AIM: To study the effect of oral garlic on arterial oxygen pressure in children with hepatopulmonary syndrome, METHODS: Garlic powder in a capsule form was given to 15 children with hepatopulmonary syndrome (confir...AIM: To study the effect of oral garlic on arterial oxygen pressure in children with hepatopulmonary syndrome, METHODS: Garlic powder in a capsule form was given to 15 children with hepatopulmonary syndrome (confirmed by contrast echocardiography) at the dosage of 1 g/1.73 m^2 per day. Patients were evaluated clinically and by arterial blood gas every four weeks. RESULTS: The garlic capsule was administered to 15 patients with hepatopulmonary syndrome. There were 10 boys and 5 girls with a mean age of 9.4 ± 3.9 years. The underlying problems were biliary tract atresia (4 patients), autoimmune hepatitis (4 patients), cryptogenic cirrhosis (4 patients) and presinusoidal portal hypertension (3 patients). Eight patients (53.3%) showed an increase of 10 mmHg in their mean arterial oxygen pressure. The baseline PaO2 was 65.6 ± 12.1 mmHg in the responder group and 47.1 ± 11.2 mmHg in nonresponder group. At the end of treatment the mean PaO2 in responders and non-responders was 92.2 ± 7.75 mmHg and 47.5 ± 11.87 mmHg, respectively (P 〈 0.01). CONCLUSION: Garlic may increase oxygenation and improve dyspnea in children with hepatopulmonary syndrome.展开更多
Objective: To evaluate the effects of treatment of integrative Chinese and Western medicine (ICWM) on arterial oxygen saturation (SaO2) in patients with severe acute respiratory syndrome (SARS). Methods:The non-random...Objective: To evaluate the effects of treatment of integrative Chinese and Western medicine (ICWM) on arterial oxygen saturation (SaO2) in patients with severe acute respiratory syndrome (SARS). Methods:The non-randomized, controlled trial was conducted on 447 SARS patients treated synchronously with western conventional treatment (WM group, n = 171) alone and ICWM (ICWM group, n = 276). The changes of the cases with normal level (≥95% ) or abnormal level (<95% ) SaO2 were observed dynamically. Results: In the 3rd-14th day of the therapeutic course, the percentage of patients with normal SaO2 in the ICWM group was higher than that in the WM group (OR = 0.5178, P = 0.0038), and this tendency was more evident in patients of the severe type (OR = 0. 18, P = 0. 0001). However, the statistical significance of difference was only shown in patients for whom the ICWM treatment started in the early period after the onset (≤7 days after it, OR = 0.3803, P = 0.006), but not shown in those who received ICWM treatment later in the mid-late period of SARS ( P>0. 05). Conclusion: ICWM treatment, particularly when it is used for intervention in the early stage, is beneficial for maintaining normal SaO2 in SARS patients.展开更多
Hepatocellular carcinoma(HCC) is among the most common malignant tumors worldwide, and transcatheter arterial chemoembolization(TACE) technology has become the first-line treatment for advanced HCC. Another important,...Hepatocellular carcinoma(HCC) is among the most common malignant tumors worldwide, and transcatheter arterial chemoembolization(TACE) technology has become the first-line treatment for advanced HCC. Another important, recently developed technique is blood oxygen level–dependent functional magnetic resonance imaging(BOLD-fMRI), which utilizes hemoglobin as an endogenous contrast agent and measures deoxygenated hemoglobin content by sampling the oxygen content of tissues, thus reflecting the hemodynamics and pathophysiologic changes in body organs. Currently this technology is being used in patients with liver tumors;that is, it serves as an important tool in follow-up after TACE. The present paper summarizes these developments.展开更多
