Circulation
Kelvin Yan in Surgical and Anaesthetic Instruments for OSCEs, 2021
This is a central venous catheter which is inserted into a central vein such as the internal jugular, subclavian and femoral veins (Figure 3.5). It is inserted using the Seldinger technique under ultrasound guidance. A central vein is first identified by its compressibility, a needle attached to a syringe is then inserted with negative pressure applied until blood is aspirated, a guidewire is then advanced through the needle followed by dilatation of the skin and subcutaneous tissues before the central venous catheter is inserted. A CXR is usually performed to confirm the position of the line. A blood gas analysis can also be done to confirm the venous placement of the catheter. It is usually a triple-lumen catheter where different ports are used for medication administration, IV fluids and the measurement of central venous pressure.
Gases
Frank A. Barile in Barile’s Clinical Toxicology, 2019
The clinical presentation of CO poisoning depends on the time of exposure and the concentration of CO in the area, as noted previously. Acute, high-concentration exposure, such as might occur in an enclosed space (automobile exhaust in a closed garage), will produce more severe signs and symptoms than chronic, low-concentration exposure (as with faulty heating systems). The latter scenario may be misdiagnosed as mimicking a bacterial or viral infection. Symptoms from acute, mild exposure range from asymptomatic to headache, dizziness, malaise, and fatigue. Moderate exposure may present with confusion, lethargy, ataxia, syncope, and nystagmus.* Severe intoxication manifests as seizures, pulmonary edema, myocardial infarction, and coma. The classic cherry-red discoloration of the face and extremities, due to uncompensated peripheral vasodilation, is evident only in severe poisoning. Blood samples for gas analysis must be obtained immediately after exposure (using blood gas CO-oximetry). The calculation of percentage of arterial blood oxyhemoglobin (SaO2), based on blood gas analysis, is often falsely elevated because of COHb high-affinity binding. Other routine clinical laboratory values may also lead to inaccurate conclusions.
Pulmonary angiography
Debabrata Mukherjee, Eric R. Bates, Marco Roffi, Richard A. Lange, David J. Moliterno, Nadia M. Whitehead in Cardiovascular Catheterization and Intervention, 2017
Electrocardiography in acute PE usually shows sinus tachycardia. The presence of the classic S1Q3T3 pattern may help in making the diagnosis; however, this is not commonly seen. Other findings may include incomplete or complete right bundle branch block and right axis deviation. The presence of a Qr pattern in lead V1 and inverted T-waves in the anterior precordial leads indicates increased risk of poor clinical outcomes.[5] A negative D-dimer has a high negative predictive value (>90%) and low specificity (45%) for PE.[6–8] Therefore, the test is useful only as a “rule-out” modality in the office setting or emergency room. Arterial blood gas analysis should not be used for screening purposes because of its low specificity in PE, but may help direct therapy. The presence of hypoxemia, hypocapnia, respiratory alkalosis, and increased alveolar-arterial gradient is usually seen.[9]
Serial Carboxyhemoglobin Levels and Its Relationship with Late Onset Sepsis in Preterm Infants: An Observational Cohort Study
Published in Fetal and Pediatric Pathology, 2020
Blood gas analysis is performed at the time of hospitalization and during follow up of many patients in the NICU. Blood gas measurements determine the level of basic metabolites, such as carboxyhemoglobin (COHb), and provide the clinician with the status of the patient’s ventilation and metabolic state. COHb is a stable complex of carbon monoxide (CO) and hemoglobin (Hb) molecules that is produced by red blood cells. Endogenous CO production primarily arises from heme catabolism by the heme oxygenase (HO) enzyme along with other degradation products [5]. In recent years, the notion that endogenous CO levels can be used as a biomarker for many diseases other than hemolysis has gained popularity [6–8]. In this study, we aimed at investigating the effectiveness of monitoring COHb levels in infants in the NICU as a biomarker in the diagnosis and follow up of LOS.
Thoracic epidural anaesthesia reduces insulin resistance and inflammatory response in experimental acute pancreatitis
Published in Upsala Journal of Medical Sciences, 2018
Ola Winsö, Josef Kral, Wanzhong Wang, Ivana Kralova, Pernilla Abrahamsson, Göran Johansson, Per-Jonas Blind
Using a cut-down technique, a catheter was placed in the common carotid artery via a branch; a central venous line was inserted in the left external jugular vein, and a pulmonary artery (PA) catheter was inserted in the right external jugular vein. For pressure recordings, a catheter filled with isotonic saline and pressure transducers (DTX-pressure transducer, Becton Dickinson, Stockholm, Sweden) positioned at the mid-axillary level were utilized. The PA catheter was used for measurements of cardiac output (CO) using the conventional thermo-dilution technique and for continuous core temperature recordings. All the data were continuously recorded utilizing a computer-based multi-channel signal acquisition and analysis system (AcqKnowledge III, Biopac System Inc., CA, USA). Arterial blood was sampled for blood gas analyses.
Lipoxin A4 attenuates the lung ischaemia reperfusion injury in rats after lung transplantation
Published in Annals of Medicine, 2021
Lijuan Zhang, Qihang Tai, Guangxiao Xu, Wei Gao
After 24 h of reperfusion, all the rats were anaesthetised with intraperitoneal injection of 3% pentobarbital sodium (30 mg/kg body weight) and cannulated. The arterial blood gas analysis was performed, and the peripheral blood was collected. After sacrificing the rats with overdose of anaesthetic, the left lungs were collected and divided into 3 parts. Upper part of the graft (the LIRI and LA4 groups) or control lung (the sham group) was stored at liquid nitrogen for further analysis of protein expression; the middle part was prepared for the histological and apoptotic evaluation; the lower part was homogenised with 0.9% saline (1: 9 weight) for testing the cytokines levels in the 10% homogenate. The peripheral blood and homogenate were centrifuged at 4 °C, 1000 g/min for 10 min, and the supernatant was collected for further analysis.
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