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.

Use of sodium bicarbonate and blood gas monitoring in diabetic ketoacidosis: A review

Diabetic ketoacidosis(DKA) is a severe and toocommon complication of uncontrolled diabetes mellitus. Acidosis is one of the fundamental disruptions stemming from the disease process, the complications of which are potentially lethal. Hydration and insulin administration have been the cornerstones of DKA therapy; however, adjunctive treatments such as the use of sodium bicarbonate and protocols that include serial monitoring with blood gas analysis have been much more controversial. There is substantial literature available regarding the use of exogenous sodium bicarbonate in mild to moderately severe acidosis; the bulk of the data argue against significant benefit in important clinical outcomes and suggest possible adverse effects with the use of bicarbonate. However, there is scant data to support or refute the role of bicarbonate therapy in very severe acidosis. Arterial blood gas(ABG) assessment is an element of some treatment protocols, including society guidelines, for DKA. We review the evidence supporting these recommendations. In addition, we review the data supporting some less cumbersome tests, including venous blood gas assessment and routine chemistries. It remains unclear that measurement of blood gas pH, via arterial or venous sampling, impacts management of the patient substantially enough to warrant the testing, especially if sodium bicarbonate administration is not being considered. There are special circumstances when serial ABG monitoring and/or sodium bicarbonate infusion are necessary, which we also review. Additional studies are needed to determine the utility of these interventions in patients with severe DKA and pH less than 7.0.

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.

Effects of Hyperventilation on Venous-Arterial Bicarbonate Concentration Difference: A Possible Pitfall in Venous Blood Gas Analysis

Objectives: Recent reports on venous blood gas analysis have shown that venous bicarbonate concentration is useful in the evaluation of the body acid-base status. Most of these reports have been based on the Bland-Altman analysis comparing arterial and venous blood gas values. We intended to elucidate any factors that decrease the agreement between venous and arterial bicarbonate concentrations, which might impair the usefulness of venous blood gas analysis. Methods: Healthy volunteers and patients with various diseases (n = 141) were evaluated by simultaneous arterial and venous blood sampling and Bland-Altman analysis. The venous-arterial bicarbonate concentration difference was compared between healthy volunteers and untreated respiratory alkalosis patients. Intentional hyperventilation (30 or 60 breaths/min, for 3 min) was also performed on 6 healthy volunteers and the venous-arterial bicarbonate concentration difference was evaluated. Results: The relative average bias in bicarbonate concentration was 2.00 mEq/l with venous bicarbonate higher than arterial bicarbonate with 95% limits of agreement of ±4.15 mEq/l. Hyperventilation challenges increased the venous-arterial bicarbonate concentration difference in an intensity-dependent manner. The venous-arterial bicarbonate concentration difference was higher in untreated respiratory alkalosis patients than in healthy volunteers (P Conclusion: Although venous bicarbonate may be useful to evaluate the body acid-base status, hyperventilation increases the venous-arterial bicarbonate concentration difference. Physicians should keep this phenomenon in mind.

Effects of Suhuang Zhike Capsule on Pulmonary Function, Blood Gas Analysis Index, Serum PCT and CRP Expression in Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease

OBJECTIVE: To observe the effects of Suhuang Zhike Capsule on pulmonary function, blood gas analysis index, serum PCT and CRP expression in patients with acute exacerbation of chronic obstructive pulmonary disease. METHODS: A total of 88 patients with acute exacerbation of chronic obstructive pulmonary disease admitted to the Department of Respiratory Medicine, Xuancheng People's Hospital of Anhui Province from December 2014 to December 2016 were randomly divided into the observation group and the control group, with 44 cases in each group. The control group was given routine clinical treatment, and the observation group was given Suhuang Zhike Capsule on the basis of the treatment method of the control group. After 7 days' treatment, the improvement of lung function indexes were observed and evaluated before and after treatment(forced expiratory volume in one second(FEV_1), forced expiratory volume occupancy in the 1^(st) second percentage of vital capacity(FEVl/FVC), peak expiatory flow(PEF)), blood gas analysis index(Arterial oxygen partial pressure(PaO_2) and arterial blood carbon dioxide partial pressure(PaCO_2), oxygenation index(OI)) and serum cytokine levels(procalcitonin(PCT) and C reactive protein(CRP). RESULTS: The total effective rate of the observation group was significantly higher than that of the control group(P < 0.05). The FEV_1, FEV_1/FVC and PEF in 2 groups were significantly increased after the treatment(P < 0.05), and the above lung function indexes in the observation group were significantly higher than the control group(P < 0.05). PaO_2 and OI were significantly increased after the treatment(P < 0.05), PaCO_2 was significantly decreased after the treatment(P < 0.05), and the improvement of above blood gas analysis indexes were significantly superior of the observation group than the control group(P < 0.05). The serum PCT and CRP levels in 2 groups were significantly decreased after the treatment(P < 0.05), and the improvement in the observation group were more significant than that in the control group(P < 0.05). CONCLUSION: Suhuang Zhike Capsule can inhibit serum inflammatory cytokine levels in patients with acute exacerbation of chronic obstructive pulmonary disease, improve blood gas analysis indicators, and improve lung functions.