The current survival sepsis guideline proposes the use of vasopressors and fluid resuscitation to maintain the mean arterial pressure (MAP) ≥ 65 mmHg. Titrating catecholamine infusion to achieve higher MAP has been d...The current survival sepsis guideline proposes the use of vasopressors and fluid resuscitation to maintain the mean arterial pressure (MAP) ≥ 65 mmHg. Titrating catecholamine infusion to achieve higher MAP has been demonstrated to improve tissue oxygenation, microcirculation, renal function and overall outcome of the patient in some studies and literature on actual hemodynamic goals is scarce. AIM: To study the influence of two MAP on tissue oxygenation and perfusion parameters in patients of septic shock on norepinephrine infusion. SUBJECT AND MATERIALS: Forty adult patients with the diagnosis of septic shock were enrolled. In all patients norepinephrine was titrated to first stabilize the MAP at 65 ± 5 mmHg (Set I), followed by MAP of 85 ± 5 mmHg (Set II). Heart rate (HR), Central venous oxygen saturation (SCVO2), Transcutaneous partial pressure of oxygen (PtcO2) by TCM 400/TINA (using miniature Clark electrode), Arterial partial pressure of oxygen(PaO2), PtO2/PaO2 ratio, Urine output and Serum Base deficit were recorded in each Set after 2 hrs of stabilization. RESULTS: There was a significant increase in transcutaneous partial pressure of oxygen PtcO2 (p tO2/PaO2 (p < 0.0001), ScvO2 (p < 0.0001), urine output (p < 0.006) on increasing the MAP from 65mmHg to 85mmHg. Serum base deficit also improved (p < 0.0001). CONCLUSION: Higher MAP with norepinephrine is associated with better perfusion, oxygenation parameters in patients with established septic shock. These findings suggest that there is improvement in tissue oxygenation parameters using escalating doses of norepinephrine to achieve higher MAP without inherent adverse展开更多
Background: The concentration of supplemental O2 should be measured during general anesthesia to determine whether patients’ pressure of arterial oxygen (PaO2) is correct. Nevertheless, we do not know standard value ...Background: The concentration of supplemental O2 should be measured during general anesthesia to determine whether patients’ pressure of arterial oxygen (PaO2) is correct. Nevertheless, we do not know standard value of PaO2 by age in supine position during general anesthesia. In this study, we evaluated the PaO2 by age at 33% or 40% O2 concentration. Materials and Methods: We retrospectively reviewed the anesthetic charts of 660 patients who were received general anesthesia from January 2001 to December 2013. Patients were divided into two groups by concentration of fraction of inspiratory oxygen: group at 33% or 40%. Second, patients aged 16 - 85 years were classified into 7 groups by age with each group covering one decade. Results: The PaO2 was 185.1 ± 19.2 mmHg (33%) and 209.8 ± 19.8 mmHg (40%) at age 16 - 25 years, 178.7 ± 23.6 mmHg (33%) and 202.7 ± 26.0 mmHg (40%) at age 26 - 35 years, 165.8 ± 30.6 mmHg (33%) and 188.9 ± 22.2 (40%) mmHg at age 36 - 45 years, 154.1 ± 22.8 mmHg (33%) and 181.8 ± 19.2 (40%) mmHg at age 46 - 55 years, 153.7 ± 21.7 mmHg (33%) and 177.5 ± 18.1 mmHg (40%) at age 56 - 65 years, 152.2 ± 24.5 mmHg and 171.0 ± 22.1 mmHg at age 66 - 75 years, and 154.6 ± 24.3 mmHg and 174.1 ± 20.2 mmHg at age 76 - 85 years. Conclusion: The PaO2 tended to decrease with age at both 33% and 40% O2 concentration.展开更多
Background: Anesthetists should measure the concentration of supplemental oxygen to determine whether patients’ partial pressure of arterial oxygen (PaO2) is correct during general anesthesia. However, the standard P...Background: Anesthetists should measure the concentration of supplemental oxygen to determine whether patients’ partial pressure of arterial oxygen (PaO2) is correct during general anesthesia. However, the standard PaO2 value in obese patients in the supine position is unknown. We evaluated the PaO2 with respect to the Broca-Katsura obesity index. Materials and Methods: From January 2001 to December 2013, we evaluated 472 patients aged ≥16 years old that underwent general anesthesia in the supine position. The anesthetic charts of 472 patients with an American Society of Anesthesiologists physical status of I or II were retrospectively reviewed to investigate the PaO2. Results: In patients aged 16 to 2 was 165.7 ± 25.6 mmHg at a Broca-Katsura index of 2 was 152.1 ± 23.8 mmHg at a Broca-Katsura index of 2 tended to decrease with age from 16 to 2 tended to decrease with age from 16 to <65 years at a Broca-Katsura index of 20% to <40%.展开更多
