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Oxygen saturation targeting

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https://www.readbyqxmd.com/read/28107266/early-fluid-overload-prolongs-mechanical-ventilation-in-children-with-viral-lower-respiratory-tract-disease
#1
Sarah A Ingelse, Hanke M G Wiegers, Job C Calis, Job B van Woensel, Reinout A Bem
OBJECTIVES: Viral-lower respiratory tract disease is common in young children worldwide and is associated with high morbidity. Acute respiratory failure due to viral-lower respiratory tract disease necessitates PICU admission for mechanical ventilation. In critically ill patients in PICU settings, early fluid overload is common and associated with adverse outcomes such as prolonged mechanical ventilation and increased mortality. It is unclear, however, if this also applies to young children with viral-lower respiratory tract disease induced acute respiratory failure...
January 19, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28088392/benefits-of-oxygen-saturation-targeting-trials-oximeter-calibration-software-revision-and-infant-saturations
#2
Robin K Whyte, Harvey Nelson, Robin S Roberts, Barbara Schmidt
It has been reported in the 3 Benefits of Oxygen Saturation Targeting (BOOST-II) trials that changes in oximeter calibration software resulted in clearer separation between the oxygen saturations in the two trial target groups. A revised analysis of the published BOOST-II data does not support this conclusion.
January 12, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/28043507/t-cell-cytokine-responses-in-peripheral-blood-mononuclear-cells-from-patients-with-multidrug-resistant-tuberculosis-following-stimulation-with-proteins-purified-from-mycobacterium-tuberculosis-mdr-clinical-isolates
#3
Alireza Hadizadeh Tasbiti, Shamsi Yari, Mostafa Ghanei, Seyed Davar Siadat, Amir Amanzadeh, Payam Tabarsi, Keyvan Saeedfar, Ahmadreza Bahrmand
OBJECTIVE: Tuberculosis (TB) is a devastating disease that remains a major health threat worldwide. The appearance of Mycobacterium tuberculosis strains resistance to current antibiotics is a growing problem, both in the third world and in developed countries. Completion of genomic sequencing of M. tuberculosis provides a strong foundation for subsequent identification of proteins to aid the understanding of protein function and the discovery of new drug targets or a TB vaccine. This study employed a proteomics approach to identify proteins from antibiotic resistant M...
December 2016: International Journal of Mycobacteriology
https://www.readbyqxmd.com/read/28027088/feasibility-of-automated-propofol-sedation-for-transcatheter-aortic-valve-implantation-a-pilot-study
#4
Cédrick Zaouter, Thomas M Hemmerling, Stefano Mion, Lionel Leroux, Alain Remy, Alexandre Ouattara
BACKGROUND: Recently, several trials have shown that closed-loop sedation is feasible. No study has used automated sedation in extremely frail patients, such as those scheduled for transcatheter aortic valve implantation (TAVI). We developed and tested a novel automated sedation system for this kind of population and surgery. The system integrates a decision support system that detects respiratory and hemodynamic events via smart alarms, which provide pertinent/related clinical suggestions and treatment options...
December 22, 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28013253/factors-affecting-the-target-oxygen-saturation-in-the-first-minutes-of-life-in-preterm-infants
#5
Sinan Uslu, Umut Zubarioglu, Sehrinaz Sozeri, Mesut Dursun, Ali Bulbul, Evrim Kiray Bas, Ebru Turkoglu Unal, Aysegul Uslu
BACKGROUND: The aim of this study was to describe the effect of factors on time to reach a pulse oxygen saturation (SpO2) level of 90% in preterm infants in the delivery room. METHODS: Preterm (<35 gestational age) infants who did not require supplemental oxygen were included in the study. Continuous recordings were taken by pulse oximetry during the first 15 min of life. RESULTS: Of 151 preterm infants, 79 (52.3%) were female and 126 (83...
December 24, 2016: Journal of Tropical Pediatrics
https://www.readbyqxmd.com/read/28012642/postoperative-cerebral-and-somatic-near-infrared-spectroscopy-saturations-and-outcome-in-hypoplastic-left-heart-syndrome
#6
George M Hoffman, Nancy S Ghanayem, John P Scott, James S Tweddell, Michael E Mitchell, Kathleen A Mussato
BACKGROUND: Circulatory vulnerability reflected by low systemic venous oxygen saturation after surgical palliation of hypoplastic left heart syndrome predicts adverse neurologic outcome and reduced survival, and targeting venous saturation may improve outcome. We herein test the hypothesis that near-infrared spectroscopy (NIRS)-derived cerebral and somatic/renal regional saturations can predict survival. METHODS: Patient data, from a prospective Institutional Review Board-approved registry of hemodynamic measures after initial palliation of hypoplastic left heart syndrome, were analyzed with logistic and multivariable mixed regression methods to determine relationships between standard hemodynamic measures, direct and NIRS measures of saturation, and outcome...
