Sample records for arterial oxygen desaturation


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    D. Attaran


    Full Text Available A significant reduction in arterial blood oxygen saturation during fiberoptic bronchoscopy has been proved but it is not yet known whether all patients need supplemental oxygen during this procedure. The aim of study is to examine the relationship between peak expiratory flow rate (PEFR before bronchoscopy and oxygen desaturation during bronchoscopy. Measurement of PEFR (% predicted performed before bronchoscopy and arterial O2 desaturation was assessed with a pulse oximeter during bronchoscopy. Study performed in 66 patients with a median age 53 years, who had been referred to our bronchoscopy unit. None of the patients received supplemental oxygen before the procedure. Thirty nine cases (59% had an episode of O2 desaturation during bronchoscopy. Of them 25 cases (38% had sustained O2 desaturation, requiring oxygen therapy while 14 cases (21% had momentary desaturation (< 20s not requiring O2 therapy. Oxygen therapy was administered in 58% of cases with PEFR % < 60 and in 83% of cases with PEFR % less than 45 (P, 0.008 and 0.001, respectively. We also observed a significant fall in mean O2 saturation during bronchoscopy (88 ± 4 % compared to prebronchoscopy levels (95 ± 2 % (P < 0.0001. It is concluded that PEFR < 60% and especially < 45% is a reliable predictor of hypoxemia and the need to O2 therapy during bronchoscopy.

  2. Predictive Factors of Arterial Blood Oxygen Desaturation During Upper Gastrointestinal Endoscopy in Nonsedated Patients

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    O Alimardani


    Full Text Available Introduction: Hypoxemia can occur during upper gastrointestinal endoscopy with or without pharmacological sedation. Pulse oximetry saturation (SpO2 levels were assessed in patients attending for routine unsedated diagnostic upper gastrointestinal endoscopy to identify factors associated with oxygen desaturation. Methods: A total of 300 patients who underwent upper gastrointestinal endoscopy without sedation were monitored with continuous pulse oximetry. Factors related to the patient, the examination, and the monitoring data that could predict severe desaturation were evaluated. Results: Mild desaturation (SpO2 between 1-4% was found in 143(47.7% of the patients, while severe desaturation (SpO2≥5% and hypoxemia occurred in 65 (21.7% of patients, 40 (61.5% of those had previous illnesses (p<0.001. The variables found to predict severe desaturation were basal SpO2 <95%, chronic obstructive pulmonary disease, anemia, age more than 60 years and coronary artery disease. Conclusion: The decrease in SpO2 is related to increase in age, basal SaO2 < 95%, respiratory disease, coronary artery disease, and anemia, .We recommend continuous monitoring of SpO2 in these high-risk patients undergoing upper gastrointestinal endoscopy.

  3. Episodic arterial oxygen desaturation and heart rate variations following major abdominal surgery

    DEFF Research Database (Denmark)

    Rosenberg, J; Dirkes, W E; Kehlet, H


    In 20 patients undergoing elective major abdominal surgery, heart rate and arterial oxygen saturation were monitored continuously during the night 2 days before operation and during the first and second nights after operation (23:00 to 07:30). Mean heart rate increased by 16 beat min-1 (P less than...... arrhythmias on the morning of the third day after operation. In another patient the episodes of desaturation correlated with increases in heart rate. There was no correlation between administration of opioids and heart rate and saturation disturbances. The mechanism and clinical relevance of episodic...

  4. Arterial oxygen desaturation response to repeated bouts of sprint exercise in healthy young women. (United States)

    Kuniyoshi, Shimpei; Endoh, Yumiko; Kobayashi, Minoru; Endoh, Hiroshi


    The decline in arterial oxygen saturation of hemoglobin during exercise has been termed exercise-induced arterial hypoxemia (EIAH). We examined whether repeated bouts of sprint exercise (SprE) would induce EIAH in healthy young men and women. Ten men and 11 women (20.4 +/- 0.3 year) performed an anaerobic power test (three bouts of 10 s cycling with 120 s intervals) using a cycle ergometer. Arterial oxygen saturation of hemoglobin measured by pulse oximeter (SpO(2)), heart rate (HR), rate perceived exertion (RPE), and the blood lactate concentration ([La](b)) were assessed at rest, during, and 5 min after repeated bouts of SprE. Women exhibited a lower maximal anaerobic power (MAnP) compared to men (498 +/- 23 vs. 759 +/- 22 watts, respectively, p women were comparable with those in men throughout the test. However, the only significant decline in SpO(2) after a single bout of SprE (95.5 +/- 0.7%) from the resting value (97.9 +/- 0.2%) was observed in women, and further declines occurred following heavier SprE (women, mild to moderate EIAH developed, whereas only 2 men showed mild EIAH. Thus, these findings suggest that repeated bouts of SprE might induce mild EIAH in young women but not men.

  5. Sidestream Capnographic Monitoring Reduces the Incidence of Arterial Oxygen Desaturation During Propofol Ambulatory Anesthesia for Surgical Abortion


    Zongming, Jiang; Zhonghua, Chen; Xiangming, Fang


    Background This study investigated whether early intervention based on additional use of sidestream capnography could reduce the incidence of oxygen desaturation and hypoxic events in patients receiving propofol anesthesia during surgical abortion. Material/Methods We recruited 704 ASAI-III female patients, 18–52 years old and scheduled for planned painless surgical abortion, and randomized them into a control group (n=359) receiving standard monitoring and an experimental group (n=341) recei...

  6. Arterial desaturation due to pulmonary arteriovenous malformations after the Kawashima Operation

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    Rohit S Loomba


    Full Text Available Arterial desaturation may occur after the Kawashima procedure and, in the absence of venovenous collaterals is usually due to pulmonary arteriovenous malformations. Stenting of the pulmonary arteries, oxygen therapy, and pulmonary vasodilators such as sildenafil have not been able to resolve the arterial desaturation and the only way to do this has been Fontan completion. The time course of the formation of these malformations after the Kawashima and the progression of cyanosis and its resolution after the Fontan has only been demonstrated in case reports and small case series. We pool the available data to model arterial saturations in patients with pulmonary arteriovenous malformations after the Kawashima procedure.

  7. Oxygen desaturations triggered by partial seizures: implications for cardiopulmonary instability in epilepsy (United States)

    Blum, A. S.; Ives, J. R.; Goldberger, A. L.; Al-Aweel, I. C.; Krishnamurthy, K. B.; Drislane, F. W.; Schomer, D. L.


    PURPOSE: The occurrence of hypoxemia in adults with partial seizures has not been systematically explored. Our aim was to study in detail the temporal dynamics of this specific type of ictal-associated hypoxemia. METHODS: During long-term video/EEG monitoring (LTM), patients underwent monitoring of oxygen saturation using a digital Spo2 (pulse oximeter) transducer. Six patients (nine seizures) were identified with oxygen desaturations after the onset of partial seizure activity. RESULTS: Complex partial seizures originated from both left and right temporal lobes. Mean seizure duration (+/-SD) was 73 +/- 18 s. Mean Spo2 desaturation duration was 76 +/- 19 s. The onset of oxygen desaturation followed seizure onset with a mean delay of 43 +/- 16 s. Mean (+/-SD) Spo2 nadir was 83 +/- 5% (range, 77-91%), occurring an average of 35 +/- 12 s after the onset of the desaturation. One seizure was associated with prolonged and recurrent Spo2 desaturations. CONCLUSIONS: Partial seizures may be associated with prominent oxygen desaturations. The comparable duration of each seizure and its subsequent desaturation suggests a close mechanistic (possibly causal) relation. Spo2 monitoring provides an added means for seizure detection that may increase LTM yield. These observations also raise the possibility that ictal ventilatory dysfunction could play a role in certain cases of sudden unexpected death in epilepsy in adults with partial seizures.

  8. NaHCO(3) does not affect arterial O(2) tension but attenuates desaturation of hemoglobin in maximally exercising Thoroughbreds. (United States)

    Manohar, Murli; Goetz, Thomas E; Hassan, Aslam S


    The objective of the present study was to examine the effects of preexercise NaHCO(3) administration to induce metabolic alkalosis on the arterial oxygenation in racehorses performing maximal exercise. Two sets of experiments, intravenous physiological saline and NaHCO(3) (250 mg/kg i.v.), were carried out on 13 healthy, sound Thoroughbred horses in random order, 7 days apart. Blood-gas variables were examined at rest and during incremental exercise, leading to 120 s of galloping at 14 m/s on a 3.5% uphill grade, which elicited maximal heart rate and induced pulmonary hemorrhage in all horses in both treatments. NaHCO(3) administration caused alkalosis and hemodilution in standing horses, but arterial O(2) tension and hemoglobin-O(2) saturation were unaffected. Thus NaHCO(3) administration caused a reduction in arterial O(2) content at rest, although the arterial-to-mixed venous blood O(2) content gradient was unaffected. During maximal exercise in both treatments, arterial hypoxemia, desaturation, hypercapnia, acidosis, hyperthermia, and hemoconcentration developed. Although the extent of exercise-induced arterial hypoxemia was similar, there was an attenuation of the desaturation of arterial hemoglobin in the NaHCO(3)-treated horses, which had higher arterial pH. Despite these observations, the arterial blood O(2) content of exercising horses was less in the NaHCO(3) experiments because of the hemodilution, and an attenuation of the exercise-induced expansion of the arterial-to-mixed venous blood O(2) content gradient was observed. It was concluded that preexercise NaHCO(3) administration does not affect the development and/or severity of arterial hypoxemia in Thoroughbreds performing short-term, high-intensity exercise.

  9. Prone position is associated with mild cerebral oxygen desaturation in elderly surgical patients.

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    Stacie Deiner

    Full Text Available PURPOSE: A variety of hemodynamic and respiratory alterations accompany patients in the prone position; however the effect of the prone position on intraoperative cerebral saturation has not been studied. We sought to examine whether the incidence of cerebral oxygen desaturation in elderly patients (≥68 years of age undergoing spine surgery in the prone position was more common than patients undergoing major surgery in the supine position. METHODS: We performed a retrospective cohort study of 205 patients; 63 patients underwent surgery in the prone position and 142 in the supine position. Patients were evaluated for cerebral desaturation with bilateral cerebral oximetry. The primary predictor was position, secondary were: length of the surgery, incidence and duration of cerebral desaturation episodes at several thresholds, average time of Bispectral index below threshold of 45 in minutes, average electroencephalogram suppression ratio >0, amount of blood transfused, and the incidence of hypotension and hypertension. RESULTS: Elderly spine surgery patients in the prone position were more than twice as likely to experience mild cerebral desaturation as patients in the supine position. Patients in the prone position had longer surgeries; however cerebral desaturation in the prone position was significantly more common even when adjusted for surgery time and the occurrence of intraoperative hypotension. CONCLUSION: Cerebral desaturation is related to the prone position in elderly surgery patients. Future studies are necessary to determine whether this translates to a higher incidence of postoperative cognitive dysfunction and delirium.

