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Oxygen Therapy in Trauma
Published in Kajal Jain, Nidhi Bhatia, Acute Trauma Care in Developing Countries, 2023
Shyam Charan Meena, Rajeev Chauhan, Ankur Luthra
Hospitals typically rely on large liquid oxygen (LOX) supplies as their primary oxygen source. One litre of LOX provides approximately 860 L of gaseous oxygen, making this the most efficient system for oxygen storage and transportation. Alternate sources for oxygen in the hospital setting consist of compressed gas cylinders, usually of the E and H sizes. E-type cylinders are of smaller size and contain approximately 680 L of oxygen. Due to their relatively low volume of gas, these cylinders are typically used for transport of ventilated and non-ventilated patients and for very short periods to avoid disruption of the main LOX system. H-type cylinders are larger and heavier, contain approximately 6900 L of gas, require a wheeled cart for moving, and are used as the main backup for the LOX system in case of longer periods of disruption.
Oxygen Transport
Published in James N. Cobley, Gareth W. Davison, Oxidative Eustress in Exercise Physiology, 2022
P.N. Chatzinikolaou, N.V. Margaritelis, A.N. Chatzinikolaou, V. Paschalis, A.A. Theodorou, I.S. Vrabas, A. Kyparos, M.G. Nikolaidis
Once inside the muscle cell, oxygen flow to mitochondria is achieved by two ways: (i) as dissolved oxygen and (ii) via myoglobin-mediated delivery (Pias, 2020). Intracellular oxygen bound to myoglobin exceeds free oxygen by a ratio of 30:1, leaving an approximate sarcoplasmic free oxygen of ≈3.2 μM at 37°C (Pias, 2020). The role of myoglobin has been debated over the years, with the prevailing theories being that it serves as a (1) short-term oxygen storage (e.g., at rest), (2) oxygen transporter to mitochondria (e.g., during exercise) and (3) redox catalyst (Meyer, 2004). Oxygen binding to myoglobin during exercise could decrease the intramyocellular oxygen pressure gradient and enhance oxygen diffusion (Clanton, Hogan and Gladden, 2013). On the other, exercise-induced muscle damage increases serum myoglobin concentration (Balnave and Thompson, 1993) limiting oxygen availability intracellularly. Another molecule with the ability to store oxygen inside muscle is cytoglobin, which is found in micromolar concentrations (Fago et al., 2004). Despite the limited information in exercise conditions, cytoglobin has been reported to buffer intracellular oxygen (Clanton, Hogan and Gladden, 2013), regulate NO• availability (Mathai et al., 2020) and serve a role in muscle repair in mice (Singh et al., 2014).
Mechanical Properties of the Lungs
Published in Peter Kam, Ian Power, Michael J. Cousins, Philip J. Siddal, Principles of Physiology for the Anaesthetist, 2020
Peter Kam, Ian Power, Michael J. Cousins, Philip J. Siddal
The functions of FRC include the following: Oxygen storage: This volume maintains oxygenation of blood passing through the lungs during expiration or during breath-holding and acts as an oxygen reserve so that alveolar oxygen partial pressure falls only by 3 mmHg during expiration (i.e. prevents fluctuations in .FRC prevents airway collapse and atelectasis by keeping the alveoli partially inflated throughout respiration.It minimizes pulmonary vascular resistance.Airway resistance is kept low when airways are open.The lungs have increased compliance.Work of breathing is reduced to a minimum.
Analysis of clinical characteristics and prognostic factors of ARDS caused by community-acquired pneumonia in people with different immune status
Published in Expert Review of Anti-infective Therapy, 2022
Zhipeng Cheng, Qiang Zhu, Jingyi Chen, Yanan Sun, Zhixin Liang
Mechanical ventilation is an important means of respiratory support treatment in ARDS patients, and both noninvasive and invasive ventilation are widely used in ARDS patients. In our study, we found that invasive ventilation is the main mode of respiratory support in both the immunocompromised and immunocompetent groups, and a greater proportion of patients in the immunocompromised group were treated with noninvasive ventilation, which is consistent with the conclusion of Cortegiani et al [13]. The main reason is that ARDS patients with severe lung injury and hypoxia are more obvious, and common oxygen therapy by nasal cannula or oxygen storage mask alone is not sufficient to meet the oxygen requirements of patients. Studies have found that patients with immunocompromised ARDS are at high risk of ventilator-associated pneumonia after tracheal intubation, leading to an increased risk of infection and death [26–28]. Therefore, in clinical practice, mechanical ventilation in immunocompromised patients with ARDS should be carefully selected and timed to improve the patient’s condition and minimize the chance of nosocomial infection.
In-vitro haemocompatibility of dextran-protein submicron particles
Published in Artificial Cells, Nanomedicine, and Biotechnology, 2019
Chiraphat Kloypan, Nittiya Suwannasom, Saranya Chaiwaree, Ausanai Prapan, Kathrin Smuda, Nuttakorn Baisaeng, Axel Pruß, Radostina Georgieva, Hans Bäumler
The haemocompatibility of particles is mainly affected by their physicochemical characteristics such as chemical composition, size, shape, surface charge, hydrophobicity or hydrophilicity [20–22]. The fabrication techniques and selection of biomaterials are the fundamental steps, which can drastically impact the haemocompatibility of the particles as well as the efficacy of the proteins in the particles. Recently, we described a new promising formulation of protein submicron particles called “One-Pot formulation” [23]. The new procedure is based on the coprecipitation-crosslinking-dissolution (CCD) method where the biopolymer particles are obtained in three main steps exploiting the ability of insoluble inorganic salts to incorporate macromolecules during precipitation in aqueous solutions. These macromolecules are subsequently crosslinked, and the inorganic precipitate is dissolved usually by complexation of the metal ions or pH change. With the one-pot procedure, coprecipitation and crosslinking were combined in one step due to the use of a biopolymer crosslinker, oxidised-dextran (Odex), which is coprecipitated together with a protein into a manganese carbonate (MnCO3) template. Odex-HbMPs fabricated by one-pot demonstrated an improved oxygen storage capability. We hypothesized that dextran is able to improve not only the protein function and stability but also the haemocompatibility of the particles because of its protein-rejecting and cell repelling abilities [36,37]. In addition, the multivalent nature of dextran is advantageous for surface immobilization of biologically active molecules.
Inpatient Capacity Management during COVID-19 Pandemic: The Yale New Haven Hospital Capacity Expansion Experience
Published in Hospital Topics, 2022
Robert L. Fogerty, Michael Aniskiewicz, Todd Hedges, Sean Ryan, Piper Brien, Peggy Beley, Marc Tangredi, Marci Mitchell, Hillary d’Atri, Laura Jansen, Ena Williams, Francine LoRusso, Mark Sevilla, Jennifer Menillo, Deirdre Doyle, Heather Parrott, Susan Sheehan, Richard A. Martinello, Michael Holmes
Additionally, there were serious concerns over the bulk oxygen storage capacity based on initial patient load projections. The Facilities group temporarily increased the capacity of the liquid oxygen storage and vaporizer based on the forecasted surge in vented patients. This was achieved by adding a mobile liquid oxygen tank & 75,000 CFM evaporator into the existing hospital supply. This was monitored daily to ensure adequate supply of oxygen in relation to vent usage.