The correlation between pulmonary endothelin receptors and alveolar-arterial oxygen gradient (A aDO2) in rats with hepatopulmonary syndrome was investigated. Animals were divided into 2 groups: Sham operated (Sham...The correlation between pulmonary endothelin receptors and alveolar-arterial oxygen gradient (A aDO2) in rats with hepatopulmonary syndrome was investigated. Animals were divided into 2 groups: Sham operated (Sham) group and common bile duct ligation (CBDL) group. Arterial blood gas was evaluated by a blood gas analyzer. The concentrations of ET-1 in blood and lung tissue sample were evaluated by radioimmunoassay. The distribution and expression of two kinds of subtype receptor of ET-1, ETRA and ETRB were examined by in situ hybridization. The results showed that the level of A aDO2, was higher in CBDI. group than that in Sham group (P〈0.05). The levels of plasma and pulmonary ET-1 in CBDL group were both higher than in Sham group (P〈0.05 ). There was no significant difference in average A of ETRA between two groups by imaging analysis (0.21±0.06 vs 0.22±0.08, P〉0.05), while that of ETRB was higher in CBDI. group than in Sham group (0.58±0.16 vs 0.28±0.07, P〈0.05). The expression of ETRBinlung was positively correlated with A aDO2(P〈0.05). It was concluded that the widened A-aDO2 may be related with enhancement of the expression of ETRB in lung.展开更多
Objective:To explore the easily applicable indicators of practical value to evaluate the prognosis of acute respiratory distress syndrome(ARDS).Methods:Blood and biochemical tests and bloodgas analyses were performe...Objective:To explore the easily applicable indicators of practical value to evaluate the prognosis of acute respiratory distress syndrome(ARDS).Methods:Blood and biochemical tests and bloodgas analyses were performed upon entry into the ICUs,12 h,24 h,48 h and 72 h after that in 72 ARDS patients(who were admitted to the ICUs of our hospital from January 2000 to December 2009).Then APACHEⅡscores were achieved by combining relevant physiological parameters and laboratory results.Results:There was a statistical difference between the death group and survival group at different time points upon entering the ICUs in terms of APACHEⅡscore, alveolar-arterial oxygen difference and arterial blood lactate clearance rate.PaO<sub>2</sub>/FiO<sub>2</sub> values were recorded to be statistically different between the death group and survival group 24 h,48 h and 72 h,respectively after entry into the ICUs.In addition,registered linear regression existed between APACHEⅡscore,alveolar-arterial oxygen difference or PaO<sub>2</sub>/FiO<sub>2</sub> value and time. APACHEⅡscore 24 h and 72 h after entering ICUs predicted mortality with an area under the ROC curve(AUC) standing respectively at 0.919 and 0.9SS.Arterial blood lactate clearance rate 12 h, 24 h,48 h and 72 h after entering ICUs predicted mortality with an area under the ROC curve (AUC) at 0.918,0.918,0.909 and 0.991,respectively.Conclusions:APACHEⅡscore applied in combination with arterial blood lactate clearance rate is of clinical significance in assessing the prognosis of ARDS patients.展开更多
To investigate the effect of aerobic exercise combined with whole-body vibration (WBV) training on metabolic syndrome risk, and inflammatory markers, and to compare its effects on arterial stiffness and several blood ...To investigate the effect of aerobic exercise combined with whole-body vibration (WBV) training on metabolic syndrome risk, and inflammatory markers, and to compare its effects on arterial stiffness and several blood parameters related to metabolic syndrome with those of aerobic training alone. Thirty healthy participants were divided into 2 groups matched for age and body mass index (BMI). Fifteen subjects were assigned to the WBV group (WBV + aerobic training) and the other 15 to the control group (aerobic training only). All participants performed a treadmill exercise 3 days/week for 4 weeks, for 50 min after 30 min rest period. Exercise was performed at a heart rate (HR) corresponding to 60% of the HR at each