scholarly journals Comparison of Acellular Solutions for Ex-situ Perfusion of Amputated Limbs

2020 ◽  
Vol 185 (11-12) ◽  
pp. e2004-e2012
Author(s):  
Valentin Haug ◽  
Branislav Kollar ◽  
Yori Endo ◽  
Nikita Kadakia ◽  
Anamika Veeramani ◽  
...  
Keyword(s):  
Creatine Kinase ◽  
Lactate Dehydrogenase ◽  
Cold Storage ◽  
Blood Gas Analysis ◽  
Gas Analysis ◽  
Ex Situ ◽  
Blood Gas ◽  
Promising Alternative ◽  
Significant Difference ◽  
Over Time

Abstract Introduction Hypothermic ex-situ machine perfusion (MP) has been shown to be a promising alternative to static cold storage (SCS) for preservation of solid organs for transplantation and vascularized composite allotransplantation. Perfusion with blood-based perfusion solutions in austere environments is problematic due to their need for appropriate storage and short shelf life, making it impractical for military and emergency use. Acellular perfusion has been shown to be effective, but the ideal perfusate solution for MP of amputated limbs is yet to be determined. The purpose of this study is to evaluate the efficacy of alternative perfusate solutions, such as dextran-enriched Phoxilium, Steen, and Phoxilium in ex-vivo hypothermic MP of amputated limbs in a porcine model. Materials and methods Amputated forelimbs from Yorkshire pigs (n = 8) were preserved either in SCS (n = 2) at 4°C for 12 hours or machine-perfused at 10°C for 12 hours with oxygenated perfusion solutions (n = 6) at a constant flow rate. The perfusates used include modified Steen-solution, Phoxilium (PHOX), or Phoxilium enriched with dextran-40 (PHODEX). The perfusate was exchanged after 1 and 6 hours of perfusion. Machine data were recorded continuously. Perfusate samples for clinical chemistry, blood gas analysis, and muscle biopsies were procured at specific timepoints and subsequently analyzed. In this semi in-vivo study, limb replantation has not been performed. Results After amputation, every limb was successfully transferred and connected to our perfusion device. The mean total ischemia time was 77.5 ± 5.24 minutes. The temperature of the perfusion solution was maintained at 10.18 ± 2.01°C, and perfusion pressure at 24.48 ± 10.72 mmHg. Limb weight increased by 3% in the SCS group, 36% in the PHODEX group, 25% in the Steen group, and 58% in the PHOX group after 12 hours. This increase was significant in the PHOX group compared with the SCS group. All perfusion groups showed a pressure increase of 10.99 mmHg over time due to edema. The levels of HIF-1a decreased over time in all groups except the Steen and the PHODEX group. The biomarkers of muscle injury in the perfusate samples, such as creatine kinase and lactate-dehydrogenase, showed a significant difference between groups, with highest values in the PHODEX group. No significant differences were found in the results of the blood gas analysis. Conclusion With the exception of significantly higher levels of creatine kinase and lactate dehydrogenase, MP with dextran-enriched Phoxilium provides similar results as that of the commercially available perfusates such as Steen, without the need for cold storage, and at circa 5% of the cost of the Steen solution. Further large-scale replantation studies are necessary to evaluate the efficacy of dextran-enriched Phoxilium as an alternate perfusate solution.

scholarly journals The effect of clamped and unclamped umbilical cord samples on blood gas analysis

2021 ◽  
Author(s):  
Elisabetta Colciago ◽  
Simona Fumagalli ◽  
Elena Ciarmoli ◽  
Laura Antolini ◽  
Antonella Nespoli ◽  
...  
Keyword(s):  
Blood Gas Analysis ◽  
Cross Sectional Study ◽  
Gas Analysis ◽  
Blood Collection ◽  
Large Sample Size ◽  
Blood Gas ◽  
Delayed Cord Clamping ◽  
Cross Sectional ◽  
High Risk Women ◽  
Significant Difference

