Objective:To investigate the effects of budesonide on blood gas and inflammation indexes in patients with chronic obstructive pulmonary disease(COPD)during remission.Methods:Fifty-one patients with COPD in remission,a...Objective:To investigate the effects of budesonide on blood gas and inflammation indexes in patients with chronic obstructive pulmonary disease(COPD)during remission.Methods:Fifty-one patients with COPD in remission,admitted to Zhongshan Hospital of Dalian University from July 2021 to December 2022,were selected and divided into two groups based on a randomized numerical table method.The control group(25 cases)received budesonide formoterol treatment,while the observation group(26 cases)received budesonide geforce treatment.Various indexes,including clinical efficacy,blood gas indexes,inflammation indexes,St.George’s Respiratory Questionnaire(SGRQ)scores,Chronic Obstructive Pulmonary Disease Assessment Test(CAT)scores,and 6-minute Walking Distance Test(6MWD)results,were compared between the two groups.Results:After 21 days of treatment,the total clinical effectiveness rate of the observation group was higher than that of the control group,with a statistically significant difference(P<0.05).Post-treatment,the PaO2 level and pH value in both groups were higher,and the PaCO_(2) level was lower compared to pre-treatment levels.The observation group showed better improvements in these indicators than the control group,with statistically significant differences(P<0.05).SGRQ and CAT scores for both groups were lower post-treatment,with the observation group scoring lower than the control group.Additionally,the 6MWD results were farther for both groups post-treatment,with the observation group achieving greater distances than the control group,with statistically significant differences(P<0.05).Conclusion:Budesonide can effectively improve blood gas indexes in patients with COPD in remission,alleviate related clinical symptoms,reduce inflammatory responses,and promote patient recovery.The treatment efficacy is significant.展开更多
BACKGROUND:Emergency patients with sepsis or septic shock are at high risk of death.Despite increasing attention to microhemodynamics,the clinical use of advanced microcirculatory assessment is limited due to its shor...BACKGROUND:Emergency patients with sepsis or septic shock are at high risk of death.Despite increasing attention to microhemodynamics,the clinical use of advanced microcirculatory assessment is limited due to its shortcomings.Since blood gas analysis is a widely used technique reflecting global oxygen supply and consumption,it may serve as a surrogate for microcirculation monitoring in septic treatment.METHODS:We performed a search using PubMed,Web of Science,and Google scholar.The studies and reviews that were most relevant to septic microcirculatory dysfunctions and blood gas parameters were identified and included.RESULTS:Based on the pathophysiology of oxygen metabolism,the included articles provided a general overview of employing blood gas analysis and its derived set of indicators for microhemodynamic monitoring in septic care.Notwithstanding flaws,several parameters are linked to changes in the microcirculation.A comprehensive interpretation of blood gas parameters can be used in order to achieve hemodynamic optimization in septic patients.CONCLUSION:Blood gas analysis in combination with clinical performance is a reliable alternative for microcirculatory assessments.A deep understanding of oxygen metabolism in septic settings may help emergency physicians to better use blood gas analysis in the evaluation and treatment of sepsis and septic shock.展开更多
Objective:To analyze the effect of combined inhalation of budesonide formoterol and tiotropium bromide on arterial blood gas and pulmonary function indexes in patients with chronic obstructive pulmonary disease(COPD)....Objective:To analyze the effect of combined inhalation of budesonide formoterol and tiotropium bromide on arterial blood gas and pulmonary function indexes in patients with chronic obstructive pulmonary disease(COPD).Methods:100 patients with COPD treated from January to December 2022 were selected as observation objects,and were divided into a control group(n=50,in which budesonide and formoterol were administered)and an experimental group(n=50,the treatment drug was budesonide formoterol combined with tiotropium bromide)according to the computer grouping method,and compared the treatment results.Results:(i)Before treatment,there was no difference in the partial pressure of carbon dioxide and partial pressure of oxygen between the control group and the experimental group(P>0.05);after treatment,the partial pressure of carbon dioxide and partial pressure of oxygen in the experimental group were higher than those in the control group,with significant differences(P<0.05).(ii)Before treatment,there was no difference in forced vital capacity(FVC),forced expiratory volume in one second(FEV1),FEV1/FVC between the control group and the experimental group(P>0.05);after treatment,the FVC,FEV1,and FEV1/FVC in the experimental group were significantly higher than those in the control group(P<0.05).(iii)There was no difference in the levels of CRP,IL-6,and TNF-αbetween the control group and the experimental group(P>0.05);after treatment,the levels of CRP,IL-6,and TNF-αin the experimental group were lower than those in the control group,with significant differences(P<0.05).(iv)Compared to the total incidence of adverse reactions in the control group(28.00%),the incidence of total adverse reactions in the experimental group was lower at 10.00%,and the difference was significant(P<0.05).Conclusion:The combined inhalation of budesonide and formoterol with tiotropium bromide has demonstrated a clear therapeutic efficacy and safety in treating chronic obstructive pulmonary disease.This treatment approach effectively enhances arterial blood gas levels and lung function,showing promising potential for widespread application.展开更多
The increasing intensity and frequency of sand-dust storms in China has led to greater prominence of associated environmentaland health issues. Many studies have focused on the health effects of air particulate contam...The increasing intensity and frequency of sand-dust storms in China has led to greater prominence of associated environmentaland health issues. Many studies have focused on the health effects of air particulate contaminants, but fewformal investigations have studied the effects of sand-dust storms on human and animal health. The aim of this study wasto investigate the effects of dust storms on rat lung by using high resolution computed tomography (HRCT) and blood gasanalysis through a wind tunnel simulating. We found that the rat lung damage effects can be detected by the HRCT imagingafter exposure to sand-dust storm environments, but had no obvious result through blood gas analysis. Exposure durationspositively correlated with the damage degree to lung tissue. These will provide some evidence for clinical diagnosis ofnon-occupational pneumoconiosis.展开更多
BACKGROUND Term pregnancy-induced labor refers to the use of artificial methods to induce uterine contractions and terminate pregnancy after 37 wk.It is a common method to prevent overdue pregnancy and to deal with hi...BACKGROUND Term pregnancy-induced labor refers to the use of artificial methods to induce uterine contractions and terminate pregnancy after 37 wk.It is a common method to prevent overdue pregnancy and to deal with high-risk pregnancies.In addition,it can alleviate maternal complications and cause the fetus to leave the adverse intrauterine environment early,which is beneficial to the outcome of pregnancy.AIM To explore the effect of a birthing ball on labor by inducing cervical ripening and its influence on labor and the neonatal blood gas index.METHODS Twenty-two women who were scheduled to undergo labor induction and delivery in the obstetrics department of our hospital were randomly divided into two groups:the delivery ball group(childbirth ball combined with COOK balloon induction)and the conventional group(COOK balloon induction alone).The cervical Bishop score before and after intervention,duration of labor at each stage,mode of delivery,neonatal umbilical venous blood pH,oxygen partial pressure(PO_(2)),carbon dioxide partial pressure(PCO_(2)),and the 1-min Apgar score were recorded.RESULTS After the intervention,the cervical Bishop score of the delivery ball group(7.84±1.52)was significantly higher than that of the conventional group(7.32±1.29)(P<0.05),and the cervical Bishop scores of the two groups after intervention were significantly higher than those before intervention(P<0.05).After the intervention,the first stage of labor(510.9±98.7 min),the second stage of labor(43.0±8.5 min),and the total duration of labor(560.0±120.9 min)in the delivery ball group were lower than those in the routine group,with a first stage of labor of 602.1±133.2 min,a second stage of labor of 48.4±9.1 min,and a total duration of labor of 656.8±148.5 min(P<0.05).There was no significant difference in the time of the third stage of labor between the two groups(P>0.05).There was no significant difference in the pH,PO_(2),and PCO_(2) values of newborns between the delivery ball group and the conventional group(P>0.05).The 1-min Apgar score of the delivery ball group was higher than that of the conventional group(9.10±0.38 points vs 8.94±0.31 points,P<0.05).The natural delivery rate of the delivery ball group was higher than that of the conventional group(91.00%vs 78.00%,P<0.05).CONCLUSION The use of a birthing ball combined with a COOK balloon for inducing labor has a better effect on promoting cervical ripening,shortening the time of labor,and improving the Apgar score of newborns.展开更多