Clinical significance of coagulation function combined with blood gas analysis and serum NT-proBNP detection in COPD patients

Objective:To investigate the clinical significance of coagulation function, blood gas analysis and serum N-terminal pro-brain natriuretic peptide (NT-proBNP) level detection in patients with chronic obstructive pulmonary disease (COPD).Methods: A total of 98 cases of COPD patients were selected and divided per different disease courses. For COPD acute exacerbation (AECOPD) stage, 53 patients were selected and set as group A. 45 cases of COPD patients in COPD stable stage were set as group B, and 50 cases of healthy people who received physical examination in our hospital in the corresponding period were collected and set as healthy controls (group C). Levels of PT, APTT, TT, Fbg, D-D, PaCO2, PaO2 and serum NT-proBNP in the whole 3 groups of patients were detected. Differences of index levels among the 3 groups and between before and after treatment in AECOPD patients were compared separately. The correlations of NT-proBNP, coagulation relevant indexes and arterial blood gas relevant indexes were analyzed.Results: (1) PT, APTT in group A and PT, APTT in group B were obviously longer than which in group C, and group A showed more significant variations. (2) Fbg, D-D, PaCO2, NT-proBNP in group A and Fbg, D-D, PaCO2, NT-proBNP in group B were obviously higher than which in group C;But PaO2 in group A and PaO2 in group B were significantly lower than which in group C;Group A showed more significant variations. (3) After treatment, PT and APTT in AECOPD patients were shorter than which before treatment, Fbg, D-D, PaCO2 and NT-proBNP were lower than before treatment, but PaO2 was higher than before treatment. (4) TT in group A were significantly longer than in group C, and differences showed no significance on comparison of TT between patients of group A and B, B and C and within A before and after treatment. (5) NT-proBNP in COPD patients showed significantly positive correlation separately with APTT, Fbg, D-D and PaCO2, showed significantly negative correlation with PaO2, but showed no obvious correlation with PT.Conclusion: Coagulation function and blood gas analysis combined with serum NT-proBNP level detection could better judge the severity of COPD. It shows significant reference value on clinical diagnosis, disease monitoring and evaluation for COPD patients.

Effects of naloxone hydrochloride on pulmonary function, blood gas changes and inflammatory factors in patients with COPD combined with respiratory failure