Abstract Purpose Delayed cord clamping for at least 60 s is recommended to improve neonatal outcomes. The aim of this study is to evaluate whether there are differences in cord BGA between samples collected after double clamping the cord or without clamping the cord, when blood collection occurs within 60 s from birth in both groups. Methods A cross-sectional study was carried out, collecting data from 6884 high-risk women who were divided into two groups based on the method of cord sampling (clamped vs unclamped). Results There were significant decrease in pH and BE values into unclamped group compared with the clamped group. This difference remained significant when considering pathological blood gas analysis parameters, with a higher percentage of pathological pH or BE values in the unclamped group. Conclusion Samples from the unclamped cord alter the acid–base parameters compared to collection from the clamped cord; however, this difference does not appear to be of clinical relevance. Findings could be due to the large sample size, which allowed to achieve a high power and to investigate very small numerical changes between groups, leading to a statistically significant difference in pH and BE between samples even when we could not appreciate any clinical relevant difference of pH or BE between groups. When blood gas analysis is indicated, the priority should be given to the timing of blood collection to allow reliable results, to assess newborns status at birth and intervene when needed.

scholarly journals Comparison of Blood Gas Analysis between Benchtop and Handheld Device

2020 ◽  
Vol 27 (1) ◽  
Author(s):  
Phey Liana ◽  
Iza Netiasa Haris ◽  
Yan Effendi Hasyim
Keyword(s):  
Clinical Decision Making ◽  
Blood Gas Analysis ◽  
Gas Analysis ◽  
P Value ◽  
Strong Positive Correlation ◽  
Blood Gas ◽  
Cross Sectional ◽  
Handheld Device ◽  
Arterial Blood ◽  
Significant Difference

The use of blood gas analysis is to determine the Acid-base status required to treat patients with emergency conditionssuch as metabolic disorders and respiratory diseases. Benchtop device is commonly used in hospitals to analyze blood gas;however, handheld devices are recently more often used in emergency settings due to its quick and simple process. Thisstudy was performed to compare blood gas analysis results between the i-STAT handheld device and the Nova pHox Ultrabenchtop device that were currently being used in the central laboratory. This cross-sectional study was conducted by using42 arterial blood patients that were measured with i-STAT handheld device dan Nova pHox Ultra benchtop device. The pH,pCO2, and pO2 parameters were then evaluated. The data were analyzed using Spearman's correlation test, Mann-Whitneytest, and Bland-Altman plots. This study showed a very strong positive correlation for all parameters. Mann-Whitneycomparison test showed that there was no significant difference between the result of the two devices (p-value > 0.05). Allparameters showed that 95% of plots were within the acceptable limit. There was no clinical significance on the mean biasesof blood gas results between both devices. The i-STAT and Nova pHox Ultra devices showed a good agreement for bloodgas measurement. Therefore, both devices can be used interchangeably with minimal effect on clinical decision-making.

Effect of anemia on intrapulmonary shunt during atelectasis in rabbits

1995 ◽  
Vol 79 (6) ◽  
pp. 1951-1957 ◽  
Author(s):  
S. Deem ◽  
M. J. Bishop ◽  
M. K. Alberts
Keyword(s):  
Hypoxic Pulmonary Vasoconstriction ◽  
Left Lung ◽  
Blood Gas Analysis ◽  
Gas Analysis ◽  
Blood Gas ◽  
Intrapulmonary Shunt ◽  
Fluorescent Microspheres ◽  
Pulmonary Vasoconstriction ◽  
Arterial Po2 ◽  
Over Time

To elucidate the effects of anemia on intrapulmonary shunt, we studied a model of left lung atelectasis in anesthetized rabbits. In 10 rabbits, isovolemic anemia was produced by sequential hemodilution. Seven control rabbits were followed over time, without hemodilution. Intrapulmonary shunt (Qs/QT) was measured by using blood gas analysis and by quantitation of the percentage of blood flow to the collapsed left lung (QLl/QT) using fluorescent microspheres. In control rabbits, Qs/QT and QLl/QT decreased over time, whereas arterial PO2 increased. In hemodiluted rabbits, there was a trend toward increased Qs/QT and QLl/QT. There were significant differences in the behavior of Qs/QT, QLl/QT, and arterial PO2 between control and hemodiluted rabbits. Hemodynamic parameters, including cardiac output and pulmonary artery pressure, were not different between groups. In a third group of rabbits with pharmacologically induced acidosis but no hemodilution, Qs/QT and QLl/QT decreased over time, and arterial PO2 increased. We conclude that acute isovolemic anemia has a deleterious effect on pulmonary gas exchange, possibly through attenuation of hypoxic pulmonary vasoconstriction.

scholarly journals Clinical observation of alveolar surface active substances in the treatment of neonatal respiratory distress syndrome at different periods

