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Anesthesia Equipment
Published in Michele Barletta, Jane Quandt, Rachel Reed, Equine Anesthesia and Pain Management, 2023
Rachel Reed, Stephanie Kleine, Michele Barletta
Ventilator settings Assist or control ventilation can be selected. Additionally, CPAP or PEEP can also be set.Tidal volume (range 0.1–20 l in 0.1 l increments), respiratory rate (range 1–30 breath/min), and inspiratory time (range 0.5–4 seconds in 0.1 seconds increments) can be modified on the touchscreen.It is possible to enter the inspiratory pause (IP) in fractions of seconds or as a percentage of the total inspiratory time.The maximum working pressure limit (MWPL), which ranges from 10 to 80 cmH2O in 1 cmH2O increments, can be set. This is the airway pressure above which ventilation is prevented.The fraction of inspired oxygen (FiO2) can be modified from 0.2 to 1.
Clinical Workflows Supported by Patient Care Device Data
Published in John R. Zaleski, Clinical Surveillance, 2020
Oxygen is administered initially through the mechanical ventilator at a level exceeding that of room air (i.e., 21%). This is usually referred to as the fraction of inspired oxygen (FiO2), and is then reduced to room air once the patient’s blood oxygenation level is determined and verified as being within a normal range. By the time of endotracheal tube extubation inspired oxygen fraction is normally around 21% (room air).
Care of Critically Ill Patients with HIV
Published in Cheston B. Cunha, Burke A. Cunha, Infectious Diseases and Antimicrobial Stewardship in Critical Care Medicine, 2020
Joseph Metmowlee Garland, Andrew Levinson, Edward Wing
For patients that are mechanically ventilated for pneumonia, it is important that best practices be followed to avoid increased mortality from mechanical ventilation. In mechanically ventilated patients with pneumonia who meet current definitions for ARDS [90], a ventilation strategy using low tidal volumes of 6–8 cc/kg ideal body weight should be followed [91,92]. One large retrospective study found that lower tidal volume ventilation is independently associated with reduced mortality in HIV-infected patients with acute lung injury and respiratory failure [91]. In addition, positive end-expiratory pressure (PEEP) should be used to lower the fraction of inspired oxygen administered (FIO2) to safe levels to avoid potential oxygen toxicity [93]. If peak pressures on the ventilator remain high, or if there is difficulty with lowering the FIO2 or ventilating at targeted low tidal volumes utilizing a lung-protective strategy, alternative therapies such as extracorporeal membrane oxygenation (ECMO) should be considered. There may be a benefit to the early use of neuromuscular blockade and proning in patients who develop severe ARDS [94,95].
Clinical value of procalcitonin-to-albumin ratio for identifying sepsis in neonates with pneumonia
Published in Annals of Medicine, 2023
Tiewei Li, Xiaojuan Li, Zhiwei Zhu, Xinrui Liu, Geng Dong, Zhe Xu, Min Zhang, Ying Zhou, Jianwei Yang, Junmei Yang, Panpan Fang, Xiaoliang Qiao
The demographic and laboratory data at admission were collected from electronic medical records, including age, gender, body weight, body temperature, respiratory rate, heart rate, systolic blood pressure, diastolic blood pressure, and the levels of PCT, C-reactive protein (CRP), alanine aminotransferase (ALT), aspartate aminotransferase (AST), and ALB. Serum PCT concentrations were measured using the Cobas 8000 modular analyzer (Roche Diagnostic, Rotkreuz, Switzerland). CRP was quantified using the UPPER analyzer (Ultrasensitive CRP kit, Upper Bio-Tech, Shanghai, China). Levels of ALT, AST, and ALB were measured using the automatic Beckman biochemical analyzer (Beckman Coulter, California). Saturation of oxygen (SaO2) was measured using ABL800 FLEX analyzer (ABL800 FLEX, Bronshoj, Denmark). The fraction of inspired oxygen (FiO2) was estimated from the interface used for oxygen delivery.
RT-PCR cycle threshold value in combination with visual scoring of chest computed tomography at hospital admission predicts outcome in COVID-19
Published in Infectious Diseases, 2022
Edvin Ingberg, Erik Ahlstrand, Per Cajander, Erika Löf, Martin Sundqvist, Matthias Wegener, Mats Lidén, Sara Cajander
The study period approximately corresponded to the first wave of the pandemic. Several viral variants were circulating in Sweden during this period, but the most common were B.1 and B.1.1 ([37,38]. The guidelines for management of COVID-19 patients recommended hospitalisation if one or more of the following criteria were met: respiratory rate >24/minute after repeated measurements, oxygen saturation <93% on room air, acute organ dysfunction, or general deterioration. Patients with an oxygen saturation <93% who did not reach satisfactory oxygen saturation with 1 L oxygen/minute were switched to high flow nasal cannula in general wards up to a limit of fraction of inspired oxygen (FiO2) of 50% and a flow rate of 40 L/minute. Patients requiring more intense high flow nasal cannula treatment or with multiple organ failure were usually transferred to the ICU unless end-of-life decisions had been made. In addition to oxygen therapy, no pharmacological treatments were routinely administered in line with guidelines at the time [39,40]. However, prophylactic low-molecular-weight heparin was used. Throughout the study period, clinicians had access to chest CT scores automatically but Ct values only on demand.
Acute chest syndrome of sickle cell disease: genetics, risk factors, prognosis, and management
Published in Expert Review of Hematology, 2022
Elizabeth S. Klings, Martin H. Steinberg
Except for point-of-care lung ultrasonography few recent advances have informed the diagnosis and treatment of ACS. Most treatment is based on expert opinion rather than controlled clinical trials. We recommend that all patients hospitalized with acute painful episodes be monitored with continuous pulse oximetry for the first 72 hours of admission. It is within this period that most new episodes of ACS following an acute VOE will occur. One means for stratifying ACS severity, particularly in adults, is by the amount of required oxygen supplementation/ventilatory support. In adults, mild disease is consistent with a need for 50% or less fraction of inspired oxygen (FiO2) supplementation; moderate disease requires a need for 50–80% FiO2 and severe disease requires >80% FiO2 or the need for noninvasive or invasive ventilation. Early monitoring might also help prevent sudden cardiac death during this fraught interval. Recommendations for treatment based on the severity of ACS are summarized in Table 1.