scholarly journals Utilization of a Swine (Sus scrofa) Model for Lipid Emulsion Resuscitation Studies

2012 ◽  
Vol 2012 ◽  
pp. 1-5 ◽  
Author(s):  
Carrie Crane ◽  
Eileen Sagini ◽  
Arthur D. Johnson ◽  
Joseph O'Sullivan
Keyword(s):  
Effect Size ◽  
Inflammatory Markers ◽  
Lipid Emulsion ◽  
Drug Carrier ◽  
Blood Gas Analysis ◽  
Gas Analysis ◽  
Before And After ◽  
Within Subjects ◽  
Using Data ◽  
Cardio Vascular

Background. There have been some discussions that using swine or rabbits in a resuscitation model to study lipid emulsion infusions may be inappropriate because of a consistent “pseudoallergic” reaction that has been found in lipid-based nanoparticle liposome drug carrier systems. Assertions have been made that the lipid emulsions may contain a certain amount of liposomes; therefore swine may not be an appropriate model for study. Methods. This study was prospective, crossover design within subjects, and research design with each Yorkshire swine receiving a 20% lipid bolus infusion followed by a lipid infusion for 10 min. Each swine had a total of four blood draws and each draw had complete blood gas analysis with three different types of inflammatory markers examined. Cardio vascular monitoring was performed every 2 minutes. Results. Using data reported in similar studies, a large effect size of 0.6 was calculated. Using the effect size of 0.6, a power of 0.8 and an alpha of 0.05 it was determined that a sample size of five swine was needed. There were no significant changes in any CV parameter both before and after lipid emulsion. Likewise there were no significant changes in any of the blood tests, nor any inflammatory markers. Conclusions. There were no significant changes in the examined parameters with swine before and after lipid emulsion infusions. It is suggested that due to the close size of swine to humans, similar physiology, and ease of using these animals, they may be utilized for lipid emulsion studies.

Salbutamol by Intermittent Positive Pressure Ventilation in Status Asthmaticus

1974 ◽  
Vol 19 (4) ◽  
pp. 191-195 ◽  
Author(s):  
Y. F. J. Choo-Kang ◽  
A. E. Tribe ◽  
I. W. B. Grant
Keyword(s):  
Status Asthmaticus ◽  
Blood Gas Analysis ◽  
Intermittent Positive Pressure Ventilation ◽  
Gas Analysis ◽  
Positive Pressure ◽  
Arterial Blood Gas ◽  
Arterial Blood ◽  
Arterial Blood Gas Analysis ◽  
Predictable Pattern ◽  
Before And After

A wet aerosol of 0.5 per cent salbutamol was administered for 3 minutes via a Bennett intermittent positive pressure ventilator driven by compressed air to 8 patients considered to be in status asthmaticus. Arterial blood gas analysis performed before and after salbutamol administration showed marked individual rises and falls in the partial pressure of oxygen with no predictable pattern of response. No dysrhythmia was observed on the E.C.G. but small changes of a non-specific nature occurred in the level of S-T segments and in the height of T-waves. It was concluded that in the dosage employed a salbutamol aerosol administered by I.P.P.V. produced no significant disturbance of myocardial function.

Effectiveness of home-based preoperative pulmonary rehabilitation in COPD patients undergoing lung cancer resection

2020 ◽  
Vol 106 (3) ◽  
pp. 203-211 ◽  
Author(s):  
Marco Rispoli ◽  
Rosario Salvi ◽  
Antonio Cennamo ◽  
Davide Di Natale ◽  
Giovanni Natale ◽  
...  
Keyword(s):  
Blood Gas Analysis ◽  
Rehabilitation Program ◽  
Pulmonary Complications ◽  
Gas Analysis ◽  
Blood Gas ◽  
Postoperative Pulmonary Complications ◽  
Home Based ◽  
Before And After ◽  
Group A ◽  
Group B

