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alveolar arterial oxygen gradient

Asifa Karamat, Shazia Awan, Muhammad Ghazanfar Hussain, Fahad Al Hameed, Faheem Butt, Ali Saeed Wahla
OBJECTIVES: Pulmonary embolism (PE) is seven times more common in cancer patients than non-cancer patients. Since the existing clinical prediction rules (CPRs) were validated predominantly in a non-cancer population, we decided to look at the utility of arterial blood gas (ABG) analysis and D-dimer in predicting PE in cancer patients. METHODS: Electronic medical records were reviewed between December 2005 and November 2010. A total of 177 computed tomography pulmonary angiograms (CTPAs) were performed...
March 2017: Oman Medical Journal
Xin Zhao, Jinyu Liu, Shijun Yang, Chen Chen, He Yin, Ting Li, Qiuting Wang, Xiaoya Li, Yulin Lin, Dayong Cai
Hepatopulmonary syndrome (HPS) has a fatal hypoxemia from pulmonary shunts. Superoxide dismutase 3 (SOD3) deficiency involves in this pathogenesis. The purpose of this study was to investigate the underlying mechanisms of diammonium glycyrrhizinate (DG) on HPS via SOD3. Carbon tetrachloride induced HPS rats were treated with captopril or DG for 56 days. Blood gas, pulmonary artery pressures, and histological changes were measured. Molecule dynamics of inducible (iNOS), endothelial (eNOS), neuronal nitric oxide synthase (nNOS) and SOD3 were assessed by immunohistochemistry, quantitative RT-PCR and western blot...
April 20, 2017: European Journal of Pharmacology
Yucel Yuce, Kutlu Hakan Erkal, Cemal Goktas, Bilal Eryildirim, Kemal Sarica
OBJECTIVE: The effects of surgical technique on respiratory mechanics, arterial oxygenation and hemodynamics in radical prostatectomy operation were investigated. METHODS: The study was planned on ASA II-III, 40-65 years old, fourty patients scheduled for radical prostatectomy under general anesthesia. They were divided into two groups: perineal and suprapubic (Group P, n = 20; Group S, n = 20). Heart rate, mean arterial blood pressure, arterial oxygen saturation (SpO2), partial pressure of end-tidal carbon dioxide (PEtCO2), Peak inspiratory pressure (PIP), plato pressure (Pplato), partial pressure of oxygen in arterial blood (PaO2), partial pressure of carbon dioxide in arterial blood (PaCO2) values were evaluated at 10 minutes after induction...
March 31, 2017: Archivio Italiano di Urologia, Andrologia
Israel Grilo Bensusan, Juan Manuel Pascasio, Juan Luis Tirado, Francisco-Jesús López-Pardo, Francisco Ortega-Ruiz, José Manuel Sousa, María José Rodríguez-Puras, María Teresa Ferrer, Miguel Ángel Gómez-Bravo, Antonio Grilo Reina
BACKGROUND: The macro-aggregated albumin lung perfusion scan (99mTc-MAA) is a diagnostic method for hepatopulmonary syndrome (HPS). GOAL: To determine the sensitivity of 99mTc-MAA in diagnosing HPS, to establish the utility of 99mTc-MAA in determining the influence of HPS on hypoxemia in patients with concomitant pulmonary disease and to determine the correlation between 99mTc-MAA values and other respiratory parameters. METHODS: Data from 115 cirrhotic patients who were eligible for liver transplantation (LT) were prospectively analyzed...
March 17, 2017: Revista Española de Enfermedades Digestivas
Khalid Turky, Amera M Abdelaziz Afify
PURPOSE: Gas exchange abnormalities and inspiratory muscle dysfunction are common postoperative pulmonary complications after cardiac surgery. The aim of this study was to investigate the changes in the alveolar arterial oxygen gradients and inspiratory muscle power after preoperative inspiratory muscle training (IMT) followed by postoperative IMT and early mobilization after coronary artery bypass graft surgery. METHODS: Patients were randomly assigned to the intervention group (n = 20) or the usual care group (n = 20)...
February 6, 2017: Journal of Cardiopulmonary Rehabilitation and Prevention
Hui Ding, Qi Lv, Shiman Wu, Shike Hou, Ziquan Liu, Ning Xu Landén, Ping Tian, Mengyang Yu, Zhiguang Sun, Haojun Fan
Smoke inhalation injury (SII) is associated with significant morbidity and mortality in burn patients, and effective treatments are lacking. Perfluorocarbons (PFCs) have a protective effect against acute lung injury. We aimed to assess the therapeutic effects of perfluorohexane on burn patients with SII. Patients with burns complicated by moderately severe SII were randomly divided into control (n = 11) and PFC groups (n = 12). The control group received conventional treatment (anti-infection, nutritional support, antishock measures, and supportive treatment)...