Continuous intra-arterial blood gas monitoring is used clinically in hospital and intensive care unit settings.The blood gas can be detected by the colormetric indicators which are sealed in the silicone membrane.The ...Continuous intra-arterial blood gas monitoring is used clinically in hospital and intensive care unit settings.The blood gas can be detected by the colormetric indicators which are sealed in the silicone membrane.The glass tubing of the sensor should be as thin as possible since it affects response time and the bicarbonate buffer shifts the sensitivity of the sensor. In this paper,the sensitivity shifts by the bicarbonate buffer was researched.When carbon dioxide diffuses into the indicator, the carbon acid is produced and the bicarbonate buffer is used to control internal acidity.Because the sensitivity of the pCO_2 sensor is increased by controlling the concentration of the bicarbonate buffer,the bicarbonate buffer is used to obtain the optimum resolution in this investigation.Moreover,the different concentrations of the bicarbonate buffer for blood gas measurements are discussed in detail.展开更多
BACKGROUND:Epileptic seizures account for 1%–2% of all admissions of patients to the emergency department(ED). The present study aimed to determine whether venous blood pH,bicarbonate,base excess,and lactate levels t...BACKGROUND:Epileptic seizures account for 1%–2% of all admissions of patients to the emergency department(ED). The present study aimed to determine whether venous blood pH,bicarbonate,base excess,and lactate levels taken within 1 hour of the last seizure episode help to determine seizure recurrence in emergency departments.METHODS:A cross-sectional study was conducted in the emergency department(ED) between January and July,2012. Patients who were admitted to the emergency department consecutively were included in the study if they were 14 years or older and within 1 hour after last seizure. Demographics,seizure type,use of antiepileptic drugs,observation period at the emergency department,seizure recurrence,pH,bicarbonate,base excess,and lactate levels from venous blood gas analysis were determined.RESULTS:A total of 94 patients aged 14 years or older were included in the study. Of these patients,10.6%(n=10) experienced recurrent seizures in the observation period at the emergency department. To predict recurrent seizures in ED,threshold venous blood gas values were determined as follows:pH<7.245 [sensitivity 80%(95%CI:44–96),negative predictive value 96.9%(95%CI:88.3–99.4)],bicarbonate<17.1 mmol/L [sensitivity 80%(95%CI:44–96),negative predictive value 97%(95%CI:89–99.5)],base excess<–11.1 mEq/L [sensitivity 80%(95%CI:44–96),negative predictive value 97%(95%CI:89–99)],and lactate>7.65 mmol/L [sensitivity 80%(95%CI:44–96),negative predictive value 96.6%(95%CI:87–99)].CONCLUSION:If venous blood gas analysis is made on pH,base excess,lactate and bicarbonate immediately one hour after the last epileptic seizure episode,it is possible to predict whether the patient will have seizure recurrence.展开更多
BACKGROUND Laparoscopic-assisted radical gastrectomy(LARG)is the standard treatment for early-stage gastric carcinoma(GC).However,the negative impact of this proce-dure on respiratory function requires the optimized i...BACKGROUND Laparoscopic-assisted radical gastrectomy(LARG)is the standard treatment for early-stage gastric carcinoma(GC).However,the negative impact of this proce-dure on respiratory function requires the optimized intraoperative management of patients in terms of ventilation.AIM To investigate the influence of pressure-controlled ventilation volume-guaranteed(PCV-VG)and volume-controlled ventilation(VCV)on blood gas analysis and pulmonary ventilation in patients undergoing LARG for GC based on the lung ultrasound score(LUS).METHODS The study included 103 patients with GC undergoing LARG from May 2020 to May 2023,with 52 cases undergoing PCV-VG(research group)and 51 cases undergoing VCV(control group).LUS were recorded at the time of entering the operating room(T0),20 minutes after anesthesia with endotracheal intubation(T1),30 minutes after artificial pneumoperitoneum(PP)establishment(T2),and 15 minutes after endotracheal tube removal(T5).For blood gas analysis,arterial partial pressure of oxygen(PaO_(2))and partial pressure of carbon dioxide(PaCO_(2))were observed.Peak airway pressure(P_(peak)),plateau pressure(Pplat),mean airway pressure(P_(mean)),and dynamic pulmonary compliance(C_(dyn))were recorded at T1 and T2,1 hour after PP establishment(T3),and at the end of the operation(T4).Postoperative pulmonary complications(PPCs)were recorded.Pre-and postoperative serum interleukin(IL)-1β,IL-6,and tumor necrosis factor-α(TNF-α)were measured by enzyme-linked immunosorbent assay.RESULTS Compared with those at T0,the whole,anterior,lateral,posterior,upper,lower,left,and right lung LUS of the research group were significantly reduced at T1,T2,and T5;in the control group,the LUS of the whole and partial lung regions(posterior,lower,and right lung)decreased significantly at T2,while at T5,the LUS of the whole and some regions(lateral,lower,and left lung)increased significantly.In comparison with the control group,the whole and regional LUS of the research group were reduced at T1,T2,and T5,with an increase in PaO_(2),decrease in PaCO_(2),reduction in P_(peak) at T1 to T4,increase in P_(mean) and C_(dyn),and decrease in Pplat at T4,all significant.The research group showed a significantly lower incidence of PPCs than the control group within 3 days postoperatively.Postoperative IL-1β,IL-6,and TNF-αsignificantly increased in both groups,with even higher levels in the control group.CONCLUSION LUS can indicate intraoperative non-uniformity and postural changes in pulmonary ventilation under PCV-VG and VCV.Under the lung protective ventilation strategy,the PCV-VG mode more significantly improved intraop-erative lung ventilation in patients undergoing LARG for GC and reduced lung injury-related cytokine production,thereby alleviating lung injury.展开更多
Background It has been stated that preoperative pulmonary function tests are essential to assess the surgical risk in patients with scoliosis.Arterial blood gas tests have also been used to evaluate pulmonary function...Background It has been stated that preoperative pulmonary function tests are essential to assess the surgical risk in patients with scoliosis.Arterial blood gas tests have also been used to evaluate pulmonary function before scoliotic surgery.However,few studies have been reported.The aim of this study was to investigate the roles of preoperative arterial blood gas tests in the surgical treatment of scoliosis with moderate or severe pulmonary dysfunction.Methods This study involved scoliotic patients with moderate or severe pulmonary dysfunction (forced vital capacity 〈60%) who underwent surgical treatment between January 2002 and April 2010.A total of 73 scoliotic patients (23 males and 50 females) with moderate or severe pulmonary dysfunction were included.The average age of the patients was 16.53 years (ranged 10-44).The demographic distribution,medical records,and radiographs of all patients were collected.All patients received arterial blood gas tests and pulmonary function tests before surgery.The arterial blood gas tests included five parameters:partial pressure of arterial oxygen,partial pressure of arterial carbon dioxide,alveolar-arterial oxygen tension gradient,pH,and standard bases excess.The pulmonary function tests included three parameters:forced expiratory volume in 1 second ratio,forced vital capacity ratio,and peak expiratory flow ratio.All five parameters of the arterial blood gas tests were compared between the two groups with or without postoperative pulmonary complications by variance analysis.Similarly,all three parameters of the pulmonary function tests were compared.Results The average coronal Cobb angle before surgery was 97.42° (range,50°-180°).A total of 15 (20.5%) patients had postoperative pulmonary complications,including hypoxemia in 5 cases (33.3%),increased requirement for postoperative ventilatory support in 4 (26.7%),pneumonia in 2 (13.3%),atelectasis in 2 (13.3%),pneumothorax in 1 (6.7%),and hydrothorax in 1 (6.7%).No significant differences in demographic characteristics or perioperative factors (P 〉0.05) existed between the two groups with or without postoperative pulmonary complications.According to the variance analysis,there were no statistically significant differences in any parameter of the arterial blood gas tests between the two groups.Conclusions No significant correlation between the results of the preoperative arterial blood gas tests and postoperative pulmonary complications existed in scoliotic patients with moderate or severe pulmonary dysfunction.However,the postoperative complications tended to increase with the decrease of partial pressure of arterial oxygen in the arterial blood gas tests.展开更多