December 21, 2016: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28009532/feed-forward-regulation-of-self-selected-exercise-intensity-in-response-to-different-rates-of-arterial-deoxygenation
#7
Saro D Farra
Arterial desaturation impairs exercise performance in a dose-dependent manner. However, new theories of exercise-induced fatigue suggest that increasing rates of arterial deoxygenation augment the fatigue response during exercise. The purpose of this dissertation is to clarify if self-selected exercise intensity, while exercising at a constant rate of perceived exertion (RPE), is sensitive to alterations in the absolute arterial saturation (SPO2) and/or the rate of change in SPO2. Subjects performed constant RPE exercise for 30 min...
January 2017: Applied Physiology, Nutrition, and Metabolism, Physiologie Appliquée, Nutrition et Métabolisme
https://www.readbyqxmd.com/read/27997739/is-oxygen-saturation-variable-of-simplified-pulmonary-embolism-severity-index-reliable-for-identification-of-patients-suitable-for-outpatient-treatment
#8
Serhat Erol, Aslıhan Gürün Kaya, Fatma Arslan Ciftçi, Aydın Çiledağ, Elif Şen, Akın Kaya, Gökhan Çelik, İsmail Savaş
INTRODUCTION: The pulmonary embolism severity index (PESI) or simplified version (sPESI) are widely validated risk scores for the identification of eligible patients for outpatient treatment. Saturation is one of these criteria. For this metric, saturation of 90% or greater is assigned zero points. However, 90% saturation does not always exclude hypoxemic respiratory failure. OBJECTIVE: The aims of this study were first was to define corresponding partial arterial oxygen pressure (PaO2 ) values according to saturation in pulmonary embolism (PE) patients, and the second was to define a target saturation that can exclude hypoxemic respiratory failure and enable secure discharge of PE patients from emergency departments...
December 20, 2016: Clinical Respiratory Journal
https://www.readbyqxmd.com/read/27977012/alarm-safety-and-oxygen-saturation-targets-in-the-vermont-oxford-network-inicq-2015-collaborative
#9
J I Hagadorn, D W Sink, M E Buus-Frank, E M Edwards, K A Morrow, J D Horbar, K Ferrelli, R F Soll
OBJECTIVES: To assess progress of neonatal intensive care units (NICUs) participating in the Vermont Oxford Network iNICQ 2015: Alarm Safety Collaborative in achieving Joint Commission 2014 alarm safety goals with respect to oximeters, and to compare patient-level oxygen saturation (SpO2) and oximeter alarm data to local policies. STUDY DESIGN: Prospective multicenter audits in February and August 2015 assessed implementation of policies addressing Joint Commission 2014 Alarm Safety goals, and ascertained SpO2 targets, oximeter alarm settings and compliance with policy-specified SpO2 targets and alarms...
December 15, 2016: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/27940510/oxygen-saturation-targets-in-preterm-infants-and-outcomes-at-18-24-months-a-systematic-review
#10
REVIEW
Veena Manja, Ola D Saugstad, Satyan Lakshminrusimha
CONTEXT: The optimal oxygen saturation target for extremely preterm infants remains unclear. OBJECTIVE: To systematically review evidence evaluating the effect of lower (85%-89%) versus higher (91%-95%) pulse oxygen saturation (Spo2) target on mortality and neurodevelopmental impairment (NDI) at 18 to 24 months. DATA SOURCES: Electronic databases and all published randomized trials evaluating lower versus higher Spo2 target in preterm infants...
January 2017: Pediatrics
https://www.readbyqxmd.com/read/27939259/oxygen-saturation-and-heart-rate-ranges-in-very-preterm-infants-requiring-respiratory-support-at-birth
#11
Emily Phillipos, Anne Lee Solevåg, Khalid Aziz, Sylvia van Os, Gerhard Pichler, Megan O'Reilly, Po-Yin Cheung, Georg M Schmölzer
OBJECTIVE: To evaluate the changes in preductal oxygen saturation (SpO2) and heart rate in preterm infants receiving continuous positive airway pressure (CPAP) and/or positive-pressure ventilation (PPV) at birth. STUDY DESIGN: A prospective observational study at birth of infants aged <32 weeks separated into 2 gestational age (GA) groups: 23(0/7)-27(6/7) weeks (group 1) and 28(0/7)-31(6/7) weeks (group 2). Infants received delayed cord clamping (DCC) in accordance with institutional protocol...