Objective: To investigate the effects of naloxone hydrochloride on pulmonary function, blood gas changes and inflammatory factors in patients with COPD combined with respiratory failure. Methods: According to random data table method, 80 cases of COPD combined with respiratory failure were randomly divided into the control group (n=40) and observation group (n=40), patients in the control group were treated with noninvasive positive pressure ventilation on the basis of routine symptomatic treatment, on the basis of the treatment of the control group, the observation group received naloxone hydrochloride therapy. The levels of pulmonary function, blood gas changes and inflammatory factors were compared in two groups before and after treatment. Results: The levels of serum FEV1, FVC, PEF, PaCO2, PaO2, PaO2/FiO2, TNF-α and PCT in the two groups before treatment were not statistically significant. After treatment, the levels of FEV1, FVC, PEF in the control group and observation group were (70.01±0.36)%, (2.16±0.41) L, (2.98±0.45) L/s and (81.71±0.53)%, (3.65±0.55) L, (4.36±0.43) L/s, which were significantly higher than those in the same group before treatment, and the levels in observation group were significantly higher than those in the control group;the levels of PaCO2, PaO2 and PaO22/FiO2 in the two groups were (59.62±6.47) mmHg, (65.53±7.36) mmHg, (323.89±10.47) and (46.59±6.64) mmHg, (73.65±8.26) mmHg, (398.64±14.06), compared with the same group before treatment, PaCO2 levels were significantly lower in both groups, and the observation group was significantly lower than the control group, PaO2,PaO2/FiO2 levels were significantly increased in both groups, and the observation group was significantly higher than the control group;the levels of TNF-α, PCT in the two groups were (23.28±4.53) pg/mL, (5.22±2.13) ng/mL and (16.61±4.12) pg/mL, (2.07±1.21) ng/mL, which were significantly lower than those in the same group before treatment, moreover, the observation group levels were significantly lower than those in the control group. Conclusion:Treatment of COPD with respiratory failure by naloxone hydrochloride can effectively reduce the level of inflammatory factors, and improved lung function and blood gas levels, which has important clinical value.

Effect of adjuvant noninvasive positive pressure ventilation on blood gas parameters, cardiac function and inflammatory state in patients with COPD and type II respiratory failure

Objective:T o analyze the effect of adjuvant noninvasive positive pressure ventilation on blood gas parameters, cardiac function and inflammatory state in patients with chronic obstructive pulmonary disease (COPD) and type II respiratory failure. Methods:90 patients with COPD and type II respiratory failure were randomly divided into observation group and control group (n=45). Control group received conventional therapy, observation group received conventional therapy+adjuvant noninvasive positive pressure ventilation, and differences in blood gas parameters, cardiac function, inflammatory state, etc., were compared between two groups of patients 2 weeks after treatment. Results:Arterial blood gas parameters pH and alveolar-arterial partial pressure of oxygen [P(A-a)O2] levels of observation group were higher than those of control group while, potassium ion (K+), chloride ion (Cl-) and carbon dioxide combining power (CO2CP) levels were lower than those of control group 2 weeks after treatment;echocardiography parameters Doppler-derived tricuspid lateral annular systolic velocity (DTIS) and pulmonary arterial velocity (PAV) levels were lower than those of control group (P<0.05) while pulmonary artery accelerating time (PAACT), left ventricular end-diastolic dimension (LVDd) and right atrioventricular tricuspid annular plane systolic excursion (TAPSE) levels were higher than those of control group (P<0.05);serum cardiac function indexes adiponectin (APN), Copeptin, N-terminal pro-B-type natriuretic peptide (NT-proBNP), cystatin C (CysC), growth differentiation factor-15 (GDF-15) and heart type fatty acid binding protein (H-FABP) content were lower than those of control group (P<0.05);serum inflammatory factors hypersensitive C-reactive protein (hs-CRP), tumor necrosis factor-α(TNF-α), interleukin-1β(IL-1β), IL-8, IL-10, and transforming growth factor-β1 (TGF-β1) content were lower than those of control group (P<0.05). Conclusions:Adjuvant noninvasive positive pressure ventilation can optimize the blood gas parameters, cardiac function and inflammatory state in patients with COPD and type II respiratory failure, and it is of positive significance in improving the overall treatment outcome.

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.

美国MEDICA Easy Blood Gas血气分析仪维修的几点体会

本文总结了针对美国MEDICAEasyBloodGas血气分析仪毛细血管血进样通道堵塞故障 ,阀组件故障 ,试剂包故障、前置放大器故障维修的体会 。

Effects of Mild Hyperthermia Treatment Using Nano-Mist Sauna on Blood Gas Parameters and Skin Appearance

Physicians often observe patients’ complexion (their natural skin color) as an indicator of health. The complexion may depend on the internal environment, however, very few researchers studied its evidence. We previously reported various benefits of a mild hyperthermia treatment on human health using the nano-mist sauna (NMS), including acceleration of gas exchange (O2 and CO2) in the venous blood, enhancement of immunity, and the modulation of autonomic nervous system. However, the effects of NMS on skin appearance are unknown. There is a historical and widespread belief that mild hyperthermic treatments such as hot springs are good for improving skin appearance. However, the effect of NMS on the skin appearance has not been examined. In the present study, we examined the color of venous blood using the CIELAB (a color space specified by the French Commission internationale de l’éclairage) method, and then compared the color changes before and after NMS stimulation. Next, we examined correlations of blood gas parameters with color elements of the venous blood, which are highly dependent on oxygen. Our results suggest that the colors and appearance of the face depend on the internal environment, because there are numerous vessels under the skin. Thus, the color of the venous blood may provide medical evidence of changes in complexion. This new method may be useful for assessment of medical complexion by physicians, for use in determining internal health based on skin color information.

