Close monitoring of the balance between oxygen demand and supply is of great importance during cardiac cardiopulmonary bypass (CPB) surgery. This study was to compare conventional intermittent venous blood gas monitor...Close monitoring of the balance between oxygen demand and supply is of great importance during cardiac cardiopulmonary bypass (CPB) surgery. This study was to compare conventional intermittent venous blood gas monitoring with continuous transcutaneous oxygen and carbon dioxide monitoring in infant patients undergoing cardiac surgery with CPB. According to paired data from 29 infant patients undergoing cardiac surgery we found that a positive correlation existed between the two techniques, with a correlation coefficient 0.9021 and 0.8021 for PO2 and PCO2 respectively. It’s concluded that transcutaneous monitoring and intermittent venous blood sampling had good correlation and transcutaneous monitoring may be used conveniently and safely clinically during CPB.展开更多
BACKGROUND Transcutaneous oxygen pressure(TcpO2)is a precise method for determining oxygen perfusion in wounded tissues.The device uses either electrochemical or optical sensors.AIM To evaluate the usefulness of TcpO2...BACKGROUND Transcutaneous oxygen pressure(TcpO2)is a precise method for determining oxygen perfusion in wounded tissues.The device uses either electrochemical or optical sensors.AIM To evaluate the usefulness of TcpO2 measurements on free flaps(FFs)in diabetic foot ulcers(DFUs).METHODS TcpO2 was measured in 17 patients with DFUs who underwent anterolateral thigh(ALT)-FF surgery and compared with 30 patients with DFU without FF surgery.RESULTS Significant differences were observed in the ankle-brachial index;duration of diabetes;and haemoglobin,creatinine,and C-reactive protein levels between the two groups.TcpO2 values were similar between two groups except on postoperative days 30 and 60 when the values in the ALT-FF group remained<30 mmHg and did not increase>50 mmHg.CONCLUSION Even if the flap is clinically stable,sympathectomy due to adventitia stripping during anastomosis and arteriovenous shunt progression due to diabetic polyneuropathy could lead to low TcpO2 values in the ALT-FF owing to its thick fat tissues,which is supported by the slow recovery of the sympathetic tone following FF.Therefore,TcpO2 measurements in patients with DFU who underwent FF reconstruction may be less accurate than in those who did not.展开更多
AIM To detect blood withdrawal for patients with arterial blood pressure monitoring to increase patient safety and provide better sample dating.METHODS Blood pressure information obtained from a patient monitor was fe...AIM To detect blood withdrawal for patients with arterial blood pressure monitoring to increase patient safety and provide better sample dating.METHODS Blood pressure information obtained from a patient monitor was fed as a real-time data stream to an experimental medical framework. This framework was connected to an analytical application which observes changes in systolic, diastolic and mean pressure to determine anomalies in the continuous data stream. Detection was based on an increased mean blood pressure caused by the closing of the withdrawal three-way tap and an absence of systolic and diastolic measurements during this manipulation. For evaluation of the proposed algorithm, measured data from animal studies in healthy pigs were used.RESULTS Using this novel approach for processing real-time measurement data of arterial pressure monitoring, the exact time of blood withdrawal could be successfully detected retrospectively and in real-time. The algorithm was able to detect 422 of 434(97%) blood withdrawals for blood gas analysis in the retrospective analysis of 7 study trials. Additionally, 64 sampling events for other procedures like laboratory and activated clotting time analyses were detected. The proposed algorithm achieved a sensitivity of 0.97, a precision of 0.96 and an F1 score of 0.97.CONCLUSION Arterial blood pressure monitoring data can be used toperform an accurate identification of individual blood samplings in order to reduce sample mix-ups and thereby increase patient safety.展开更多
