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Inhalant Anesthesia and Partial Intravenous Anesthesia
Published in Michele Barletta, Jane Quandt, Rachel Reed, Equine Anesthesia and Pain Management, 2023
Factors that do not influence MAC: Hypertension.Metabolic alkalosis.Duration of anesthesia.Type of surgical stimulus.
Cardiovascular system
Published in Jagdish M. Gupta, John Beveridge, MCQs in Paediatrics, 2020
Jagdish M. Gupta, John Beveridge
8.22. In congenital heart disease, cyanosisis distinguished from that of respiratory origin by its failure to diminish on breathing 100% oxygen for 10 min.requires at least 5g/100ml of reduced Hb for recognition.causes polycythaemia.characteristically causes hyperventilation and respiratory alkalosis.requires urgent investigation.
The Respiratory System and Its Disorders
Published in Walter F. Stanaszek, Mary J. Stanaszek, Robert J. Holt, Steven Strauss, Understanding Medical Terms, 2020
Walter F. Stanaszek, Mary J. Stanaszek, Robert J. Holt, Steven Strauss
The inability of the lungs to eliminate carbon dioxide results in a condition called respiratory acidosis, a decrease in serum pH from the excess carbonic acid of dissolved CO2. Alkalosis is a condition that results when the lungs eliminate too much carbon dioxide, increasing serum pH. Diseases that impair the ability of the lungs to transfer oxygen to the blood may produce hypoxia, in which oxygen in the blood is insufficient for the tissues, or anoxia, in which no oxygen enters the blood.
Prevalence of hyperventilation in patients with asthma
Published in Journal of Asthma, 2022
Duco D. Deenstra, Hanneke A. C. van Helvoort, Remco S. Djamin, Cathelijne van Zelst, Johannes C. C. M. in’t Veen, Jeanine C. Antons, Martijn A. Spruit, Alex J. van ’t Hul
In this study, for the first time large-scale blood gas analysis was performed in patients with stable asthma, that is, without acute exacerbation. A remarkably large proportion of patients, namely 40%, appeared to have a hyperventilation blood gas. A metabolic compensated respiratory alkalosis was found in 23% of the patients, indicating the presence of a longer lasting hyperventilation. An uncompensated respiratory alkalosis was observed in another 17% of the patients, representing an acute hyperventilation. Patients with a chronic hyperventilation were younger, more often female and had the best spirometric outcomes compared to patients without hyperventilation. The NQ turned out not to be a valid tool for use as a screening instrument for hyperventilation in patients with asthma.
PDE3-inhibitor enoximone prevented mechanical ventilation in patients with SARS-CoV-2 pneumonia
Published in Experimental Lung Research, 2021
Jan Beute, Pieter Boermans, Bart Benraad, Jan Telman, Zuzana Diamant, Alex KleinJan
Similar to our previous experiences in CAS, enoximone achieved a rapid symptomatic relief in two out of four patients, with full recovery within a few hours (patients 1 and 4), while the other two patients (patients 2 and 3, with comorbid obesity or COPD GOLD III) required a longer time to respond (24–36 h) due to sputum retention. Compared to controls, the enoximone-treated patients had no need for mechanical ventilation (Chi-Square Tests, Fisher’s exact test p = 0.029), had a shorter stay in ICU (2–5 days for enoximone-treated patients versus 12–31 days for controls), and an overall shorter stay in hospital (13–15 days for enoximone-treated patients versus 22–46 days for controls) as well as a shorter recovery time (Figure 1; Table 3) (Mann-Whitney U test p = 0.05). Blood gas analysis (Supplementary Table 1) showed a minimal improvement in three out of four patients between before and 1 h after enoximone. The apparent alkalosis is mainly due to hyperventilation (in turn due to patient anxiety). pO2 levels are all at the right side of the sigmoid curve of saturation, reflecting maximal oxygen saturation despite severe dyspnea (Supplementary Table 1).
Clinical introduction and benefits of non-invasive ventilation for above C3 cervical spinal cord injury
Published in The Journal of Spinal Cord Medicine, 2021
Akiko Toki, Takeshi Nakamura, Yukihide Nishimura, Mikio Sumida, Fumihiro Tajima
Our protocol for the introduction of NIV allowed successful weaning of mechanical ventilation. First, we were apprehensive about the possible development of respiratory alkalosis when the tidal volume was increased to 20 mL/kg body weight at steps 1, 2 and 3 of the NIV protocol. The dead space was adjusted in some of the patients to prevent alkalosis, and no discontinuation of NIV was based on the development of alkalosis in this study. We assume that improvement of chest wall motion and prevention of atelectasis worked against alkalosis in these patients. Second, patients who used NIV with a mouthpiece were able to start spontaneous breathing safely and without assistance. They practiced voluntary ventilation with the continued use of NIV, which promoted ventilatory sufficiency and prevented fatigue.7 In other words, strengthening of respiratory accessory muscles should be an important goal of NIV therapy.