Objective: In order to explore the mechanism of C hinese traditional breath training, the effects of end-inspiratory pause br eathing (EIPB) on the respiratory mechanics and arterial blood gas were studied in pati...Objective: In order to explore the mechanism of C hinese traditional breath training, the effects of end-inspiratory pause br eathing (EIPB) on the respiratory mechanics and arterial blood gas were studied in patients with chronic obstructive pulmo nary disease (COPD).Methods: Ten patients in steady stage participating in the stud y had a breath training of regulating the respiration rhythm as to having a pause betw een the deep and slow inspiration and the slow expiration.Effect of the training was observed by visual feedback from the screen of the re spiratory inductive plethysmograph. The dynamic change of partial pressure of oxygen saturation in blood (SpO 2) was recorded with sphygmo-oximeter, the pulmonary mechanics and EIPB were determined with spirometer, and the data o f arterial blood gases in tranquilized breathing and EIPB were analysed.Results: After EIPB training, SpO 2 increased progressively, PaO 2 increased and PaCO 2 decreased, and the PaO 2 increment was greater than the PaCO 2 decrement. Furthermore, the tidal volume increased and the frequency of respira tion decreased significantly, both inspiration time and expiration time were prolonged. There was no significant change in both mean inspiration flow rate (VT/Ti) and expir ation flow rate (VT/Te). The baselines in spirogram during EIPB training had no raise. Conclusion: EIPB could decrease the ratio of the dead space and ti dal volume (VD/VT), cause increase of PaO 2 more than the decrease of PaCO 2, suggesting that this training could impro ve both the function of ventilation and gaseous exchange in the lung. EIPB training might be a breath ing training pattern for rehabilitation of patients with COPD.展开更多
Objective:To evaluate the predictive ability of neonate condition through the traditional parameters and artery umbilical cord blood gas(aUCBG).Methods:A prospective cohort study was conducted in obstetrics and gyneco...Objective:To evaluate the predictive ability of neonate condition through the traditional parameters and artery umbilical cord blood gas(aUCBG).Methods:A prospective cohort study was conducted in obstetrics and gynecology department between October 2017 and August 2018 at Tongji Hospital in Wuhan,China,and 360 aUCBG samples were collected.The average age of pregnant women was(29.50±4.42)years,range from 19 to 48 years old.The gestational age range from 28+4 weeks to 41+3 weeks at admission.Logistic regression and area under the curve(AUC)from Receiver operating characteristic curves were used to identify risk factors,such as,premature rupture of membranes(PROM),high blood pressure,premature delivery(PD),low 1-minute Apgar scores(Apgar 1),low 5-minute Apgar scores(Apgar 5),pH,base excess,bicarbonate,neonatal blood sugar(NBS),and so on,to predict neonatal condition and evaluate the predictive ability of traditional and aUCBG parameters.Results:In all cases,PROM,PD,Apgar 1,Apgar 5,pH,base excess,bicarbonate,total carbon dioxide,and neonatal blood sugar were risk factors and were associated with poor condition of neonate.Apgar 1 were an independent risk factor.Combined traditional and aUCBG parameters had higher AUC of 0.895(95%confidence interval(C/):0.830-0.960,P<0.001).In cesarean section subgroup,high blood pressure,PD,and Apgar 1 were risk factors and were associated with poor condition of neonate.Apgar 1 and low pH were the independent risk factors.Combined traditional and aUCBG parameters had highest AUC of 0.940(95%C/:0.886-0.993,P<0.001).In vaginal delivery subgroup,maternal age above 35 years,PROM,PD,Apgar 1,Apgar 5,and male newborn were risk factors and were associated with poor condition of neonate.Maternal age above 35 years was an independent risk factor.Combined traditional and aUCBG parameters had highest AUC of 0.897(95%Cl:0.828-0.965,P<0.001).For pregnant women without comorbidities and complications of pregnancy,aUCBG may not be necessat7.Conclusion:In high-risk pregnancies,especially lower Apgar scores,PD,and maternal age above 35-year old,aUCBG is recommended.Traditional parameters combined with aUCBG might increase the predicting ability of neonate condition.展开更多
BACKGROUND Severe pneumonia is a common severe respiratory infection worldwide,and its treatment is challenging,especially for patients in the intensive care unit(ICU).AIM To explore the effect of communication and co...BACKGROUND Severe pneumonia is a common severe respiratory infection worldwide,and its treatment is challenging,especially for patients in the intensive care unit(ICU).AIM To explore the effect of communication and collaboration between nursing teams on the treatment outcomes of patients with severe pneumonia in ICU.METHODS We retrospectively analyzed 60 patients with severe pneumonia who were treated at the ICU of the hospital between January 1,2021 and December 31,2023.We compared and analyzed the respiratory mechanical indexes[airway resistance(Raw),mean airway pressure(mPaw),peak pressure(PIP)],blood gas analysis indexes(arterial oxygen saturation,arterial oxygen partial pressure,and oxygenation index),and serum inflammatory factor levels[C-reactive protein(CRP),procalcitonin(PCT),cortisol(COR),and high mobility group protein B1(HMGB1)]of all patients before and after treatment.RESULTS Before treatment,there was no significant difference in respiratory mechanics index and blood gas analysis index between 2 groups(P>0.05).However,after treatment,the respiratory mechanical indexes of patients in both groups were significantly improved,and the improvement of Raw,mPaw,plateau pressure,PIP and other indexes in the combined group after communication and collaboration with the nursing team was significantly better than that in the single care group(P<0.05).The serum CRP and PCT levels of patients were significantly decreased,and the difference was statistically significant compared with that of nursing group alone(P<0.05).The levels of serum COR and HMGB1 before and after treatment were also significantly decreased between the two groups.CONCLUSION The communication and collaboration of the nursing team have a significant positive impact on respiratory mechanics indicators,blood gas analysis indicators and serum inflammatory factor levels in the treatment of severe pneumonia patients in ICU.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
Objective: To explore the consistency and relevance of the results of the bedside rapid blood gas analyzer GEM premier 3000, the Vitros5.1+5600 biochemical immunoassay analyzer and the SYSMEX XN-9000 automatic blood c...Objective: To explore the consistency and relevance of the results of the bedside rapid blood gas analyzer GEM premier 3000, the Vitros5.1+5600 biochemical immunoassay analyzer and the SYSMEX XN-9000 automatic blood cell analyzer in the central laboratory detecting serum potassium (K<sup>+</sup>), serumsodium (Na<sup>+</sup>), blood glucose (Glu), hemoglobin (Hb) and red blood cell volume (Hct). And to provide a reference for the accurate interpretation of the bedside blood gas analysis report. Method: Usually, ICU patients will be taken arterial blood gas, biochemical and blood samples through the arterial indwelling needle;at the same time patients’ potassium, serum sodium, blood glucose, hemoglobin and red blood cell volume will be detected. This study implemented paired t-test and correlation regression analysis on each group of data, and used the analysis quality requirements (allowable total error) of CLIA’88 proficiency testing program as the criteria for clinical acceptance. Results: The paired t-test showed that the serum potassium, serum sodium and blood glucose detected by GEM premier 3000 and Vitros5.1+5600 were significantly different;and the hemoglobin and red blood cell volume detected by GEM premier 3000 and SYSMEX XN-9000 were significantly different (P < 0.05). The Pearson correlation coefficients (r) of hemoglobin, red blood cell volume and red blood cell volume were 0.860, 0.886, 0.924, 0.841 and 0.856, respectively, and the above test items all had good correlations (P < 0.05). The average (SE) of the paired differences of K<sup>+</sup>, Na<sup>+</sup>, Glu, Hb and Hct detected by the two sets of instruments is less than the allowable error of CLIA’88, and the SE of blood Na<sup>+</sup> and Hb is less than half of the allowable error of CLIA’88. Conclusion: The test results of GEM premier 3000, the central laboratory Vitros5.1+5600 and SYSMEX XN-9000 have good correlation, but the consistency is not good. The test results of GEM premier 3000 cannot replace the central laboratory.展开更多