AIM: To characterize the profiles of alveolar hypoventilation during colonoscopies performed under sedoanalgesia with a combination of alfentanil and either midazolam or propofol. METHODS: Consecutive patients undergo...AIM: To characterize the profiles of alveolar hypoventilation during colonoscopies performed under sedoanalgesia with a combination of alfentanil and either midazolam or propofol. METHODS: Consecutive patients undergoing routine colonoscopy were randomly assigned to sedation with either propofol or midazolam in an open-labeled design using a titration scheme. All patients received 4 μg/kg per body weight alfentanil for analgesia and 3 L of supplemental oxygen. Oxygen saturation (SpO 2 ) was measured by pulse oximetry (POX), and capnography (PcCO 2 ) was continuously measured using a combined dedicated sensor at the ear lobe. Instances of apnea resulting in measures such as stimulation of the patient, a chin lift, a mask maneuver, or withholding of sedation were recorded. PcCO 2 values (as a parameter of sedation-induced hypoventilation) were compared between groups at the following distinct time points: baseline, maximal rise, termination of the procedure and 5 min after termination of the procedure. The number of patients in both study groups who regained baseline PcCO 2 values (± 1.5 mmHg) five minutes after the procedure was determined.RESULTS: A total of 97 patients entered this study. The data from 14 patients were subsequently excluded for clinical procedure-related reasons or for technical problems. Therefore, 83 patients (mean age 62 ± 13 years) were successfully randomized to receive propofol (n = 42) or midazolam (n = 41) for sedation. Most of the patients were classified as American Society of Anesthesiologists (ASA) Ⅱ [16 (38%) in the midazolam group and 15 (32%) in the propofol group] and ASA Ⅲ [14 (33%) and 13 (32%) in the midazolam and propofol groups, respectively]. A mean dose of 5 (4-7) mg of Ⅳ midazolam and 131 (70-260) mg of Ⅳ propofol was used during the procedure in the corresponding study arms. The mean SpO 2 at baseline (%) was 99 ± 1 for the midazolam group and 99 ± 1 for the propofol group. No cases of hypoxemia (SpO 2 < 85%) or apnea were recorded. However, an increase in PcCO 2 that indicated alveolar hypoventilation occurred in both groups after administration of the first drug and was not detected with pulse oximetry alone. The mean interval between the initiation of sedation and the time when the PcCO 2 value increased to more than 2 mmHg was 2.8 ± 1.3 min for midazolam and 2.8 ± 1.1 min for propofol. The mean maximal rise was similar for both drugs: 8.6 ± 3.7 mmHg for midazolam and 7.4 ± 3.2 mmHg for propofol. Five minutes after the end of the procedure, the mean difference from the baseline values was significantly lower for the propofol treatment compared with midazolam (0.9 ± 3.0 mmHg vs 4.3 ± 3.7 mmHg, P = 0.0000169), and significantly more patients in the propofol group had regained their baseline value ± 1.5 mmHg (32 of 41vs 12 of 42,P = 0.0004). CONCLUSION: A significantly higher number of patients sedated with propofol had normalized PcCO 2 values five minutes after sedation when compared with patients sedated with midazolam.展开更多
背景:一般情况下经皮氧分压测定有氧能力水平越高,安静状态时值越高,训练过程中呈下降趋势,提示机体疲劳加深,肌肉缺氧程度加大,机能状态下降,经皮二氧化碳分压则反之。目的:分析6周高原训练期间优秀男子赛艇运动员肱二头肌经皮氧分压...背景:一般情况下经皮氧分压测定有氧能力水平越高,安静状态时值越高,训练过程中呈下降趋势,提示机体疲劳加深,肌肉缺氧程度加大,机能状态下降,经皮二氧化碳分压则反之。目的:分析6周高原训练期间优秀男子赛艇运动员肱二头肌经皮氧分压、经皮二氧化碳分压变化特点与其训练负荷之间的关系。方法:将整个高原训练板块分为高原前、高原训练、高原后3个阶段,每周运动员休息时早晨空腹状态下使用PeriFlux System 5000激光多普勒血流监测仪对10名男子赛艇运动员进行无创测试,测试指标包括经皮氧分压、经皮二氧化碳分压及乳酸值的变化;同时在上高原前1周及下高原后2周分别对运动员进行测功仪6 km及6级负荷测试。结果与结论:(1)高原训练中经皮氧分压、经皮氧分压/经皮二氧化碳分压呈现出"W"型变化趋势,经皮二氧化碳分压呈现"V"型变化趋势。(2)结果说明:高原训练"平原阶段储备体能、高原训练前期加量后期加度"的训练模式较为合理,可为今后高原训练提供一个较好的范式;经皮氧分压、经皮二氧化碳尤其是二者比值对评价运动负荷对运动员的刺激程度有着重要参考作用;经皮氧分压测定还量化了高原训练中运动员毛细血管的含氧量;建议将经皮氧分压作为一种无创性指标应用于运动员有氧能力变化的监测。展开更多
目的探讨四肢多普勒联合经皮氧分压在诊断糖尿病周围血管病变的价值。方法检测192例糖尿病患者下肢血管多普勒频谱及测定踝肱指数(ABI)、经皮氧分压(TcPO2)等值。结果踝/肱指数(ABI):34例ABI<0.9,11例ABI在0.9～1.0,134例ABI在1.0～1...目的探讨四肢多普勒联合经皮氧分压在诊断糖尿病周围血管病变的价值。方法检测192例糖尿病患者下肢血管多普勒频谱及测定踝肱指数(ABI)、经皮氧分压(TcPO2)等值。结果踝/肱指数(ABI):34例ABI<0.9,11例ABI在0.9～1.0,134例ABI在1.0～1.3,13例ABI 1.3～1.4;经皮氧分压Tc-PO2:9例TcPO2在<20 mm Hg,101例TcPO2在20～39 mm Hg,81例TcPO2≥40 mmHg;两项检查结果完全正常者55例。结论四肢多普勒联合经皮氧分压对于早期诊断糖尿病周围血管病变尤其对无症状早期患者具有一定临床应用价值。展开更多
文摘Close monitoring of the balance between oxygen demand and supply is of great importance during cardiac cardiopulmonary bypass (CPB) surgery. This study was to compare conventional intermittent venous blood gas monitoring with continuous transcutaneous oxygen and carbon dioxide monitoring in infant patients undergoing cardiac surgery with CPB. According to paired data from 29 infant patients undergoing cardiac surgery we found that a positive correlation existed between the two techniques, with a correlation coefficient 0.9021 and 0.8021 for PO2 and PCO2 respectively. It’s concluded that transcutaneous monitoring and intermittent venous blood sampling had good correlation and transcutaneous monitoring may be used conveniently and safely clinically during CPB.
