scholarly journals Rapid Clinical and Radiological Improvement in a Patient with Severe COVID-19 Infection Treated with Convalescent Plasma

Reports ◽  
2021 ◽  
Vol 4 (2) ◽  
pp. 15
Author(s):  
Stephen Malnick ◽  
Waleed Ghannam ◽  
Adam Abu Sharb ◽  
Pavel Alin

The COVID-19 pandemic has affected more than 100 million people worldwide. One of the major presentations is pneumonia. Patients are classified as severe when they have an arterial oxygen saturation of less than 94% on breathing room air. We present a case of a healthy 29-year-old man who had severe COVID-19 pneumonia and responded dramatically to two doses of convalescent plasma. This case underlines the importance of administering the plasma in the first few days of the disease.

1988 ◽  
Vol 16 (2) ◽  
pp. 182-186 ◽  
Author(s):  
R. H. Riley ◽  
N. J. Davis ◽  
K. E. Finucane ◽  
P. Christmas

There is no published study that examines oxygenation of anaesthetised patients during transport from anaesthesia induction room to operating room. Arterial oxygen saturation (S a O 2 ) was measured in twenty-five anaesthetised patients before and during transfer to an adjacent operating room and continuously recorded on a calibrated chart recorder. A telemetry ECG recorder was used to detect cardiac dysrhythmias. All anaesthetists followed their usual anaesthetic practice. Patients ventilated via face-mask and via endotracheal tube were studied. During transfer patients were either apnoeic (n = 8) or breathing room air spontaneously (n= 17) Mean S a o 2 before induction was 95.4 (SD 2.5)%, was higher after induction of anaesthesia, 98.5 (SD 1.4)% and fell after transfer, 95.7 (SD 2.6)%. A fall in S a O 2 was recorded for 21 patients. No S a O 2 value below 90% was seen. The decrease in S a O 2 was related to the time taken to transfer the patients and spontaneous ventilation (Multiple regression analysis); it was not related to the body mass index although two of the greatest decreases were seen in obese patients. Transfer time averaged 51 seconds (range: 24–97 s). No changes in cardiac rhythm were seen. Transfer of anaesthetised patients was accompanied by variable falls in S a O 2 which related to duration of transfer and spontaneous breathing of room air and which were not associated with new dysrhythmias.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Shinshu Katayama ◽  
Jun Shima ◽  
Ken Tonai ◽  
Kansuke Koyama ◽  
Shin Nunomiya

AbstractRecently, maintaining a certain oxygen saturation measured by pulse oximetry (SpO2) range in mechanically ventilated patients was recommended; attaching the INTELLiVENT-ASV to ventilators might be beneficial. We evaluated the SpO2 measurement accuracy of a Nihon Kohden and a Masimo monitor compared to actual arterial oxygen saturation (SaO2). SpO2 was simultaneously measured by a Nihon Kohden and Masimo monitor in patients consecutively admitted to a general intensive care unit and mechanically ventilated. Bland–Altman plots were used to compare measured SpO2 with actual SaO2. One hundred mechanically ventilated patients and 1497 arterial blood gas results were reviewed. Mean SaO2 values, Nihon Kohden SpO2 measurements, and Masimo SpO2 measurements were 95.7%, 96.4%, and 96.9%, respectively. The Nihon Kohden SpO2 measurements were less biased than Masimo measurements; their precision was not significantly different. Nihon Kohden and Masimo SpO2 measurements were not significantly different in the “SaO2 < 94%” group (P = 0.083). In the “94% ≤ SaO2 < 98%” and “SaO2 ≥ 98%” groups, there were significant differences between the Nihon Kohden and Masimo SpO2 measurements (P < 0.0001; P = 0.006; respectively). Therefore, when using automatically controlling oxygenation with INTELLiVENT-ASV in mechanically ventilated patients, the Nihon Kohden SpO2 sensor is preferable.Trial registration UMIN000027671. Registered 7 June 2017.


1944 ◽  
Vol 79 (1) ◽  
pp. 9-22 ◽  
Author(s):  
Frank L. Engel ◽  
Helen C. Harrison ◽  
C. N. H. Long

1. In a series of rats subjected to hemorrhage and shock a high negative correlation was found between the portal and peripheral venous oxygen saturations and the arterial blood pressure on the one hand, and the blood amino nitrogen levels on the other, and a high positive correlation between the portal and the peripheral oxygen saturations and between each of these and the blood pressure. 2. In five cats subjected to hemorrhage and shock the rise in plasma amino nitrogen and the fall in peripheral and portal venous oxygen saturations were confirmed. Further it was shown that the hepatic vein oxygen saturation falls early in shock while the arterial oxygen saturation showed no alteration except terminally, when it may fall also. 3. Ligation of the hepatic artery in rats did not affect the liver's ability to deaminate amino acids. Hemorrhage in a series of hepatic artery ligated rats did not produce any greater rise in the blood amino nitrogen than a similar hemorrhage in normal rats. The hepatic artery probably cannot compensate to any degree for the decrease in portal blood flow in shock. 4. An operation was devised whereby the viscera and portal circulation of the rat were eliminated and the liver maintained only on its arterial circulation. The ability of such a liver to metabolize amino acids was found to be less than either the normal or the hepatic artery ligated liver and to have very little reserve. 5. On complete occlusion of the circulation to the rat liver this organ was found to resist anoxia up to 45 minutes. With further anoxia irreversible damage to this organ's ability to handle amino acids occurred. 6. It is concluded that the blood amino nitrogen rise during shock results from an increased breakdown of protein in the peripheral tissues, the products of which accumulate either because they do not circulate through the liver at a sufficiently rapid rate or because with continued anoxia intrinsic damage may occur to the hepatic parenchyma so that it cannot dispose of amino acids.