December 6, 2016: Journal of Pediatrics
https://www.readbyqxmd.com/read/27930564/effects-of-intraoperative-dexmedetomidine-with-intravenous-anesthesia-on-postoperative-emergence-agitation-delirium-in-pediatric-patients-undergoing-tonsillectomy-with-or-without-adenoidectomy-a-consort-prospective-randomized-controlled-clinical-trial
#12
Jun-Li Cao, Yu-Ping Pei, Jing-Qiu Wei, Yue-Ying Zhang
Postoperative emergence agitation/delirium (POED) is a common complication in pediatric surgery patients, which increases the risk of developing postoperative airway obstruction and respiratory depression. This study aims to investigate the safety and efficacy of intraoperative infusion of dexmedetomidine (DEX) and its effects on POED in pediatric patients undergoing tonsillectomy with or without adenoidectomy.Sixty patients scheduled for tonsillectomy with or without adenoidectomy, aged 2 to 8 years, were randomly allocated into 2 groups (n = 30)...
December 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27908340/end-points-of-sepsis-resuscitation
#13
REVIEW
John C Greenwood, Clinton J Orloski
Resuscitation goals for the patient with sepsis and septic shock are to return the patient to a physiologic state that promotes adequate end-organ perfusion along with matching metabolic supply and demand. Ideal resuscitation end points should assess the adequacy of tissue oxygen delivery and oxygen consumption, and be quantifiable and reproducible. Despite years of research, a single resuscitation end point to assess adequacy of resuscitation has yet to be found. Thus, the clinician must rely on multiple end points to assess the patient's overall response to therapy...
February 2017: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/27903260/clinical-physiologic-and-radiographic-factors-contributing-to-development-of-hypoxemia-in-moderate-to-severe-copd-a-cohort-study
#14
J Michael Wells, Raul San Jose Estepar, Merry-Lynn N McDonald, Surya P Bhatt, Alejandro A Diaz, William C Bailey, Francine L Jacobson, Mark T Dransfield, George R Washko, Barry J Make, Richard Casaburi, Edwin J R van Beek, Eric A Hoffman, Frank C Sciurba, James D Crapo, Edwin K Silverman, Craig P Hersh
BACKGROUND: Hypoxemia is a major complication of COPD and is a strong predictor of mortality. We previously identified independent risk factors for the presence of resting hypoxemia in the COPDGene cohort. However, little is known about characteristics that predict onset of resting hypoxemia in patients who are normoxic at baseline. We hypothesized that a combination of clinical, physiologic, and radiographic characteristics would predict development of resting hypoxemia after 5-years of follow-up in participants with moderate to severe COPD METHODS: We analyzed 678 participants with moderate-to-severe COPD recruited into the COPDGene cohort who completed baseline and 5-year follow-up visits and who were normoxic by pulse oximetry at baseline...
December 1, 2016: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/27894154/perfusion-controlled-mobilization-after-lower-extremity-free-flaps-pushing-the-limits-of-time-and-intensity
#15
Ulf Dornseifer, Charlotte Kleeberger, Lukas Kargl, Markus Schönberger, Daniel Rohde, Milomir Ninkovic, Arndt Schilling
Background The current standard to gradually adapt the fragile perfusion in lower extremity free flaps to an upright posture is the dangling maneuver. This type of flap training neither fits the orthostatic target load of an upright posture, nor does it assist in mobilizing the patients effectively. In this study, we quantitatively analyzed training effects of an early and full mobilization on flap perfusion. Methods A total of 15 patients with gracilis flaps for distal lower extremity reconstruction were included...
November 28, 2016: Journal of Reconstructive Microsurgery
https://www.readbyqxmd.com/read/27888413/improving-manual-oxygen-titration-in-preterm-infants-by-training-and-guideline-implementation
#16
Henriëtte A van Zanten, Steffen C Pauws, Evelien C Beks, Ben J Stenson, Enrico Lopriore, Arjan B Te Pas
: To study oxygen saturation (SpO2) targeting before and after training and guideline implementation of manual oxygen titration, two cohorts of preterm infants <30 weeks of gestation needing respiratory support and oxygen therapy were compared. The percentage of the time spent with SpO2 within the target range (85-95%) was calculated (%SpO2-wtr). SpO2 was collected every minute when oxygen is >21%. ABCs where oxygen therapy was given were identified and analyzed. After training and guideline implementation the %SpO2-wtr increased (median interquartile range (IQR)) 48...