2019 ◽  
Author(s):  
Han Han ◽  
Xiao-xia Li ◽  
Xiang-hua Shuai ◽  
Zhi-qun Zhang ◽  
Jing Li ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Rescue Therapy ◽  
Total Duration ◽  
Blood Gas Analysis ◽  
Gas Analysis ◽  
Blood Gas ◽  
Systemic Hemodynamic ◽  
Significant Difference ◽  
Group A ◽  
Group B

Abstract Background: Mechanical ventilation joint PS replacement therapy is an effective method in treatment of NRDS recognized, PS treatment of children with early can improve the oxygenation by increasing gas exchange area, but before FiO 2 to reduce the application of PS can cause local and/or systemic hemodynamic changes, making the use of PS has some potential problems, such as increasing the incidence of the IVH, PH, PDA and so on. SR rescue therapy can be divided into early treatment and delayed treatment, but the specific boundary point of the appropriate time period has not been clear. This paper aims to compare the efficacy differences of PS administration at different time periods and provide basis for the selection of clinical application period of PS. Methods: Case-control study . 135 children diagnosed with NRDS in neonatology department of our hospital. The patients were divided into two groups according to the use time of PS. Group A was applied within 3 hours after birth, and group B was applied 3 hours after birth. The changes of blood gas analysis parameter，mechanical ventilation time, incidence of complications, hospital stay and mortality were compared between the two groups. Results : The decrease of blood gas PaCO 2 in group A before and after treatment was more significant than that of group B (P<0.05), but the improvement of PaO 2 and OI in group B was better than that in group A (P<0.05). Although there were significant differences in birth weight between the two groups, there were no significant differences in the total duration of mechanical ventilation and mortality (P>0.05). Except PDA and BPD, there was no significant difference in the incidence of common complications between the two groups. Conclusion: PS treatment within 3 hours after birth can better improve ventilation, reduce the incidence of PDA. It can also help to reduce the death rate of high-risk children and the total duration of mechanical ventilation.

scholarly journals Arterialised Capillary Blood Gases in Accident and Emergency Department Patients - a Reliable Alternative to Arterial Sampling?

2020 ◽  
Vol 7 (2) ◽  
Author(s):  
Faheem Shakur ◽  
Suzanne Mason
Keyword(s):  
Blood Gases ◽  
Blood Gas Analysis ◽  
Gas Analysis ◽  
Capillary Blood ◽  
Blood Gas ◽  
Arterial Blood Gas ◽  
Arterial Blood ◽  
Arterial Blood Gas Analysis ◽  
Significant Difference ◽  
Emergency Department Patients

OBJECTIVES: Many patients with respiratory complaints who present to the Accident & Emergency (A & E) department have an arterial blood gas analysis performed at some point. It is our belief that there is no difference between arterial and capillary blood gas values in patients presenting to the A & E department. It is also anticipated that body temperature and blood pressure may play a part, so these will also be reported and associations will be investigated. METHODS: Patients who require arterial blood gas analysis at any stage during their stay in the A & E department at the Northern General hospital of Sheffield are eligible for inclusion in the study. In total there were 32 patients. PROCEDURE:Transvasin cream was applied to the ear lobe to improve local blood flow by dilating the capillaries. When ten minutes have elapsed after the application of the Transvasin cream, a capillary sample is taken from the ear lobe by the researchers. CONCLUSION: From the t-tests conducted, no significant difference was seen between the arterial and capillary blood gas samples for the parameters pO2 and O2 saturation. However, for pCO2, pH and [HCO3] there were significant differences observed. This result seems to disagree with the findings of most other studies that have so far shown stronger correlations generally for pH, pCO2 and bicarbonate, than for oxygen measuring parameters.

scholarly journals Micro-arteriovenous fistula in patients with lower limb lymphedema

2021 ◽  
Vol 48 (2) ◽  
pp. 219-223
Author(s):  
Hikaru Kono ◽  
Hisashi Sakuma ◽  
Shiho Watanabe ◽  
Takaya Murayama ◽  
Masashi Takemaru
Keyword(s):  
Arteriovenous Fistula ◽  
Lower Limb ◽  
Venous Blood ◽  
Blood Gas Analysis ◽  
Gas Analysis ◽  
Blood Gas ◽  
Secondary Lymphedema ◽  
Significant Difference ◽  
Venous Blood Gas ◽  
Venous Blood Gas Analysis