  10. A Randomized Trial of Long-Term Oxygen for COPD with Moderate Desaturation. (United States)

    Albert, Richard K; Au, David H; Blackford, Amanda L; Casaburi, Richard; Cooper, J Allen; Criner, Gerard J; Diaz, Philip; Fuhlbrigge, Anne L; Gay, Steven E; Kanner, Richard E; MacIntyre, Neil; Martinez, Fernando J; Panos, Ralph J; Piantadosi, Steven; Sciurba, Frank; Shade, David; Stibolt, Thomas; Stoller, James K; Wise, Robert; Yusen, Roger D; Tonascia, James; Sternberg, Alice L; Bailey, William


    Background Long-term treatment with supplemental oxygen has unknown efficacy in patients with stable chronic obstructive pulmonary disease (COPD) and resting or exercise-induced moderate desaturation. Methods We originally designed the trial to test whether long-term treatment with supplemental oxygen would result in a longer time to death than no use of supplemental oxygen among patients who had stable COPD with moderate resting desaturation (oxyhemoglobin saturation as measured by pulse oximetry [Spo2], 89 to 93%). After 7 months and the randomization of 34 patients, the trial was redesigned to also include patients who had stable COPD with moderate exercise-induced desaturation (during the 6-minute walk test, Spo2 ≥80% for ≥5 minutes and oxygen (supplemental-oxygen group) or no long-term supplemental oxygen (no-supplemental-oxygen group). In the supplemental-oxygen group, patients with resting desaturation were prescribed 24-hour oxygen, and those with desaturation only during exercise were prescribed oxygen during exercise and sleep. The trial-group assignment was not masked. Results A total of 738 patients at 42 centers were followed for 1 to 6 years. In a time-to-event analysis, we found no significant difference between the supplemental-oxygen group and the no-supplemental-oxygen group in the time to death or first hospitalization (hazard ratio, 0.94; 95% confidence interval [CI], 0.79 to 1.12; P=0.52), nor in the rates of all hospitalizations (rate ratio, 1.01; 95% CI, 0.91 to 1.13), COPD exacerbations (rate ratio, 1.08; 95% CI, 0.98 to 1.19), and COPD-related hospitalizations (rate ratio, 0.99; 95% CI, 0.83 to 1.17). We found no consistent between-group differences in measures of quality of life, lung function, and the distance walked in 6 minutes. Conclusions In patients with stable COPD and resting or exercise-induced moderate desaturation, the prescription of long-term supplemental oxygen did not result in a longer time to death or first

  11. Cerebral Oxygenation and Oxygen Extraction in the Preterm Infant during Desaturation : Effects of Increasing FiO(2) to Assist Recovery

    NARCIS (Netherlands)

    Baerts, Willem; Lemmers, Petra M. A.; van Bel, Frank


    Background: In the clinical setting, episodes of desaturation in newborn infants are often treated by increasing the fraction of inspired oxygen (FiO(2)). Objectives: To study the effect of an increase in FiO(2) on cerebral oxygenation during recovery from desaturation, as measured by near-infrared

  12. The effect of weight loss on sleep-disordered breathing and oxygen desaturation in morbidly obese men. (United States)

    Harman, E M; Wynne, J W; Block, A J


    Four morbidly obese men who had been found to have significant sleep-disordered breathing and oxygen desaturation were restudied after an average weight loss of 108 kg (range 53-155 kg). In all subjects, weight loss was accompanied by a significant reduction in the number of episodes per hour of sleep-disordered breathing events. In three of the four subjects, there was improvment in the severity of desaturation accompanying abnormal breathing. The two subjects with daytime somnolence and hypercapnia prior to weight loss showed the most dramatic improvement in desaturation. This suggests that obesity is a cause, rather than an effect, of the sleep apnea syndrome.

  13. Use of cluster analysis to describe desaturator phenotypes in COPD: correlations between pulmonary function tests and nocturnal oxygen desaturation

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    Toraldo DM


    Full Text Available Domenico Maurizio Toraldo1, Francesco De Nuccio2, Annarita Gaballo1, Giuseppe Nicolardi21A Galateo Lung Disease Hospital, Regional Service Puglia, San Cesario di Lecce, 2Laboratory of Human Anatomy, Department of Biological and Environmental Sciences and Technologies, University of Lecce, Lecce, ItalyBackground: Significant heterogeneity of clinical presentation and disease progression exists within chronic obstructive pulmonary disease (COPD. Although forced expiratory volume in 1 second (FEV1 inadequately describes this heterogeneity, a clear alternative has not emerged. This article discusses and refines the concept of phenotyping desaturators in COPD and shows a possible pattern which could be used as a framework for future research.Recent findings: COPD is a complex condition with pulmonary and extrapulmonary manifestations. We suggest that COPD phenotypes should be associated with clinically meaningful outcomes. The innovation of COPD phenotyping is defined as COPD desaturators. Sleep-related hypoxemia and hypercapnia are well recognized in COPD and the development of systemic inflammation during sleep. These sleep-related changes predispose to nocturnal cardiac arrhythmias, pulmonary hypertension, and possibly death, particularly during acute exacerbations.Conclusion: A more focused definition makes possible a classification of patients into two distinct subgroups for both clinical and research purposes. Establishing a common language for future research will facilitate our understanding and management of such diseases. Even if different treatment strategies have different outcomes for these groups, we will have confirmation, or otherwise, of the clinical value of cluster analysis. This knowledge could lead to pharmacological treatment and other interventions directed to specific phenotypic groups.Keywords: phenotypes, chronic obstructive pulmonary disease, desaturator, nocturnal hypoxemia, systemic inflammation, intermittent hypoxia

  14. Raynaud's phenomenon in a child presenting as oxygen desaturation during transfusion with cold blood. (United States)

    Zhang, Xiaopeng; Coté, Charles J


    We report a case of Raynaud's phenomenon (RP) triggered by transfusion of cold blood to a pediatric burn patient under general anesthesia. The child was febrile so a decision was made to not use a blood warmer. When the blood was rapidly administered the child suddenly developed 'desaturation'. The child was placed on 100% oxygen, adequate ventilation assured, and the color of his oral mucosa assessed as 'pink'. Placement of the oximeter on the opposite hand revealed 100% saturation. To our knowledge, this is the first case of apparent RP reported in a pediatric patient triggered by transfusion of cold blood.

  15. Relationship of Hemoglobin to Arterial Oxygen Desaturation during Aeromedical Evacuation (United States)


    civilians and contractors with issues concerning for myocardial ischemia or myocardial infarction . In this setting it may be important to consider the...demonstrating pre- flight hypoxemia (defined as SpO2 < 92%), hypoventilation secondary to narcotic use, or the diagnosis of traumatic brain injury (TBI...hypoxemia on patients who have some form of TBI [6-9]. Unfortunately, the study data cannot ascertain the number of patients with a diagnosis of

  16. Effect of oxygen on tachycardia and arterial oxygen saturation during colonoscopy

    DEFF Research Database (Denmark)

    Holm, C; Christensen, M; Schulze, S;


    through nasal prongs (2 L/min), and 20 patients breathed room air during colonoscopy. All patients were given conscious sedation and were monitored with a pulse oximeter during colonoscopy. MAIN OUTCOME MEASURES: Tachycardia (pulse rate>100 min(-1)) and arterial oxygen desaturation (SpO2... colonoscopy. RESULTS: There were no differences in the incidence of tachycardia or mean heart rate during endoscopy between the two groups, and no patient developed symptomatic cardiac arrhythmias or hypotensive episodes. 10 patients in the room air compared with none in the oxygen treatment group (p = 0...

  17. Pulse oximetry recorded from the Phone Oximeter for detection of obstructive sleep apnea events with and without oxygen desaturation in children. (United States)

    Garde, Ainara; Dehkordi, Parastoo; Wensley, David; Ansermino, J Mark; Dumont, Guy A


    Obstructive sleep apnea (OSA) disrupts normal ventilation during sleep and can lead to serious health problems in children if left untreated. Polysomnography, the gold standard for OSA diagnosis, is resource intensive and requires a specialized laboratory. Thus, we proposed to use the Phone Oximeter™, a portable device integrating pulse oximetry with a smartphone, to detect OSA events. As a proportion of OSA events occur without oxygen desaturation (defined as SpO2 decreases ≥ 3%), we suggest combining SpO2 and pulse rate variability (PRV) analysis to identify all OSA events and provide a more detailed sleep analysis. We recruited 160 children and recorded pulse oximetry consisting of SpO2 and plethysmography (PPG) using the Phone Oximeter™, alongside standard polysomnography. A sleep technician visually scored all OSA events with and without oxygen desaturation from polysomnography. We divided pulse oximetry signals into 1-min signal segments and extracted several features from SpO2 and PPG analysis in the time and frequency domain. Segments with OSA, especially the ones with oxygen desaturation, presented greater SpO2 variability and modulation reflected in the spectral domain than segments without OSA. Segments with OSA also showed higher heart rate and sympathetic activity through the PRV analysis relative to segments without OSA. PRV analysis was more sensitive than SpO2 analysis for identification of OSA events without oxygen desaturation. Combining SpO2 and PRV analysis enhanced OSA event detection through a multiple logistic regression model. The area under the ROC curve increased from 81% to 87%. Thus, the Phone Oximeter™ might be useful to monitor sleep and identify OSA events with and without oxygen desaturation at home.

  18. Oxygen desaturation during night sleep affects decision-making in patients with obstructive sleep apnea. (United States)

    Delazer, Margarete; Zamarian, Laura; Frauscher, Birgit; Mitterling, Thomas; Stefani, Ambra; Heidbreder, Anna; Högl, Birgit


    This study assessed decision-making and its associations with executive functions and sleep-related factors in patients with obstructive sleep apnea. Thirty patients with untreated obstructive sleep apnea and 20 healthy age- and education-matched controls performed the Iowa Gambling Task, a decision-making task under initial ambiguity, as well as an extensive neuropsychological test battery. Patients, but not controls, also underwent a detailed polysomnographic assessment. Results of group analyses showed that patients performed at the same level of controls on the Iowa Gambling Task. However, the proportion of risky performers was significantly higher in the patient group than in the control group. Decision-making did not correlate with executive functions and subjective ratings of sleepiness, whereas there was a significant positive correlation between advantageous performance on the Iowa Gambling Task and percentage of N2 sleep, minimal oxygen saturation, average oxygen saturation and time spent below 90% oxygen saturation level. Also, the minimal oxygen saturation accounted for 27% of variance in decision-making. In conclusion, this study shows that a subgroup of patients with obstructive sleep apnea may be at risk of disadvantageous decision-making under ambiguity. Among the sleep-related factors, oxygen saturation is a significant predictor of advantageous decision-making.

  19. Determinants of exercise-induced oxygen desaturation including pulmonary emphysema in COPD: Results from the ECLIPSE study. (United States)

    Andrianopoulos, Vasileios; Celli, Bartolome R; Franssen, Frits M E; Pinto-Plata, Victor M; Calverley, Peter M A; Vanfleteren, Lowie E G W; Vogiatzis, Ioannis; Vestbo, Jørgen; Agusti, Alvar; Bakke, Per S; Rennard, Stephen I; MacNee, William; Tal-Singer, Ruth; Yates, Julie C; Wouters, Emiel F M; Spruit, Martijn A


    Exercise-induced oxygen desaturation (EID) is related to mortality in patients with chronic obstructive pulmonary disease (COPD). We investigated: (1) the prevalence of EID; (2) the relative-weight of several physiological determinants of EID including pulmonary emphysema, and (3) the relationship of EID with certain patients' clinical characteristics. Data from 2050 COPD patients (age: 63.3 ± 7.1years; FEV1: 48.7 ± 15.7%pred.) were analyzed. The occurrence of EID (SpO2post ≤88%) at the six-minute walking test (6MWT) was investigated in association with emphysema quantified by computed-tomography (QCT), and several clinical characteristics. 435 patients (21%) exhibited EID. Subjects with EID had more QCT-emphysema, lower exercise capacity and worse health-status (BODE, ADO indexes) compared to non-EID. Determinant of EID were obesity (BMI≥30 kg/m(2)), impaired FEV1 (≤44%pred.), moderate or worse emphysema, and low SpO2 at rest (≤93%). Linear regression indicated that each 1-point increase on the ADO-score independently elevates odds ratio (≤1.5fold) for EID. About one in five COPD patients in the ECLIPSE cohort present EID. Advanced emphysema is associated with EID. In addition, obesity, severe airflow limitation, and low resting oxygen saturation increase the risk for EID. Patients with EID in GOLD stage II have higher odds to have moderate or worse emphysema compared those with EID in GOLD stage III-IV. Emphysematous patients with high ADO-score should be monitored for EID.