Objective:To describe the strategies and outcomes of mechanical ventilation in a poorly equipped facility.Methods:This retrospective descriptive study included patients with COVID-19 who were admitted to the intensive...Objective:To describe the strategies and outcomes of mechanical ventilation in a poorly equipped facility.Methods:This retrospective descriptive study included patients with COVID-19 who were admitted to the intensive care unit(ICU)and mechanically ventilated between September 1,2020,and May 31,2021.Data were collected from medical records and databases.Results:54 Patients aged(62.9±13.3)years were included.Among these cases,79.6%had at least one comorbidity.On admission,all patients had hypoxia.The median peripheral oxygen saturation in room air was 76%(61%,83%).Non-invasive ventilation(NIV)was performed in 75.9%of the patients,and invasive mechanical ventilation(IMV)in 68.5%.IMV was performed on patients due to severe coma(8.1%),failure of standard oxygen therapy(27.0%),and failure of NIV(64.9%).An arterial blood gas test was performed in 14.8%of the patients.NIV failed in 90.2%of cases and succeeded in 9.8%.IMV was successful in 5.4%of cases,vs.94.6%of mortality.The overall mortality rate of patients on ventilation in the ICU was 88.9%.The causes of death included severe respiratory distress syndrome(85.2%),multiple organ failure(14.8%),and pulmonary embolism(13.0%).Conclusions:The ventilation management of COVID-19 patients in the ICU with NIV and IMV in a scarce resource setting is associated with a high mortality rate.Shortcomings are identified in ventilation strategies,protocols,and monitoring.Required improvements were also proposed.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
Although hyperbaric oxygen (HBO) therapy can promote the recovery of neural function in patients who have suffered traumatic brain injury (TBI), the underlying mechanism is unclear. We hypothesized that hyperbaric...Although hyperbaric oxygen (HBO) therapy can promote the recovery of neural function in patients who have suffered traumatic brain injury (TBI), the underlying mechanism is unclear. We hypothesized that hyperbaric oxygen treatment plays a neuroprotective role in TBI by increasing regional transcranial oxygen saturation (rSO2) and oxygen partial pressure (PaO2). To test this idea, we compared two groups: a control group with 20 healthy people and a treatment group with 40 TBI patients. The 40 patients were given 100% oxygen of HBO for 90 minutes. Changes in rSO2 were measured. The controls were also examined for rSO2 and PaO2, but received no treatment, rSO2 levels in the patients did not differ significantly after treatment, but levels before and after treatment were significantly lower than those in the control group. PaO2 levels were significantly decreased after the 30-minute HBO treatment. Our findings suggest that there is a disorder of oxygen metabolism in patients with sub-acute TBI. HBO does not immediately affect cerebral oxygen metabolism, and the underlying mechanism still needs to be studied in depth.展开更多
BACKGROUND:Due to the still sparse literature in China,the investigation of hyperoxemia management is required.Thus,we aim to conduct a retrospective study to provide more information about hyperoxemia management in i...BACKGROUND:Due to the still sparse literature in China,the investigation of hyperoxemia management is required.Thus,we aim to conduct a retrospective study to provide more information about hyperoxemia management in intensive care unit(ICU)patients.METHODS:We retrospectively screened the medical records of adult patients(age≥18 years)who required mechanical ventilation(MV)≥24 hours from January 1,2018,to December 31,2018.All arterial blood gas(ABG)tested during MV was retrieved,and MV settings were recorded.The median arterial partial pressure of oxygen(PaO2)>120 mmHg(1 mmHg=0.133 kPa)was defined as mild to moderate hyperoxemia,and PaO2>300 mmHg as extreme hyperoxemia.Intensivists’response to hyperoxemia was assessed based on the reduction of fraction of inspired oxygen(FiO2)within one hour after hyperoxemia was recorded.Multivariable logistic regression analysis was performed to determine the independent factors associated with the intensivists’response to hyperoxemia.RESULTS:A total of 592 patients were fi nally analyzed.The median Acute Physiology and Chronic Health Evaluation II(APACHE II)score was 21(15-26).The PaO2,arterial oxygen saturation(SaO2),FiO2,and positive end expiratory pressure(PEEP)were 96.4(74.0-126.0)mmHg,97.8%(95.2%-99.1%),0.4(0.4-0.5),and 5(3-6)cmH2O,respectively.Totally 174(29.39%)patients had PaO2>120 mmHg,and 19(3.21%)patients had extreme hyperoxemia at PaO2>300 mmHg.In cases of mild to moderate hyperoxemia with FiO2≤0.4,only 13(2.20%)patients had a decrease in FiO2 within one hour.The multivariable logistic regression analysis showed that a positive response was independently associated with FiO2(odds ratio[OR]1.09,95%confi dence interval[CI]1.06-1.12,P<0.001),PaO2(OR 1.01,95%CI 1.00-1.01,P=0.002),and working shifts(OR 5.09,95%CI 1.87-13.80,P=0.001).CONCLUSIONS:Hyperoxemia occurs frequently and is neglected in most cases,particularly when mild to moderate hyperoxemia,hyperoxemia with lower FiO2,hyperoxemia during night and middle-night shifts,or FiO2 less likely to be decreased.Patients may be at a risk of oxygen toxicity because of the liberal oxygen strategy.Therefore,further research is needed to improve oxygen management for patients with MV in the ICUs.展开更多
Background:Plasma expanders are widely used for acute normovolemic hemodilution(ANH).However,existing studies have not focused on large-volume infusion with colloidal plasma expanders,and there is a lack of studies th...Background:Plasma expanders are widely used for acute normovolemic hemodilution(ANH).However,existing studies have not focused on large-volume infusion with colloidal plasma expanders,and there is a lack of studies that compare the effects of different plasma expanders.Methods:The viscosity,hydrodynamic radius(Rh)and colloid osmotic pressure(COP)of plasma expanders were determined by a cone-plate viscometer,Zetasizer and cut-off membrane,respectively.Sixty male rats were randomized into five groups with Gelofusine(Gel),Hydroxyethyl Starch 200/0.5(HES200),Hydroxyethyl Starch 130/0.4(HES130),Hydroxyethyl Starch 40(HES40),and Dextran 40(Dex40),with 12 rats used in each group to build the ANH model.ANH was performed by the withdrawal of blood and simultaneous infusion of plasma expanders.Acid-base,lactate,blood gas and physiological parameters were detected.Results:Gel had a lower intrinsic viscosity than HES200 and HES130(P<0.01),but at a low shear rate in a mixture of colloids,red cells and plasma,Gel had a higher viscosity(P<0.05 or P<0.01,respectively).For hydroxyethyl starch plasma expanders,the COP at a certain concentration decreases from 11.1 mmHg to 6.1 mmHg with the increase of Rh from 10.7 nm to 20.2 nm.A severe ANH model,with the hematocrit of 40%of the baseline level,was established and accompanied by disturbances in acid-base,lactate and blood gas parameters.At the end of ANH and 60 min afterward,the Dex40 group showed a worse outcome in maintaining the acid-base balance and systemic oxygenation compared to the other groups.The systolic blood pressure(SBP),diastolic blood pressure(DBP),and mean arterial pressure(MAP)decreased significantly in all groups at the end of ANH.The DBP and MAP in the Dex40 group further decreased 60 min after the end of ANH.During the process of ANH,the Dex40 group showed a drop and recovery in SBP,DBP and MAP.The DBP and MAP in the HES200 group were significantly higher than those in the other groups at some time points(P<0.05 or P<0.01).Conclusions:Gel had a low intrinsic viscosity but may increase the whole blood viscosity at low shear rates.Rh and COP showed a strong correlation among hydroxyethyl starch plasma expanders.Dex40 showed a worse outcome in maintaining the acid-base balance and systemic oxygenation compared to the other plasma expanders.During the process of ANH,Dex40 displayed a V-shaped recovery pattern for blood pressure,and HES200 had the advantage in sustaining the DBP and MAP at some time points.展开更多
OBJECTIVE To investigate whether Renqing Changjue has a protective effect on acute respiratory distress syndrome(ARDS)induced by endotoxin lipopolysaccharide(LPS)in rabbits.METHODS Thirty-six healthy male New Zealand ...OBJECTIVE To investigate whether Renqing Changjue has a protective effect on acute respiratory distress syndrome(ARDS)induced by endotoxin lipopolysaccharide(LPS)in rabbits.METHODS Thirty-six healthy male New Zealand white rabbits were randomly divided into six groups:normal control group,model group,dexamethasone group,Renqing Changjue high,middle and low dose group,with six rabbits in each group.LPS was used to replicate the ARDS model after five consecutive days of gavage.Arterial pressure,respiratory rate and anal temperature blood were recorded for arterial blood gas analysis at 0,0.5,1,2 and 4 h,respectively.At the end of the four-hour experiment,rabbits were killed by bloodletting,and the lung tissue was quickly removed to determine the cytokines,SOD,MDA and pathological examination of rabbit lung.RESULTS Renqing Changjue can significantly reduce the pathological changes of lung in ARDS model group.The expression of AQP1 and MPO in rabbit lung was significantly decreased by immunohistochemistry(P<0.05),reduce the lung wet/dry weight ratio,increase the ratio of PaO_(2)/FiO_(2),inhibit the release of inflammatory factors and scavenge free radicals and antioxidant effects.CONCLUSION Renqing Changjue can effectively protect rabbits with acute respiratory distress syndrome induced by LPS,and may protect the lung by inhibiting the release of cytokines and anti-oxidation.展开更多