January 10, 2017: Journal of Burn Care & Research: Official Publication of the American Burn Association
J G Toffaletti, C R Rackley
Although part of a common "blood gas" test panel with pH and pCO2, the pO2, %O2Hb, and related parameters are independently used to detect and monitor oxygen deficits from a variety of causes. Measurement of blood gases and cooximetry may be done by laboratory analyzers, point of care testing, noninvasive pulse oximetry, and transcutaneous blood gases. The specimen type and mode of monitoring oxygenation that are chosen may be based on a combination of urgency, practicality, clinical need, and therapeutic objectives...
2016: Advances in Clinical Chemistry
Israel Grilo-Bensusan, Juan Manuel Pascasio-Acevedo
Hepatopulmonary syndrome (HPS) is characterized by abnormalities in blood oxygenation caused by the presence of intrapulmonary vascular dilations (IPVD) in the context of liver disease, generally at a cirrhotic stage. Knowledge about the subject is still only partial. The majority of the information about the etiopathogenesis of HPS has been obtained through experiments on animals. Reported prevalence in patients who are candidates for a liver transplantation (LT) varies between 4% and 32%, with a predominance of mild or moderate cases...
July 7, 2016: World Journal of Gastroenterology: WJG
Yingming Amy Chen, Vikramaditya Prabhudesai, Helene Castel, Samir Gupta
BACKGROUND: Hepatopulmonary syndrome (HPS) is defined by liver dysfunction, intrapulmonary vascular dilatations, and impaired oxygenation. The gold standard for detection of intrapulmonary vascular dilatations in HPS is contrast echocardiography. However, two small studies have suggested that patients with HPS have larger segmental pulmonary arterial diameters than both normal subjects and normoxemic subjects with cirrhosis, when measured by CT. We sought to compare CT imaging-based pulmonary vasodilatation in patients with HPS, patients with liver dysfunction without HPS, and matching controls on CT imaging...
2016: PloS One
X Li, Y Chen, L Wang, G Shang, C Zhang, Z Zhao, H Zhang, A Liu
Quercetin shows protective effects against hepatopulmonary syndrome (HPS), as demonstrated in a rat model. However, whether these effects involve pulmonary vascular angiogenesis in HPS remains unclear. Therefore, this study aimed to assess the effect of quercetin on pulmonary vascular angiogenesis and explore the underlying mechanisms. Male Sprague-Dawley rats weighing 200-250 g underwent sham operation or common bile duct ligation (CBDL). Two weeks after surgery, HIF-1α and NFκB levels were assessed in rat lung tissue by immunohistochemistry and western blot...
July 4, 2016: Brazilian Journal of Medical and Biological Research, Revista Brasileira de Pesquisas Médicas e Biológicas
Marco Morosin, Carlo Vignati, Angela Novi, Elisabetta Salvioni, Fabrizio Veglia, Marina Alimento, Guido Merli, Susanna Sciomer, Gianfranco Sinagra, Piergiuseppe Agostoni
In chronic heart failure (HF), the alveolar-capillary membrane undergoes a remodeling process that negatively affects gas exchange. In case of alveolar-capillary gas diffusion impairment, arterial desaturation (SaO2) is rarely observed in HF patients. At play are 3 factors: overall pulmonary diffusing capacity (assessed as lung diffusion for CO, DLCO), global O2 consumption (VO2) and alveolar (A) to arterial (a) pO2 gradient (AaDO2). In 100 consecutive stable HF patients, DLCO, resting respiratory gases and arterial blood gases were measured to determine VO2, paO2, pAO2 and AaDO2...
November 2016: Respiratory Physiology & Neurobiology
Matthias Held, Philipp Kolb, Maria Grün, Berthold Jany, Gudrun Hübner, Aleksandar Grgic, Regina Holl, Hans-Joachim Schaefers, Heinrike Wilkens
BACKGROUND: Patients with chronic thromboembolic pulmonary disease (CTED) have persistent pulmonary vascular obstruction and exercise intolerance without pulmonary hypertension at rest and may benefit from pulmonary endarterectomy. However, up to now, CTED has been poorly characterized. OBJECTIVES: This study aimed to analyze the exercise capacity and limiting factors in CTED. METHODS: We compared right heart catheterization and cardiopulmonary exercise test results of patients with CTED [mean pulmonary artery pressure (mPAP) at rest <25 mm Hg, n = 10], chronic thromboembolic pulmonary hypertension (CTEPH, n = 31) and a control group (n = 41) presenting with dyspnea but normal pulmonary vascular imaging and excluded pulmonary hypertension...
2016: Respiration; International Review of Thoracic Diseases
Caglar Cosarderelioglu, Arif M Cosar, Merve Gurakar, Nabil N Dagher, Ahmet Gurakar
A severe and common pulmonary vascular complication of liver disease is hepatopulmonary syndrome (HPS). It is a triad of liver dysfunction and/or portal hypertension, intrapulmonary vascular dilatations, and increased alveolar-arterial oxygen gradient. Prevalence varies according to various study groups from 4%-47%. While the most common presenting symptom of HPS is dyspnea, it is usually asymptomatic, and thus all liver transplant candidates should be screened for its presence. Pulse oximetry is a useful screening method, but arterial blood gas examination is the gold standard...
