scholarly journals Impact of High-Flow Nasal Cannula on Arterial Blood Gas Parameters in the Emergency Department

Cureus ◽  
2020 ◽  
Author(s):  
Emre Şancı ◽  
Feride Ercan Coşkun ◽  
Basak Bayram
Keyword(s):  
Emergency Department ◽  
High Flow ◽  
Nasal Cannula ◽  
Blood Gas ◽  
High Flow Nasal Cannula ◽  
Arterial Blood Gas ◽  
Arterial Blood ◽  
Blood Gas Parameters

scholarly journals How to treat patients with acute respiratory failure? Conventional oxygen therapy versus high-flow nasal cannula in the emergency department

2019 ◽  
pp. 102490791988624
Author(s):  
Mustafa Gedikloglu ◽  
Muge Gulen ◽  
Salim Satar ◽  
Yahya Kemal Icen ◽  
Akkan Avci ◽  
...  
Keyword(s):  
Respiratory Failure ◽  
Acute Respiratory Failure ◽  
Oxygen Therapy ◽  
Vital Signs ◽  
High Flow ◽  
Nasal Cannula ◽  
Blood Gas ◽  
High Flow Nasal Cannula ◽  
Arterial Blood Gas ◽  
Arterial Blood

Objective: To investigate whether high-flow nasal cannula oxygen therapy could reduce the rate of endotracheal intubation and improve arterial blood gas values, vital signs, and clinical outcomes of patients with hypoxemic acute respiratory failure as compared with conventional oxygen therapy alone. Methods: This retrospective, observational study was performed in the 15-month study period and included adult patients with tachypnea and hypoxemia, whose vital signs and arterial blood gas were monitored. The high-flow nasal cannula oxygen group consisted of patients admitted to the emergency department with acute respiratory failure when high-flow nasal cannula oxygen treatment was available in the hospital, while the conventional oxygen therapy group consisted of patients who have presented to the emergency department with acute respiratory failure in the absence of high-flow nasal cannula oxygen device in the hospital. The primary outcome of the study was improvement in vital signs and arterial blood gas values within first and fourth hours of the treatment. The second outcome was the need for intubation in the emergency department, length of hospital stay, and hospital mortality. Results: The decrease in the pulse and respiratory rate of high-flow nasal cannula oxygen–treated group was significantly greater than the conventional oxygen therapy group on the first and fourth hours of treatment (p < 0.001). PaO2 values were significantly higher in the high-flow nasal cannula oxygen group at the first and fourth hours of treatment (p ⩽ 0.001). Likewise, mean SaO2 levels of patients receiving high-flow nasal cannula oxygen treatment was significantly higher than those of patients in the conventional oxygen therapy group (p = 0.006 at 1 h and p < 0.001 at 4 h). In the hypercapnic patients, the decrease in PaCO2 and increase in pH and PaO2 values were significantly greater in high-flow nasal cannula oxygen group (p < 0.001). The difference between the groups regarding the need for invasive mechanical ventilation was not statistically significant (p = 0.179). Conclusion: High-flow nasal cannula oxygen treatment has been associated with favorable effects in vital signs and arterial blood gas values in patients with acute respiratory failure. High-flow nasal cannula oxygen might be considered as the first-line therapy for patients with hypoxemic and/or hypercapnic acute respiratory failure.

scholarly journals Benefits of High-Flow Nasal Cannula Therapy for Acute Pulmonary Edema in Patients with Heart Failure in the Emergency Department: A Prospective Multi-Center Randomized Controlled Trial

2020 ◽  
Vol 9 (6) ◽  
pp. 1937 ◽  
Author(s):  
Dong Ryul Ko ◽  
Jinho Beom ◽  
Hye Sun Lee ◽  
Je Sung You ◽  
Hyun Soo Chung ◽  
...  
Keyword(s):  
Heart Failure ◽  
Emergency Department ◽  
Pulmonary Edema ◽  
Oxygen Therapy ◽  
Controlled Trial ◽  
High Flow ◽  
Nasal Cannula ◽  
High Flow Nasal Cannula ◽  
Arterial Blood Gas ◽  
Arterial Blood

Heart failure patients with pulmonary edema presenting to the emergency department (ED) require an effective approach to deliver sufficient oxygen and reduce the rate of intubation and mechanical ventilation in the ED; conventional oxygen therapy has proven ineffective in delivering enough oxygen to the tissues. We aimed to identify whether high-flow nasal cannula (HFNC) therapy over time improved the respiratory rate (RR), lactate clearance, and certain arterial blood gas (ABG) parameters, in comparison with conventional oxygen therapy, in patients with cardiogenic pulmonary edema. This prospective, multi-institutional, and interventional study (clinical trial, reference KCT0004578) conducted between 2016 and 2019 included adult patients diagnosed with heart failure within the previous year and pulmonary edema confirmed at admission. Patients were randomly assigned to the conventional or HFNC group and treated with the goal of maintaining oxygen saturation (SpO2) ≥ 93. We obtained RR, SpO2, lactate levels, and ABG parameters at baseline and 30 and 60 min after randomization. All parameters showed greater improvement with HFNC therapy than with conventional therapy. Significant changes in ABG parameters were achieved within 30 min. HFNC therapy could therefore be considered as initial oxygen therapy. Physicians may consider advanced ventilation if there is no significant improvement in ABG parameters within 30 min of HFNC therapy.