Background A micro-arteriovenous fistula (AVF) is a minute, short shunt between an artery and a vein that does not pass through a capillary. We investigated the association between micro-AVFs and lymphedema using computed tomography angiography (CTA) and venous blood gas analysis.<br/>Methods In 95 patients with lower limb lymphedema, the presence or absence of early venous return (EVR) was compared between patients with primary and secondary lymphedema. Furthermore, we investigated the difference in the timing of edema onset in patients with secondary lymphedema with or without EVR using CTA. In 20 patients with lower limb lymphedema with confirmed early EVR in a unilateral lower limb, the partial pressure of oxygen (PO2) was compared between the lower limb with EVR and the contralateral lower limb.<br/>Results Secondary lymphedema with or without EVR occurred at an average of 36.0±59.3 months and 93.5±136.1 months, respectively; however, no significant difference was noted. PO2 was 57.6±11.7 mmHg and 44.1±16.4 mmHg in the EVR and non-EVR limbs, respectively, which was a significant difference (P=0.005).<br/>Conclusions EVR and venous blood gas analysis suggested the presence of micro-AVFs in patients with lower extremity edema. Further research is warranted to examine the cause of micro-AVFs, to advance technology to facilitate the confirmation of micro-AVFs by angiography, and to improve lymphedema by ligation of micro-AVFs.

scholarly journals Do carboxyhemoglobin and methemoglobin levels predict the return of spontaneous circulation and prognosis of cardiac arrest patients?

2021 ◽  
Author(s):  
Onur Tezel ◽  
Sedat Bilge ◽  
Yahya Ayhan Acar ◽  
Gokhan Ozkan
Keyword(s):  
Cardiac Arrest ◽  
Prognostic Marker ◽  
Blood Gas Analysis ◽  
Predictive Marker ◽  
Spontaneous Circulation ◽  
Gas Analysis ◽  
Blood Gas ◽  
Return Of Spontaneous Circulation ◽  
Survivor Group ◽  
Significant Difference

Introduction: Early prediction of return of spontaneous circulation (ROSC) for cardiac arrest (CA) patients is a major challenge. This study’s goal was to investigate the value of the carboxyhemoglobin (COHb) and methemoglobin (MetHb) levels as a predictive marker for ROSC and prognostic marker for patients who achieve ROSC. Methods: A total of 241 adult patients (109 female, 132 male) diagnosed as non-traumatic CA were included in the study. The patients were divided into two groups based on whether they achieved ROSC. Complete blood count parameters, routine biochemistry measurements, coagulation parameters, and blood gas analysis, and cardiac markers values were compared between the groups. Results: COHb levels were significantly lower in the non-ROSC group (0.71 ± 0.57%) than in the ROSC group (0.95 ± 0.76%) and in the non-survival group (0.78 ± 0.53%) compared to the survivor group (1.45 ± 1.31%) (p =0.002, 0.022 respectively). There was no significant difference between the ROSC and non-ROSC groups and survivor group and non-survivor groups in terms of MetHb levels (p = 0.769 and 0.668, respectively). Conclusions: COHb levels in the blood gas analysis at the time of admission could be used as a predictive marker for ROSC and prognostic marker for the patients who achieved ROSC.

scholarly journals Clinical Study on the Effects of Different Positions on Supine Hypotensive Syndrome in Cesarean Section after Lumbar Anesthesia

2020 ◽  
Vol 4 (3) ◽  
Author(s):  
Chunyan Zhao ◽  
Yi Tang ◽  
Cibo Chen ◽  
Bingchun Xia
Keyword(s):  
Blood Pressure ◽  
Cesarean Section ◽  
Supine Position ◽  
Blood Gas Analysis ◽  
Gas Analysis ◽  
Blood Gas ◽  
Significant Difference ◽  
Group A ◽  
Hypotensive Syndrome ◽  
Group B