  20. Oxygen transfer in human carotid artery bifurcation

    Institute of Scientific and Technical Information of China (English)

    Z.G.Zhang; Y.B.Fan; X.Y.Deng


    Arterial bifurcations are places where blood flow may be disturbed and slow recirculation flow may occur.To reveal the correlation between local oxygen transfer and atherogenesis, a finite element method was employed to simulate the blood flow and the oxygen transfer in the human carotid artery bifurcation. Under steady-state flow conditions, the numerical simulation demonstrated a variation in local oxygen transfer at the bifurcation, showing that the convective condition in the disturbed flow region may produce uneven local oxygen transfer at the blood/wall interface.The disturbed blood flow with formation of slow eddies in the carotid sinus resulted in a depression in oxygen supply to the arterial wall at the entry of the sinus, which in turn may lead to an atherogenic response of the arterial wall, and contribute to the development of atherosclerotic stenosis there.

  1. Transcutaneous Determination of Arterial Oxygen Tension (United States)

    Fenner, A.; And Others


    Evaluated were two techniques (the conventional method and the new transcutaneous method) of measuring arterial oxygen tension in 20 severely ill preterm and term infants and in 70 healthy infants. (Author/CL)

  2. Association of apneic oxygenation with decreased desaturation rates during rapid sequence intubation by a Chinese emergency medicine service. (United States)

    Mao, Yong; Qin, Zong-He


    Rapid and safe airway management has always been of paramount importance in successful management of critically ill and injured patients in the emergency department. The achievement rate of emergency medicine inhabitants in airway management improved enhanced essentially subsequent to finishing anaesthesiology turn. There was a slightly higher rate of quick sequence intubation in the postapneic oxygenation groups (preapneic oxygenation 6.4%; postapneic oxygenation 9.1%). The majority of patients intubated in both groups were men (preapneic oxygenation 72.3%; postapneic oxygenation 63.5%). A higher percentage of patients in the preapneic oxygenation group had a Cormack-Lehane grade III or worse view (23.2% versus 11.8%). Anaesthesiology turns should be considered as an essential component of emergency medicine training programs. A collateral curriculum of this nature should also focus on the acquisition of skills in airway management.

  3. Association of apneic oxygenation with decreased desaturation rates during rapid sequence intubation by a Chinese emergency medicine service


    Mao, Yong; Qin, Zong-He


    Rapid and safe airway management has always been of paramount importance in successful management of critically ill and injured patients in the emergency department. The achievement rate of emergency medicine inhabitants in airway management improved enhanced essentially subsequent to finishing anaesthesiology turn. There was a slightly higher rate of quick sequence intubation in the postapneic oxygenation groups (preapneic oxygenation 6.4%; postapneic oxygenation 9.1%). The majority of patie...

  4. Inspiratory Muscle Training and Arterial Blood Oxygen Saturation in Patients With Chronic Obstructive Pulmonary Disease

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    Bakhshandeh Bavarsad


    Full Text Available Background One of the problems of the patients with chronic obstructive pulmonary disease (COPD is the weakness of the respiratory muscles that causes oxygen desaturation at rest and activity and decreases exercise tolerance. Objectives This study aimed to investigate the effect of inspiratory muscle training on arterial oxygen saturation (SPO2. Patients and Methods Forty patients with mild to very severe COPD were recruited for this study, which is a randomized control trail. The patients were randomized to IMT (inspiratory muscle training and control group. Training was performed with Respivol (a kind of inspiratory muscle trainer for 8 weeks (15 min/d for 6 d/week. SPSS software version 16 was used to analyze the data by performing independent t test, paired t test, and Fisher exact test. Results Results showed that, after 8 weeks of inspiratory muscle training, there was a little increase (but not statistically significant improvement in SPO2 (from 92.6 ± 8.71 % to 95.13 ± 7.08 %, with P = 0.06, whereas it remained unchanged in the control group (from 96.0 ± 3.46 % to 96.4 ± 3.35 % with P = 0.51. No statistically significant difference was seen between the two groups (P > 0.05. Conclusions Although inspiratory muscles training can prevent desaturation, which is caused by activity, it fails to improve it.

  5. Do dental procedures affect lung function and arterial oxygen saturation in asthmatic patients?

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    Magdy Mahmoud Emara


    Conclusion: Asthmatic patients may be at a higher risk of developing oxygen desaturation after dental procedures regardless of their type with and without local anesthesia and a decrease in PEF after dental procedures with local anesthesia.

  6. Arterial oxygen saturation in preterm infants at discharge from the hospital and six weeks later. (United States)

    Poets, C F; Stebbens, V A; Alexander, J R; Arrowsmith, W A; Salfield, S A; Southall, D P


    To obtain normal data on arterial oxygen saturation (SaO2) in preterm infants and to study early developmental changes in SaO2, we obtained overnight tape recordings of SaO2 and breathing movements in 160 preterm infants at their discharge from three special care baby units (mean gestational age at birth 33 weeks; at time of study, 37 weeks). One hundred ten infants (69%) underwent a second recording 6 weeks later. Median baseline SaO2 during regular breathing was 99.5% (range 88.7% to 100%) at discharge, and 100% (range 95.3% to 100%) at follow-up (p less than 0.001). The number of episodes of desaturation, defined as a fall in SaO2 to less than or equal to 80% for at least 4 seconds, corrected to the mean duration of recording (12.2 hours), decreased from a median of 3 (0 to 355) to 0 (0 to 17) (p less than 0.001). The median duration of each episode of desaturation remained unchanged (5.2 (4.0 to 22.7) vs 5.5 (4.2 to 24.0) seconds). At discharge, a small minority of infants had a clinically unrecognized low baseline SaO2 (lowest, 88.7%; 5th percentile, 95.7%) or a high number of desaturation episodes (the highest was six times the 95th percentile value). At follow-up, all outlying values had normalized. Follow-up recordings made between 42 and 47 weeks of gestational age (n = 53) were compared with similar recordings from 67 term infants at the same gestational age. The preterm infants had a significantly higher baseline SaO2 and no more desaturation than the infants born at term. Knowledge of normal ranges of oxygenation and their changes with age may be of value in identifying clinically undetected hypoxemia in preterm infants at discharge from the hospital. The potential influence of such hypoxemia on clinical outcome remains to be determined.

  7. Respiratory muscle training with normocapnic hyperpnea improves ventilatory pattern and thoracoabdominal coordination, and reduces oxygen desaturation during endurance exercise testing in COPD patients

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    Bernardi E


    Full Text Available Eva Bernardi,1 Luca Pomidori,1 Faisy Bassal,1 Marco Contoli,2 Annalisa Cogo11Biomedical Sport Studies Center, University of Ferrara, Ferrara, 2Respiratory Section, Department of Medical Sciences, University of Ferrara, Cona (FE, ItalyBackground: Few data are available about the effects of respiratory muscle training with normocapnic hyperpnea (NH in COPD. The aim is to evaluate the effects of 4 weeks of NH (Spirotiger® on ventilatory pattern, exercise capacity, and quality of life (QoL in COPD patients.Methods: Twenty-six COPD patients (three females, ages 49–82 years, were included in this study. Spirometry and maximal inspiratory pressure, St George Respiratory Questionnaire, 6-minute walk test, and symptom-limited endurance exercise test (endurance test to the limit of tolerance [tLim] at 75%–80% of peak work rate up to a Borg Score of 8–9/10 were performed before and after NH. Patients were equipped with ambulatory inductive plethysmography (LifeShirt® to evaluate ventilatory pattern and thoracoabdominal coordination (phase angle [PhA] during tLim. After four supervised sessions, subjects trained at home for 4 weeks – 10 minutes twice a day at 50% of maximal voluntary ventilation. The workload was adjusted during the training period to maintain a Borg Score of 5–6/10.Results: Twenty subjects completed the study. After NH, maximal inspiratory pressure significantly increased (81.5±31.6 vs 91.8±30.6 cmH2O, P<0.01; exercise endurance time (+150 seconds, P=0.04, 6-minute walk test (+30 meters, P=0.03, and QoL (-8, P<0.01 all increased. During tLim, the ventilatory pattern changed significantly (lower ventilation, lower respiratory rate, higher tidal volume; oxygen desaturation, PhA, and dyspnea Borg Score were lower for the same work intensity (P<0.01, P=0.02, and P<0.01, respectively; one-way ANOVA. The improvement in tidal volume and oxygen saturation after NH were significantly related (R2=0.65, P<0.01.Conclusion: As

  8. Renal vein oxygen saturation in renal artery stenosis

    DEFF Research Database (Denmark)

    Nielsen, K; Rehling, M; Henriksen, Jens Henrik Sahl


    Renal vein oxygen-saturation was measured in 56 patients with arterial hypertension and unilateral stenosis or occlusion of the renal artery. Oxygen-saturation in blood from the ischaemic kidney (84.4%, range 73-93%) was significantly higher than that from the 'normal' contralateral kidney (81...

  9. The impact of arterial oxygen tension on venous oxygen saturation in circulatory failure. (United States)

    Ho, Kwok Ming; Harding, Richard; Chamberlain, Jenny


    Central and mixed venous oxygen saturations have been used to guide resuscitation in circulatory failure, but the impact of arterial oxygen tension on venous oxygen saturation has not been thoroughly evaluated. This observational study investigated the impact of arterial oxygen tension on venous oxygen saturation in circulatory failure. Twenty critically ill patients with circulatory failure requiring mechanical ventilation and a pulmonary artery catheter in an intensive care unit in a tertiary hospital in Western Australia were recruited. Samples of arterial blood, central venous blood, and mixed venous blood were simultaneously and slowly drawn from the arterial, central venous, and pulmonary artery catheter, respectively, at baseline and after the patient was ventilated with 100% inspired oxygen for 5 min. The blood samples were redrawn after a significant change in cardiac index (>or =10%) from the baseline, occurring within 24 h of study enrollment while the patient was ventilated with the same baseline inspired oxygen concentration, was detected. An increase in inspired oxygen concentration significantly increased the arterial oxygen tension from 12.5 to 38.4 kPa (93.8-288 mmHg) (mean difference, 25.9 kPa; 95% confidence interval [CI], 7.5-31.9 kPa; P arterial oxygen tension on venous oxygen saturation was more significant than the effect associated with changes in cardiac index (mean difference, 2.8%; 95% CI, -0.2% to 5.8%; P = 0.063). In conclusion, arterial oxygen tension has a significant effect on venous oxygen saturation, and this effect is more significant and consistent than the effect associated with changes in cardiac index.