March 28, 2016: Journal of Clinical and Translational Hepatology
Wei Wu, Junlan Zhang, Wenli Yang, Bingqian Hu, Michael B Fallon
BACKGROUND AND AIM: Pulmonary monocyte infiltration plays a significant role in the development of angiogenesis in experimental hepatopulmonary syndrome (HPS) after common bile duct ligation (CBDL). Hepatic monocytes are also increased after CBDL, but the origins remain unclear. Splenic reservoir monocytes have been identified as a major source of monocytes that accumulate in injured tissues. Whether splenic monocytes contribute to monocyte alterations after CBDL is unknown. This study evaluates monocyte distributions and assesses effects of splenectomy on monocyte levels and pulmonary vascular and hepatic abnormalities in experimental HPS...
November 2016: Journal of Gastroenterology and Hepatology
Thierry Thévenot, Delphine Weil, Armand Garioud, Hortensia Lison, Jean-François Cadranel, Bruno Degano
Hepatopulmonary syndrome (HPS) is defined by the association of portal hypertension, increased alveolar-arterial oxygen gradient and intrapulmonary vascular dilations. Pathophysiological mechanisms of hypoxemia are characterized by ventilation-perfusion mismatch, oxygen diffusion limitation between alveolus and the centre of the dilated capillary, and right-to-left shunting. An excess of vasodilator molecules (like nitric monoxide) and proangiogenic factors (like VEGF) play an important role in the occurrence of HPS...
May 2016: La Presse Médicale
Abdullah Al-Harbi, Khalid Abdullah, Abdulmajeed Al-Abdulkareem, Ali Alghamdi, Hamdan Al-Jahdali
BACKGROUND: Hepatopulmonary syndrome (HPS) is commonly encountered in the setting of end-stage liver disease (ESLD). Past studies have reported conflicting results in terms of demonstrating an association between HPS and mortality. The aim of this study was to determine the prevalence of HPS in patients with ESLD referred for assessment of transplantation suitability. In addition, we investigated survival rates in the setting of HPS, with and without liver transplantation. MATERIAL AND METHODS: The medical records of 524 consecutive patients with ESLD evaluated for potential liver transplantation were retrospectively reviewed...
March 29, 2016: Annals of Transplantation: Quarterly of the Polish Transplantation Society
Junichi Okamoto, Hirotoshi Kubokura, Jitsuo Usuda
BACKGROUND: In the elderly patients, optimal surgical treatment can be difficult to achieve, because of comorbidity. Therefore, we aimed to clarify the preferred surgical management in this patient group. METHODS: A retrospective study was conducted between April 2008 and March 2015 that included patients with non-small cell lung cancer (NSCLC) aged ≥ 75 years. RESULTS: We included 44 patients who underwent partial resection (n = 20) or lobectomy (n = 24)...
June 20, 2016: Annals of Thoracic and Cardiovascular Surgery
Gerwin E Engels, Jan van Klarenbosch, Y John Gu, Willem van Oeveren, Adrianus J de Vries
OBJECTIVES: In addition to its blood-sparing effects, intraoperative cell salvage may reduce lung injury following cardiac surgery by removing cytokines, neutrophilic proteases and lipids that are present in cardiotomy suction blood. To test this hypothesis, we performed serial measurements of biomarkers of the integrity of the alveolar-capillary membrane, leucocyte activation and general inflammation. We assessed lung injury clinically by the duration of postoperative mechanical ventilation and the alveolar arterial oxygen gradient...
March 2016: Interactive Cardiovascular and Thoracic Surgery
Toshihiro Okamoto, David Wheeler, Qiang Liu, Cristiano Quintini, J Steven Hata, Kenneth R McCurry
BACKGROUND: The pressure of arterial oxygen to fractional inspired oxygen concentration (PaO2/FiO2, P/F) ratio has been the gold standard in the assessment of transplant suitability in ex vivo lung perfusion (EVLP) with red blood cells. However, several reports using mathematical models and clinical data analysis suggest that the P/F ratio fluctuates at different FiO2. The purpose of this study was to examine the variations in P/F ratio at different FiO2 during EVLP and develop a practicable decision making algorithm in the EVLP...
December 2015: Transplantation
Yasuyuki Kaneko, Shidow Torisu, Mitsuyoshi Hagio, Ryoji Yamaguchi, Shinya Mizutani, Kiyokazu Naganobu
Hepatopulmonary syndrome (HPS) is a respiratory complication of hepatic disease, that is well recognized in humans and defined by the presence of 1) liver disease, 2) hypoxemia and/or high alveolar-arterial oxygen gradient (AaDO2) and 3) intrapulmonary vasodilatation. The present report describes a similar case of HPS in a dog. A six-month-old Papillon was diagnosed with ductal plate malformation with chronic active hepatitis and showed progressive increases in AaDO2 over the course of the following six months...
March 2016: Journal of Veterinary Medical Science
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