Objective: To investigate the effectiveness of a home-based preoperative rehabilitation program for improving preoperative lung function and surgical outcome of patients with chronic obstructive pulmonary disease (COPD) undergoing lobectomy for cancer. Methods: This was a prospective, observational, single-center study including 59 patients with mild COPD who underwent lobectomy for lung cancer. All patients attended a home-based preoperative rehabilitation program including a minimum of 3 sessions each week for 4 weeks. Each session included aerobic and anaerobic exercises. Participants recorded the frequency and the duration of exercise performed in a diary. The primary end point was to evaluate changes in lung function including predicted postoperative (PPO) forced expiratory volume in 1 second (FEV1), 6-minute walking distance test (6MWD), PPO diffusing capacity for carbon monoxide (DLCO) %, and blood gas analysis values before and after the rehabilitation program. Postoperative pulmonary complications were recorded and multivariable analysis was used to identify independent prognostic factors (secondary end point). Results: All patients completed the 4-week rehabilitation program. Thirteen of 59 (22%) patients (Group A) performed <3 sessions per week (mean sessions per week: 2.3±1.3); 46 of 59 (78%) patients (Group B) performed ⩾3 sessions per week (mean sessions per week: 3.5±1.6). The comparison of PPO FEV1% and 6MWD before and after rehabilitation showed a significant improvement only in Group B. No significant changes in PPO DLCO% or in blood gas analysis values were seen. Nine patients presented postoperative pulmonary complications, including atelectasis ( n = 6), pneumonia ( n = 1), respiratory failure ( n = 1), and pulmonary embolism ( n = 1). Group A presented higher number of postoperative pulmonary complications than Group B (6 vs 3; p = 0.0005). Multivariate analysis showed that the number of weekly rehabilitation sessions was the only independent predictive factor ( p = 0.001). Conclusions: Our simple and low-cost rehabilitation program could improve preoperative clinical function in patients with mild to moderate COPD undergoing lobectomy and reduce postoperative pulmonary complications. All patients should be motivated to complete at least 3 rehabilitation sessions per week in order to obtain significant clinical benefits. Our preliminary results should be confirmed by larger prospective studies.

scholarly journals Evaluation of the clinical and cardiorespiratory effects of propofol microemulsion in dogs

2013 ◽  
Vol 43 (6) ◽  
pp. 1107-1113 ◽  
Author(s):  
André Luís Corrêa ◽  
Renato Batista Tamanho ◽  
Aury Nunes de Moraes ◽  
Suzane Lilian Beier ◽  
Doughlas Regalin ◽  
...  
Keyword(s):  
Lipid Emulsion ◽  
Droplet Diameter ◽  
Blood Gas Analysis ◽  
Gas Analysis ◽  
Total Recovery ◽  
Arterial Blood ◽  
Respiratory Parameters ◽  
Constant Rate ◽  
Healthy Female ◽  
Hemodynamic Characteristics

This research aimed to evaluate the clinical and cardiorespiratory effects of a propofol formulation with nanometer droplet diameter in dogs. Six adult healthy female dogs weighing 14.8±1.2kg were used in this study. Each dog received two treatments with a 15-day washout period. A microemulsion (MICRO) or lipid emulsion (EMU) of propofol was administered intravenously (IV) for induction and maintenance of anesthesia. Anesthesia was maintained with a constant rate infusion of propofol (0.4mg kg-1 minute-1). Cardiorespiratory variables were recorded before induction (baseline), immediately after and at 15-minute intervals for 90 minutes after treatment. Arterial blood samples were also taken for blood gas analysis, except at 45 and 75 minutes after induction. The mean arterial pressure decreased significantly during both treatments, while the cardiac index decreased significantly only in MICRO treatment. The time to extubation, sternal recumbency, ambulation and total recovery was similar in both treatments. Opisthotonos was observed in 33% of the animals in each treatment. The propofol microemulsion presented clinical and respiratory parameters similar to those obtained with the lipid emulsion commercially available, but had some significantly different hemodynamic characteristics when used for inducing and maintaining anesthesia. Based only in these results, no advantages are seen in the use of this new microemulsion.