individual’s maximum oxygen uptake (VO2max). Body weight and BMI after training were significantly lower than those before training in the WBV group (P < 0.01). Concerning arterial stiffness, the pulse-wave velocity after training was significantly lower than that before training in the WBV group (1048.7 ± 105.6 vs. 1008.4 ± 101.1 cm/s, P < 0.05). Meanwhile, the VO2max after training was significantly higher than that before training in the WBV group (47.7 ± 12.8 vs. 51.4 ± 14.1 mL·min-1·kg-1, P < 0.01). However, no significant differences were observed in any parameters before and after training in the control group. Our results suggest that aerobic exercise combined with WBV training may be effective in reducing arterial stiffness and improving cardiorespiratory fitness than aerobic training alone.展开更多
The mixed venous-to-arterial carbon dioxide(CO_2)tension difference[P(v-a) CO_2]is the difference between carbon dioxide tension(PCO_2) in mixed venous blood(sampled from a pulmonary artery catheter) and the PCO_2 in ...The mixed venous-to-arterial carbon dioxide(CO_2)tension difference[P(v-a) CO_2]is the difference between carbon dioxide tension(PCO_2) in mixed venous blood(sampled from a pulmonary artery catheter) and the PCO_2 in arterial blood.P(v-a) CO_2 depends on the cardiac output and the global CO_2 production,and on the complex relationship between PCO_2 and CO_2 content.Experimental and clinical studies support the evidence that P(v-a) CO_2 cannot serve as an indicator of tissue hypoxia,and should be regarded as an indicator of the adequacy of venous blood to wash out the total CO_2generated by the peripheral tissues.P(v-a) CO_2 can be replaced by the central venous-to-arterial CO_2 difference(△PCO_2),which is calculated from simultaneous sampling of central venous blood from a central vein catheter and arterial blood and,therefore,more easy to obtain at the bedside.Determining the △PCO_2 during the resuscitation of septic shock patients might be useful when deciding when to continue resuscitation despite a central venous oxygen saturation(SCVO_2) > 70%associated with elevated blood lactate levels.Because high blood lactate levels is not a discriminatory factor in determining the source of that stress,an increased △PCO_2(> 6 mmHg)could be used to identify patients who still remain inadequately resuscitated.Monitoring the △PCO_2 from the beginning of the reanimation of septic shock patients might be a valuable means to evaluate the adequacy of cardiac output in tissue perfusion and,thus,guiding the therapy.In this respect,it can aid to titrate inotropes to adjust oxygen delivery to CO_2 production,or to choose between hemoglobin correction or fluid/inotrope infusion in patients with a too low ScvO_2 related to metabolic demand.The combination of P(v-a) CO_2 or △PCO_2 with oxygen-derived parameters through the calculation of the P(v-a) CO_2 or △PCO_2/arteriovenous oxygen content difference ratio can detect the presence of global anaerobic metabolism.展开更多
文摘AIM: To study the effect of oral garlic on arterial oxygen pressure in children with hepatopulmonary syndrome, METHODS: Garlic powder in a capsule form was given to 15 children with hepatopulmonary syndrome (confirmed by contrast echocardiography) at the dosage of 1 g/1.73 m^2 per day. Patients were evaluated clinically and by arterial blood gas every four weeks. RESULTS: The garlic capsule was administered to 15 patients with hepatopulmonary syndrome. There were 10 boys and 5 girls with a mean age of 9.4 ± 3.9 years. The underlying problems were biliary tract atresia (4 patients), autoimmune hepatitis (4 patients), cryptogenic cirrhosis (4 patients) and presinusoidal portal hypertension (3 patients). Eight patients (53.3%) showed an increase of 10 mmHg in their mean arterial oxygen pressure. The baseline PaO2 was 65.6 ± 12.1 mmHg in the responder group and 47.1 ± 11.2 mmHg in nonresponder group. At the end of treatment the mean PaO2 in responders and non-responders was 92.2 ± 7.75 mmHg and 47.5 ± 11.87 mmHg, respectively (P 〈 0.01). CONCLUSION: Garlic may increase oxygenation and improve dyspnea in children with hepatopulmonary syndrome.
