin, Nadezda N Stepanova, Grigorii I Morgunov, Julia N Lunina, Ramil K Allayarov, Vladimir A Samoilenko, Igor G Morgunov
Isocitric acid exists in the form of four stereoisomers, of which only the threo -Ds-form (ICA) is a natural active compound, an intermediate of Krebs cycle, and suitable for nutritional and pharmaceutical use. In this paper, we propose a method for ICA production from ethanol by yeast Yarrowia lipolytica . The effects of temperature, pH of the medium, and aeration on the growth of the producer Y. lipolytica VKM Y-2373 and synthesis of ICA were studied. An optimal fermentation regime, which ensures a good growth of the producer and directed synthesis of the target product, was determined...
2018: BioMed Research International
https://www.readbyqxmd.com/read/29564540/surgical-outcomes-of-overlapping-lateral-pharyngoplasty-with-or-without-coblator-tongue-base-resection-for-obstructive-sleep-apnea
#7
Do-Yang Park, Hyo Jin Chung, Sang Chul Park, Jin Won Kim, Joo-Heon Yoon, Jeung-Gweon Lee, Chang-Hoon Kim, Hyung-Ju Cho
PURPOSE: Considerable number of patients with obstructive sleep apnea (OSA) failed to respond to positive airway pressure therapy and so turned to surgical procedures. A wide variety of surgical procedures have been developed and advanced, according to obstruction and target site through nasal cavity to trachea. We introduced our overlapping lateral pharyngoplasty (OLP) technique as a surgical option for OSA and evaluated its surgical outcomes both with and without endoscope-guided coblator tongue base resection (CobTBR)...
March 21, 2018: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/29535830/inhibition-of-nuclear-factor-of-activated-t-cells-nfat-c3-activation-attenuates-acute-lung-injury-and-pulmonary-edema-in-murine-models-of-sepsis
#8
Manjula Karpurapu, Yong Gyu Lee, Ziqing Qian, Jin Wen, Megan N Ballinger, Luiza Rusu, Sangwoon Chung, Jing Deng, Feng Qian, Brenda F Reader, Teja Srinivas Nirujogi, Gye Young Park, Dehua Pei, John W Christman
Specific therapies targeting cellular and molecular events of sepsis induced Acute Lung Injury (ALI) pathogenesis are lacking. We have reported a pivotal role for Nuclear Factors of Activated T cells (NFATc3) in regulating macrophage phenotype during sepsis induced ALI and subsequent studies demonstrate that NFATc3 transcriptionally regulates macrophage CCR2 and TNFα gene expression. Mouse pulmonary microvascular endothelial cell monolayer maintained a tighter barrier function when co-cultured with LPS stimulated NFATc3 deficient macrophages whereas wild type macrophages caused leaky monolayer barrier...
February 13, 2018: Oncotarget
https://www.readbyqxmd.com/read/29516853/the-feasibility-of-early-pulmonary-rehabilitation-and-activity-after-copd-exacerbations-external-pilot-randomised-controlled-trial-qualitative-case-study-and-exploratory-economic-evaluation
#9
Matthew Cox, Catherine O'Connor, Katie Biggs, Daniel Hind, Oscar Bortolami, Matthew Franklin, Barbara Collins, Stephen Walters, Allan Wailoo, Julie Channell, Paul Albert, Ursula Freeman, Stephen Bourke, Michael Steiner, Jon Miles, Tom O'Brien, David McWilliams, Terry Schofield, John O'Reilly, Rodney Hughes
BACKGROUND: Chronic obstructive pulmonary disease (COPD) affects > 3 million people in the UK. Acute exacerbations of COPD (AECOPD) are the second most common reason for emergency hospital admission in the UK. Pulmonary rehabilitation is usual care for stable COPD but there is little evidence for early pulmonary rehabilitation (EPR) following AECOPD, either in hospital or immediately post discharge. OBJECTIVE: To assess the feasibility of recruiting patients, collecting data and delivering EPR to patients with AECOPD to evaluate EPR compared with usual care...
March 2018: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/29467516/packed-red-blood-cells-transfusion-in-neonates-effect-on-fio-2-and-pao-2-sao-2-ratio-and-implications-for-neonatal-saturation-targeting
#10
Itamar Nitzan, Cathy Hammerman, Francis B Mimouni, Alona Bin-Nun
OBJECTIVE: To assess the effect of blood transfusions in neonates on partial pressure of oxygen in arterial blood (PaO2 ), arterial hemoglobin oxygen saturation (SaO2 ) and arterial hemoglobin oxygen saturation as measured by pulse oximetry (SpO2 ). STUDY DESIGN: Retrospective study of neonates that received a first blood transfusion while having an indwelling arterial line. We compared PaO2 , SaO2, SpO2, SaO2 /PaO2 ratio and fraction of inspired oxygen (FiO2 ) 12 h before and after blood transfusion...