文摘Objective:To investigate the effects of budesonide on blood gas and inflammation indexes in patients with chronic obstructive pulmonary disease(COPD)during remission.Methods:Fifty-one patients with COPD in remission,admitted to Zhongshan Hospital of Dalian University from July 2021 to December 2022,were selected and divided into two groups based on a randomized numerical table method.The control group(25 cases)received budesonide formoterol treatment,while the observation group(26 cases)received budesonide geforce treatment.Various indexes,including clinical efficacy,blood gas indexes,inflammation indexes,St.George’s Respiratory Questionnaire(SGRQ)scores,Chronic Obstructive Pulmonary Disease Assessment Test(CAT)scores,and 6-minute Walking Distance Test(6MWD)results,were compared between the two groups.Results:After 21 days of treatment,the total clinical effectiveness rate of the observation group was higher than that of the control group,with a statistically significant difference(P<0.05).Post-treatment,the PaO2 level and pH value in both groups were higher,and the PaCO_(2) level was lower compared to pre-treatment levels.The observation group showed better improvements in these indicators than the control group,with statistically significant differences(P<0.05).SGRQ and CAT scores for both groups were lower post-treatment,with the observation group scoring lower than the control group.Additionally,the 6MWD results were farther for both groups post-treatment,with the observation group achieving greater distances than the control group,with statistically significant differences(P<0.05).Conclusion:Budesonide can effectively improve blood gas indexes in patients with COPD in remission,alleviate related clinical symptoms,reduce inflammatory responses,and promote patient recovery.The treatment efficacy is significant.
基金supported by the grants from Innovation Fund for Medical Sciences (CIFMS) from Chinese Academy of Medical Sciences (No.2021-I2M-1-062)National Key R&D Program of China from Ministry of Science and Technology of the People’s Republic of China (No.2022YFC2304601,2021YFC2500801)+1 种基金National High Level Hospital Clinical Research Funding (2022-PUMCH-D-005,2022-PUMCH-D-111,2022-PUMCH-B-126)National key clinical specialty construction projects from National Health Commission。
文摘BACKGROUND:Emergency patients with sepsis or septic shock are at high risk of death.Despite increasing attention to microhemodynamics,the clinical use of advanced microcirculatory assessment is limited due to its shortcomings.Since blood gas analysis is a widely used technique reflecting global oxygen supply and consumption,it may serve as a surrogate for microcirculation monitoring in septic treatment.METHODS:We performed a search using PubMed,Web of Science,and Google scholar.The studies and reviews that were most relevant to septic microcirculatory dysfunctions and blood gas parameters were identified and included.RESULTS:Based on the pathophysiology of oxygen metabolism,the included articles provided a general overview of employing blood gas analysis and its derived set of indicators for microhemodynamic monitoring in septic care.Notwithstanding flaws,several parameters are linked to changes in the microcirculation.A comprehensive interpretation of blood gas parameters can be used in order to achieve hemodynamic optimization in septic patients.CONCLUSION:Blood gas analysis in combination with clinical performance is a reliable alternative for microcirculatory assessments.A deep understanding of oxygen metabolism in septic settings may help emergency physicians to better use blood gas analysis in the evaluation and treatment of sepsis and septic shock.
文摘Objective:To analyze the effect of combined inhalation of budesonide formoterol and tiotropium bromide on arterial blood gas and pulmonary function indexes in patients with chronic obstructive pulmonary disease(COPD).Methods:100 patients with COPD treated from January to December 2022 were selected as observation objects,and were divided into a control group(n=50,in which budesonide and formoterol were administered)and an experimental group(n=50,the treatment drug was budesonide formoterol combined with tiotropium bromide)according to the computer grouping method,and compared the treatment results.Results:(i)Before treatment,there was no difference in the partial pressure of carbon dioxide and partial pressure of oxygen between the control group and the experimental group(P>0.05);after treatment,the partial pressure of carbon dioxide and partial pressure of oxygen in the experimental group were higher than those in the control group,with significant differences(P<0.05).(ii)Before treatment,there was no difference in forced vital capacity(FVC),forced expiratory volume in one second(FEV1),FEV1/FVC between the control group and the experimental group(P>0.05);after treatment,the FVC,FEV1,and FEV1/FVC in the experimental group were significantly higher than those in the control group(P<0.05).(iii)There was no difference in the levels of CRP,IL-6,and TNF-αbetween the control group and the experimental group(P>0.05);after treatment,the levels of CRP,IL-6,and TNF-αin the experimental group were lower than those in the control group,with significant differences(P<0.05).(iv)Compared to the total incidence of adverse reactions in the control group(28.00%),the incidence of total adverse reactions in the experimental group was lower at 10.00%,and the difference was significant(P<0.05).Conclusion:The combined inhalation of budesonide and formoterol with tiotropium bromide has demonstrated a clear therapeutic efficacy and safety in treating chronic obstructive pulmonary disease.This treatment approach effectively enhances arterial blood gas levels and lung function,showing promising potential for widespread application.
基金supported by the National Natural Science Foundation of China (41161019, 41461020)
文摘The increasing intensity and frequency of sand-dust storms in China has led to greater prominence of associated environmentaland health issues. Many studies have focused on the health effects of air particulate contaminants, but fewformal investigations have studied the effects of sand-dust storms on human and animal health. The aim of this study wasto investigate the effects of dust storms on rat lung by using high resolution computed tomography (HRCT) and blood gasanalysis through a wind tunnel simulating. We found that the rat lung damage effects can be detected by the HRCT imagingafter exposure to sand-dust storm environments, but had no obvious result through blood gas analysis. Exposure durationspositively correlated with the damage degree to lung tissue. These will provide some evidence for clinical diagnosis ofnon-occupational pneumoconiosis.
基金Science and Technology Project of Municipal Health Commission of Lianyungang,No.QN202010.
文摘BACKGROUND Term pregnancy-induced labor refers to the use of artificial methods to induce uterine contractions and terminate pregnancy after 37 wk.It is a common method to prevent overdue pregnancy and to deal with high-risk pregnancies.In addition,it can alleviate maternal complications and cause the fetus to leave the adverse intrauterine environment early,which is beneficial to the outcome of pregnancy.AIM To explore the effect of a birthing ball on labor by inducing cervical ripening and its influence on labor and the neonatal blood gas index.METHODS Twenty-two women who were scheduled to undergo labor induction and delivery in the obstetrics department of our hospital were randomly divided into two groups:the delivery ball group(childbirth ball combined with COOK balloon induction)and the conventional group(COOK balloon induction alone).The cervical Bishop score before and after intervention,duration of labor at each stage,mode of delivery,neonatal umbilical venous blood pH,oxygen partial pressure(PO_(2)),carbon dioxide partial pressure(PCO_(2)),and the 1-min Apgar score were recorded.RESULTS After the intervention,the cervical Bishop score of the delivery ball group(7.84±1.52)was significantly higher than that of the conventional group(7.32±1.29)(P<0.05),and the cervical Bishop scores of the two groups after intervention were significantly higher than those before intervention(P<0.05).After the intervention,the first stage of labor(510.9±98.7 min),the second stage of labor(43.0±8.5 min),and the total duration of labor(560.0±120.9 min)in the delivery ball group were lower than those in the routine group,with a first stage of labor of 602.1±133.2 min,a second stage of labor of 48.4±9.1 min,and a total duration of labor of 656.8±148.5 min(P<0.05).There was no significant difference in the time of the third stage of labor between the two groups(P>0.05).There was no significant difference in the pH,PO_(2),and PCO_(2) values of newborns between the delivery ball group and the conventional group(P>0.05).The 1-min Apgar score of the delivery ball group was higher than that of the conventional group(9.10±0.38 points vs 8.94±0.31 points,P<0.05).The natural delivery rate of the delivery ball group was higher than that of the conventional group(91.00%vs 78.00%,P<0.05).CONCLUSION The use of a birthing ball combined with a COOK balloon for inducing labor has a better effect on promoting cervical ripening,shortening the time of labor,and improving the Apgar score of newborns.
