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CO oximetry

Andrew C Faust, Emily Guy, Nidhu Baby, Anthony Ortegon
BACKGROUND: Methemoglobinemia is a well-recognized adverse drug reaction related to the use of certain local anesthetic agents. The mainstay of treatment for methemoglobinemia is i.v. methylene blue, along with provision of supplemental oxygen; however, methylene blue is listed as a category X teratogen. This poses an issue should methemoglobinemia develop during pregnancy. CASE REPORT: A 35-year-old, 20-week and 5-day gravid female was transferred from an outpatient oral surgeon's office for hypoxia...
March 5, 2018: Journal of Emergency Medicine
Cristina Martínez, Ciro Casanova, Juan P de-Torres, José M Marín, Pilar de Lucas, Antonia Fuster, Borja G Cosío, Myriam Calle, Germán Peces-Barba, Ingrid Solanes, Ramón Agüero, Nuria Feu-Collado, Inmaculada Alfageme, Amparo Romero Plaza, Eva Balcells, Alfredo de Diego, Margarita Marín Royo, Amalia Moreno, Antonia Llunel Casanova, Juan B Galdiz, Rafael Golpe, Celia Lacárcel Bautista, Carlos Cabrera, Alicia Marin, Joan B Soriano, Jose Luis Lopez-Campos
BACKGROUND: Despite the existing evidence-based smoking cessation interventions, chances of achieving that goal in real-life are still low among COPD patients. We sought to evaluate the clinical consequences of changes in smoking habits in a large cohort of COPD patients. METHODS: CHAIN is a Spanish multicenter study carried out at pulmonary clinics including active and former smokers with COPD. Smoking status was certified by clinical history and co-oximetry. Clinical presentation and disease impact were recorded via validated questionnaires, including the London Chest Activity of Daily Living (LCADL) and the Hospital Anxiety and Depression Scale (HADS)...
February 21, 2018: Chest
Chan Kai Man, Lam Koon Ngai
Extracorporeal membrane oxygenation (ECMO)-related hemolysis is a rare but devastating condition. Death is inevitable without early recognition and prompt management. Endogenous carbon monoxide production, as an epiphenomenon of hemolysis, potentially allows rapid detection of such condition by use of point-of-care CO-oximetry carboxyhemoglobin.
February 2018: Clinical Case Reports
Patrick Chow Yuen Ng, Brit Long, Alex Koyfman
Carbon monoxide (CO) is a colorless, odorless gas that is found in the environment, in the home, and in the human body as a normal part of mammalian metabolism. Poisoning from CO, a common exposure, is associated with significant morbidity and mortality if not recognized and treated in a timely manner. This review evaluates the signs and symptoms of CO poisoning, conditions that present similar to CO poisoning, and an approach to the recognition and management for CO poisoning. CO poisoning accounts for thousands of emergency department visits annually...
February 12, 2018: Internal and Emergency Medicine
Isabel E Mawson, Pratusha L Babu, John M Simpson, Grenville F Fox
A retrospective review of admission preductal oxygen saturations of neonates with antenatally diagnosed critical congenital heart disease (CCHD) was performed to investigate the differences in newborn pulse oximetry (Pulsox) by specific CCHD diagnosis. Saturations were recorded at median of < 1 h (range < 1-9 h) after delivery. Data was stratified by CCHD diagnosis and analysed according to the three different admission Pulsox thresholds, ≤ 90, ≤ 92 and ≤ 95%. Of the 276 neonates studied, 208 were clinically well at admission, with no co-morbidities, gestation > 34 weeks and birth weight > 1...
February 5, 2018: European Journal of Pediatrics
Marilyn Schallom, Donna Prentice, Carrie Sona, Cassandra Arroyo, John Mazuski
BACKGROUND: In critically ill patients, clinicians can have difficulty obtaining accurate oximetry measurements. OBJECTIVE: To compare the accuracy of nasal alar and forehead sensor measurements and incidence of pressure injury. METHODS: 43 patients had forehead and nasal alar sensors applied. Arterial samples were obtained at 0, 24, and 120 hours. Oxygen saturations measured by co-oximetry were compared to sensor values. Skin was assessed every 8 hours...
