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https://www.readbyqxmd.com/read/27906717/spectrum-of-postoperative-complications-in-pulmonary-hypertension-and-obesity-hypoventilation-syndrome
#1
Roop K Kaw
PURPOSE OF REVIEW: The purpose of this review is to identify chronic pulmonary conditions which may often not be recognized preoperatively especially before elective noncardiac surgery and which carry the highest risk of perioperative morbidity and mortality. RECENT FINDINGS: This review discusses some of the most recent studies that highlight the perioperative complications, and their prevention and management strategies. SUMMARY: Pulmonary hypertension is a well recognized risk factor for postoperative complications after cardiac surgery but the literature surrounding noncardiac surgery is sparse...
November 30, 2016: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/27898867/angus-calves-born-and-raised-at-high-altitude-adapt-to-hypobaric-hypoxia-by-increasing-alveolar-ventilation-rate-but-not-hematocrit
#2
A K Gulick, F B Garry, T N Holt, K Retallick-Trennepohl, R M Enns, M G Thomas, J M Neary
The objective of this study was to evaluate the effect of altitude on arterial blood-gases and hematocrit in Angus-based calves. It was hypothesized that alveolar ventilation rate, as indicated by arterial pCO, would increase with altitude but hematocrit would not. Five Angus-based herds ( = 30 to 80 per cohort) located at 105 m, 1,470 m, 2,010 m, 2,170 m, and 2,730 m above sea level were enrolled in this prospective cohort study. A portable analyzer measured blood-gas tensions in coccygeal arterial blood. Calves at 1,470 m, 2,170 m, and 2,730 m were sampled twice, at approximately 4 mo and 7 mo of age...
October 2016: Journal of Animal Science
https://www.readbyqxmd.com/read/27869558/polynitroxylated-pegylated-hemoglobin-a-novel-small-volume-therapeutic-for-traumatic-brain-injury-resuscitation-comparison-to-whole-blood-and-dose-response-evaluation
#3
Erik C Brockman, Travis C Jackson, C Edward Dixon, Hulya Bayir, Robert Clark, Vincent A Vagni, Keri L Janesko, Catherine Byrd, Li Ma, Carleton J C Hsia, Patrick M Kochanek
: Resuscitation with polynitroxylated pegylated hemoglobin (PNPH), a PEGylated bovine hemoglobin decorated with nitroxides, eliminated the need for fluid administration, reduced ICP and brain edema, and produced neuroprotection in vitro and in vivo vs. lactated Ringer's (LR) in experimental traumatic brain injury (TBI) plus hemorrhagic shock (HS). HYPOTHESIS: Resuscitation with PNPH will improve acute physiology vs. whole blood after TBI+HS and will be safe and effective across a wide dosage range...
November 21, 2016: Journal of Neurotrauma
https://www.readbyqxmd.com/read/27867566/effectiveness-of-temporary-positive-expiratory-pressure-t-pep-at-home-and-at-hospital-in-patients-with-severe-chronic-obstructive-pulmonary-disease
#4
Valentina Mascardi, Bruna Grecchi, Cornelius Barlascini, Paolo Banfi, Antonello Nicolini
BACKGROUND: Temporary positive airway pressure (T-PEP) is a tool recently introduced in the treatment of chronic obstructive pulmonary disease (COPD) or bronchiectasis. It demonstrated encouraging results also in severe COPD patients. The aim of this study is verify if adding T-PEP to best bronchodilator therapy both in clinic and home administering could reduce disease exacerbations and improve lung function in patients with severe COPD. METHODS: A total of 142 patients with severe COPD (FEV1 <50%) were enrolled; 120 were randomized in three groups: a group treated with T-PEP at home, a group with T-PEP at hospital and a group with medical therapy only (control group)...
October 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/27842708/-effects-of-different-levels-of-end-expiratory-pressure-on-hemodynamic-respiratory-mechanics-and-systemic-stress-response-during-laparoscopic-cholecystectomy
#5
Oznur Sen, Yasemin Erdogan Doventas
OBJECTIVE: General anesthesia causes reduction of functional residual capacity. And this decrease can lead to atelectasis and intrapulmonary shunting in the lung. In this study we want to evaluate the effects of 5 and 10cmH2O PEEP levels on gas exchange, hemodynamic, respiratory mechanics and systemic stress response in laparoscopic cholecystectomy. METHODS: American Society of Anesthesiologist I-II physical status 43 patients scheduled for laparoscopic cholecystectomy were randomly selected to receive external PEEP of 5cmH2O (PEEP 5 group) or 10cmH2O PEEP (PEEP 10 group) during pneumoperitoneum...