基金This item is one of the items of State 863 Plan (No.2003AA208101) a special subject of clinical study of State administration of TCM an important item of Beijing Scientific-Technology Plan(No. H020920010031)
文摘Objective: To evaluate the effects of treatment of integrative Chinese and Western medicine (ICWM) on arterial oxygen saturation (SaO2) in patients with severe acute respiratory syndrome (SARS). Methods:The non-randomized, controlled trial was conducted on 447 SARS patients treated synchronously with western conventional treatment (WM group, n = 171) alone and ICWM (ICWM group, n = 276). The changes of the cases with normal level (≥95% ) or abnormal level (<95% ) SaO2 were observed dynamically. Results: In the 3rd-14th day of the therapeutic course, the percentage of patients with normal SaO2 in the ICWM group was higher than that in the WM group (OR = 0.5178, P = 0.0038), and this tendency was more evident in patients of the severe type (OR = 0. 18, P = 0. 0001). However, the statistical significance of difference was only shown in patients for whom the ICWM treatment started in the early period after the onset (≤7 days after it, OR = 0.3803, P = 0.006), but not shown in those who received ICWM treatment later in the mid-late period of SARS ( P>0. 05). Conclusion: ICWM treatment, particularly when it is used for intervention in the early stage, is beneficial for maintaining normal SaO2 in SARS patients.
基金supported by the National Natural Science Foundation of China (Nos. 81571784 30870695)+2 种基金the Provincial Natural Science Foundation of Hunan (2019JJ531)the Foundation of Hunan Province and Technology Department, China (No. 2015SF2020-4)the Foundation of Hunan Provincial Development and the Reform Commission, China (No. 201583)
文摘Hepatocellular carcinoma(HCC) is among the most common malignant tumors worldwide, and transcatheter arterial chemoembolization(TACE) technology has become the first-line treatment for advanced HCC. Another important, recently developed technique is blood oxygen level–dependent functional magnetic resonance imaging(BOLD-fMRI), which utilizes hemoglobin as an endogenous contrast agent and measures deoxygenated hemoglobin content by sampling the oxygen content of tissues, thus reflecting the hemodynamics and pathophysiologic changes in body organs. Currently this technology is being used in patients with liver tumors;that is, it serves as an important tool in follow-up after TACE. The present paper summarizes these developments.
文摘The current survival sepsis guideline proposes the use of vasopressors and fluid resuscitation to maintain the mean arterial pressure (MAP) ≥ 65 mmHg. Titrating catecholamine infusion to achieve higher MAP has been demonstrated to improve tissue oxygenation, microcirculation, renal function and overall outcome of the patient in some studies and literature on actual hemodynamic goals is scarce. AIM: To study the influence of two MAP on tissue oxygenation and perfusion parameters in patients of septic shock on norepinephrine infusion. SUBJECT AND MATERIALS: Forty adult patients with the diagnosis of septic shock were enrolled. In all patients norepinephrine was titrated to first stabilize the MAP at 65 ± 5 mmHg (Set I), followed by MAP of 85 ± 5 mmHg (Set II). Heart rate (HR), Central venous oxygen saturation (SCVO2), Transcutaneous partial pressure of oxygen (PtcO2) by TCM 400/TINA (using miniature Clark electrode), Arterial partial pressure of oxygen(PaO2), PtO2/PaO2 ratio, Urine output and Serum Base deficit were recorded in each Set after 2 hrs of stabilization. RESULTS: There was a significant increase in transcutaneous partial pressure of oxygen PtcO2 (p tO2/PaO2 (p < 0.0001), ScvO2 (p < 0.0001), urine output (p < 0.006) on increasing the MAP from 65mmHg to 85mmHg. Serum base deficit also improved (p < 0.0001). CONCLUSION: Higher MAP with norepinephrine is associated with better perfusion, oxygenation parameters in patients with established septic shock. These findings suggest that there is improvement in tissue oxygenation parameters using escalating doses of norepinephrine to achieve higher MAP without inherent adverse