scholarly journals Sedative and cardiopulmonary effects of acepromazine, midazolam, butorphanol, acepromazine-butorphanol and midazolam-butorphanol on propofol anaesthesia in goats

2009 ◽  
Vol 80 (1) ◽  
Author(s):  
T.B. Dzikitia ◽  
G.F. Stegmanna ◽  
L.J. Hellebrekers ◽  
R.E.J. Auer ◽  
L.N. Dzikiti
Keyword(s):  
Saline Group ◽  
Control Group ◽  
Blood Gas ◽  
Arterial Blood Gas ◽  
Induction Dose ◽  
Normal Limits ◽  
Arterial Blood ◽  
Blood Gas Parameters ◽  
Induction Of Anaesthesia

The sedative, propofol-sparing and cardiopulmonary effects of acepromazine, midazolam, butorphanol and combinations of butorphanol with acepromazine or midazolam in goats were evaluated. Six healthy Boer - Indigenous African crossbreed goats were by randomised cross-over designated to 6 groups: Group SAL that received saline, Group ACE that received acepromazine, Group MID that received midazolam, Group BUT that received butorphanol, Group ACEBUT that received acepromazine and butorphanol and Group MIDBUT that received midazolam and butorphanol as premedication agents intramuscularly on different occasions at least 3 weeks apart. The degree of sedation was assessed 20 minutes after administration of the premedication agents. Thirty minutes after premedication, the dose of propofol required for induction of anaesthesia adequate to allow placement of an endotracheal tube was determined. Cardiovascular, respiratory and arterial blood-gas parameters were assessed up to 30 minutes after induction of general anaesthesia. Acepromazine and midazolam produced significant sedation when administered alone, but premedication regimens incorporating butorphanol produced inconsistent results. The dose of propofol required for induction of anaesthesia was significantly reduced in goats that received midazolam alone, or midazolam combined with either acepromazine or butorphanol. The quality of induction of anaesthesia was good in all groups, including the control group. Cardiovascular, respiratory and blood-gas parameters were within normal limits in all groups and not significantly different between or within all groups. In conclusion: sedation with midazolam alone, or midazolam combined with either acepromazine or butorphanol significantly reduces the induction dose of propofol with minimal cardiopulmonary effects in goats.

An update report on the harmonization of adult reference intervals in Australasia

2018 ◽  
Vol 0 (0) ◽  
Author(s):  
Gus Koerbin ◽  
Ken Sikaris ◽  
Graham R.D. Jones ◽  
Robert Flatman ◽  
Jillian R. Tate
Keyword(s):  
Royal College ◽  
Clinical Chemistry ◽  
Metrological Traceability ◽  
Reference Intervals ◽  
Evidence Based ◽  
Blood Gas ◽  
Arterial Blood Gas ◽  
The Past ◽  
Arterial Blood ◽  
Blood Gas Parameters

Abstract The Australasian Association of Clinical Biochemists (AACB) has over the past 5 years been actively working to achieve harmonized reference intervals (RIs) for common clinical chemistry analytes using an evidence-based checklist approach where there is sound calibration and metrological traceability. It has now recommended harmonized RIs for 18 common clinical chemistry analytes which are performed in most routine laboratories and these have been endorsed by the Royal College of Pathologists of Australasia (RCPA). In 2017 another group of analytes including urea, albumin and arterial blood gas parameters were considered and suggested harmonized RIs proposed. This report provides an update of those harmonization efforts.

A Model Pilot

2020 ◽  
pp. 71-76
Author(s):  
Pat Croskerry
Keyword(s):  
Emergency Department ◽  
Respiratory Rate ◽  
Correct Diagnosis ◽  
Anxiety State ◽  
Blood Gas ◽  
Blurred Vision ◽  
Arterial Blood Gas ◽  
The Past ◽  
Arterial Blood ◽  
Eye Examination

In this case, a 43-year-old male presents to the emergency department complaining of blurred vision during the past few days. He appears apprehensive. His eye examination is completely normal. On the basis of his increased respiratory rate and apprehension, a diagnosis of anxiety state is made, and he is discharged home. He returns the next day with continuing symptoms. On this occasion, an arterial blood gas is ordered, which eventually reveals his correct diagnosis.

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