1993 ◽  
Vol 22 (4) ◽  
pp. 269-272 ◽  
Author(s):  
JIMMY ELIZABETH ◽  
JOSEPH SINGARAYAR ◽  
JOHN ELLUL ◽  
DAVID BARER ◽  
MICHAEL LYE

2000 ◽  
Author(s):  
Ralph J. F. Houston ◽  
Jan Menssen ◽  
Marco C. van der Sluijs ◽  
Willy N. Colier ◽  
Berend Oeseburg

PEDIATRICS ◽  
1995 ◽  
Vol 95 (6) ◽  
pp. 860-863 ◽  
Author(s):  
Christian F. Poets ◽  
Valerie A. Stebbens ◽  
David Richard ◽  
David P. Southall

Objective. To determine whether episodes of prolonged hypoxemia occur without prolonged apneic pauses (≥20 seconds) and without bradycardia (pulse rate, ≤100 beats per minute) in apparently well preterm infants. Methods. Long-term recordings of arterial oxygen saturation as measured by pulse oximetry (SpO2), photoplethysmographic (pulse) waveforms from the oximeter, and breathing movements were performed in 96 preterm infants (median gestational age at birth, 34 weeks; range, 28 to 36 weeks) who were breathing room air. Recordings started at a median age of 4 days (range, 1 to 60 days). Results. During a median duration of recording of 25 hours, 88 episodes in which SpO2 fell to 80% or less and remained there for 20 seconds or longer were identified in 15 infants. The median duration of these prolonged desaturations was 27 seconds (range, 20 to 81 seconds). In 73 episodes (83%), SpO2 continued to fall to 60% or less. Twenty-three desaturations were associated with prolonged apneic pauses and 54 with bradycardia; 19 of these were associated with both apnea and bradycardia. Thirty desaturations (34%; 10 infants) occurred without bradycardia and without prolonged apnea. Conclusions. These results indicate that a proportion of apparently well preterm infants exhibit episodes of severe prolonged hypoxemia unaccompanied by prolonged apneic pauses or bradycardia. Such episodes, therefore, would be difficult to detect if only breathing movements and heart rate are monitored. Indications for the use of oxygenation monitors in preterm infants should be reconsidered.


2018 ◽  
Vol 47 (1-3) ◽  
pp. 240-245 ◽  
Author(s):  
Laura M. Rosales ◽  
Hanjie Zhang ◽  
Marilou Mateo ◽  
Brenda Chan ◽  
Israel Campos ◽  
...  

Background: The time between the creation of an arteriovenous fistula (AVF) and its successful use is significantly longer in hemodialysis (HD) patients in the United States compared to those in other countries, and there is an urgent need to reduce the residence time of central-venous catheters (CVC). Methods: Successful AVF creation and maturation results in typical hemodynamic changes, such as an increase in cardiac output and upper body blood flow (UBBF). In patients with CVC as vascular access, we measured once per minute intradialytic central-venous oxygen saturation (ScvO2) and hemoglobin levels simultaneously using the Crit-Line Monitor. Under conditions of stable upper body oxygen consumption and arterial oxygen saturation, ScvO2 and hemoglobin concentration allows the calculation of estimated UBBF (eUBBF). In a quality improvement project, we used ScvO2 and eUBBF to track the hemodynamic changes accompanying AVF maturation. Results: Out of 11 patients (9 incident to HD, 1 female, age 61 ± 13 years), AVF maturation was successful in 9. In 1 patient, the AVF did not mature. One patient died from sudden cardiac death with a maturing AVF. In the 9 patients with successful AVF maturation, ScvO2 increased from 60.9 ± 2.7% prior to AVF creation to 73.4 ± 3.6% a week after AVF creation (19.6 ± 6.3% increase). eUBBF increased from 1.3 ± 0.3 to 2.2 ± 0.6 L/min (62.7 ± 37.5% increase); no material ScvO2 or eUBBF changes occurred in the other 2 patients. Conclusion: Our results indicate the potential utility of ScvO2 and eUBBF to track the hemodynamic response to AVF maturation. To what extent these insights translate into shortening of the time between AVF creation and successful cannulation warrants further investigations.


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