Comparative Analysis of Budesonide Treatments on Blood Gas and Inflammation in Chronic Obstructive Pulmonary Disease Remission

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.

Blood gas analysis as a surrogate for microhemodynamic monitoring in sepsis

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.

Effects of Combined Inhalation of Budesonide,Formoterol,and Tiotropium Bromide on Arterial Blood Gas and Pulmonary Function Indexes in Patients with Chronic Obstructive Pulmonary Disease

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.

An investigation of the effects of dust storms on rat lung using HRCT and blood gas analysis

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.

Birthing ball on promoting cervical ripening and its influence on the labor process and the neonatal blood gas index

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.

Effect of blood gas analysis in patients with bed rest and blood sampling through the dorsal artery:A meta-analysis

Objective:To systematic evaluation by the dorsalis pedis artery puncture for bed patients blood gas analysis of application effect of impact.Methods:A randomized controlled trial of the effect of arterial blood extraction on blood gas analysis in PubMed,CNKI,Wanfang database and VIP database.After selecting the literature,extracting the data and evaluating the quality of the literature.Meta- analysis was carried out by RevMan 5.3 software.Results:Twelve randomized controlled trials were included and 1696 patients were enrolled.After meta-analysis,the arterial puncture can effectively improve the success of arterial puncture in patients with bed [Z = 5.78,95%CI(1.90,3.66),P<0.001],reduce the occurrence of hematoma [Z = 4.27,95%CI(0.19,0.54),P<0.001],reduce the mistaken into the vein [Z = 4.60,95%CI(0.08,0.36),P<0.001],reduce cyanosis [Z = 2.84,95%CI(0.23,0.81),P<0.008],the difference was statistically significant.Conclusion:Dorsalis pedis artery puncture can improve the success rate of blood gas analysis in bedridden patients,reduce the incidence of hematoma and the incidence of venous leakage,and can be widely used in clinical practice.

Study on the Blood Gas Sensor Based on Optical Absorption Technology

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.

Effects of Imidapril on Venous Blood Gas Values in Broiler Chickens Exposed to Low Ambient Temperature

ObjectiveThis study was designed to evaluate the effects of imidapril on blood gas parameters in broiler chickens. MethodTwenty-four chickens were randomly divided into three groups (n=8), control group, low temperature group and imidapril group. Chickens in low temperature group and imidapril group were exposed to low ambient temperature (12-18 ℃) from age at 14 d to 45 d, whereas the control group was exposed to 24-30 ℃; chickens in imidapril group were gavaged with imidapril (3 mg/kg) once daily for 30 d. At age of 45 d, blood was taken from wing vein and blood gas parameters were evaluated by blood gas analyzer in Luoyang Central Hospital Affiliated to Zhengzhou University. ResultImidapril significantly increased hematocrit (HCT) and total hemoglobin content (T HBC ) and blood Na concentration in broiler chickens exposed to low ambient temperature. No significant differences were observed in pH, P CO 2 , P O 2 , K + , Ca 2+ , HCO 3-, HCO 3std , T CO 2 , BE and SO 2c . ConclusionImidapril increases hematocrit, total hemoglobin content and blood Na + concentration in chickens exposed to low ambient temperature.

Can venous blood gas analysis be used for predicting seizure recurrence in emergency department?

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.

A retrospective analysis of the relationship between dermatomyositis-associated interstitial lung disease and disease duration,age,arterial blood gas pH,and serum Cl^(-)levels

Background:Dermatomyositis-associated interstitial lung disease(DM-ILD)represents a severe and insidious complication of dermatomyositis(DM).The study aimed to investigate the association between DM-ILD and arterial blood gas indices,serum ion levels,and the timing of interstitial lung disease onset,with the goal of identifying potential predictors for DM-ILD.Methods:The investigation involved the collection of basic data from 89 patients with DM hospitalized at the Chinese PLA General Hospital between January 2019 and April 2022,and 43 normal control patients hospitalized for physical examinations during the same period.Analyses were conducted to explore the relationship between DM-ILD,arterial blood gas indices,disease duration,and serum ions.A regression model to predict DM-ILD was developed using these indices,and a receiver operating characteristic curve was generated.Results:Significant differences were observed in pH and PaO2 between the control group and the disease group(p<0.05).The DM group exhibited higher levels of pH,actual bicarbonate,and base excess(BE)compared with the control group.In contrast,pH and BE levels were lower in the DM-ILD group than in the DM group,with these differences being statistically significant(p<0.05).Interstitial lung disease was correlated with the duration of the disease and pH levels(p<0.05).The cutoff values for age,disease duration,pH,and Cl^(-)were 55.5 years,5.5 years,7.432,and 101.5 mmol/L,respectively.The model demonstrated a prediction sensitivity and specificity for DM-ILD of 0.809 and 0.722,respectively,with an area under the curve of 0.809.Conclusion:Arterial blood gas analysis and serum Cl^(-)levels may assist in predicting DM-ILD.A combined monitoring approach involving arterial blood gas pH,disease duration,age,and serum Cl^(-)levels could enhance the accuracy of DM-ILD predictions and hold significant clinical evaluation potential.

Lung ultrasound score evaluation of the effect of pressure-controlled ventilation volume-guaranteed on patients undergoing laparoscopicassisted radical gastrectomy

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.

Roles of preoperative arterial blood gas tests in the surgical treatment of scoliosis with moderate or severe pulmonary dysfunction

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.

Effects of Breath Training Pattern “End-Inspir atory Pause” on Respiratory Mechanics and Arterial Blood Gas of Pa tients with COPD

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.

The Clinical Value of Artery Umbilical Cord Blood Gas in Predicting Neonate Condition:A Prospective Cohort Study

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.

Effects of nursing team communication and collaboration on treatment outcomes in intensive care unit patients with severe pneumonia

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.

Experimental study on therapy of ultraviolet blood irradiation and oxygenation in acute soman intoxication in rabbits

Objective:To study the therapy effect of ultraviolet blood irradiation and oxygenation （UBIO） on blood AChe activity and lung injury due to acute soman intoxication in rabbits. Methods:Forty rabbits were randomly divided into 4 groups: normal control group, intoxication group, routine therapy group and UBIO therapy group. Blood AChe activity and artery blood gas were analyzed 2 h after intoxication. ACP and AKP activities in BALF were determined respectively. Results:Blood AChe activity in intoxication group was lower than that in normal control group （P<0.05）. BALF ACP and AKP activities in intoxication group were higher than that in normal control group. Blood AChe activities in UBIO therapy group increased and were higher than that in intoxication and routine therapy groups. Compared with intoxication group, BALF ACP and AKP activities were decreased （P<0.05） in UBIO therapy group, while artery blood pH, PaO2 and SaO2 increased （P<0.05）. Conclusion: UBIO therapy can elevate blood AChe activity and alleviate lung injury induced by soman intoxication. So it may be a new way to treat acute soman intoxication.

Algorithm-based arterial blood sampling recognition increasing safety in point-of-care diagnostics

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.

Correlation between GEM Premier 3000 and Vitros5.1+5600, SYSMEX XN-9000 in Detecting Electrolytes and Red Blood Cell Volume

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+), serumsodium (Na+), 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+, Na+, 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+ 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.

Mechanical ventilation and outcomes in COVID-19 patients admitted to intensive care unit in a low-resources setting: A retrospective study

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.

Does the advantage of transcutaneous oximetry measurements in diabetic foot ulcer apply equally to free flap reconstruction?

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.