文摘Continuous intra-arterial blood gas monitoring is used clinically in hospital and intensive care unit settings.The blood gas can be detected by the colormetric indicators which are sealed in the silicone membrane.The glass tubing of the sensor should be as thin as possible since it affects response time and the bicarbonate buffer shifts the sensitivity of the sensor. In this paper,the sensitivity shifts by the bicarbonate buffer was researched.When carbon dioxide diffuses into the indicator, the carbon acid is produced and the bicarbonate buffer is used to control internal acidity.Because the sensitivity of the pCO_2 sensor is increased by controlling the concentration of the bicarbonate buffer,the bicarbonate buffer is used to obtain the optimum resolution in this investigation.Moreover,the different concentrations of the bicarbonate buffer for blood gas measurements are discussed in detail.
文摘BACKGROUND:Epileptic seizures account for 1%–2% of all admissions of patients to the emergency department(ED). The present study aimed to determine whether venous blood pH,bicarbonate,base excess,and lactate levels taken within 1 hour of the last seizure episode help to determine seizure recurrence in emergency departments.METHODS:A cross-sectional study was conducted in the emergency department(ED) between January and July,2012. Patients who were admitted to the emergency department consecutively were included in the study if they were 14 years or older and within 1 hour after last seizure. Demographics,seizure type,use of antiepileptic drugs,observation period at the emergency department,seizure recurrence,pH,bicarbonate,base excess,and lactate levels from venous blood gas analysis were determined.RESULTS:A total of 94 patients aged 14 years or older were included in the study. Of these patients,10.6%(n=10) experienced recurrent seizures in the observation period at the emergency department. To predict recurrent seizures in ED,threshold venous blood gas values were determined as follows:pH<7.245 [sensitivity 80%(95%CI:44–96),negative predictive value 96.9%(95%CI:88.3–99.4)],bicarbonate<17.1 mmol/L [sensitivity 80%(95%CI:44–96),negative predictive value 97%(95%CI:89–99.5)],base excess<–11.1 mEq/L [sensitivity 80%(95%CI:44–96),negative predictive value 97%(95%CI:89–99)],and lactate>7.65 mmol/L [sensitivity 80%(95%CI:44–96),negative predictive value 96.6%(95%CI:87–99)].CONCLUSION:If venous blood gas analysis is made on pH,base excess,lactate and bicarbonate immediately one hour after the last epileptic seizure episode,it is possible to predict whether the patient will have seizure recurrence.
文摘BACKGROUND Laparoscopic-assisted radical gastrectomy(LARG)is the standard treatment for early-stage gastric carcinoma(GC).However,the negative impact of this proce-dure on respiratory function requires the optimized intraoperative management of patients in terms of ventilation.AIM To investigate the influence of pressure-controlled ventilation volume-guaranteed(PCV-VG)and volume-controlled ventilation(VCV)on blood gas analysis and pulmonary ventilation in patients undergoing LARG for GC based on the lung ultrasound score(LUS).METHODS The study included 103 patients with GC undergoing LARG from May 2020 to May 2023,with 52 cases undergoing PCV-VG(research group)and 51 cases undergoing VCV(control group).LUS were recorded at the time of entering the operating room(T0),20 minutes after anesthesia with endotracheal intubation(T1),30 minutes after artificial pneumoperitoneum(PP)establishment(T2),and 15 minutes after endotracheal tube removal(T5).For blood gas analysis,arterial partial pressure of oxygen(PaO_(2))and partial pressure of carbon dioxide(PaCO_(2))were observed.Peak airway pressure(P_(peak)),plateau pressure(Pplat),mean airway pressure(P_(mean)),and dynamic pulmonary compliance(C_(dyn))were recorded at T1 and T2,1 hour after PP establishment(T3),and at the end of the operation(T4).Postoperative pulmonary complications(PPCs)were recorded.Pre-and postoperative serum interleukin(IL)-1β,IL-6,and tumor necrosis factor-α(TNF-α)were measured by enzyme-linked immunosorbent assay.RESULTS Compared with those at T0,the whole,anterior,lateral,posterior,upper,lower,left,and right lung LUS of the research group were significantly reduced at T1,T2,and T5;in the control group,the LUS of the whole and partial lung regions(posterior,lower,and right lung)decreased significantly at T2,while at T5,the LUS of the whole and some regions(lateral,lower,and left lung)increased significantly.In comparison with the control group,the whole and regional LUS of the research group were reduced at T1,T2,and T5,with an increase in PaO_(2),decrease in PaCO_(2),reduction in P_(peak) at T1 to T4,increase in P_(mean) and C_(dyn),and decrease in Pplat at T4,all significant.The research group showed a significantly lower incidence of PPCs than the control group within 3 days postoperatively.Postoperative IL-1β,IL-6,and TNF-αsignificantly increased in both groups,with even higher levels in the control group.CONCLUSION LUS can indicate intraoperative non-uniformity and postural changes in pulmonary ventilation under PCV-VG and VCV.Under the lung protective ventilation strategy,the PCV-VG mode more significantly improved intraop-erative lung ventilation in patients undergoing LARG for GC and reduced lung injury-related cytokine production,thereby alleviating lung injury.
文摘Background It has been stated that preoperative pulmonary function tests are essential to assess the surgical risk in patients with scoliosis.Arterial blood gas tests have also been used to evaluate pulmonary function before scoliotic surgery.However,few studies have been reported.The aim of this study was to investigate the roles of preoperative arterial blood gas tests in the surgical treatment of scoliosis with moderate or severe pulmonary dysfunction.Methods This study involved scoliotic patients with moderate or severe pulmonary dysfunction (forced vital capacity 〈60%) who underwent surgical treatment between January 2002 and April 2010.A total of 73 scoliotic patients (23 males and 50 females) with moderate or severe pulmonary dysfunction were included.The average age of the patients was 16.53 years (ranged 10-44).The demographic distribution,medical records,and radiographs of all patients were collected.All patients received arterial blood gas tests and pulmonary function tests before surgery.The arterial blood gas tests included five parameters:partial pressure of arterial oxygen,partial pressure of arterial carbon dioxide,alveolar-arterial oxygen tension gradient,pH,and standard bases excess.The pulmonary function tests included three parameters:forced expiratory volume in 1 second ratio,forced vital capacity ratio,and peak expiratory flow ratio.All five parameters of the arterial blood gas tests were compared between the two groups with or without postoperative pulmonary complications by variance analysis.Similarly,all three parameters of the pulmonary function tests were compared.Results The average coronal Cobb angle before surgery was 97.42° (range,50°-180°).A total of 15 (20.5%) patients had postoperative pulmonary complications,including hypoxemia in 5 cases (33.3%),increased requirement for postoperative ventilatory support in 4 (26.7%),pneumonia in 2 (13.3%),atelectasis in 2 (13.3%),pneumothorax in 1 (6.7%),and hydrothorax in 1 (6.7%).No significant differences in demographic characteristics or perioperative factors (P 〉0.05) existed between the two groups with or without postoperative pulmonary complications.According to the variance analysis,there were no statistically significant differences in any parameter of the arterial blood gas tests between the two groups.Conclusions No significant correlation between the results of the preoperative arterial blood gas tests and postoperative pulmonary complications existed in scoliotic patients with moderate or severe pulmonary dysfunction.However,the postoperative complications tended to increase with the decrease of partial pressure of arterial oxygen in the arterial blood gas tests.