  10. Measuring blood oxygenation of pulsatile arteries using photoacoustic microscopy (United States)

    Li, Qian; Yu, Tianhao; Li, Lin; Chai, Xinyu; Zhou, Chuanqing


    Heart pumps blood through the blood vessels to provide body with oxygen and nutrients. As the result, the blood flow, volume and oxygenation in arteries has a pulsatile nature. Measuring these pulsatile parameters enables more precise monitoring of oxygen metabolic rate and is thus valuable for researches and clinical applications. Photoacoustic microscopy (PAM) is a proven label-free method for in vivo measuring blood oxygenation at single blood vessel level. However, studies using PAM to observe the pulsatile nature of blood oxygenation in arteries were not reported. In this paper, we use optical-resolution PAM (OR-PAM) technology to study the blood oxygenation dynamics of pulsatile arteries. First, the ability of our OR-PAM system to accurately reflect the change of optical absorption in imaged objects is demonstrated in a phantom study. Then the system is used to image exposed cortical blood vessels of cat. The pulsatile nature of blood volume and oxygenation in arteries is clearly reflected in photoacoustic (PA) signals, whereas it's not observable in veins. By using a multi-wavelength laser, the dynamics of the blood oxygenation of pulsatile arteries in cardiac cycles can be measured, based on the spectroscopic method.

  11. A conversion formula for comparing pulse oximeter desaturation rates obtained with different averaging times.

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    Jan Vagedes

    Full Text Available OBJECTIVE: The number of desaturations determined in recordings of pulse oximeter saturation (SpO2 primarily depends on the time over which values are averaged. As the averaging time in pulse oximeters is not standardized, it varies considerably between centers. To make SpO2 data comparable, it is thus desirable to have a formula that allows conversion between desaturation rates obtained using different averaging times for various desaturation levels and minimal durations. METHODS: Oxygen saturation was measured for 170 hours in 12 preterm infants with a mean number of 65 desaturations <90% per hour of arbitrary duration by using a pulse oximeter in a 2-4 s averaging mode. Using 7 different averaging times between 3 and 16 seconds, the raw red-to-infrared data were reprocessed to determine the number of desaturations (D. The whole procedure was carried out for 7 different minimal desaturation durations (≥ 1, ≥ 5, ≥ 10, ≥ 15, ≥ 20, ≥ 25, ≥ 30 s below SpO2 threshold values of 80%, 85% or 90% to finally reach a conversion formula. The formula was validated by splitting the infants into two groups of six children each and using one group each as a training set and the other one as a test set. RESULTS: Based on the linear relationship found between the logarithm of the desaturation rate and the logarithm of the averaging time, the conversion formula is: D2 = D1 (T2/T1(c, where D2 is the desaturation rate for the desired averaging time T2, and D1 is the desaturation rate for the original averaging time T1, with the exponent c depending on the desaturation threshold and the minimal desaturation duration. The median error when applying this formula was 2.6%. CONCLUSION: This formula enables the conversion of desaturation rates between different averaging times for various desaturation thresholds and minimal desaturation durations.

  12. New technique for servo-control of arterial oxygen tension in preterm infants. (United States)

    Beddis, I R; Collins, P; Levy, N M; Godfrey, S; Silverman, M


    Equipment has been developed for the servo-control of arterial oxygen tension in sick, newborn babies. Using an indwelling umbilical arterial oxygen electrode as sensor, the equipment successfully regulated the administration of oxygen to 12 newborn babies with respiratory distress syndrome, significantly improving the stability of arterial oxygen tension and lessening the duration of episodes of hypoxia and hyperoxia.

  13. Diffuse coronary artery spasm treated by extracorporeal membrane oxygenation. (United States)

    Smith, Chez; Akowuah, Enoch; Theodore, Sanjay; Brown, Robin


    Diffuse coronary vasospasm is an unpredictable and serious complication following coronary artery bypass surgery. The treatment of this emergency is dependent on patient suitability for angiography and direct injection of vasodilators into the affected vessels. In patients unable to proceed to angiography the diagnosis can only be suspected but treatment is nevertheless still towards reinstitution of coronary blood flow. We present one such case in which re-grafting and extracorporeal membranous oxygenation proved successful in restoring cardiac function in a patient with diffuse coronary artery spasm.

  14. Comparison of pulseoximetry oxygen saturation and arterial oxygen saturation in open heart intensive care unit

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    Alireza Mahoori


    Full Text Available Background: Pulseoximetry is widely used in the critical care setting, currently used to guide therapeutic interventions. Few studies have evaluated the accuracy of SPO2 (puls-eoximetry oxygen saturation in intensive care unit after cardiac surgery. Our objective was to compare pulseoximetry with arterial oxygen saturation (SaO2 during clinical routine in such patients, and to examine the effect of mild acidosis on this relationship.Methods: In an observational prospective study 80 patients were evaluated in intensive care unit after cardiac surgery. SPO2 was recorded and compared with SaO2 obtained by blood gas analysis. One or serial arterial blood gas analyses (ABGs were performed via a radial artery line while a reliable pulseoximeter signal was present. One hundred thirty seven samples were collected and for each blood gas analyses, SaO2 and SPO2 we recorded.Results: O2 saturation as a marker of peripheral perfusion was measured by Pulseoxim-etry (SPO2. The mean difference between arterial oxygen saturation and pulseoximetry oxygen saturation was 0.12%±1.6%. A total of 137 paired readings demonstrated good correlation (r=0.754; P<0.0001 between changes in SPO2 and those in SaO2 in samples with normal hemoglobin. Also in forty seven samples with mild acidosis, paired readings demonstrated good correlation (r=0.799; P<0.0001 and the mean difference between SaO2 and SPO2 was 0.05%±1.5%.Conclusion: Data showed that in patients with stable hemodynamic and good signal quality, changes in pulseoximetry oxygen saturation reliably predict equivalent changes in arterial oxygen saturation. Mild acidosis doesn’t alter the relation between SPO2 and SaO2 to any clinically important extent. In conclusion, the pulse oximeter is useful to monitor oxygen saturation in patients with stable hemodynamic.

  15. Guided desaturation of unactivated aliphatics (United States)

    Voica, Ana-Florina; Mendoza, Abraham; Gutekunst, Will R.; Fraga, Jorge Otero; Baran, Phil S.


    The excision of hydrogen from an aliphatic carbon chain to produce an isolated olefin (desaturation) without overoxidation is one of the most impressive and powerful biosynthetic transformations for which there are no simple and mild laboratory substitutes. The versatility of olefins and the range of reactions they undergo are unsurpassed in functional group space. Thus, the conversion of a relatively inert aliphatic system into its unsaturated counterpart could open new possibilities in retrosynthesis. In this article, the invention of a directing group to achieve such a transformation under mild, operationally simple, metal-free conditions is outlined. This ‘portable desaturase’ (TzoCl) is a bench-stable, commercial entity (Aldrich, catalogue number L510092) that is facile to install on alcohol and amine functionalities to ultimately effect remote desaturation, while leaving behind a synthetically useful tosyl group.

  16. Oronasopharyngeal suction at birth: effects on arterial oxygen saturation. (United States)

    Carrasco, M; Martell, M; Estol, P C


    The effect of oronasopharyngeal suction (ONPS) on arterial oxygen saturation (SaO2) is described in a controlled study of 30 normal term newborn infants. In 15 of them, ONPS was performed immediately after birth. The SaO2 value was recorded through a pulse oximeter. The ONPS group had a significantly lower SaO2 between the first and the sixth minutes of life and took longer to reach 86% and 92% saturation. According to this study, ONPS should not be performed as a routine procedure in normal, term, vaginally born infants.

  17. [Veno-venous extracorporeal oxygenation and veno-arterial extracorporeal oxygenation. Questions, answers]. (United States)

    Isetta, C; Lebreton, G; Janot, N; Prommenschenkel, M; Rilos, Z; Roques, F; Longrois, D


    A round table, organized by the French Society of Perfusion (Sofraperf) at the French national congress on extracorporeal circulations (Perfusion 2013), was attended by perfusionists, anaesthesiologists, intensivists and surgeons around the theme of respiratory veno-venous support and veno-arterial circulatory support with extracorporeal oxygenation in intensive care units. The debate was conducted in a participatory manner by bi-directional questions-answers session between moderators and assistance. The authors report management of this type of therapy that is not perfectly homogeneous, supported on literature data. Cannulae, cannulation, circuit, oxygenator, anticoagulation, control, surveillance, weaning are subject to paragraphs with defined entry whose contents are mutually enriching.

  18. Developmental Effects Determine Submaximal Arterial Oxygen Saturation in Peruvian Quechua. (United States)

    Kiyamu, Melisa; León-Velarde, Fabiola; Rivera-Chira, María; Elías, Gianpietro; Brutsaert, Tom D


    Kiyamu, Melisa, Fabiola León-Velarde, María Rivera-Chira, Gianpietro Elías, and Tom D. Brutsaert. Developmental effects determine submaximal arterial oxygen saturation in Peruvian Quechua. High Alt Med Biol 16, 138-146, 2015.--Andean high altitude natives show higher arterial oxygen saturation (Sao(2)) during exercise in hypoxia, compared to acclimatized sojourners. In order to evaluate the effects of life-long exposure to high altitude on Sao(2), we studied two groups of well-matched, self-identified Peruvian Quechua natives who differed in their developmental exposure to hypoxia before and after a 2-month training period. Male and female volunteers (18-35 years) were recruited in Lima, Peru (150 m). The two groups were: a) Individuals who were born and raised at sea-level (BSL, n=34) and b) Individuals who were born and raised at high altitude (BHA, n=32), but who migrated to sea-level as adults (>16 years old). Exercise testing was conducted using a submaximal exercise protocol in normobaric hypoxia in Lima (BP=750 mmHg, Fio(2)=0.12), in order to measure Sao(2) (%), ventilation (VE L/min) and oxygen consumption (Vo(2), L/min). Repeated-measures ANOVA, controlling for VE/VO(2) (L/min) and sex during the submaximal protocol showed that BHA maintained higher Sao(2) (%) compared to BSL at all workloads before (p=0.005) and after training (p=0.017). As expected, both groups showed a decrease in Sao(2) (%) (p<0.001), as workload increased. Resting Sao(2) levels were not found to be different between groups. The results suggest that developmental exposure to altitude contributes to the maintenance of higher Sao(2) levels during submaximal exercise at hypoxia.