Aim: To explore the effects of different positions on supine hypotensive syndrome in cesarean section after lumbar anesthesia. Methods: 600 full-term parturient were randomly divided into 4 groups. The patented positioning pads (patent number: ZL 2017 2 0618886.5) in our department was used in the left-leaning position. The parturient lied in a supine position for anesthesia in, and then the group of positioning pads was placed after turning into the lateral position. The parturient were divided into group A (supine position), group B (left-leaning to 10 °), group C (left-leaning to 20 °), and group D (30 °). Observation index: Main index: Comparison of maternal blood pressure changes and neonatal blood gas analysis in the supine position without using a position pad and with the use of patent positioning pads in different tilt angles (10°, 20°, 30°). Minor index: 1) the use and frequency of vasoactive drugs, whether a left-leaning operating bed or uterine displacement is required; 2) the consciousness of the parturient; 3) newborn’s Apgar scores of 1 minute, 5 minutes, and 10 minutes after birth; 4) whether the obstetrician can perform the operation smoothly in the corresponding left leaning position. Results: The blood pressure at the supine position after anesthesia, the beginning of surgery and the time when the newborn was delivered in group A and group B were significantly different from those in group C (P<0.05). There were significant differences at different timings in group A and group B, and the decline was more significant at the supine position after anesthesia, the beginning of surgery and the time when the newborn was delivered (P<0.05). The pH value of blood gas analysis of newborns in group A, group B and group C was between 7.25 and 7.37, and there was no significant difference between the three groups (P?0.05). Conclusion: The use of positioning pads can prevent the adverse effects of supine hypotensive syndrome on parturient and newborns to a certain extent.

scholarly journals Blood Gas Analysis in Neonatal Tetanus

2018 ◽  
Vol 34 (1-2) ◽  
pp. 44-7
Author(s):  
Taslim S. Soetomenggolo ◽  
Dwi Putro Widodo ◽  
Jimmy Passat ◽  
Sofyan Ismael
Keyword(s):  
Metabolic Acidosis ◽  
Blood Gas Analysis ◽  
Gas Analysis ◽  
Neonatal Tetanus ◽  
Common Finding ◽  
Blood Gas ◽  
Acid Base Balance ◽  
Arterial Blood Gas ◽  
Arterial Blood ◽  
Significant Difference

We reviewed the results of arterial blood gas analysis in 127 patients with neonatal tetanus on admission, and in 52 of such patients on the day before they died. All patients were hospitalized at the Department of Child Health, Cipto Mangunkusumo Hospital, Jakarta. On admission, most patients showed uncompensated metabolic acidosis. The mortality of patients wjth pH ofless than 7 was 100%. There was no significant difference between the mortality of patients with pH 7.35-7.45 and those with pH of less than 7.35. Analysis of acid-base balance indicated that ventilatory fw1ure was the most common finding in 52 patients who subsequently died. We recommend using intravenous fluid containing a combination of 5% dextrose and sodium bicarbonate with 4 : 1 (vol/vol) ratio from the fust day of hospitalization to reduce the possibility of the development of ongoing metabolic acidosis in patients with neonatal tetanus. Maintaining adequate ventilation is mandatory ln such patients.

The effect of sputum suction at different decubitus of low muscle strength patients with ventilators

2020 ◽  
Author(s):  
Yang Luo ◽  
Jia Wan ◽  
Lijuan Feng ◽  
Sisi Li ◽  
Jingting He
Keyword(s):  
Muscle Strength ◽  
Pulmonary Infection ◽  
Blood Gas Analysis ◽  
Orotracheal Intubation ◽  
Gas Analysis ◽  
Blood Gas ◽  
Clinical Indicators ◽  
Significant Difference ◽  
Baseline Characteristics ◽  
Safety Assessments

Abstract BACKGROUND Sputum suction with ventilators is a method to save the life of respiratory failure patients. However, the effect of different decubitus in the process of sputum suction on low muscle strength patients is not understood. METHODS The low muscle strength patients received the sputum suction using orotracheal intubation were randomly divided into 0°decubitus group and 30°decubitus group. The clinical indicators and blood gas analysis were used to compare the advantages of the two groups. In addition, 11 main complications and incidents were selected to evaluate the safety of the 0°decubitus group and 30°decubitus group. RESULTS There was no significant difference between 0°decubitus group and 30°decubitus group in baseline characteristics and safety assessments. For clinical indicators, the 0°decubitus group displayed the earlier appearance of pulmonary infection control (PIC) window, shorter time of invasive ventilation and hospital stay, shorter total time of ventilation, lower reintubation rate and ventilator-associated pneumonia (VAP) rate, and higher weaning success rate compared with the 30°decubitus group. In addition, the blood gas analysis showed that the concentrations of O2 (PaO2) and oxygen saturation (SaO2) were higher in 0°decubitus group than in 30°decubitus group, while the concentrations of CO2 (PaCO2) was lower in 0°decubitus group than that in 30°decubitus group. CONCLUSIONS The sputum suction at 0°decubitus had more advantages than at 30°decubitus for the low muscle strength patients with ventilators.

Sign in / Sign up

Export Citation Format

Share Document