文摘Objective: In order to explore the mechanism of C hinese traditional breath training, the effects of end-inspiratory pause br eathing (EIPB) on the respiratory mechanics and arterial blood gas were studied in patients with chronic obstructive pulmo nary disease (COPD).Methods: Ten patients in steady stage participating in the stud y had a breath training of regulating the respiration rhythm as to having a pause betw een the deep and slow inspiration and the slow expiration.Effect of the training was observed by visual feedback from the screen of the re spiratory inductive plethysmograph. The dynamic change of partial pressure of oxygen saturation in blood (SpO 2) was recorded with sphygmo-oximeter, the pulmonary mechanics and EIPB were determined with spirometer, and the data o f arterial blood gases in tranquilized breathing and EIPB were analysed.Results: After EIPB training, SpO 2 increased progressively, PaO 2 increased and PaCO 2 decreased, and the PaO 2 increment was greater than the PaCO 2 decrement. Furthermore, the tidal volume increased and the frequency of respira tion decreased significantly, both inspiration time and expiration time were prolonged. There was no significant change in both mean inspiration flow rate (VT/Ti) and expir ation flow rate (VT/Te). The baselines in spirogram during EIPB training had no raise. Conclusion: EIPB could decrease the ratio of the dead space and ti dal volume (VD/VT), cause increase of PaO 2 more than the decrease of PaCO 2, suggesting that this training could impro ve both the function of ventilation and gaseous exchange in the lung. EIPB training might be a breath ing training pattern for rehabilitation of patients with COPD.
基金the National Key Research&Development Program of China(2016YFC1000400,2018YFC1002903).
文摘Objective:To evaluate the predictive ability of neonate condition through the traditional parameters and artery umbilical cord blood gas(aUCBG).Methods:A prospective cohort study was conducted in obstetrics and gynecology department between October 2017 and August 2018 at Tongji Hospital in Wuhan,China,and 360 aUCBG samples were collected.The average age of pregnant women was(29.50±4.42)years,range from 19 to 48 years old.The gestational age range from 28+4 weeks to 41+3 weeks at admission.Logistic regression and area under the curve(AUC)from Receiver operating characteristic curves were used to identify risk factors,such as,premature rupture of membranes(PROM),high blood pressure,premature delivery(PD),low 1-minute Apgar scores(Apgar 1),low 5-minute Apgar scores(Apgar 5),pH,base excess,bicarbonate,neonatal blood sugar(NBS),and so on,to predict neonatal condition and evaluate the predictive ability of traditional and aUCBG parameters.Results:In all cases,PROM,PD,Apgar 1,Apgar 5,pH,base excess,bicarbonate,total carbon dioxide,and neonatal blood sugar were risk factors and were associated with poor condition of neonate.Apgar 1 were an independent risk factor.Combined traditional and aUCBG parameters had higher AUC of 0.895(95%confidence interval(C/):0.830-0.960,P<0.001).In cesarean section subgroup,high blood pressure,PD,and Apgar 1 were risk factors and were associated with poor condition of neonate.Apgar 1 and low pH were the independent risk factors.Combined traditional and aUCBG parameters had highest AUC of 0.940(95%C/:0.886-0.993,P<0.001).In vaginal delivery subgroup,maternal age above 35 years,PROM,PD,Apgar 1,Apgar 5,and male newborn were risk factors and were associated with poor condition of neonate.Maternal age above 35 years was an independent risk factor.Combined traditional and aUCBG parameters had highest AUC of 0.897(95%Cl:0.828-0.965,P<0.001).For pregnant women without comorbidities and complications of pregnancy,aUCBG may not be necessat7.Conclusion:In high-risk pregnancies,especially lower Apgar scores,PD,and maternal age above 35-year old,aUCBG is recommended.Traditional parameters combined with aUCBG might increase the predicting ability of neonate condition.
文摘BACKGROUND Severe pneumonia is a common severe respiratory infection worldwide,and its treatment is challenging,especially for patients in the intensive care unit(ICU).AIM To explore the effect of communication and collaboration between nursing teams on the treatment outcomes of patients with severe pneumonia in ICU.METHODS We retrospectively analyzed 60 patients with severe pneumonia who were treated at the ICU of the hospital between January 1,2021 and December 31,2023.We compared and analyzed the respiratory mechanical indexes[airway resistance(Raw),mean airway pressure(mPaw),peak pressure(PIP)],blood gas analysis indexes(arterial oxygen saturation,arterial oxygen partial pressure,and oxygenation index),and serum inflammatory factor levels[C-reactive protein(CRP),procalcitonin(PCT),cortisol(COR),and high mobility group protein B1(HMGB1)]of all patients before and after treatment.RESULTS Before treatment,there was no significant difference in respiratory mechanics index and blood gas analysis index between 2 groups(P>0.05).However,after treatment,the respiratory mechanical indexes of patients in both groups were significantly improved,and the improvement of Raw,mPaw,plateau pressure,PIP and other indexes in the combined group after communication and collaboration with the nursing team was significantly better than that in the single care group(P<0.05).The serum CRP and PCT levels of patients were significantly decreased,and the difference was statistically significant compared with that of nursing group alone(P<0.05).The levels of serum COR and HMGB1 before and after treatment were also significantly decreased between the two groups.CONCLUSION The communication and collaboration of the nursing team have a significant positive impact on respiratory mechanics indicators,blood gas analysis indicators and serum inflammatory factor levels in the treatment of severe pneumonia patients in ICU.
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Objective: To explore the consistency and relevance of the results of the bedside rapid blood gas analyzer GEM premier 3000, the Vitros5.1+5600 biochemical immunoassay analyzer and the SYSMEX XN-9000 automatic blood cell analyzer in the central laboratory detecting serum potassium (K<sup>+</sup>), serumsodium (Na<sup>+</sup>), blood glucose (Glu), hemoglobin (Hb) and red blood cell volume (Hct). And to provide a reference for the accurate interpretation of the bedside blood gas analysis report. Method: Usually, ICU patients will be taken arterial blood gas, biochemical and blood samples through the arterial indwelling needle;at the same time patients’ potassium, serum sodium, blood glucose, hemoglobin and red blood cell volume will be detected. This study implemented paired t-test and correlation regression analysis on each group of data, and used the analysis quality requirements (allowable total error) of CLIA’88 proficiency testing program as the criteria for clinical acceptance. Results: The paired t-test showed that the serum potassium, serum sodium and blood glucose detected by GEM premier 3000 and Vitros5.1+5600 were significantly different;and the hemoglobin and red blood cell volume detected by GEM premier 3000 and SYSMEX XN-9000 were significantly different (P < 0.05). The Pearson correlation coefficients (r) of hemoglobin, red blood cell volume and red blood cell volume were 0.860, 0.886, 0.924, 0.841 and 0.856, respectively, and the above test items all had good correlations (P < 0.05). The average (SE) of the paired differences of K<sup>+</sup>, Na<sup>+</sup>, Glu, Hb and Hct detected by the two sets of instruments is less than the allowable error of CLIA’88, and the SE of blood Na<sup>+</sup> and Hb is less than half of the allowable error of CLIA’88. Conclusion: The test results of GEM premier 3000, the central laboratory Vitros5.1+5600 and SYSMEX XN-9000 have good correlation, but the consistency is not good. The test results of GEM premier 3000 cannot replace the central laboratory.