  19. Assessment of Arterial Oxygen Saturation by Pulse Oximetry Before, During and After Electroconvulsive Therapy

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    SH Tarig


    Full Text Available Introduction & Objective: Electroconvulsive therapy (ECT is used widely in psychiatric practice. The goal of anesthesia for ECT is the prevention of complications such as discomfort, fractures, aspiration of gastric contents and hypoxia. However, general anesthesia can cause some adverse effects as hypoxia. Prevention and treatment of hypoxia is important due to its undesirable effects on seizure duration and cardiovascular system. This study was designed to detect the incidence and probable times of desaturation in patients receiving ECT. Materials & Methods: This prospective randomized clinical trial was carried out on 100 patients (18-50 y/o with ASA I or II who were scheduled for ECT. After pre-oxygenation and similar anesthesia induction the patients received ECT. The patients were ventilated by oxygen and face masked until the return of their spontaneous respiration with adequate tidal volume and respiratory rate. Then they were transferred to recovery room where there was no oxygen supplementation. Oxygen saturation was measured by a Nell core pulse oximeter and was recorded at six stages: before and after anesthesia induction, during ECT, after ECT, 5 minutes after entering recovery room and before leaving there. The data were analyzed by standard statistical tests using SPSS software Results: Data analysis revealed that desaturation was not noticed at any stage except for the 5th stage (5 minutes after entering recovery room, when 13% of patients developed Sao2% less than 90%. Also there was a significant difference between Sao2% of patients between this stage (5th and other stages (p<0.001. Conclusion: According to our findings, appropriate oxygen supplementation and pulse oximetry monitoring during recovery period after ECT can be recommend

  20. The Effects of Synthetic Cannabinoids on Alveolar-Arterial Oxygen Gradient

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    Egemen Kucuk


    Full Text Available Aim: Synthetic cannabinoids are chemicals that produce several marijuana-like effects in humans. Aim of this study is to investigate the effects of synthetic cannabinoids on to alveolar-arterial oxygen gradient. Material and Method: A total of 112 patients, who admitted directly to emergency clinic with synthetic cannabinoid usage, were determined between February 2014 and August 2014. Blood gases of 41 patients were determined as arterial blood gases on room air, and included in to study. Patients were evaluated according to age, sex, decade, partial pressure of arterial oxygen, partial pressure of arterial carbon dioxide, pH, bicarbonate, metabolic status, age consistent expected alveolar-arterial oxygen gradient and calculated alveolar-arterial oxygen gradient. Results: Synthetic cannabinoid using was higher in males, mean age of patients was 23.32±6.14 years. Number of patients in the third decade were significantly higher than the other decades. The calculated alveolar-arterial oxygen gradient value of patients was significantly higher than age consistent expected alveolar-arterial oxygen gradient value. Respiratory acidosis, was significantly higher than the other types of the metabolic disorders. The best cutoff point for calculated alveolar-arterial oxygen gradient was 12.70, with sensitivity of 90% and specifity of 85%. Area under curve was 0.70 for calculated alveolar-arterial oxygen gradient. Discussion: The value of alveolar-arterial oxygen gradient has been increased due to synthetic cannabinoid usage. This can be used as a supportive parameter in the diagnosis of synthetic cannabinoid usage.

  1. Implantable telemetry capsule for monitoring arterial oxygen saturation and heartbeat. (United States)

    Kuwana, K; Dohi, T; Hashimoto, Y; Matsumoto, K; Shimoyama, I


    In this study, we have developed an implantable telemetry capsule for monitoring heartbeat. The capsule has three main functions, monitoring vital signs, transmitting the vital signs, and receiving energy for driving the capsule without wires. We used two wavelengths of LEDs and a photodiode sensitive to the two wavelengths for heartbeat sensor. The arterial oxygen saturation is calculated from the amplitude of the heartbeat signal. We fabricated an FM transmitter whose carrier frequency was 80 MHz. Though the GHz range frequency is generally used in transmission, the attenuation in the human body is large. The size of a common linear antenna is about a quarter of its operating wavelength. We employed a coil-based antenna which can reduce size below the quarter of the wavelength. We fabricated a miniaturized transmitter with the coil-based antenna at lower frequency. Our capsule was driven intermittently. We used a rechargeable battery. When the battery ran down, the battery was charged by wireless using the induced electromotive force. This means that the capsule is capable of monitoring vital signs over the long term. We measured the heartbeat from the middle finger of hand in a water tank as a model of a human body.

  2. The Association Between Arterial Oxygen Tension and Neurological Outcome After Cardiac Arrest. (United States)

    Johnson, Nicholas J; Dodampahala, Kalani; Rosselot, Babette; Perman, Sarah M; Mikkelsen, Mark E; Goyal, Munish; Gaieski, David F; Grossestreuer, Anne V


    A number of observational studies have evaluated the association between arterial oxygen tensions and outcome after cardiac arrest with variable results. The objective of this study is to determine the association between arterial oxygen tension and neurological outcome after cardiac arrest. A retrospective cohort analysis was performed using the Penn Alliance for Therapeutic Hypothermia registry. Adult patients who experienced return of spontaneous circulation after in-hospital or out-of-hospital cardiac arrest (OHCA) and had a partial pressure of arterial oxygen (PaO2) recorded within 48 hours were included. Our primary exposure of interest was PaO2. Hyperoxemia was defined as PaO2 > 300 mmHg, hypoxemia as PaO2 arterial oxygen tension measured within the first 48 hours after cardiac arrest and neurological outcome.

  3. Effect of balloon atrial septostomy on cerebral oxygenation in neonates with transposition of the great arteries

    NARCIS (Netherlands)

    van der Laan, Michelle E.; Verhagen, Elise A.; Bos, Arend F.; Berger, Rolf M. F.; Kooi, Elisabeth M. W.


    BACKGROUND: The aim of this study was to determine the effect of balloon atrial septostomy (BAS) on cerebral oxygenation in neonates with transposition of the great arteries (TGA). METHODS: In term neonates with TGA, regional cerebral tissue oxygen saturation (r(c)SO(2)) was measured using, near-inf

  4. Predictive factors of oxygen desaturation of patients submitted to endoscopic retrograde cholangiopancreatography under conscious sedation Fatores preditivos de dessaturação de oxigênio de pacientes submetidos a colangiopancreatografia endoscópica retrógrada sob sedação consciente

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    Suzana Müller


    Full Text Available BACKGROUND AND AIMS: Hypoxemia can occur during endoscopic retrograde cholangiopancreatography probably induced by the analgesia and sedation done. Moreover the patient’s prone position difficults the adequate ventilation. The hypoxemia and hypoventilation may not be noticed by nursing staff. A transversal study was used to investigate possible predictive factors of oxygen desaturation in sedated patients with midazolam associated to meperidine undergoing endoscopic retrograde cholangiopancreatography. PATIENTS AND METHODS: A total of 186 patients were monitored with continuous pulse oximetry. Poisson regression was used to measure the independent effect of each factor adjusted for effects of each of the other factors. The variables studied were: age, gender, hematocrit and hemoglobin levels, scopolamine use, diagnostic or therapeutic exam, American Society of Anesthesiologists Scores (ASA, duration time of exam, sedative used midazolam in the average of 0.07 mg/kg and analgesic drug meperidine in the average of 0.7 mg/kg that was titrated according patient’s reaction. RESULTS: No desaturation was found in 113 (60.8% patients, mild desaturation (SpO2 60 years old and ASA score III. The duration of exam was barely significant for desaturation. CONCLUSIONS:The variables of age of 60 years old or more, and ASA III score are identified as increased risk for desaturation for patients who undergo endoscopic retrograde cholangiopancreatography under conscious sedation. Long time of exam suggests the patient oxygen desaturate. Such patients require very close monitoring to desaturation and hypoventilation by the assistants and nursing staff alerting to respiratory depression. The use of pulse oximeter and asking for deep breaths during the exam helps to diminish such risks.RACIONAL: A hipoxemia pode ocorrer durante a colangiopancreatografia endoscópica retrógrada, provavelmente induzida pela analgesia e sedação realizadas, além da posição do

  5. Arterial blood oxygen saturation during blood pressure cuff-induced hypoperfusion (United States)

    Kyriacou, P. A.; Shafqat, K.; Pal, S. K.


    Pulse oximetry has been one of the most significant technological advances in clinical monitoring in the last two decades. Pulse oximetry is a non-invasive photometric technique that provides information about the arterial blood oxygen saturation (SpO2) and heart rate, and has widespread clinical applications. When peripheral perfusion is poor, as in states of hypovolaemia, hypothermia and vasoconstriction, oxygenation readings become unreliable or cease. The problem arises because conventional pulse oximetry sensors must be attached to the most peripheral parts of the body, such as finger, ear or toe, where pulsatile flow is most easily compromised. Pulse oximeters estimate arterial oxygen saturation by shining light at two different wavelengths, red and infrared, through vascular tissue. In this method the ac pulsatile photoplethysmographic (PPG) signal associated with cardiac contraction is assumed to be attributable solely to the arterial blood component. The amplitudes of the red and infrared ac PPG signals are sensitive to changes in arterial oxygen saturation because of differences in the light absorption of oxygenated and deoxygenated haemoglobin at these two wavelengths. From the ratios of these amplitudes, and the corresponding dc photoplethysmographic components, arterial blood oxygen saturation (SpO2) is estimated. Hence, the technique of pulse oximetry relies on the presence of adequate peripheral arterial pulsations, which are detected as photoplethysmographic (PPG) signals. The aim of this study was to investigate the effect of pressure cuff-induced hypoperfusion on photoplethysmographic signals and arterial blood oxygen saturation using a custom made finger blood oxygen saturation PPG/SpO2 sensor and a commercial finger pulse oximeter. Blood oxygen saturation values from the custom oxygen saturation sensor and a commercial finger oxygen saturation sensor were recorded from 14 healthy volunteers at various induced brachial pressures. Both pulse

  6. Arterial blood oxygen saturation during blood pressure cuff-induced hypoperfusion

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    Kyriacou, P A [School of Engineering and Mathematical Sciences, City University, London EC1V 0HB (United Kingdom); Shafqat, K [School of Engineering and Mathematical Sciences, City University, London EC1V 0HB (United Kingdom); Pal, S K [St Andrew' s Centre for Plastic Surgery and Burns, Broomfield Hospital, Chelmsford, CM1 7ET (United Kingdom)


    Pulse oximetry has been one of the most significant technological advances in clinical monitoring in the last two decades. Pulse oximetry is a non-invasive photometric technique that provides information about the arterial blood oxygen saturation (SpO{sub 2}) and heart rate, and has widespread clinical applications. When peripheral perfusion is poor, as in states of hypovolaemia, hypothermia and vasoconstriction, oxygenation readings become unreliable or cease. The problem arises because conventional pulse oximetry sensors must be attached to the most peripheral parts of the body, such as finger, ear or toe, where pulsatile flow is most easily compromised. Pulse oximeters estimate arterial oxygen saturation by shining light at two different wavelengths, red and infrared, through vascular tissue. In this method the ac pulsatile photoplethysmographic (PPG) signal associated with cardiac contraction is assumed to be attributable solely to the arterial blood component. The amplitudes of the red and infrared ac PPG signals are sensitive to changes in arterial oxygen saturation because of differences in the light absorption of oxygenated and deoxygenated haemoglobin at these two wavelengths. From the ratios of these amplitudes, and the corresponding dc photoplethysmographic components, arterial blood oxygen saturation (SpO{sub 2}) is estimated. Hence, the technique of pulse oximetry relies on the presence of adequate peripheral arterial pulsations, which are detected as photoplethysmographic (PPG) signals. The aim of this study was to investigate the effect of pressure cuff-induced hypoperfusion on photoplethysmographic signals and arterial blood oxygen saturation using a custom made finger blood oxygen saturation PPG/SpO{sub 2} sensor and a commercial finger pulse oximeter. Blood oxygen saturation values from the custom oxygen saturation sensor and a commercial finger oxygen saturation sensor were recorded from 14 healthy volunteers at various induced brachial pressures

  7. Oxygen tension and normalisation pressure modulate nifedipine-sensitive relaxation of human placental chorionic plate arteries. (United States)

    Cooper, E J; Wareing, M; Greenwood, S L; Baker, P N


    Fetoplacental blood vessel constriction in response to reduced oxygenation has been demonstrated in placenta perfused in vitro. In pulmonary vessels, hypoxic vasoconstriction involves Ca2+ influx into smooth muscle through membrane ion channels including voltage-gated Ca2+ channels (VGCCs). We hypothesised that VGCCs are involved in agonist-induced constriction of fetoplacental resistance vessels and that their contribution is modulated by oxygen. Chorionic plate small arteries were studied using wire myography. Arteries were normalised at high (0.9 of L(13.3 kPa)) or low (0.9 of L(5.1 kPa)) stretch and experiments performed at 156, 38 or 15 mmHg oxygen. At low stretch, U46619 (thromboxane-mimetic) or KCl (smooth muscle depolarisation) constriction was greater at 38 than 156 or 15 mmHg oxygen. An L-type VGCC blocker nifedipine, inhibited KCl constriction by >85% but was less effective in U46619 constrictions (43-67%). At high stretch, nifedipine inhibition of KCl- and U46619-induced constriction was less at 15 than 38 or 156 mmHg oxygen. Oxygen did not affect constriction to U46619 or nifedipine-induced relaxation when vessels were normalised at high stretch. In conclusion, oxygen modulates chorionic plate arterial constriction at low stretch but regulation is lost at high stretch. U46619 constriction is underlain by VGCCs and nifedipine-insensitive processes; their relative contribution is influenced by oxygen.