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.

Clinical effect of tiotropium bromide on pulmonary function,arterial blood gas and serum inflammatory cytokine in elderly patients with COPD at stable stage

Objective: To observe the clinical effect of tiotropium bromide in elderly patients with COPD at stable stage and its effects on pulmonary function,blood and serum inflammatory cytokine. Methods: 80 elderly patients with COPD s at stable stage were randomly divided into treatment group and control group with 40 patients in each group. The control group was treated with normal treatment. The treatment group was treated with tiotropium bromide on the basis of control group. 3 months after treatment, the pulmonary function、arterial blood gas and serum inflammatory cytokine were detected and compared in the two groups. Results:There was no significant difference in lung function index and TNF- alpha level between the two groups before treatment (P>0.05). The levels of FVC, FEV1% and PEF were increased and serum TNF-α was decreased significantly after treatment in two groups (P<0.05), and they were better than in treatment group than those in control group (all P<0.05);There was no significant difference in blood gas index between the two groups before treatment (P>0.05);In addition, there were no significant difference in the level of PCT, PaO2, PaCO2 and PaO2/FiO2 after treatment in control group, but the level of PCT and PaCO2 were higher and PaO2 and PaO2/FiO2 were lower obviously after treatment (P<0.01). The treatment group was superior to the control group (all P<0.05);Moreover, the curative effect of treatment group was better than that in control group (P<0.05). Conclusion: Tiotropium bromide can improve pulmonary function, pulmonary function、arterial blood gas and serum inflammatory cytokine in elderly stable COPD patients.

The influence of ganglioside on the blood gas analysis and serum inflammatory cytokines in newborns with anoxic ischemic encephalopathy

Objective:To observe the influence of ganglioside on the blood gas analysis and serum levels of inflammatory cytokines in newborns with anoxic ischemic encephalopathy.Method: A total of 100 newborns with anoxic ischemic encephalopathy in our hospital were selected and randomly divided into 2 groups: the control group and the observation group. Conventional oxygen inhalation, reducing intracranial pressure, controlling eclampsia and neurotrophic drug treatment were given to the observation group. Treatment of ganglioside was given to the control group on the basis of observation group. Blood gas analysis and serum levels of inflammatory cytokines were detected before treatment (T0), 3 d after treatment (T1), and 7 d after treatment (T2).Result: (1) The comparison of pH, PaO2, PaCO2, SaO2 in the two groups in T0 was not statistically significant. The comparison of pH, PaO2, PaCO2, SaO2 in T0, T1, T2 was considered to be statistically significant. Among these, the result of comparision of pH, PaO2, SaO2: T0<T1<T2. comparision of PaCO2: T0>T1>T2. The pH, PaO2, SaO2 in observation group were higher, PaCO2 in observation group was lower compared with that in control group in T1 and T2. The difference was considered to be statistically significant. (2) The comparision of IL-2, IL-6, hs-CRP, TNF-α in the two groups in T0 was not statistically significant. IL-2 in the observation in T1 and T2 was higher than that in the control group, IL-6, hs-CRP, TNF-α in the observation in T1 and T2 was lower than that in the control group. The difference was considered to be statistically significant.Conclusion: Ganglioside can improve blood gas analysis indexes, decrease the serum inflammatory cytokines in newborns with anoxic ischemic encephalopathy.