Clinically Meaningful Change

Methodology ◽  
2019 ◽  
Vol 15 (3) ◽  
pp. 97-105
Author(s):  
Rodrigo Ferrer ◽  
Antonio Pardo
Keyword(s):  
Effect Size ◽  
False Negative ◽  
False Negative Rate ◽  
Point Of View ◽  
Skewed Distribution ◽  
Effect Sizes ◽  
False Negatives ◽  
Large Size ◽  
Before And After ◽  
Post Test

Abstract. In a recent paper, Ferrer and Pardo (2014) tested several distribution-based methods designed to assess when test scores obtained before and after an intervention reflect a statistically reliable change. However, we still do not know how these methods perform from the point of view of false negatives. For this purpose, we have simulated change scenarios (different effect sizes in a pre-post-test design) with distributions of different shapes and with different sample sizes. For each simulated scenario, we generated 1,000 samples. In each sample, we recorded the false-negative rate of the five distribution-based methods with the best performance from the point of view of the false positives. Our results have revealed unacceptable rates of false negatives even with effects of very large size, starting from 31.8% in an optimistic scenario (effect size of 2.0 and a normal distribution) to 99.9% in the worst scenario (effect size of 0.2 and a highly skewed distribution). Therefore, our results suggest that the widely used distribution-based methods must be applied with caution in a clinical context, because they need huge effect sizes to detect a true change. However, we made some considerations regarding the effect size and the cut-off points commonly used which allow us to be more precise in our estimates.

Efficacy of Near-Infrared Spectrometry for Monitoring the Cerebral Effects of Severe Dilutional Anemia

2014 ◽  
Vol 17 (3) ◽  
pp. 154 ◽  
Author(s):  
Arıtürk Cem ◽  
Ustalar Serpil ◽  
Toraman Fevzi ◽  
Ökten Murat ◽  
Güllü Ümit ◽  
...  
Keyword(s):  
Blood Flow ◽  
Cardiac Surgery ◽  
Blood Lactate ◽  
Near Infrared ◽  
Bypass Graft ◽  
Blood Gas Analysis ◽  
Gas Analysis ◽  
Infrared Spectrometry ◽  
Control Group ◽  
Near Infrared Spectrometry

<p><strong>Introduction:</strong> Clear guidelines for red cell transfusion during cardiac surgery have not yet been established. The current focus on blood conservation during cardiac surgery has increased the urgency to determine the minimum safe hematocrit for these patients. The aim of this study was to determine whether monitoring of cerebral regional oxygen saturation (rSO<sub>2</sub>) via near-infrared spectrometry (NIRS) is effective for assessing the cerebral effects of severe dilutional anemia during elective coronary arterial bypass graft surgery (CABG).</p><p><strong>Methods:</strong> The prospective observational study involved patients who underwent cerebral rSO<sub>2</sub> monitoring by NIRS during elective isolated first-time CABG: an anemic group (<em>N</em>=15) (minimum Hemoglobin (Hb) N=15) (Hb &gt;8 g/dL during CPB). Mean arterial pressure (MAP), pump blood flow, blood lactate level, pCO<sub>2</sub>, pO<sub>2</sub> at five time points and cross-clamp time, extracorporeal circulation time were recorded for each patient. Group results statistically were compared.</p><p><strong>Results:</strong> The anemic group had significantly lower mean preoperative Hb than the control group (10.3 mg/dL versus 14.2 mg/dL; <em>P</em> = .001). The lowest Hb levels were observed in the hypothermic period of CPB in the anemic group. None of the controls exhibited a &gt;20% decrease in cerebral rSO<sub>2</sub>. Eleven (73.3%) of the anemic patients required an increase in pump blood flow to raise their cerebral rSO<sub>2</sub>.</p><p><strong>Conclusions:</strong> In this study, the changes in cerebral rSO<sub>2</sub> in the patients with low Hb were within acceptable limits, and this was in concordance with the blood lactate levels and blood-gas analysis. It can be suggested that NIRS monitoring of cerebral rSO<sub>2</sub> can assist in decision making related to blood transfusion and dilutional anemia during CPB.</p>

Blood gas analysis in newborns with low cardiac output syndrome after cardiac surgery.