February 2, 2018: Heart & Lung: the Journal of Critical Care
Pradeep Padmanabhan, Chikelue Oragwu, Bibhuti Das, John A Myers, Ashok Raj
Pain crisis in children with sickle cell disease (SCD) is typically managed with intravenous fluids and parenteral opioids in the pediatric emergency department. Electrical cardiometry (EC) can be utilized to measure cardiac output (CO) and cardiac index (CI) non-invasively. Near-infrared spectroscopy (NIRS) measuring cerebral (rCO₂) and splanchnic regional (rSO₂) mixed venous oxygenation non-invasively has been utilized for monitoring children with SCD. We studied the value and correlation of NIRS and EC in monitoring hemodynamic status in children with SCD during pain crisis...
January 29, 2018: Children
Mark Van Gastel, Sander Stuijk, Gerard De Haan
Camera-based pulse-oximetry has recently shown to be feasible, even when the signal is corrupted by noise and motion artifacts. Earlier work showed that using three instead of the common two wavelengths improves robustness of the measurement, however without a thorough investigation on the optimal wavelength selection. We therefore performed a search to identify these wavelengths to further improve the robustness of the measurement. Besides motion, it is empirically known that there are several other factors that influence the measurement leading to falsely-low or falsely-high SpO2 readings...
January 1, 2018: Biomedical Optics Express
Matthijs Oyaert, Tom Van Maerken, Silke Bridts, Silvi Van Loon, Heleen Laverge, Veronique Stove
BACKGROUND: Point-of-care blood gas test results may benefit therapeutic decision making by their immediate impact on patient care. We evaluated the (pre-)analytical performance of a novel cartridge-type blood gas analyzer, the GEM Premier 5000 (Werfen), for the determination of pH, partial carbon dioxide pressure (pCO2), partial oxygen pressure (pO2), sodium (Na+), potassium (K+), chloride (Cl-), ionized calcium (iCa2+), glucose, lactate, and total hemoglobin (tHb). METHODS: Total imprecision was estimated according to the CLSI EP5-A2 protocol...
January 12, 2018: Clinical Biochemistry
Abdelmoneim Adel, Wael Awada, Bassant Abdelhamid, Heba Omar, Omnia Abd El Dayem, Ahmed Hasanin, Ashraf Rady
The evolution of non-invasive hemoglobin measuring technology would save time and improve transfusion practice. The validity of pulse co-oximetry hemoglobin (SpHb) measurement in the perioperative setting was previously evaluated; however, the accuracy of SpHb in different volume statuses as well as in different perfusion states was not well investigated. The aim of this work is to evaluate the accuracy and trending of SpHb in comparison to laboratory hemoglobin (Lab-Hb) during acute bleeding and after resuscitation...
January 15, 2018: Journal of Clinical Monitoring and Computing
Yong-Hee Park, Seho Lim, Hyun Kang, Hwa-Yong Shin, Chong Wha Baek, Young Cheol Woo
We measured noninvasive hemoglobin (SpHb) levels during the pre-anesthesia visit in patients planning elective surgery. Differences between SpHb and laboratory-measured hemoglobin (Hblab) were compared between adult and pediatric patients. In the pre-anesthesia visiting office, we routinely monitor noninvasive Hb levels with oxygen saturation and heart rate using Masimo Radical-7® Pulse CO-Oximetry (Masimo Corp., Irvine, CA, USA). We attached the R1 20 (body weight, 10-50 kg) or R1 25 (body weight > 30 kg) probe on the index finger...
January 4, 2018: Journal of Clinical Monitoring and Computing
Jonathan Schimmel, Naomi George, John Schwarz, Sami Yousif, Selim Suner, Jason B Hack
INTRODUCTION: Non-invasive screening of carboxyhemoglobin saturation (SpCO) in the emergency department to detect occult exposure is increasingly common. The SpCO threshold to consider exposure in smokers is up to 9%. The literature supporting this cutoff is inadequate, and the impact of active smoking on SpCO saturation remains unclear. The primary objective was to characterize baseline SpCO in a cohort of smokers outdoors. Secondary objectives were to explore the impact of active smoking on SpCO and to compare SpCO between smokers and non-smokers...
December 28, 2017: Journal of Medical Toxicology: Official Journal of the American College of Medical Toxicology
Tammy Slater, Julie Stanik-Hutt, Patricia Davidson
BACKGROUND: Strokes following adult cardiac surgery contribute to burdensome neurocognitive complications, which are often difficult to detect during the perioperative period. Fluctuations in regional cerebral perfusion and co-morbid conditions, such as hypertension, diabetes, prior stroke, symptomatic carotid stenosis, aortic atherosclerotic disease, and peripheral vascular disease are associated with perioperative strokes. Approaches to achieve optimal cerebral perfusion remain elusive and traditional strategies for perioperative monitoring are not always sufficiently sensitive to detect acute changes in cerebral perfusion...