基金the National Research Foundation of Korea Grant funded by the Korean government(MSIT)(2020R1A2C1100891 and 2021R1G1A1008337)the Soonchunhyang University Research Fund.
文摘BACKGROUND Transcutaneous oxygen pressure(TcpO2)is a precise method for determining oxygen perfusion in wounded tissues.The device uses either electrochemical or optical sensors.AIM To evaluate the usefulness of TcpO2 measurements on free flaps(FFs)in diabetic foot ulcers(DFUs).METHODS TcpO2 was measured in 17 patients with DFUs who underwent anterolateral thigh(ALT)-FF surgery and compared with 30 patients with DFU without FF surgery.RESULTS Significant differences were observed in the ankle-brachial index;duration of diabetes;and haemoglobin,creatinine,and C-reactive protein levels between the two groups.TcpO2 values were similar between two groups except on postoperative days 30 and 60 when the values in the ALT-FF group remained<30 mmHg and did not increase>50 mmHg.CONCLUSION Even if the flap is clinically stable,sympathectomy due to adventitia stripping during anastomosis and arteriovenous shunt progression due to diabetic polyneuropathy could lead to low TcpO2 values in the ALT-FF owing to its thick fat tissues,which is supported by the slow recovery of the sympathetic tone following FF.Therefore,TcpO2 measurements in patients with DFU who underwent FF reconstruction may be less accurate than in those who did not.
文摘AIM To detect blood withdrawal for patients with arterial blood pressure monitoring to increase patient safety and provide better sample dating.METHODS Blood pressure information obtained from a patient monitor was fed as a real-time data stream to an experimental medical framework. This framework was connected to an analytical application which observes changes in systolic, diastolic and mean pressure to determine anomalies in the continuous data stream. Detection was based on an increased mean blood pressure caused by the closing of the withdrawal three-way tap and an absence of systolic and diastolic measurements during this manipulation. For evaluation of the proposed algorithm, measured data from animal studies in healthy pigs were used.RESULTS Using this novel approach for processing real-time measurement data of arterial pressure monitoring, the exact time of blood withdrawal could be successfully detected retrospectively and in real-time. The algorithm was able to detect 422 of 434(97%) blood withdrawals for blood gas analysis in the retrospective analysis of 7 study trials. Additionally, 64 sampling events for other procedures like laboratory and activated clotting time analyses were detected. The proposed algorithm achieved a sensitivity of 0.97, a precision of 0.96 and an F1 score of 0.97.CONCLUSION Arterial blood pressure monitoring data can be used toperform an accurate identification of individual blood samplings in order to reduce sample mix-ups and thereby increase patient safety.