November 11, 2016: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/27818327/an-educational-intervention-optimizes-the-utilization-of-arterial-blood-gases-across-intensive-care-units-from-different-specialties-a-quality-improvement-study
#6
Carlos D Martínez-Balzano, Paulo Oliveira, Michelle O'Rourke, Luanne Hills, Andrés F Sosa
BACKGROUND: Arterial blood gas (ABG) overutilization leads to increased costs, inefficient use of staff work-hours, patient discomfort and blood loss. We developed guidelines to optimize ABG utilization in the intensive care unit (ICU). METHODS: ABG utilization guidelines were implemented on all adult ICUs in our institution: three medical, two trauma-surgery, one cardiovascular and one neurosurgical ICU. While relying on pulse oximetry, we encouraged the utilization of ABGs after an acute respiratory event or for a rational clinical concern, and discouraged obtaining ABGs for routine surveillance, after planned changes of PEEP or FiO2 on the mechanical ventilator, for spontaneous breathing trials, or when a disorder was not suspected...
November 3, 2016: Chest
https://www.readbyqxmd.com/read/27816133/anesthesia-for-patients-with-concomitant-sepsis-and-cardiac-dysfunction
#7
REVIEW
Abed Abubaih, Charles Weissman
Anesthesiologists faced with a patient with sepsis and concurrent cardiac dysfunction must be cognizant of the patient's cardiac status and cause of the cardiac problem to appropriately adapt physiologic and metabolic monitoring and anesthetic management. Anesthesia in such patients is challenging because the interaction of sepsis and cardiac dysfunction greatly complicates management. Intraoperative anesthesia management requires careful induction and maintenance of anesthesia; optimizing intravascular volume status; avoiding lung injury during mechanical ventilation; and close monitoring of arterial blood gases, serum lactate concentrations, and hematology renal and electrolyte parameters...
December 2016: Anesthesiology Clinics
https://www.readbyqxmd.com/read/27812638/is-there-a-rationale-for-pulmonary-rehabilitation-following-successful-chemotherapy-for-tuberculosis
#8
Marcela Muñoz-Torrico, Adrian Rendon, Rosella Centis, Lia D'Ambrosio, Zhenia Fuentes, Carlos Torres-Duque, Fernanda Mello, Margareth Dalcolmo, Rogelio Pérez-Padilla, Antonio Spanevello, Giovanni Battista Migliori
The role of tuberculosis as a public health care priority and the availability of diagnostic tools to evaluate functional status (spirometry, plethysmography, and DLCO determination), arterial blood gases, capacity to perform exercise, lesions (chest X-ray and CT), and quality of life justify the effort to consider what needs to be done when patients have completed their treatment. To our knowledge, no review has ever evaluated this topic in a comprehensive manner. Our objective was to review the available evidence on this topic and draw conclusions regarding the future role of the "post-tuberculosis treatment" phase, which will potentially affect several million cases every year...
September 2016: Jornal Brasileiro de Pneumologia: Publicaça̋o Oficial da Sociedade Brasileira de Pneumologia e Tisilogia
https://www.readbyqxmd.com/read/27812301/blood-gas-testing-and-related-measurements-national-recommendations-on-behalf-of-the-croatian-society-of-medical-biochemistry-and-laboratory-medicine
#9
REVIEW
Lora Dukić, Lara Milevoj Kopčinović, Adrijana Dorotić, Ivana Baršić
Blood gas analysis (BGA) is exposed to risks of errors caused by improper sampling, transport and storage conditions. The Clinical and Laboratory Standards Institute (CLSI) generated documents with recommendations for avoidance of potential errors caused by sample mishandling. Two main documents related to BGA issued by the CLSI are GP43-A4 (former H11-A4) Procedures for the collection of arterial blood specimens; approved standard - fourth edition, and C46-A2 Blood gas and pH analysis and related measurements; approved guideline - second edition...
October 15, 2016: Biochemia Medica: časopis Hrvatskoga Društva Medicinskih Biokemičara
https://www.readbyqxmd.com/read/27811445/a-retrospective-analysis-of-blood-gases-with-two-different-insulin-infusion-protocols-in-patients-undergoing-cardiovascular-surgery
#10
S M Kuskonmaz, Ö Kurtipek, M E Aydın, M E Erbatur, M Alkan, Y Ünal, M Arslan
AIM: Intraoperative blood glucose concentration is known to be an independent risk factor for morbidity and mortality in patients undergoing cardiovascular surgery. Arterial blood gas analysis is an important investigation to monitor the acid-base balance and gas exchange in these patients. Hyperglycemia leads to a series of metabolic changes which affect acid-base balance and serum electrolytes. In this study, we aimed to look into the effect of glycemic control on arterial blood gas parameters, serum electrolytes, and hemoglobin (Hb)...