  8. Shear Stress, Reactive Oxygen Species, and Arterial Structure and Function

    NARCIS (Netherlands)

    H.L. Matlung; E.N. Bakker; E. VanBavel


    Shear stress is well known to be a key factor in the regulation of small-artery tone and structure. Although nitric oxide is a major endothelium-derived factor involved in short-and long-term regulation of vascular caliber, it is clear that other mechanisms also can be involved. This review discusse

  9. T2DM 患者夜间低氧与血糖的关系及无创通气治疗对 OWD 患者昼夜血糖的影响%The relationship between nocturnal oxygen desaturation and blood sugar level and noninvasive ventilation therapy effect on the blood sugar level of OWD patients

    Institute of Scientific and Technical Information of China (English)

    何忠明; 陈龙; 石娟; 阿力旦毛达汗; 雷清生; 韩芳


    目的:探讨2型糖尿病(T2DM)患者夜间低氧与血糖的关系及无创通气治疗对2型糖尿病合并睡眠呼吸暂停低通气综合征(OWD)患者昼夜血糖的影响。方法对750例 T2DM 打鼾患者进行夜间脉搏-氧饱和度监测,根据夜间出现低氧情况分为夜间低氧组(484例)与无夜间低氧组(266例),对两组患者年龄、体质指数(BMI)、颈围、腹围、空腹血糖(FBG)进行分析,并对7例 OWD 患者进行睡眠监测、脉搏血氧监测及96 h 动态血糖监测(CGMS),呼吸机无创通气治疗48 h 前后,比较 OWD 患者昼夜血糖变化。结果夜间低氧组和夜间无低氧组 BMI 分别为(27.2±4.8)、(25.5±3.0)kg/m2,颈围分别为(36.7±3.8)、(35.7±3.0)cm,腰围分别为(94.3±11.5)、(89.1±11.1)cm,空腹血糖分别为(6.9±2.4)、(6.5±2.0)mol/L,组间差异均有统计学意义(P <0.05)。7例 OWD 患者无创通气治疗前后,昼夜动态动态血糖水平差异有统计学意义(P <0.05)。结论T2DM 患者空腹血糖与夜间低氧相关,无创通气治疗可以降低 OWD 患者昼夜血糖水平。%Objective To study the relationship of nocturnal oxygen desaturation and blood sugar level,and the effects noninvasive ventilation(NIV)therapy on the blood sugar level of OWD.Methods 750 snoring patients were received the nocturnal oxygen desaturation test.According the test results,the 750 patients were divided into:the normal and the low nocturnal oxygen desaturation group,to compare the BMI,neck circumference,abdominal circumference and the blood sugar.The blood sugar level were measured and compared before and after the nocturnal NIV therapy.Results The results showed:(1)There were sig-nificant differences between the normal and the low nocturnal oxygen desaturation group on the body mass [(27.2±4.8)kg/m2 vs.(25.5±3.9)kg/m2 ],neck circumference [(36.7

  10. A simple model of oxygen diffusion out of the retinal artery (United States)

    Beach, J. M.; Ning, J.; Khoobehi, B.; Rice, D. A.


    The purpose of this study is to explore the possibility that oxygen (O2) diffusion out of the retinal artery (RA) can explain the observed significant (Ptension (PO2). O2 flux across the arterial wall was calculated by Fick's law. The percentage of O2 diffusing out of the RA were 0.6% at IOP of 10 mmHg, and 38% at IOP of 55 mmHg. Confirmation still requires measurement of blood velocity.

  11. Prolonged postoperative desaturation in a child with Down syndrome and atrial septal defect

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    Renu Sinha


    Full Text Available We report prolonged desaturation in a child with Down syndrome (DS and atrial septal defect due to undiagnosed interstitial lung disease. An 18-month-old child with DS was scheduled for bilateral lens aspiration for cataract. The child had atrial septal defect and hypothyroidism. He also had delayed milestones and hypotonia with episodes of recurrent respiratory tract infection necessitating repeated hospitalization. Preoperative evaluation was unremarkable. General anaesthesia and controlled ventilation using proseal laryngeal mask airway was instituted. He had uneventful intraoperative period. In the postoperative period, the child had desaturation 1 hour after surgery on discontinuation of oxygen supplementation by face mask, which improved with oxygen therapy. Supplemental oxygen via face mask was continued and weaned off over several days. On further evaluation, the child was diagnosed as having interstitial lung disease. He improved and discharged from the hospital 15 days after the surgery with room air saturation of 90%.

  12. Evaluation of the Quadrox-I neonatal oxygenator with an integrated arterial filter. (United States)

    Salavitabar, Arash; Qiu, Feng; Kunselman, Allen; Ündar, Akif


    Cardiopulmonary bypass (CPB) can be a potential cause of morbidity in patients for several reasons, including significantly higher gaseous microemboli (GME) formation than extracorporeal life support (ECLS) and physiological circulation, diverted blood flow from the patient via an open purge line of the arterial filter, and pressure drop across the oxygenator that is used in the circuit. Using a combined oxygenator and arterial filter may minimize these harmful factors and can effectively reduce the chances for postoperative morbidity. This study investigated the new QUADROX-i Neonatal Oxygenator (D-72145, Maquet, Hirrlingen, Germany) with an integrated arterial filter in terms of the hemodynamic properties and ability to clear GME in response to hypothermic versus normothermic conditions, open versus closed arterial filter purge line, and varying flow rates in a simulated CPB circuit identical to that of the clinical setting. A flow probe, pressure transducer, and Emboli Detection and Classification (EDAC) quantifier transducer were placed upstream and downstream to the oxygenator to measure changes in each parameter. The circuit was primed with fresh human blood with an hematocrit (Hct) of 26% diluted with Ringer's lactate solution. Five milliliters of air were injected proximal to the venous cardiotomy reservoir, under non-pulsatile perfusion, with flow rates of 500 ml/min, 750 ml/min, and 1000 ml/min. A total of 8 air bolus injections were made at each individual set of conditions for a total of 96 injections. Results showed that the QUADROX-i Neonatal Oxygenator with an integrated filter has excellent hemodynamic properties with extremely low pressure drops and blood flow diverted from the patient, as well as high rates of GME capturing. The arterial filter purge line has a significant effect on the degree of blood flow diverted from the patient (p pressure drop across the oxygenator.

  13. Investigation of tissue oxygenation by in vivo laser-induced photodissociation of cutaneous arterial blood oxyhemoglobin (United States)

    Asimov, M. M.; Korolevich, A. N.


    A novel method of direct control of local tissue oxygenation based on laser-induced photodissociation of oxyhemoglobin in cutaneous blood vessels is discussed. New technology in selective and local increase of the concentration of free molecular oxygen in tissue that enhances metabolism of cells is demonstrated. Direct in vivo measurements of the tissue oxygen tension are carried out on human skin. Kinetics of oxygen tension in tissue is investigated under the effect of He-Ne laser radiation at the power of 1mW relatively to initial value of tissue oxygen tension. The results of experimental study the kinetics of oxygen distribution into tissue from arterial blood is presented. Biomedical applications of proposed new technology in laser therapy of pathologies where elimination of local tissue hypoxia is critical are discussed.

  14. Nocturnal hypoxia in ALS is related to cognitive dysfunction and can occur as clusters of desaturations.

    Directory of Open Access Journals (Sweden)

    Su-Yeon Park

    Full Text Available BACKGROUND: Amyotrophic lateral sclerosis (ALS is a neurodegenerative disease that leads to progressive weakness of the respiratory and limb muscles. Consequently, most patients with ALS exhibit progressive hypoventilation, which worsens during sleep. The aim of this study was to evaluate the relationship between nocturnal hypoxia and cognitive dysfunction and to assess the pattern of nocturnal hypoxia in patients with ALS. METHOD: Twenty-five patients with definite or probable ALS underwent neuropsychologic testing, nocturnal pulse oximetry, and capnography. Patients were grouped according to the presence of nocturnal hypoxia (SpO2<95% for ≥10% of the night and their clinical characteristics and cognitive function were compared. RESULTS: Compared to patients without nocturnal hypoxia, those with nocturnal hypoxia (n = 10, 40% had poor memory retention (p = 0.039 and retrieval efficiency (p = 0.045. A cluster-of-desaturation pattern was identified in 7 patients (70% in the Hypoxia Group. CONCLUSIONS: These results suggest that nocturnal hypoxia can be related to cognitive dysfunction in ALS. In addition, a considerable number of patients with ALS may be exposed to repeated episodes of deoxygenation-reoxygenation (a cluster-of-desaturation pattern during sleep, which could be associated with the generation of reactive oxygen species. Further studies are required to define the exact causal relationships between these phenomena, the exact manifestations of nocturnal cluster-of-desaturation patterns, and the effect of clusters of desaturation on ALS progression.

  15. Dessaturação noturna: preditores e influência no padrão do sono de pacientes portadores de doença pulmonar obstrutiva crônica com hipoxemia leve em vigília Nocturnal desaturation: predictors and the effect on sleep patterns in patients with chronic obstructive pulmonary disease and concomitant mild daytime hypoxemia

    Directory of Open Access Journals (Sweden)

    Renata Claudia Zanchet


    predicting nocturnal desaturation, and to evaluate the influence of nocturnal desaturation on the sleep pattern of these patients. METHODS: Twenty-five patients were divided into two groups: those with nocturnal desaturation and those without. RESULTS: Comparing the first group (52% with the second, we found the following: age, 63 ± 5 years versus 63 ± 6 years; forced expiratory volume in the first second = 53 ± 31% versus 56 ± 19% predicted; ratio of forced expiratory volume in the first second to forced vital capacity, 49 ± 14% versus 52 ± 10%; arterial oxygen tension, 68 ± 8 mmHg versus 72 ± 68 mmHg; and arterial oxygen saturation, 93 ± 2% versus 94 ± 1%. Patients in the nocturnal desaturation group presented lower daytime arterial oxygen saturation and nocturnal arterial oxygen saturation by pulse oximetry. There was no difference between the two groups in terms of the sleep patterns observed. The ratio of forced expiratory volume in the first second to forced vital capacity was found to correlate with forced vital capacity, daytime arterial oxygen tension and daytime arterial oxygen saturation. In addition, arterial oxygen saturation by pulse oximetry during exercise was found to correlate with nocturnal arterial oxygen saturation by pulse oximetry. However, only daytime arterial oxygen saturation was predictive of nocturnal desaturation. CONCLUSION: The only variable capable of predicting nocturnal desaturation was daytime arterial oxygen saturation. Nocturnal desaturation did not influence the sleep patterns of patients with chronic obstructive pulmonary disease accompanied by mild daytime hypoxemia.