February 21, 2018: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/29443767/effect-of-oxycodone-hydrochloride-combined-with-flurbiprofen-axetil-for-intravenous-patient-controlled-analgesia-in-lower-abdominal-patients-a-randomized-trial
#11
Xiaobing Xiang, Xiaohong Yuan, Yanhong Lian, Jun Fang, Yingli Wu
BACKGROUND: Problems like postoperative pain are still common phenomena after general anesthesia. Oxycodone hydrochloride is a semisynthetic opioid with a safe and excellent therapeutic effect on visceral pain. Flurbiprofen axetil has the efficacy of targeted analgesia. We hypothesize that different doses of oxycodone hydrochloride combined with flurbiprofen axetil would generate great results on postoperative intravenous analgesia in lower abdominal patients. METHODS: In the clinical trial, 90 American Society of Anesthesiologists I or II patients scheduled for elective general anesthesia were randomly divided into 3 groups, 30 cases in each group...
February 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29432783/effect-of-target-temperature-management-at-32-34%C3%A2-%C3%A2-c-in-cardiac-arrest-patients-considering-assessment-by-regional-cerebral-oxygen-saturation-a-multicenter-retrospective-cohort-study
#12
Yuka Nakatani, Takeo Nakayama, Kei Nishiyama, Yoshimitsu Takahashi
AIM: Target temperature management (TTM) is used in comatose post-cardiac arrest patients, but the recommended temperature range is wide. This study aimed to assess the effectiveness of TTM at 32 to 34 °C while considering the degree of cerebral injury and cerebral circulation, as assessed by regional cerebral oxygen saturation (rSO2). METHODS: This is a secondary analysis of prospectively collected registry data from comatose patients who were transferred to 15 hospitals in Japan after out-of-hospital cardiac arrest (OHCA) from 2011 to 2013...
February 9, 2018: Resuscitation
https://www.readbyqxmd.com/read/29428622/targeted-increase-in-pulmonary-blood-flow-in-a-bidirectional-glenn-circulation
#13
Samuel L Casella, Aditya Kaza, Pedro Del Nido, James E Lock, Audrey Marshall
Objective In patients with a Glenn shunt and unilateral pulmonary vascular abnormalities, supplemental pulmonary blood flow may improve antegrade flow in the target lung and may permit eventual Fontan completion, while mitigating the risks of uncontrolled additional flow to the contralateral lung. We attempted this by inserting a small aortopulmonary shunt into the affected pulmonary artery and banding the central pulmonary artery. .Methods We performed a retrospective review of all patients who underwent this procedure from 2000-2015...
February 8, 2018: Seminars in Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29419556/determining-the-upper-and-lower-limits-of-cerebral-autoregulation-with-cerebral-oximetry-autoregulation-curves-a-case-series
#14
Lucia Rivera-Lara, Andres Zorrilla-Vaca, Ryan J Healy, Wendy Ziai, Charles Hogue, Romergryko Geocadin, Batya Radzik, Caitlin Palmisano, Marek A Mirski
OBJECTIVE: Critical care guidelines recommend a single target value for mean arterial blood pressure in critically ill patients. However, growing evidence regarding cerebral autoregulation challenges this concept and supports individualizing mean arterial blood pressure targets to prevent brain and kidney hypo- or hyperperfusion. Regional cerebral oxygen saturation derived from near-infrared spectroscopy is an acceptable surrogate for cerebral blood flow and has been validated to measure cerebral autoregulation...
February 6, 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29406439/oxygen-and-preterm-infant-resuscitation-what-else-do-we-need-to-know
#15
Ju-Lee Oei, Ola D Saugstad, Maximo Vento
PURPOSE OF REVIEW: To evaluate current evidence for the use of lower or higher oxygen strategies for preterm infant resuscitation RECENT FINDINGS: The equipoise for using higher fraction of inspired oxygen (FiO2) (>0.4) to initiate preterm infant respiratory stabilization has been lost. Recent meta-analyses of randomized controlled trials assessing outcomes after using higher (FiO2 ≥ 0.6) vs. lower (FiO2 ≤ 0.3) oxygen strategies to initiate preterm resuscitation shows no difference in the rates of death or major morbidities...