November 2016: Nigerian Journal of Clinical Practice
https://www.readbyqxmd.com/read/27802696/features-of-the-non-contact-carotid-pressure-waveform-cardiac-and-vascular-dynamics-during-rebreathing
#11
S Casaccia, E J Sirevaag, E J Richter, J A O'Sullivan, L Scalise, J W Rohrbaugh
This report amplifies and extends prior descriptions of the use of laser Doppler vibrometry (LDV) as a method for assessing cardiovascular activity, on a non-contact basis. A rebreathing task (n = 35 healthy individuals) was used to elicit multiple effects associated with changes in autonomic drive as well as blood gases including hypercapnia. The LDV pulse was obtained from two sites overlying the carotid artery, separated by 40 mm. A robust pulse signal was obtained from both sites, in accord with the well-described changes in carotid diameter over the blood pressure cycle...
October 2016: Review of Scientific Instruments
https://www.readbyqxmd.com/read/27799777/high-frequency-oscillatory-ventilation-is-an-effective-treatment-for-severe-pediatric-acute-respiratory-distress-syndrome-with-refractory-hypoxemia
#12
Yu-Xiong Guo, Zhao-Ni Wang, Ya-Ting Li, Li Pan, Li-Fen Yang, Yan Hu, Yue-Yu Sun, Liang-Ming Cai, Zhuang-Gui Chen
BACKGROUND AND PURPOSE: Early or primary application of high-frequency oscillatory ventilation (HFOV) has been recently suggested not to offer benefit to patients with acute respiratory distress syndrome (ARDS). However, the rescue effects of HFOV on severe pediatric acute respiratory distress syndrome (PARDS) with hypoxemia refractory to conventional mechanical ventilation (CMV) remain unclear. This study aimed to determine whether severe PARDS children would benefit from HFOV when oxygenation deteriorated on CMV and to identify any potential risk factors related to mortality...
2016: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/27795903/effects-of-pressure-controlled-and-volume-controlled-ventilation-on-respiratory-mechanics-and-systemic-stress-response-during-prone-position
#13
Oznur Sen, Mefkur Bakan, Tarik Umutoglu, Nurdan Aydın, Mehmet Toptas, Ibrahim Akkoc
BACKGROUND: Prone position during general anesthesia for special surgical operations may be related with increased airway pressure, decreased pulmonary and thoracic compliance that may be explained by restriction of chest expansion and compression of abdomen. The optimum ventilation mode for anesthetized patients on prone position was not described and studies comparing volume-controlled ventilation (VCV) and pressure-controlled ventilation (PCV) during prone position are limited. We hypothesized that PCV instead of VCV during prone position could achieve lower airway pressures and reduce the systemic stress response...
2016: SpringerPlus
https://www.readbyqxmd.com/read/27794584/heliox-driven-nebulization-has-a-positive-effect-on-the-lung-function-in-lipopolysaccharide-induced-chronic-obstructive-pulmonary-disease-rat-model
#14
Wenwen Wu, Xi Chen, Xiaohan Liu, Chengyuan Liu, Gendi Lu
BACKGROUND Chronic obstructive pulmonary disease (COPD) is a serious lung disease that severely threatens people's health. This study aimed to investigate the effects of heliox-driven nebulization (HDN) on lung function and arterial blood gases in a COPD rat model. MATERIAL AND METHODS Twelve healthy male Wistar rats were selected as controls and 34 rats were used to establish a COPD model induced by lipopolysaccharide. Then 6 rats each from the control and model groups were selected for their symptoms to be observed...
October 30, 2016: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/27792046/ivabradine-attenuates-the-microcirculatory-derangements-evoked-by-experimental-sepsis
#15
Marcos L Miranda, Michelle M Balarini, Daniela S Balthazar, Lorena S Paes, Maria-Carolina S Santos, Eliete Bouskela
BACKGROUND: Experimental data suggest that ivabradine, an inhibitor of the pacemaker current in sinoatrial node, exerts beneficial effects on endothelial cell function, but it is unclear if this drug could prevent microcirculatory dysfunction in septic subjects, improving tissue perfusion and reducing organ failure. Therefore, this study was designed to characterize the microcirculatory effects of ivabradine on a murine model of abdominal sepsis using intravital videomicroscopy. METHODS: Twenty-eight golden Syrian hamsters were allocated in four groups: sham-operated animals, nontreated septic animals, septic animals treated with saline, and septic animals treated with ivabradine (2...