  16. Effectiveness of ventilation of nondependent lung for a brief period in improving arterial oxygenation during one-lung ventilation: A prospective study

    Directory of Open Access Journals (Sweden)

    Keerthi Chigurupati


    Full Text Available Background: Hypoxemia is common during one-lung ventilation(OLV, predominantly due to transpulmonary shunt. None of the strategies tried showed consistent results. We evaluated the effectiveness of ventilating the operated, non-dependent lung (NDL with small tidal volumes in improving the oxygenation during OLV. Methods: 30 ASA 1 and 2 patients undergoing elective, open thoracotomy were studied. After standard induction of anesthesia, lung seperation was acheived with left sided DLT. The ventilatory settings for two lung ventilation (TLV were: FiO 2 of 0.5, tidal volume of 8-10ml/kg and respiratory rate of 10-12/min. After initiating OLV, the dependent lung alone was ventilated with the above settings for 15 minutes and an arterial blood gas (ABG analysis was done. Then the NDL was ventilated with a separate ventilator, with FiO 2 of 1, tidal volume of 70 ml, I:E ratio of 1:10 and respiratory rate of 6/min for 15 minutes. The NDL ventilation was started early if the patients desaturated to <95%. ABG was done at 5 and 15 mins of NDL ventilation. We compared the PaO 2 values. Results: The mean PaO 2 decreased from 232.2 ± 67.2 mm of Hg (TLV-ABG1 to 91.2 ± 31.7 mm of Hg on OLV (OLV-ABG1. The ABG after 5 minutes and 15 minutes after institution of NDL ventilation during OLV showed a PaO2 of 145.7 ± 50.2 mm of Hg and 170.6 ± 50.4 mm of Hg which were significantly higher compared to the one lung ventilation values.

  17. Clinical evolution of mediastinitis in patients undergoing adjuvant hyperbaric oxygen therapy after coronary artery bypass surgery (United States)

    do Egito, Julyana Galvão Tabosa; Abboud, Cely Saad; de Oliveira, Aline Pâmela Vieira; Máximo, Carlos Alberto Gonçalves; Montenegro, Carolina Moreira; Amato, Vivian Lerner; Bammann, Roberto; Farsky, Pedro Silvio


    ABSTRACT Objective: To evaluate the use of hyperbaric oxygen therapy as an adjunctive treatment in mediastinitis after coronary artery bypass surgery. Methods: This is a retrospective descriptive study, performed between October 2010 and February 2012. Hyperbaric oxygen therapy was indicated in difficult clinical management cases despite antibiotic therapy. Results: We identified 18 patients with mediastinitis during the study period. Thirty three microorganisms were isolated, and polymicrobial infection was present in 11 cases. Enterobacteriaceae were the most prevalent pathogens and six were multi-resistant agents. There was only 1 hospital death, 7 months after the oxygen therapy caused by sepsis, unrelated to hyperbaric oxygen therapy. This treatment was well-tolerated. Conclusion: The initial data showed favorable clinical outcomes. PMID:24136762

  18. Clinical evaluation of the air removal characteristics of an oxygenator with integrated arterial filter in a minimized extracorporeal circuit. (United States)

    Stehouwer, Marco C; Boers, Chris; de Vroege, Roel; C Kelder, Johannes; Yilmaz, Alaaddin; Bruins, Peter


    The use of minimized extracorporeal circuits (MECC) in cardiac surgery is an important measure to increase the biocompatibility of cardiopulmonary bypass during coronary artery bypass grafting (CABG). These circuits eliminate volume storage reservoirs and bubble traps to minimize the circuit. However, the reduction in volume may increase the risk of gaseous microemboli (GME). The MECC system as used by our group consists of a venous bubble trap, centrifugal pump, and an oxygenator. To further reduce the risk of introducing GME, an oxygenator with an integrated arterial filter was developed based on the concept of minimal volume and foreign surface. We studied the air removal characteristics of this oxygenator with and without integrated arterial filter. The quantity and volume of GME were measured with precision at both the inlet and outlet of the devices. Our results showed that integration of an arterial filter into this oxygenator increased GME reducing capacity from 69.2% to 92%. Moreover, we were able to obtain data on the impact of an arterial filter on the exact size-distribution of GME entering the arterial line. The present study demonstrates that an MECC system and oxygenator with integrated arterial filter significantly reduces the volume and size of GME. The use of an integrated arterial filter in an MECC system may protect the patient from the deleterious effects of CPB and may further improve patient safety.

  19. Influence of arterial dissolved oxygen level on venous oxygen saturation: don't forget the PaO2! (United States)

    Legrand, Matthieu; Vallée, Fabrice; Mateo, Joaquim; Payen, Didier


    Dissolved oxygen (i.e., unbound to hemoglobin) is often neglected as a determinant of central venous oxygen saturation (ScvO2) in review articles and textbooks. These statements may lead to potential misinterpretation of SCvO2 value across FiO2 changes. In this study, we aimed to explore the influence of PaO2 and FiO2 on ScvO2 in ventilated critically ill patients. This was a prospective observational study in two surgical intensive care units. Mechanically ventilated and sedated patients with cardiac output and ScvO2 monitoring and PaO2/FiO2 > 200 with inspiratory oxygen (FiO2) ≤ 0.5 were enrolled (cohort [ScvO2]). A second cohort of brain-injured patients with jugular venous oxygen saturation monitoring was studied to assess the application of the results to regional circulation (cohort [SjvO2]). Central venous oxygen saturation was measured at baseline FiO2 and at FiO2 = 1. We finally estimated the participation of the dissolved oxygen (PadissolvO2) to the ScvO2 variations. Twenty patients formed the cohort ScvO2 and eight formed the cohort SjvO2. Central venous oxygen saturation rose from 71% (69%-76%) to 84% (78%-88%) after increasing FiO2, whereas PaO2 rose from 100 (85-124) mmHg to 387 (360-449) mmHg. The rise of ScvO2 was mostly ascribable to the dissolved oxygen. The increase of ScvO2 was not explained by changes in cardiac output or hemoglobin levels. Jugular venous oxygen saturation rose from 71% (58%-78%) to 83% (78%-89%) after increasing FiO2. Arterial dissolved oxygen level can significantly influence the ScvO2 value. Therefore, PaO2 should not be overlooked while considering the ScvO2 value as a therapeutic goal. Interpretation of ScvO2 variations in response to a therapeutic challenge (i.e., fluid challenge, inotropic drug initiation) should be performed at constant FiO2.

  20. Effect of oral garlic on arterial oxygen pressure in children with hepatopulmonary syndrome

    Institute of Scientific and Technical Information of China (English)

    Mehri Najafi Sani; Hamid Reza Kianifar; Abdolrazagh Kianee; Gholamreza Khatami


    AIM: To study the effect of oral garlic on arterial oxygen pressure in children with hepatopulmonary syndrome.METHODS: Garlic powder in a capsule form was given to 15 children with hepatopulmonary syndrome (confirmed by contrast echocardiography) at the dosage of 1g/1.73 m2 per day. Patients were evaluated clinically and by arterial blood gas every four weeks.RESULTS: The garlic capsule was administered to 15patients with hepatopulmonary syndrome. There were 10 boys and 5 girls with a mean age of 9.4±3.9 years.The underlying problems were biliary tract atresia (4patients), autoimmune hepatitis (4 patients), cryptogenic cirrhosis (4 patients) and presinusoidal portal hypertension (3 patients). Eight patients (53.3%) showed an increase of 10 mmHg in their mean arterial oxygen pressure. The baseline PaO2 was 65.6±12.1 mmHg in the responder group and 47.1±11.2 mmHg in nonresponder group. At the end of treatment the mean PaO2 in responders and non-responders was 92.2±7.75mmHg and 47.5±11.87 mmHg, respectively (P<0.01).CONCLUSION: Garlic may increase oxygenation and improve dyspnea in children with hepatopulmonary syndrome.

  1. Real-time frequency-domain fiber optic sensor for intra-arterial blood oxygen measurements (United States)

    Alcala, J. R.; Scott, Ian L.; Parker, Jennifer W.; Atwater, Beauford W.; Yu, Clement; Fischer, Russell; Bellingrath, K.


    A real time frequency domain phosphorimeter capable of measuring precise and accurate excited state lifetimes for determining oxygen is described. This frequency domain instrument does not make use of cross correlation techniques traditionally used in frequency domain fluorometers. Instead, the electrical signal from the detector is filtered to contain only the first several harmonics. This filtered signal is then sampled and averaged over a few thousand cycles. The absolute phase and absolute modulation of each sampled harmonic of the excitation and of the luminescence is computed by employing fast Fourier transform algorithms. The phase delay and the modulation ratio is then calculated at each harmonic frequency. A least squares fit is performed in the frequency domain to obtain the lifetimes of discrete exponentials. Oxygen concentrations are computed from these lifetimes. Prototypes based on these techniques were built employing commercially available components. Results from measurements in saline solution and in the arterial blood of dogs show that oxygen concentrations can be determined reproducibly. The system drift is less than 1% in over 100 hours of continuous operation. The performance of fiber optic sensors was evaluated in dogs over a period of 10 hours. The sensors tracked changes in arterial oxygen tension over the course of the experiment without instabilities. The overall response of the system was about 90 seconds. The update time was 3 seconds.

  2. Hyperbaric oxygen therapy for the prevention of arterial gas embolism in food grade hydrogen peroxide ingestion. (United States)

    Hendriksen, Stephen M; Menth, Nicholas L; Westgard, Bjorn C; Cole, Jon B; Walter, Joseph W; Masters, Thomas C; Logue, Christopher J


    Food grade hydrogen peroxide ingestion is a relatively rare presentation to the emergency department. There are no defined guidelines at this time regarding the treatment of such exposures, and providers may not be familiar with the potential complications associated with high concentration hydrogen peroxide ingestions. In this case series, we describe four patients who consumed 35% hydrogen peroxide, presented to the emergency department, and were treated with hyperbaric oxygen therapy. Two of the four patients were critically ill requiring intubation. All four patients had evidence on CT or ultrasound of venous gas emboli and intubated patients were treated as if they had an arterial gas embolism since an exam could not be followed. After hyperbaric oxygen therapy each patient was discharged from the hospital neurologically intact with no other associated organ injuries related to vascular gas emboli. Hyperbaric oxygen therapy is an effective treatment for patients with vascular gas emboli after high concentration hydrogen peroxide ingestion. It is the treatment of choice for any impending, suspected, or diagnosed arterial gas embolism. Further research is needed to determine which patients with portal venous gas emboli should be treated with hyperbaric oxygen therapy.