January 2017: European Journal of Pediatrics
https://www.readbyqxmd.com/read/27881420/elongation-of-long-chain-fatty-acid-family-member-6-elovl6-driven-fatty-acid-metabolism-regulates-vascular-smooth-muscle-cell-phenotype-through-amp-activated-protein-kinase-kr%C3%A3-ppel-like-factor-4-ampk-klf4-signaling
#17
Hiroaki Sunaga, Hiroki Matsui, Saki Anjo, Mas Risky A A Syamsunarno, Norimichi Koitabashi, Tatsuya Iso, Takashi Matsuzaka, Hitoshi Shimano, Tomoyuki Yokoyama, Masahiko Kurabayashi
BACKGROUND: Fatty acids constitute the critical components of cell structure and function, and dysregulation of fatty acid composition may exert diverging vascular effects including proliferation, migration, and differentiation of vascular smooth muscle cells (VSMCs). However, direct evidence for this hypothesis has been lacking. We investigated the role of elongation of long-chain fatty acid member 6 (Elovl6), a rate-limiting enzyme catalyzing the elongation of saturated and monounsaturated long-chain fatty acid, in the regulation of phenotypic switching of VSMC...
November 23, 2016: Journal of the American Heart Association
https://www.readbyqxmd.com/read/27853941/pulse-oximeter-saturation-target-limits-for-preterm-infants-a-survey-among-european-neonatal-intensive-care-units
#18
Maurice J Huizing, Eduardo Villamor-Martínez, Máximo Vento, Eduardo Villamor
: The optimum range of pulse oximeter oxygen saturation (SpO2) for preterm infants remains controversial. Between November 2015 and February 2016, we conducted a web-based survey aimed to investigate the current and former practices on SpO2 targets in European neonatal intensive care units (NICUs). We obtained valid responses from 193 NICUs, treating 8590 newborns ≤28 weeks per year, across 27 countries. Forty different saturation ranges were reported, ranging from 82-93 to 94-99%...
January 2017: European Journal of Pediatrics
https://www.readbyqxmd.com/read/27834782/alarms-oxygen-saturations-and-spo2-averaging-time-in-the-nicu
#19
C McClure, S Young Jang, K Fairchild
BACKGROUND: Alarm overload is a significant concern in the Neonatal Intensive Care Unit (NICU). Selecting a longer oxygen saturation (SpO2) averaging time will reduce the number of alarms but may mask fluctuations in oxygenation. OBJECTIVE: Characterize bedside monitor alarms in the NICU and estimate the impact of longer SpO2 averaging time and alarm delay. METHODS: All bedside monitor alarms were analyzed over a 12-month period in the University of Virginia NICU, using the default averaging time (8 seconds) and SpO2 alarm limits set at 88-95% for infants on supplemental oxygen...
2016: Journal of Neonatal-perinatal Medicine
https://www.readbyqxmd.com/read/27809868/efficacy-of-naloxone-in-reducing-postictal-central-respiratory-dysfunction-in-patients-with-epilepsy-study-protocol-for-a-double-blind-randomized-placebo-controlled-trial
#20
Sylvain Rheims, Luc Valton, Véronique Michel, Louis Maillard, Vincent Navarro, Philippe Convers, Fabrice Bartolomei, Arnaud Biraben, Arielle Crespel, Philippe Derambure, Bertrand de Toffol, Edouard Hirsch, Philippe Kahane, Martine Lemesle Martin, Didier Tourniaire, Sébastien Boulogne, Catherine Mercier, Pascal Roy, Philippe Ryvlin
BACKGROUND: Generalized tonic-clonic seizures (GTCSs) are the main risk factor for sudden unexpected death in epilepsy (SUDEP). Experimental and clinical data strongly suggest that the majority of SUDEP results from a postictal respiratory dysfunction progressing to terminal apnea. Postictal apnea could partly derive from a seizure-induced massive release of endogenous opioids. The main objective of this study is to evaluate the efficacy of an opioid antagonist, naloxone, administered in the immediate aftermath of a GTCS, in reducing the severity of the postictal central respiratory dysfunction...
November 3, 2016: Trials
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