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Anesthesia Monitoring and Management
Published in Michele Barletta, Jane Quandt, Rachel Reed, Equine Anesthesia and Pain Management, 2023
Blood gas values will give accurate information on ventilation, oxygenation, as well as the acid-base status. This is especially important for the critically ill equine patient. The normal values are: pH 7.38 to 7.41.PaCO2 36–46 mmHg.PaO2 on room air at sea level should be approximately 100 mmHg in healthy subjects.On 100% oxygen, as with anesthesia, PaO2 values should exceed 200 mmHg (can be as high as 5 x inspired oxygen concentration, approximately 500 mmHg).
Shock in Trauma Patients
Published in Kajal Jain, Nidhi Bhatia, Acute Trauma Care in Developing Countries, 2023
Jeetinder Kaur Makkar, Mandeep Tundak
Arterial blood gas estimation – Normal pH is 7.4. Acidosis can be diagnosed if the base excess is less than –6 mmol/L. Higher mortality and morbidity were observed if the base deficit exceeded –6 mmol/L. Serum lactate > 4 mmol/L is an additional indicator of acidosis.
Critical Care
Published in Vincenzo Berghella, Maternal-Fetal Evidence Based Guidelines, 2022
Jaimie Maines, Lauren A. Plante
Nurses have special qualifications, and the nurse-to-patient ratio should not be more than 1:3. Physicians have specialty training (e.g., medicine, surgery, anesthesiology) and may have ICU training. Allied health professionals are part of the ICU team. Monitoring, in addition to the noninvasive capabilities above, includes invasive technologies such as arterial and central lines. Blood gas analysis is immediately available. These units can handle endotracheal intubation, positive-pressure ventilation, vasoactive infusions, and renal replacement therapies. Level 2 ICUs are referral centers for local hospitals.
Experiences with point-of-care blood gas measurements in a prehospital setting
Published in Scandinavian Journal of Clinical and Laboratory Investigation, 2022
Jonas E. Pedersen, Mads Nybo, Eva R. B. Petersen, Jimmy H. Holm, Søren Mikkelsen, Stine T. Zwisler
Blood gas analyses are used in acute traumatised or ill patients to assess the degree of respiratory insufficiency, and in disorders of acid-base balance as well as in monitoring patients subjected to mechanical ventilation. During the recent years, blood gas analyses including electrolytes and lactate has become part of the prehospital analyses repertoire [6]. They have the potential to increase diagnostic ability and to accelerate and guide diagnosis and treatment at the prehospital site. We have previously described implementation of a blood gas analyser, the ABL90 FLEX (Radiometer, Denmark), in a ground-based anaesthesiologist-staffed Mobile Emergency Care Unit (MECU) [7]. Furthermore, we have investigated whether access to arterial blood gas analysis increased the prehospital diagnostic accuracy by prehospital anaesthesiologists [8] and showed that it significantly increased the quality of treatment provided to acute critically ill patients. The aim of the present paper is in a more casuistic way to describe advantages of rapid access to full blood gas analyses in a prehospital setting with two cases exemplifying its usefulness. Further, it is important to discuss advantages and limitations in the use of a POCT blood gas analyser.
Staphylococcus-induced proliferative glomerulonephritis and cerebral hemorrhage – fatal complications in a young female with postpartum cardiomyopathy and an implanted left ventricular assist device: a case report and review of the literature
Published in Acta Chirurgica Belgica, 2022
Carmen Elena Opris, Horatiu Suciu, Laura Banias, Cosmin Marian Banceu, Cosmin Opris, Marius Harpa, Mihaela Ispas, Simona Gurzu
Blood analysis revealed anemia (hematocrit 19%, hemoglobin 6.2 g/L, red blood cells 2.26 × 109/µL), normal leukocyte count (7880/µL), and normal platelet (PLT) count (290,000/µL). The anticoagulation treatment was effective, with an international normalized ratio (INR) of 2.22, a prothrombin time (PT) of 28.7 s, and a PT% of 31.7. Serum levels of thyroid hormones were also within the normal range: thyroid stimulating hormone (TSH) of 3.65 µUI/mL (normal range 0.27–4.20 µUI/mL) and FT4 of 1.34 ng/dL (normal range 0.82–1.77 ng/dL). The serum level of C-reactive protein was increased to 1.25 mg/dL (normal range < 0.5 mg/dL) and the erythrocyte sedimentation rate (ESR) was 28 mm/h. Arterial blood gas examination was normal. Urine analysis was positive for Escherichia coli. The blood culture was positive for methicillin-resistant Staphylococcus aureus (MRSA) (Table 1).
A case of pseudohyperchloraemia caused by sodium nitrate ingestion
Published in Clinical Toxicology, 2022
Christopher J. Perkins, Gareth E. Wahl, Melissa J. Gillett
The patient’s initial blood gas results contained a number of abnormal findings. His hypernatraemia could be attributed to dehydration in the setting of vomiting, with a possible contribution from ingested sodium nitrate salt. His hypokalaemia likely represents gut losses and kaliuresis secondary to hyperaldosteronism, again expected in the setting of dehydration. Increased pCO2 is consistent with his use of multiple central nervous system depressant medications, whilst the elevated bicarbonate may be due to a metabolic alkalosis of vomiting. The combination of these two disturbances produced a minimal net change in pH. His acute kidney injury was also most likely caused by dehydration. Methaemoglobinaemia is a recognized feature of both nitrite and nitrate poisoning. It was responsible for his cyanosis, and in this case, did not require specific treatment.