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Clinical Workflows Supported by Patient Care Device Data
Published in John R. Zaleski, Clinical Surveillance, 2020
Because the cardiovascular and respiratory systems of the patient are depressed during this postoperative stage, they require help in providing the body and all of its sub systems with oxygenated blood. One way to ensure that enough oxygen is received by the body is to ventilate the patient on high levels of pure oxygen. As the patient’s cardiovascular and respiratory systems regain their natural function, the amount of oxygen is reduced. Pulse oximetry is used and calibrated against arterial blood-gas (ABG) oxygenation measurements several times to verify the accuracy of these non-invasive pulse oximetry measurements.
pH Management During Hypothermic Cardiopulmonary Bypass with Circulatory Arrest
Published in Richard A. Jonas, Jane W. Newburger, Joseph J. Volpe, John W. Kirklin, Brain Injury and Pediatric Cardiac Surgery, 2019
Two strategies have been used in response to the pH shift during hypothermic bypass. From the 1960s to the late 1970s, the more popular strategy was the pH-stat strategy, in which carbon dioxide is added to the gas mixture in the oxygenator to compensate for the alkaline shift. The resulting respiratory acidosis causes the pH to remain constant at 7.40 as determined at the patient’s hypothermic body temperature. As measured at 37°C—as is standard in blood-gas analyzers, which warm the cold blood sample to 37°C to perform the analysis—there will appear to be an increasing respiratory acidosis as the temperature decreases. The alternative alpha-stat strategy does not compensate for the natural shift in pH. With the alpha-stat strategy the pH remains at 7.40 as measured at 37°C. Generally, pure oxygen is used as the gas mixture in the oxygenator.2
Anaesthesia for ECT
Published in Alan Weiss, The Electroconvulsive Therapy Workbook, 2018
Oxygenation is defined as ventilation with 100% oxygen in a positive pressure environment and a respiratory rate of between to 15-20 breaths per minute. The patient is asked to take deep breaths of pure oxygen administered through a mask during the set-up process, usually two to three minutes before the treatment begins (Mankad and Weiner, 2010). In some patients the mask can induce anxiety and they should be given the option of holding it onto their face themselves or putting the plastic tube between their teeth.
Modeling normal bladder injury after radiation therapy
Published in International Journal of Radiation Biology, 2023
Sarah L. Kerns, Jacqueline P. Williams, Brian Marples
Whilst few durable or molecular-targeted therapies exist to prevent the incidence of radiation-induced bladder toxicities, especially for radiation cystitis (Pascoe et al. 2019), some therapies have been shown to lessen the symptoms of injury. For example, hyperbaric oxygen (HBO) therapy has long been shown to alleviate symptoms of RC (Smit and Heyns 2010; Oscarsson et al. 2019). HBO alleviates underlying pathophysiology of progressive endarteritis that characterizes radiation cystitis and shows a 60–100% efficacy for complete hematuria response (Tanaka et al. 2019). The likely mechanism of this therapy is a hyperoxia-induced nitric oxide-mediated mobilization of bone marrow stem cells, linked to endothelial progenitor cell release into circulation and enhanced perfusion and wound healing in ischemic tissues (Goldstein et al. 2006; Gallagher et al. 2007). However, the widespread adoption of HBO as a routine therapy for RC has been hindered by overall cost, the scarcity of HBO treatment centers and patient contraindications that limit its use. For example, the breathing of pure oxygen in a pressurized environment required for HBO therapy is not well-tolerated by some patients and, because multiple treatments are needed, this has led to poor patient compliance.
Association between asthma and falls: A nationwide population-based study
Published in Journal of Asthma, 2018
Jae Ho Chung, Tae Ho Kim, Chang Hoon Han
We found that asthma was a risk factor for falls. Lung disease affects much more than breathing. Chronic respiratory diseases such as asthma can cause shortness of breath, rendering one dizzy, weak, and fatigued. Poor breathing depletes blood oxygen levels, affecting body function. Although our study does not reveal the mechanism for the increased fall risk in patients with asthma, asthma may increase the fall risk in several ways. First, it compromises blood oxygenation and thus various organs including the brain receive inadequate oxygen; a supply of pure oxygen may be required. Other symptoms of lung disease that increase the risk of falling include leg muscle weakness and impaired balance, both of which are essential for safe standing. Other asthma symptoms may also affect the fall risk. Anti-inflammatory drugs such as corticosteroids are commonly prescribed for asthma patients. Corticosteroids interfere with the production of sex hormones in both females and males, contributing to bone loss, and can cause muscle weakness, increasing the risk of falls and fractures as a result of falling. Such drugs also reduce calcium absorption, increase calcium loss via the kidneys, and reduce bone formation. Some asthma patients consider that milk triggers asthma attacks; this may be true only if a milk allergy is in play. Unnecessary avoidance of calcium-rich dairy products can be particularly damaging to the bone health of asthmatics; calcium is required to build strong bones. As exercise often triggers an asthma attack, many asthma patients avoid the weight-bearing physical exercises known to strengthen bones.
A prospective randomized clinical trial to evaluate the impact of intraoperative ventilation with high oxygen content on the extent of postoperative pneumocephalus in patients undergoing craniotomies
Published in British Journal of Neurosurgery, 2019
G. Sandhu, A. Gonzalez-Zacarias, J. Fiorda-Diaz, S. Soghomonyan, M. Abdel-Rasoul, L. M. Prevedello, A. A. Uribe, N. Stoicea, D. Targonski, D. M. Prevedello, S. D. Bergese
Our intraoperative ventilation with pure oxygen was performed during stage 2 of the surgery. When comparing the length of stage 2 between groups, no statistical significance was found (median 49 min and 55 min respectively; p = .36). Recently, Siegel et al. reported the efficacy of administering high-flow oxygen (30 L/min) through a nasal cannula (HFNC) for the treatment of postoperative pneumocephalus.6 After extubation, our patients received supplemental oxygen (3 L/min) through a conventional nasal cannula during the lapsing time between the end of the surgery and the postoperative head CT scan with no statistical differences between group A and B (median 89 min and 80 min respectively; p = .82).