文摘Objective:To describe the strategies and outcomes of mechanical ventilation in a poorly equipped facility.Methods:This retrospective descriptive study included patients with COVID-19 who were admitted to the intensive care unit(ICU)and mechanically ventilated between September 1,2020,and May 31,2021.Data were collected from medical records and databases.Results:54 Patients aged(62.9±13.3)years were included.Among these cases,79.6%had at least one comorbidity.On admission,all patients had hypoxia.The median peripheral oxygen saturation in room air was 76%(61%,83%).Non-invasive ventilation(NIV)was performed in 75.9%of the patients,and invasive mechanical ventilation(IMV)in 68.5%.IMV was performed on patients due to severe coma(8.1%),failure of standard oxygen therapy(27.0%),and failure of NIV(64.9%).An arterial blood gas test was performed in 14.8%of the patients.NIV failed in 90.2%of cases and succeeded in 9.8%.IMV was successful in 5.4%of cases,vs.94.6%of mortality.The overall mortality rate of patients on ventilation in the ICU was 88.9%.The causes of death included severe respiratory distress syndrome(85.2%),multiple organ failure(14.8%),and pulmonary embolism(13.0%).Conclusions:The ventilation management of COVID-19 patients in the ICU with NIV and IMV in a scarce resource setting is associated with a high mortality rate.Shortcomings are identified in ventilation strategies,protocols,and monitoring.Required improvements were also proposed.
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.
基金supported by a grant from Suzhou Key Medicine Project Fund of China,No.Szxk201504
文摘Although hyperbaric oxygen (HBO) therapy can promote the recovery of neural function in patients who have suffered traumatic brain injury (TBI), the underlying mechanism is unclear. We hypothesized that hyperbaric oxygen treatment plays a neuroprotective role in TBI by increasing regional transcranial oxygen saturation (rSO2) and oxygen partial pressure (PaO2). To test this idea, we compared two groups: a control group with 20 healthy people and a treatment group with 40 TBI patients. The 40 patients were given 100% oxygen of HBO for 90 minutes. Changes in rSO2 were measured. The controls were also examined for rSO2 and PaO2, but received no treatment, rSO2 levels in the patients did not differ significantly after treatment, but levels before and after treatment were significantly lower than those in the control group. PaO2 levels were significantly decreased after the 30-minute HBO treatment. Our findings suggest that there is a disorder of oxygen metabolism in patients with sub-acute TBI. HBO does not immediately affect cerebral oxygen metabolism, and the underlying mechanism still needs to be studied in depth.
文摘BACKGROUND:Due to the still sparse literature in China,the investigation of hyperoxemia management is required.Thus,we aim to conduct a retrospective study to provide more information about hyperoxemia management in intensive care unit(ICU)patients.METHODS:We retrospectively screened the medical records of adult patients(age≥18 years)who required mechanical ventilation(MV)≥24 hours from January 1,2018,to December 31,2018.All arterial blood gas(ABG)tested during MV was retrieved,and MV settings were recorded.The median arterial partial pressure of oxygen(PaO2)>120 mmHg(1 mmHg=0.133 kPa)was defined as mild to moderate hyperoxemia,and PaO2>300 mmHg as extreme hyperoxemia.Intensivists’response to hyperoxemia was assessed based on the reduction of fraction of inspired oxygen(FiO2)within one hour after hyperoxemia was recorded.Multivariable logistic regression analysis was performed to determine the independent factors associated with the intensivists’response to hyperoxemia.RESULTS:A total of 592 patients were fi nally analyzed.The median Acute Physiology and Chronic Health Evaluation II(APACHE II)score was 21(15-26).The PaO2,arterial oxygen saturation(SaO2),FiO2,and positive end expiratory pressure(PEEP)were 96.4(74.0-126.0)mmHg,97.8%(95.2%-99.1%),0.4(0.4-0.5),and 5(3-6)cmH2O,respectively.Totally 174(29.39%)patients had PaO2>120 mmHg,and 19(3.21%)patients had extreme hyperoxemia at PaO2>300 mmHg.In cases of mild to moderate hyperoxemia with FiO2≤0.4,only 13(2.20%)patients had a decrease in FiO2 within one hour.The multivariable logistic regression analysis showed that a positive response was independently associated with FiO2(odds ratio[OR]1.09,95%confi dence interval[CI]1.06-1.12,P<0.001),PaO2(OR 1.01,95%CI 1.00-1.01,P=0.002),and working shifts(OR 5.09,95%CI 1.87-13.80,P=0.001).CONCLUSIONS:Hyperoxemia occurs frequently and is neglected in most cases,particularly when mild to moderate hyperoxemia,hyperoxemia with lower FiO2,hyperoxemia during night and middle-night shifts,or FiO2 less likely to be decreased.Patients may be at a risk of oxygen toxicity because of the liberal oxygen strategy.Therefore,further research is needed to improve oxygen management for patients with MV in the ICUs.
基金supported by the National Key Research and Development Program of China(2018YFC1106503)。
文摘Background:Plasma expanders are widely used for acute normovolemic hemodilution(ANH).However,existing studies have not focused on large-volume infusion with colloidal plasma expanders,and there is a lack of studies that compare the effects of different plasma expanders.Methods:The viscosity,hydrodynamic radius(Rh)and colloid osmotic pressure(COP)of plasma expanders were determined by a cone-plate viscometer,Zetasizer and cut-off membrane,respectively.Sixty male rats were randomized into five groups with Gelofusine(Gel),Hydroxyethyl Starch 200/0.5(HES200),Hydroxyethyl Starch 130/0.4(HES130),Hydroxyethyl Starch 40(HES40),and Dextran 40(Dex40),with 12 rats used in each group to build the ANH model.ANH was performed by the withdrawal of blood and simultaneous infusion of plasma expanders.Acid-base,lactate,blood gas and physiological parameters were detected.Results:Gel had a lower intrinsic viscosity than HES200 and HES130(P<0.01),but at a low shear rate in a mixture of colloids,red cells and plasma,Gel had a higher viscosity(P<0.05 or P<0.01,respectively).For hydroxyethyl starch plasma expanders,the COP at a certain concentration decreases from 11.1 mmHg to 6.1 mmHg with the increase of Rh from 10.7 nm to 20.2 nm.A severe ANH model,with the hematocrit of 40%of the baseline level,was established and accompanied by disturbances in acid-base,lactate and blood gas parameters.At the end of ANH and 60 min afterward,the Dex40 group showed a worse outcome in maintaining the acid-base balance and systemic oxygenation compared to the other groups.The systolic blood pressure(SBP),diastolic blood pressure(DBP),and mean arterial pressure(MAP)decreased significantly in all groups at the end of ANH.The DBP and MAP in the Dex40 group further decreased 60 min after the end of ANH.During the process of ANH,the Dex40 group showed a drop and recovery in SBP,DBP and MAP.The DBP and MAP in the HES200 group were significantly higher than those in the other groups at some time points(P<0.05 or P<0.01).Conclusions:Gel had a low intrinsic viscosity but may increase the whole blood viscosity at low shear rates.Rh and COP showed a strong correlation among hydroxyethyl starch plasma expanders.Dex40 showed a worse outcome in maintaining the acid-base balance and systemic oxygenation compared to the other plasma expanders.During the process of ANH,Dex40 displayed a V-shaped recovery pattern for blood pressure,and HES200 had the advantage in sustaining the DBP and MAP at some time points.
基金2020 Project of Tibetan Medicine Administration of Tibet Autonomous Region(JJKT202004)and 2020 Reform and Development Special Project(324042000101)。
文摘OBJECTIVE To investigate whether Renqing Changjue has a protective effect on acute respiratory distress syndrome(ARDS)induced by endotoxin lipopolysaccharide(LPS)in rabbits.METHODS Thirty-six healthy male New Zealand white rabbits were randomly divided into six groups:normal control group,model group,dexamethasone group,Renqing Changjue high,middle and low dose group,with six rabbits in each group.LPS was used to replicate the ARDS model after five consecutive days of gavage.Arterial pressure,respiratory rate and anal temperature blood were recorded for arterial blood gas analysis at 0,0.5,1,2 and 4 h,respectively.At the end of the four-hour experiment,rabbits were killed by bloodletting,and the lung tissue was quickly removed to determine the cytokines,SOD,MDA and pathological examination of rabbit lung.RESULTS Renqing Changjue can significantly reduce the pathological changes of lung in ARDS model group.The expression of AQP1 and MPO in rabbit lung was significantly decreased by immunohistochemistry(P<0.05),reduce the lung wet/dry weight ratio,increase the ratio of PaO_(2)/FiO_(2),inhibit the release of inflammatory factors and scavenge free radicals and antioxidant effects.CONCLUSION Renqing Changjue can effectively protect rabbits with acute respiratory distress syndrome induced by LPS,and may protect the lung by inhibiting the release of cytokines and anti-oxidation.