December 28, 2017: Contemporary Nurse
Ian Marie Lano, Andrew W Lyon, Li Wang, Rob Ruskin, Martha E Lyon
BACKGROUND: Clinically significant variation has been reported within and between plasma and whole blood total bilirubin methods used to identify neonates for whom clinical intervention for hyperbilirubinemia may be required. OBJECTIVE: To evaluate total bilirubin measurements between the Radiometer whole blood co-oximeter and plasma bilirubin methods from Roche Diagnostics and Ortho Clinical Diagnostics using neonatal specimens. METHODS: Total bilirubin levels were analyzed by whole blood co-oximetry (Radiometer® ABL90)...
December 20, 2017: Clinical Biochemistry
Radhakrishnan Muthuchellappan, Ramesh V J, Umamaheswara Rao Ganne S, Thennarasu K, Anjana Jacob, Sripathy G, Bhadrinarayan V, Mohanvelu K
Blood pressure (BP), a surrogate of cardiac output (CO), is also dependent on systemic vascular resistance (SVR). But SVR is not routinely monitored in daily clinical practice. We hypothesise that the time difference between the peripheral arterial waveform and the finger plethysmographic waveform (time lag index - TLi) could indicate the systemic vascular resistance. In this study, we correlated TLi with the systemic vascular resistance measured by minimally invasive CO monitor (pulse contour analysis). SVR changes in response to administration of mannitol were studied...
December 18, 2017: Journal of Medical Engineering & Technology
Deanna Britton, Amy Roeske, Stephanie K Ennis, Joshua O Benditt, Cassie Quinn, Donna Graville
Pulse oximetry is a commonly used means to measure peripheral capillary oxyhemoglobin saturation (SpO2 ). Potential use of pulse oximetry to detect aspiration is attractive to clinicians, as it is readily available, quick, and noninvasive. However, research regarding validity has been mixed. This systematic review examining evidence on the use of pulse oximetry to detect a decrease in SpO2 indicating aspiration during swallowing is undertaken to further inform clinical practice in dysphagia assessment. A multi-engine electronic search was conducted on 8/25/16 and updated on 4/8/17 in accordance with standards published by the Preferred Reporting for Items for Systematic Reviews and Meta-Analysis Protocols (PRISMA)...
December 14, 2017: Dysphagia
Susan M Murphy, Shahed Omar
BACKGROUND: The primary objective of this study was to assess the clinical usefulness of a point-of-care device which measures hemoglobin noninvasively (SpHb) in a group of critically ill participants with dark skin pigmentation. METHODS: One hundred forty-six adult and pediatric participants from a multidisciplinary intensive care unit had intermittent readings of noninvasive hemoglobin measurements performed at a minimum of 4 hourly intervals. A total of 371 readings were analyzed...
December 11, 2017: Anesthesia and Analgesia
Ian L Gunsolus, Sara A Love, Louis P Kohl, Martin Schmidt, Fred S Apple
Objectives: The present study addressed the accuracy of calculated oxygen saturation (sO2) using point-of-care (POC) testing compared with measured values on a blood gas analyzer. Methods: In total, 3,323 sO2 values were measured in 1,180 patients using a CO-oximeter (ABL 800 Flex; Radiometer, Copenhagen, Denmark). Measured parameters were then used to calculate an expected sO2 for the POC method (Abbott i-STAT; Abbott POC, Princeton, NJ). Cases in which calculated sO2 differed from measured sO2 by 10% or more were analyzed...
December 20, 2017: American Journal of Clinical Pathology
Cesáreo Álvarez Rodríguez, Manuel José Vázquez Lima
No abstract text is available yet for this article.
February 2017: Emergencias: Revista de la Sociedad Española de Medicina de Emergencias
August Supervía Caparrós, Oriol Pallàs Villaronga, Carlos Clemente Rodríguez, María Dolores Aranda Cárdenas, María Pi-Figueras Valls, Isabel Cirera Lorenzo
OBJECTIVES: To compare cases of poisoning according to age to detect differences in frequency of visits to the emergency department, patient characteristics, case management, and immediate outcome in terms of related mortality. MATERIAL AND METHODS: Descriptive study of a retrospective series of patients who visited a university hospital emergency department for treatment of poisoning between 2009 and 2014. We collected patient characteristics and data related to the event, case management, and poisoning-related death...
October 2017: Emergencias: Revista de la Sociedad Española de Medicina de Emergencias
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