October 28, 2016: Anesthesiology
https://www.readbyqxmd.com/read/27789806/the-frequency-and-severity-of-metabolic-acidosis-related-to-topiramate
#16
Hatice Türe, Özgül Keskin, Ülkem Çakır, Canan Aykut Bingöl, Uğur Türe
OBJECTIVE: We planned a cross-sectional analysis to determine the frequency and severity of metabolic acidosis in patients taking topiramate while awaiting craniotomy. METHODS: Eighty patients (18 - 65 years) taking topiramate to control seizures while awaiting elective craniotomy were enrolled. Any signs of metabolic acidosis or topiramate-related side effects were investigated. Blood chemistry levels and arterial blood gases, including lactate, were obtained. The severity of metabolic acidosis was defined according to base excess levels as mild or moderate...
October 26, 2016: Journal of International Medical Research
https://www.readbyqxmd.com/read/27784322/spontaneous-breathing-trial-and-post-extubation-work-of-breathing-in-morbidly-obese-critically-ill-patients
#17
Martin Mahul, Boris Jung, Fabrice Galia, Nicolas Molinari, Audrey de Jong, Yannaël Coisel, Rosanna Vaschetto, Stefan Matecki, Gérald Chanques, Laurent Brochard, Samir Jaber
BACKGROUND: Predicting whether an obese critically ill patient can be successfully extubated may be specially challenging. Several weaning tests have been described but no physiological study has evaluated the weaning test that would best reflect the post-extubation inspiratory effort. METHODS: This was a physiological randomized crossover study in a medical and surgical single-center Intensive Care Unit, in patients with body mass index (BMI) >35 kg/m(2) who were mechanically ventilated for more than 24 h and underwent a weaning test...
October 27, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27782948/sevoflurane-abolishes-oxygenation-impairment-in-a-long-term-rat-model-of-acute-lung-injury
#18
Patrick Kellner, Mattia Müller, Tobias Piegeler, Philipp Eugster, Christa Booy, Martin Schläpfer, Beatrice Beck-Schimmer
BACKGROUND: Patients experiencing acute lung injury (ALI) often need mechanical ventilation for which sedation may be required. In such patients, usually the first choice an intravenously administered drug. However, growing evidence suggests that volatile anesthetics such as sevoflurane are a valuable alternative. In this study, we evaluate pulmonary and systemic effects of long-term (24-hour) sedation with sevoflurane compared with propofol in an in vivo animal model of ALI. METHODS: Adult male Wistar rats were subjected to ALI by intratracheal lipopolysaccharide (LPS) application, mechanically ventilated and sedated for varying intervals up to 24 hours with either sevoflurane or propofol...
October 24, 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27769308/the-modified-save-score-predicting-survival-using-urgent-veno-arterial-extracorporeal-membrane-oxygenation-within-24%C3%A2-hours-of-arrival-at-the-emergency-department
#19
Wei-Cheng Chen, Kuo-Yang Huang, Chih-Wei Yao, Cing-Feng Wu, Shinn-Jye Liang, Chia-Hsiang Li, Chih-Yeh Tu, Hung-Jen Chen
BACKGROUND: Although many risk models have been tested in patients who undergo extracorporeal membrane oxygenation, few have been assessed for patients who received veno-arterial extracorporeal membrane oxygenation (VA-ECMO) support in the emergency department (ED). This study aimed to successfully predict outcomes of patients with cardiac or noncardiac failure who received VA-ECMO in the ED within 24 hours of arrival at the ED. METHOD: This retrospective, observational cohort study included 154 patients, who were classified as cardiac (n = 127) and noncardiac (n = 27) patients and received VA-ECMO within 24 hours after arrival at the China Medical University Hospital ED in Taiwan between January 2009 and September 2014...
October 22, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27746564/premedication-with-midazolam-prior-to-cesarean-delivery-in-preeclamptic-parturients-a-randomized-controlled-trial
#20
Ali M Mokhtar, Ahmed I Elsakka, Hassan M Ali
BACKGROUND: Anxiety is a concern in obstetrics, especially in preeclamptic mothers. Sedation is not commonly used in parturients for fear of adverse neonatal effect. We investigated maternal and neonatal outcome of midazolam as an adjuvant to spinal anesthesia for elective cesarean delivery. METHODS: A prospective randomized controlled trial, in which eighty preeclamptic parturients received either an intravenous dose of 0.035 mg/kg of midazolam or an equal volume of normal saline, 30 min before spinal anesthesia...
September 2016: Anesthesia, Essays and Researches
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