文摘Background: The concentration of supplemental O2 should be measured during general anesthesia to determine whether patients’ pressure of arterial oxygen (PaO2) is correct. Nevertheless, we do not know standard value of PaO2 by age in supine position during general anesthesia. In this study, we evaluated the PaO2 by age at 33% or 40% O2 concentration. Materials and Methods: We retrospectively reviewed the anesthetic charts of 660 patients who were received general anesthesia from January 2001 to December 2013. Patients were divided into two groups by concentration of fraction of inspiratory oxygen: group at 33% or 40%. Second, patients aged 16 - 85 years were classified into 7 groups by age with each group covering one decade. Results: The PaO2 was 185.1 ± 19.2 mmHg (33%) and 209.8 ± 19.8 mmHg (40%) at age 16 - 25 years, 178.7 ± 23.6 mmHg (33%) and 202.7 ± 26.0 mmHg (40%) at age 26 - 35 years, 165.8 ± 30.6 mmHg (33%) and 188.9 ± 22.2 (40%) mmHg at age 36 - 45 years, 154.1 ± 22.8 mmHg (33%) and 181.8 ± 19.2 (40%) mmHg at age 46 - 55 years, 153.7 ± 21.7 mmHg (33%) and 177.5 ± 18.1 mmHg (40%) at age 56 - 65 years, 152.2 ± 24.5 mmHg and 171.0 ± 22.1 mmHg at age 66 - 75 years, and 154.6 ± 24.3 mmHg and 174.1 ± 20.2 mmHg at age 76 - 85 years. Conclusion: The PaO2 tended to decrease with age at both 33% and 40% O2 concentration.
文摘Background: Anesthetists should measure the concentration of supplemental oxygen to determine whether patients’ partial pressure of arterial oxygen (PaO2) is correct during general anesthesia. However, the standard PaO2 value in obese patients in the supine position is unknown. We evaluated the PaO2 with respect to the Broca-Katsura obesity index. Materials and Methods: From January 2001 to December 2013, we evaluated 472 patients aged ≥16 years old that underwent general anesthesia in the supine position. The anesthetic charts of 472 patients with an American Society of Anesthesiologists physical status of I or II were retrospectively reviewed to investigate the PaO2. Results: In patients aged 16 to 2 was 165.7 ± 25.6 mmHg at a Broca-Katsura index of 2 was 152.1 ± 23.8 mmHg at a Broca-Katsura index of 2 tended to decrease with age from 16 to 2 tended to decrease with age from 16 to <65 years at a Broca-Katsura index of 20% to <40%.
文摘The correlation between pulmonary endothelin receptors and alveolar-arterial oxygen gradient (A aDO2) in rats with hepatopulmonary syndrome was investigated. Animals were divided into 2 groups: Sham operated (Sham) group and common bile duct ligation (CBDL) group. Arterial blood gas was evaluated by a blood gas analyzer. The concentrations of ET-1 in blood and lung tissue sample were evaluated by radioimmunoassay. The distribution and expression of two kinds of subtype receptor of ET-1, ETRA and ETRB were examined by in situ hybridization. The results showed that the level of A aDO2, was higher in CBDI. group than that in Sham group (P〈0.05). The levels of plasma and pulmonary ET-1 in CBDL group were both higher than in Sham group (P〈0.05 ). There was no significant difference in average A of ETRA between two groups by imaging analysis (0.21±0.06 vs 0.22±0.08, P〉0.05), while that of ETRB was higher in CBDI. group than in Sham group (0.58±0.16 vs 0.28±0.07, P〈0.05). The expression of ETRBinlung was positively correlated with A aDO2(P〈0.05). It was concluded that the widened A-aDO2 may be related with enhancement of the expression of ETRB in lung.