2018 ◽  
Vol 19 (5) ◽  
pp. 676-687
Author(s):  
G.G. Khubulava ◽  
A.B. Naumov ◽  
S.P. Marchenko ◽  
O.Yu. Chupaeva ◽  
A.A. Seliverstova ◽  
...  
Keyword(s):  
Cardiac Output ◽  
Cardiac Surgery ◽  
Blood Gas Analysis ◽  
Gas Analysis ◽  
Blood Gas ◽  
Low Cardiac Output Syndrome ◽  
Low Cardiac Output

Prognostic Value of Oxygenated Hemoglobin Assessed during Acute Exacerbations of Chronic Pulmonary Disease

Respiration ◽  
2021 ◽  
pp. 1-8
Author(s):  
Clemens F. Hinke ◽  
Rudolf A. Jörres ◽  
Peter Alter ◽  
Robert Bals ◽  
Florian Bornitz ◽  
...  
Keyword(s):  
Pulmonary Disease ◽  
Predictive Value ◽  
Hemoglobin Concentration ◽  
Blood Gas Analysis ◽  
Study Data ◽  
Gas Analysis ◽  
Chronic Obstructive ◽  
Acute Exacerbations ◽  
All Cause Mortality

<b><i>Background:</i></b> Oxygenated hemoglobin(OxyHem) is a simple-to-measure marker of oxygen content capable of predicting all-cause mortality in stable chronic obstructive pulmonary disease (COPD). <b><i>Objectives:</i></b> We aimed to analyze its predictive value during acute exacerbations of COPD (AECOPD). <b><i>Methods:</i></b> In this retrospective study, data from 227 patients discharged after severe AECOPD at RoMed Clinical Center Rosenheim, Germany, between January 2012 and March 2018, was analyzed. OxyHem (hemoglobin concentration [Hb] × fractional SpO<sub>2</sub>, g/dL) was calculated from oxygen saturation measured by pulse oximetry and hemoglobin assessed within 24 h after admission. The follow-up (1.7 ± 1.5 years) covered all-cause mortality, including readmissions for severe AECOPD. <b><i>Results:</i></b> During the follow-up period, 127 patients died, 56 due to AECOPD and 71 due to other reasons. Survivors and non-survivors showed differences in age, FVC % predicted, C-reactive protein, hemoglobin, Cr, Charlson Comorbidity Index (CCI), and OxyHem (<i>p</i> &#x3c; 0.05 each). Significant independent predictors of survival were BMI, Cr or CCI, FEV<sub>1</sub> % predicted or FVC % predicted, Hb, or OxyHem. The predictive value of OxyHem (<i>p</i> = 0.006) was superior to that of Hb or SpO<sub>2</sub> and independent of oxygen supply during blood gas analysis. OxyHem was also predictive when using a cutoff value of 12.1 g/dL identified via receiver operating characteristic curves in analyses including either the CCI (hazard ratio 1.85; 95% CI 1.20, 2.84; <i>p</i> = 0.005) or Cr (2.04; 95% CI 1.35, 3.10; <i>p</i> = 0.001) as covariates. <b><i>Conclusion:</i></b> The concentration of OxyHem provides independent, easy-to-assess information on long-term mortality risk in COPD, even if measured during acute exacerbations. It therefore seems worth to be considered for broader clinical use.

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