Effects of terbutaline combined with methylprednisolone on pulmonary function, blood gas analysis and inflammatory factors in patients with chronic obstructive pulmonary disease

Objective: To investigate the effects of terbutaline combined with methylprednisolone on pulmonary function, blood gas analysis and inflammatory factors in patients with chronic obstructive pulmonary disease (COPD). Methods: A total of 100 patients with COPD were randomly divided into control group (n=50) and observation group (n=50) according to the lottery method. Both groups were treated with conventional therapy. On this basis, the control group was given inhalation of terbutaline. The observation group was given terbutaline inhalation and combination therapy with methylprednisolone. The changes of lung function, changes of blood gas analysis and inflammatory factors were measured before and after treatment in both groups. Results: There were no significant differences in lung function between the two groups before treatment. After treatment, the levels of FVC and FEV1 in both groups were significantly higher than those before treatment, and that of the observation group was higher than those of the control group. Before treatment, there was no significant difference between the two groups. After treatment, PaO2 levels in both groups were significantly higher than those before treatment, and that of the observation group was higher than those of the control group. After treatment, PaCO2 levels in both groups were significantly lower than those before treatment, and the observation group was lower than the control group after treatment. There were no significant differences in the levels of inflammatory factors between the two groups before treatment. After treatment, the levels of PCT and TNF-α in both groups were significantly lower than those before treatment, and those of the observation group was lower than those of the control group after treatment. Conclusion: The effect of Terbutaline combined with methylprednisolone treatment of COPD is better, which can significantly improve lung function, stable blood gas analysis, reduce the concentration of inflammatory factors, and be a potential effective treatment programs.

Accuracy of a hand-held lactate meter in measuring umbilical cord blood lactate at all lactate levels

Objective: Fetal scalp lactate has largely replaced pH analysis to assess intrapartum hypoxia. Many obstetrics units use hand-held lactate meters to measure umbilical blood because of its affordability and ease of use. We sought to investigate the agreement of Lactate ProTM with a reference method blood gas analyser and to determine its usefulness with a recommended cutoff value of 4.8 mmol/L. Methods: Prospective study carried out at a tertiary institution where 237 arterial and 233 venous samples from umbilical cords of 16 elective caesarean and 285 emergency deliveries were measured using Lactate ProTM and ABL735 Sesries Acid-Base analyser. Limits of agreement were analysed using Bland-Altman plots. Results: Lactate ProTM differentiated fewer deliveries as “high risk” (≥4.8 mmol/L) and more as “low risk” (<2.2 mmol/L). Limits of agreement for lactate values (as measured by Lactate ProTM) were –1.46 - 0.97 mmol/L for arterial lactate levels <4.8 mmol/L and –3.21 - 0.88 mmol/L for arterial lactate levels ≥ 4.8 mmol/L. Conclusion: There was a poorer agreement between the two devices at higher lactate values. Lactate ProTM underestimates by up to 3.2 mmol/L;a 4.8 mmol/L reading may actually signify a lactate level of 8.0 mmol/L, indicating severe metabolic acidosis. We caution the use of this device in assessing fetal lactate levels.

Cardiovascular System Response to Chronic Exposure to Emissions from Gas Turbines Power Plants

Objectives: Heart Rate and Blood Pressure have been reported to be susceptible to the effects of air pollution. Effect of emissions from gas turbine power station among workers is relatively unexplored. Therefore, this study aimed at assessing the effect of emissions from gas turbines on cardiovascular functions and C-reactive protein level in workers of power generating stations. Methodology: 440 individuals made up of 228 workers of gas-fired power plant stations and 212 non-power generating station workers volunteered for this study. A detailed questionnaire was carefully filled by volunteers and anthropometric data measured and recorded. Blood pressure, heart rate and C-reactive protein level (CRP) were measured using standard laboratory techniques in all subjects. Results were presented as Mean ± Standard Error of Mean (SEM) and appropriate analysis was done using Independent student’s t-test and Analysis of Variance (ANOVA). P-value Results: Result showed increased systolic blood pressure (SBP), 142.45 ± 8.87 mmHg of test subjects compared to that of the control (P 0.05) which was 121.32 ± 2.25 mmHg. However, there was no statistically significant difference in the Diastolic Blood Pressure (DBP) of the test and control groups. The Pulse Rate (PR) increased significantly in the test group (89.00 ± 0.02 bpm) when compared to that of the control group (74.34 ± 1.23 bpm). There was also an elevated plasma level of CRP, 6.69 ± 0.03 mg/L in the test group compared to the control (P Conclusion: Exposure to gas emission from natural gas-fired power plants on workers of power generating stations increased SBP, PR and C-reactive Protein level.

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.