文摘AIM: To characterize the profiles of alveolar hypoventilation during colonoscopies performed under sedoanalgesia with a combination of alfentanil and either midazolam or propofol. METHODS: Consecutive patients undergoing routine colonoscopy were randomly assigned to sedation with either propofol or midazolam in an open-labeled design using a titration scheme. All patients received 4 μg/kg per body weight alfentanil for analgesia and 3 L of supplemental oxygen. Oxygen saturation (SpO 2 ) was measured by pulse oximetry (POX), and capnography (PcCO 2 ) was continuously measured using a combined dedicated sensor at the ear lobe. Instances of apnea resulting in measures such as stimulation of the patient, a chin lift, a mask maneuver, or withholding of sedation were recorded. PcCO 2 values (as a parameter of sedation-induced hypoventilation) were compared between groups at the following distinct time points: baseline, maximal rise, termination of the procedure and 5 min after termination of the procedure. The number of patients in both study groups who regained baseline PcCO 2 values (± 1.5 mmHg) five minutes after the procedure was determined.RESULTS: A total of 97 patients entered this study. The data from 14 patients were subsequently excluded for clinical procedure-related reasons or for technical problems. Therefore, 83 patients (mean age 62 ± 13 years) were successfully randomized to receive propofol (n = 42) or midazolam (n = 41) for sedation. Most of the patients were classified as American Society of Anesthesiologists (ASA) Ⅱ [16 (38%) in the midazolam group and 15 (32%) in the propofol group] and ASA Ⅲ [14 (33%) and 13 (32%) in the midazolam and propofol groups, respectively]. A mean dose of 5 (4-7) mg of Ⅳ midazolam and 131 (70-260) mg of Ⅳ propofol was used during the procedure in the corresponding study arms. The mean SpO 2 at baseline (%) was 99 ± 1 for the midazolam group and 99 ± 1 for the propofol group. No cases of hypoxemia (SpO 2 < 85%) or apnea were recorded. However, an increase in PcCO 2 that indicated alveolar hypoventilation occurred in both groups after administration of the first drug and was not detected with pulse oximetry alone. The mean interval between the initiation of sedation and the time when the PcCO 2 value increased to more than 2 mmHg was 2.8 ± 1.3 min for midazolam and 2.8 ± 1.1 min for propofol. The mean maximal rise was similar for both drugs: 8.6 ± 3.7 mmHg for midazolam and 7.4 ± 3.2 mmHg for propofol. Five minutes after the end of the procedure, the mean difference from the baseline values was significantly lower for the propofol treatment compared with midazolam (0.9 ± 3.0 mmHg vs 4.3 ± 3.7 mmHg, P = 0.0000169), and significantly more patients in the propofol group had regained their baseline value ± 1.5 mmHg (32 of 41vs 12 of 42,P = 0.0004). CONCLUSION: A significantly higher number of patients sedated with propofol had normalized PcCO 2 values five minutes after sedation when compared with patients sedated with midazolam.
文摘背景:一般情况下经皮氧分压测定有氧能力水平越高,安静状态时值越高,训练过程中呈下降趋势,提示机体疲劳加深,肌肉缺氧程度加大,机能状态下降,经皮二氧化碳分压则反之。目的:分析6周高原训练期间优秀男子赛艇运动员肱二头肌经皮氧分压、经皮二氧化碳分压变化特点与其训练负荷之间的关系。方法:将整个高原训练板块分为高原前、高原训练、高原后3个阶段,每周运动员休息时早晨空腹状态下使用PeriFlux System 5000激光多普勒血流监测仪对10名男子赛艇运动员进行无创测试,测试指标包括经皮氧分压、经皮二氧化碳分压及乳酸值的变化;同时在上高原前1周及下高原后2周分别对运动员进行测功仪6 km及6级负荷测试。结果与结论:(1)高原训练中经皮氧分压、经皮氧分压/经皮二氧化碳分压呈现出"W"型变化趋势,经皮二氧化碳分压呈现"V"型变化趋势。(2)结果说明:高原训练"平原阶段储备体能、高原训练前期加量后期加度"的训练模式较为合理,可为今后高原训练提供一个较好的范式;经皮氧分压、经皮二氧化碳尤其是二者比值对评价运动负荷对运动员的刺激程度有着重要参考作用;经皮氧分压测定还量化了高原训练中运动员毛细血管的含氧量;建议将经皮氧分压作为一种无创性指标应用于运动员有氧能力变化的监测。
文摘目的探讨四肢多普勒联合经皮氧分压在诊断糖尿病周围血管病变的价值。方法检测192例糖尿病患者下肢血管多普勒频谱及测定踝肱指数(ABI)、经皮氧分压(TcPO2)等值。结果踝/肱指数(ABI):34例ABI<0.9,11例ABI在0.9～1.0,134例ABI在1.0～1.3,13例ABI 1.3～1.4;经皮氧分压Tc-PO2:9例TcPO2在<20 mm Hg,101例TcPO2在20～39 mm Hg,81例TcPO2≥40 mmHg;两项检查结果完全正常者55例。结论四肢多普勒联合经皮氧分压对于早期诊断糖尿病周围血管病变尤其对无症状早期患者具有一定临床应用价值。