基金sponsored by Guangdong Science and Technology Project(No:2009B03081118)
文摘Objective:To explore the easily applicable indicators of practical value to evaluate the prognosis of acute respiratory distress syndrome(ARDS).Methods:Blood and biochemical tests and bloodgas analyses were performed upon entry into the ICUs,12 h,24 h,48 h and 72 h after that in 72 ARDS patients(who were admitted to the ICUs of our hospital from January 2000 to December 2009).Then APACHEⅡscores were achieved by combining relevant physiological parameters and laboratory results.Results:There was a statistical difference between the death group and survival group at different time points upon entering the ICUs in terms of APACHEⅡscore, alveolar-arterial oxygen difference and arterial blood lactate clearance rate.PaO<sub>2</sub>/FiO<sub>2</sub> values were recorded to be statistically different between the death group and survival group 24 h,48 h and 72 h,respectively after entry into the ICUs.In addition,registered linear regression existed between APACHEⅡscore,alveolar-arterial oxygen difference or PaO<sub>2</sub>/FiO<sub>2</sub> value and time. APACHEⅡscore 24 h and 72 h after entering ICUs predicted mortality with an area under the ROC curve(AUC) standing respectively at 0.919 and 0.9SS.Arterial blood lactate clearance rate 12 h, 24 h,48 h and 72 h after entering ICUs predicted mortality with an area under the ROC curve (AUC) at 0.918,0.918,0.909 and 0.991,respectively.Conclusions:APACHEⅡscore applied in combination with arterial blood lactate clearance rate is of clinical significance in assessing the prognosis of ARDS patients.
文摘To investigate the effect of aerobic exercise combined with whole-body vibration (WBV) training on metabolic syndrome risk, and inflammatory markers, and to compare its effects on arterial stiffness and several blood parameters related to metabolic syndrome with those of aerobic training alone. Thirty healthy participants were divided into 2 groups matched for age and body mass index (BMI). Fifteen subjects were assigned to the WBV group (WBV + aerobic training) and the other 15 to the control group (aerobic training only). All participants performed a treadmill exercise 3 days/week for 4 weeks, for 50 min after 30 min rest period. Exercise was performed at a heart rate (HR) corresponding to 60% of the HR at each individual’s maximum oxygen uptake (VO2max). Body weight and BMI after training were significantly lower than those before training in the WBV group (P < 0.01). Concerning arterial stiffness, the pulse-wave velocity after training was significantly lower than that before training in the WBV group (1048.7 ± 105.6 vs. 1008.4 ± 101.1 cm/s, P < 0.05). Meanwhile, the VO2max after training was significantly higher than that before training in the WBV group (47.7 ± 12.8 vs. 51.4 ± 14.1 mL·min-1·kg-1, P < 0.01). However, no significant differences were observed in any parameters before and after training in the control group. Our results suggest that aerobic exercise combined with WBV training may be effective in reducing arterial stiffness and improving cardiorespiratory fitness than aerobic training alone.
文摘The mixed venous-to-arterial carbon dioxide(CO_2)tension difference[P(v-a) CO_2]is the difference between carbon dioxide tension(PCO_2) in mixed venous blood(sampled from a pulmonary artery catheter) and the PCO_2 in arterial blood.P(v-a) CO_2 depends on the cardiac output and the global CO_2 production,and on the complex relationship between PCO_2 and CO_2 content.Experimental and clinical studies support the evidence that P(v-a) CO_2 cannot serve as an indicator of tissue hypoxia,and should be regarded as an indicator of the adequacy of venous blood to wash out the total CO_2generated by the peripheral tissues.P(v-a) CO_2 can be replaced by the central venous-to-arterial CO_2 difference(△PCO_2),which is calculated from simultaneous sampling of central venous blood from a central vein catheter and arterial blood and,therefore,more easy to obtain at the bedside.Determining the △PCO_2 during the resuscitation of septic shock patients might be useful when deciding when to continue resuscitation despite a central venous oxygen saturation(SCVO_2) > 70%associated with elevated blood lactate levels.Because high blood lactate levels is not a discriminatory factor in determining the source of that stress,an increased △PCO_2(> 6 mmHg)could be used to identify patients who still remain inadequately resuscitated.Monitoring the △PCO_2 from the beginning of the reanimation of septic shock patients might be a valuable means to evaluate the adequacy of cardiac output in tissue perfusion and,thus,guiding the therapy.In this respect,it can aid to titrate inotropes to adjust oxygen delivery to CO_2 production,or to choose between hemoglobin correction or fluid/inotrope infusion in patients with a too low ScvO_2 related to metabolic demand.The combination of P(v-a) CO_2 or △PCO_2 with oxygen-derived parameters through the calculation of the P(v-a) CO_2 or △PCO_2/arteriovenous oxygen content difference ratio can detect the presence of global anaerobic metabolism.