April 2018: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/29404495/nicotinamide-n-methyltransferase-expression-decreases-in-iron-overload-exacerbating-toxicity-in-mouse-hepatocytes
#16
Tiago Koppe, Bonnie Patchen, Aaron Cheng, Manoj Bhasin, Chris Vulpe, Robert E Schwartz, Jose Maria Moreno-Navarrete, Jose Manuel Fernandez-Real, Pavlos Pissios, Paula G Fraenkel
Iron overload causes the generation of reactive oxygen species that can lead to lasting damage to the liver and other organs. The goal of this study was to identify genes that modify the toxicity of iron overload. We studied the effect of iron overload on the hepatic transcriptional and metabolomic profile in mouse models using a dietary model of iron overload and a genetic model, the hemojuvelin knockout mouse. We then evaluated the correlation of nicotinamide N-methyltransferase (NNMT) expression with body iron stores in human patients and the effect of NNMT knockdown on gene expression and viability in primary mouse hepatocytes...
October 2017: Hepatology Communications
https://www.readbyqxmd.com/read/29366758/transcriptomic-profiling-reveals-gene-expression-kinetics-in-patients-with-hypoxia-and-high-altitude-pulmonary-edema
#17
Li Yuhong, Wuren Tana, Bai Zhengzhong, Tang Feng, Ga Qin, Yang Yingzhong, Guan Wei, Wang Yaping, Charles Langelier, Matthew T Rondina, Ri-Li Ge
OBJECTIVE: High altitude pulmonary edema (HAPE) is a life threatening condition occurring in otherwise healthy individuals who rapidly ascend to high altitude. However, the molecular mechanisms of its pathophysiology are not well understood. The objective of this study is to evaluate differential gene expression in patients with HAPE during acute illness and subsequent recovery. METHODS: Twenty-one individuals who ascended to an altitude of 3780 m were studied, including 12 patients who developed HAPE and 9 matched controls without HAPE...
April 20, 2018: Gene
https://www.readbyqxmd.com/read/29362258/cost-effectiveness-of-freeo-2-in-patients-with-chronic-obstructive-pulmonary-disease-hospitalised-for-acute-exacerbations-analysis-of-a-pilot-study-in-quebec
#18
Thomas G Poder, Christian R C Kouakou, Pierre-Alexandre Bouchard, Véronique Tremblay, Sébastien Blais, François Maltais, François Lellouche
OBJECTIVE: Conduct a cost-effectiveness analysis of FreeO2 technology versus manual oxygen-titration technology for patients with chronic obstructive pulmonary disease (COPD) hospitalised for acute exacerbations. SETTING: Tertiary acute care hospital in Quebec, Canada. PARTICIPANTS: 47 patients with COPD hospitalised for acute exacerbations. INTERVENTION: An automated oxygen-titration and oxygen-weaning technology. METHODS AND OUTCOMES: The costs for hospitalisation and follow-up for 180 days were calculated using a microcosting approach and included the cost of FreeO2 technology...
January 23, 2018: BMJ Open
https://www.readbyqxmd.com/read/29344301/wst11-vascular-targeted-photodynamic-therapy-effect-monitoring-by-multispectral-optoacoustic-tomography-msot-in-mice
#19
Volker Neuschmelting, Kwanghee Kim, Jaber Malekzadeh-Najafabadi, Sylvia Jebiwott, Jaya Prakash, Avigdor Scherz, Jonathan A Coleman, Moritz F Kircher, Vasilis Ntziachristos
Objective: Monitoring emerging vascular-targeted photodynamic therapy (VTP) and understanding the time-dynamics of treatment effects remains challenging. We interrogated whether handheld multispectral optoacoustic tomography (MSOT) could noninvasively monitor the effect of VTP using WST11, a vascular-acting photosensitizer, on tumor tissues over time using a renal cell cancer mouse model. We also investigated whether MSOT illumination can induce VTP, to implement a single-modality theranostic approach. Materials and Methods: Eight BalB/c mice were subcutaneously implanted with murine renal adenocarcinoma cells (RENCA) on the flank...
2018: Theranostics
https://www.readbyqxmd.com/read/29343048/physiology-intervention-and-outcome-three-critical-questions-about-cerebral-tissue-oxygen-saturation-monitoring
#20
Lingzhong Meng, Shaun E Gruenbaum, Feng Dai, Tianlong Wang
The balance between cerebral tissue oxygen consumption and supply can be continuously assessed by cerebral tissue oxygen saturation (SctO2) monitor. A construct consisting of three sequential questions, targeting the physiology monitored, the intervention implemented, and the outcomes affected, is proposed to critically appraise this monitor. The impact of the SctO2- guided care on patient outcome was examined through a systematic literature search and meta- analysis. We concluded that the physiology monitored by SctO2 is robust and dynamic, fragile (prone to derangement), and adversely consequential when deranged...
January 17, 2018: Minerva Anestesiologica
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