  3. Evaluation of Quadrox-i adult hollow fiber oxygenator with integrated arterial filter. (United States)

    Guan, Yulong; Su, Xiaowei; McCoach, Robert; Wise, Robert; Kunselman, Allen; Undar, Akif


    Gaseous microemboli (GME) remain a challenge for cardiopulmonary bypass procedures in adult as well as pediatric cardiac surgery patients. The present study tested the effectiveness of a new adult membrane oxygenator in models both with and without an integrated arterial filter to evaluate GME trapping capability and determine membrane pressure drops at various flow rates and temperatures. The experimental circuit included a RotaFlow centrifugal blood pump, Quadrox-i (n = 8) or Quadrox (n = 8) adult microporous membrane oxygenator, and Sorin adult tubing package. A Sorin Cardiovascular VVR 4000i venous reservoir served as pseudo-patient. The circuit was primed with 900 mL heparinized human red blood cells and 300 mL Lactated Ringer's solution. The final hematocrit was 36%. Tests were performed at different flow rates (4 L/min, 5 L/min, and 6 L/min) and temperatures (35 degrees and 30 degrees). Five mL of bolus air was injected into the venous line over 15 seconds using a syringe connected to a 3/8 x 1/2 luer connector. The Quadrox-i adult microporous membrane oxygenator with integrated arterial filter had a similar pressure drop at 4 L/min and 35 degrees C compared with Quadrox membrane oxygenator whereas it had higher pressure drops at 5 L/min and 6 L/min (p filter and Softline coating has improved GME handling capacity.

  4. A clinical evaluation of the Maquet Quadrox-i Neonatal oxygenator with integrated arterial filter. (United States)

    Ginther, R M; Gorney, R; Cruz, R


    High-performance, low-prime-volume oxygenators for the pediatric patient population have become a growing market among manufacturers. In the summer of 2011, our institution clinically evaluated the performance of the newly released Maquet Quadrox-i Neonatal oxygenator with integrated arterial filter. The static priming volume, including the integrated arterial filter, is 40 ml and the maximum rated blood flow is 1.5 liters per minute (LPM). The device was used on seven pediatric patients, ranging from 3.2 to 14 kg, undergoing various congenital heart defect repairs. Data were collected to calculate gas transfer, trans-oxygenator pressure drop, and heat exchange performance. The mean cardiopulmonary bypass time was 85 minutes and the mean cross-clamp time was 56 minutes. The average oxygen transfer was 34.3 ± 22.8 ml/O2/min and increased with both blood flow and FiO2. The average carbon dioxide transfer was 22.3 ± 17.8 ml/min and increased with both blood flow and gas sweep to blood flow ratio. The average trans-oxygenator pressure drop per blood flow was 53.3 ± 15.5 mmHg/L/min and increased with flow. The average heat exchanger performance factor was 47.6 ± 11.6% and decreased with flow. The heat exchange performance factor at maximum observed clinical flow, 1.42 LPM, was 36.4%. During this evaluation, the Maquet Quadrox-i Neonatal oxygenator adequately performed within its operational flow in the clinical setting.

  5. High oxygen modifies vasodilator effect of cysteine via enhanced oxidative stress and thromboxane production in the rat mesenteric artery. (United States)

    Yasuda, Yoshitaka; Feng, Guo-Gang; Li, Jiazheng; Nakamura, Emi; Hayashi, Hisaki; Sato, Motohiko; Fujiwara, Yoshihiro; Kinoshita, Hiroyuki


    Whether high oxygen is harmful to the vascular function is unclear. The present study examined if high oxygen modifies vasodilator effect of cysteine via enhanced oxidative stress and thromboxane production. Rat mesenteric arteries with endothelium at 95 or 50 % oxygen were subjected to isometric force recordings, measurement of thromboxane B2 levels, determination of superoxide and peroxynitrite levels and evaluation of NADPH oxidase subunit protein expression, respectively. L-cysteine (0.01-3 mM) constricted or dilated arteries at 95 and 50 % oxygen, respectively. Thromboxane receptor antagonist SQ-29,548 (1 μM) abolished the constriction at 95 % oxygen. L-cysteine (3 mM) increased levels of thromboxane B2 in arteries upon 95 % oxygen application. L-cysteine relaxed arteries treated with superoxide inhibitor tiron (2 mM) or NADPH oxidase inhibitor gp91ds-tat (1 μM) irrespective of the oxygen concentration while ATP-sensitive K(+) channel inhibitor glibenclamide (1 μM) and cystathionine-γ-lyase (CSE) inhibitor DL-propargylglycine (10 mM) similarly abolished the relaxation. L-cysteine (3 mM) with 95 % oxygen augmented levels of superoxide as well as nitrotyrosine within the artery, concomitantly with enhanced membrane protein expression of NADPH oxidase subunit p47phox. The higher concentration of oxygen attenuates L-cysteine-induced vasodilation via superoxide production mediated by NADPH oxidase along with thromboxane A2 production, resulting in vasoconstriction. The increased levels of superoxide, as well as peroxynitrite, coexist with the impaired vasodilation related to ATP-sensitive K(+) channels and CSE. Higher oxygen with plasma cysteine may cause oxidative stress and vasoconstrictor prostanoid production in blood vessels.

  6. Oxygen desaturation index can reflect nocturnal hyoxemia perfectly in patients with obstructive sleep apneahypopnea syndrome%氧减指数可较好反映阻塞性睡眠呼吸暂停低通气综合征患者夜间低氧血症

    Institute of Scientific and Technical Information of China (English)

    张孝斌; 林其昌; 黄建钗; 时玲燕; 黄瑞强; 蔡志明; 赵建铭


    目的 对阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea hypopnea syndrome,OSAHS)患者夜间低氧血症的相关指标与呼吸暂停低通气指数(apnea-hypopnea index,AHI)进行相关性分析,找出反应夜间低氧血症的最佳指标,以便家庭便携式血氧监测仪在初筛中应用.方法 收集在我科进行多导睡眠呼吸监测的491例监测对象,将体质量指数(body mass index,BMI)、Epworth嗜睡评分(Epworth sleepiness scale,ESS)、氧减指数(oxygen desaturation index,ODI)、氧饱和度低于90%的时间占监测时间的百分比(time spent below oxygen saturation of 90%,TS90%)、呼吸暂停低通气时间指数(apnea-hypopnea time index,AHTI)、最低血氧饱和度(minimal saturation O2,MiniSO2)与AHI行相关性分析,找出反应夜间低氧血症的指标,并与AHI进行比较,计算其敏感度、特异度及受试者工作特性曲线.结果 ①各组之间的AHI(χ2值=436.40,P=0.000)、ESS(χ2值-319.15,P=0.000)、AHTI (χ2值=340.53,P=0.000)、ODI(χ2值=347.87,P=0.000)、TS90%(χ2值=281.73,P=0.000)差异有统计学意义;②所有患者的ESS、AHTI、ODI、TS90%、MiniSO2与AHI呈显著相关,相关系数r分别为0.822、0.871、0.893、0.790、-0.742(P值均<0.01),其中ODI与AHI相关性最为密切(r=0.893,P<0.01);③当以ODI≥6次/h做为诊断指标时,其诊断OSAHS的敏感度、特异度分别为89.36%、90.00%,而以ODf≥20次/h为指标时,诊断中重度OSAHS的特异度达95.2%.结论 ODI是反应OSAHS患者夜间低氧血症的较好指标,可在家庭便携式血氧监测仪初筛OSAHS中应用.%Objective To investigate the correlationship between nocturnal hyoxemia indexs and apnea-hypopnea index (AHI) in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS),then to explore the best determinant of nocturnal hyoxemia and facilitate the use of this determinant in family portable oximeter in such patients. Methods A total of 491 subjects who complained snoring and

  7. Renal hemodynamics and oxygenation in transient renal artery occluded rats evaluated with iron-oxide particles and oxygenation-sensitive imaging

    Energy Technology Data Exchange (ETDEWEB)

    Pedersen, Michael [Aarhus Univ. Hospital (Denmark). MR Research Centre; Aarhus Univ. (Denmark). Inst. of Experimental Clinical Medicine; Univ. Victor Segalen Bordeaux 2 (France). Lab. Imagerie Moleculaire et Fonctionnelle: de la physiologie a la therapie CNRS UMR 5231; Laustsen, Christoffer [Aarhus Univ. Hospital (Denmark). MR Research Centre; Perot, Vincent; Grenier, Nicolas [Hopital Pellegrin, CHU Bordeaux (France). Service d' Imagerie Diagnostique et Therapeutique de l' Adulte; Basseau, Fabrice; Moonen, Chrit [Univ. Victor Segalen Bordeaux 2 (France). Lab. Imagerie Moleculaire et Fonctionnelle: de la physiologie a la therapie CNRS UMR 5231


    Mild or severe renal arterial occlusion is a phenomenon occasionally observed in daily clinical practice, potentially leading to renal ischemia and a general impairment of renal function. Secondly, closing the blood flow to the kidneys can also occur during kidney transplantation procedures. However, the exact physiological effects of these conditions on renal blood perfusion as well as the renal oxygen handling are poorly understood. The objectives of this study were therefore to measure the lateral changes of renal blood perfusion in rats subjected to transient unilateral arterial occlusion (RAS), and in addition, to measure the consequences on the intrarenal oxygenation. Experimental studies were performed using sixteen adolescent rats. The left renal artery was exposed through a flank incision and acute RAS for 45 min was achieved by placing a ligature around the renal artery. MRI was performed 3 days after the surgical procedure, where a blood oxygenation sensitive sequence (BOLD MRI) was performed, followed by a perfusion-weighted imaging sequence using a single bolus of the iron-oxide nanoparticle Sinerem. The renal oxygenation of blood was indirectly measured by the BOLD-parameter R2{sup *}, and perfusion measures include relative renal blood flow, relative renal blood volume and mean transit time. Histopathologic changes through the outer stripe of the outer medulla showing typical histopathologic findings of ischemia. This study demonstrated that rats with transient renal arterial stenosis (for 45 min) showed a reduction in intrarenal oxygenation and intrarenal blood flow three days after the surgical procedure. A decreased R2{sup *} was measured within the ipsilateral medulla in parallel with a decreased medullary blood flow, is probably related to a lower reabsorption load within the ipsilateral kidney. MRI may therefore be a promising tool in long-term evaluation of RAS. (orig.)

  8. Clinical evaluation of the Terumo Capiox FX05 hollow fiber oxygenator with integrated arterial line filter. (United States)

    Deptula, Joseph; Valleley, Melinda; Glogowski, Kimberly; Detwiler, John; Hammel, James; Duncan, Kim


    Perfusion techniques and equipment in pediatric open heart surgery have continued to focus on decreasing prime volumes and lowering surface areas of the cardiopulmonary bypass circuit. While this has improved drastically over the last 20 years, greater demand is being placed on the perfusionist to reduce the deleterious effects of bypass without compromising safety or efficiency. Specifically, manufacturers of disposable perfusion equipment have focused on providing pediatric perfusionists with oxygenators that provide the smallest prime and surface area possible while attempting to maximize performance. Recently,Terumo Cardiovascular has introduced the Capiox FX05, a neonatal hollow fiber oxygenator that includes an integrated arterial line filter. The FX05 provides a blood flow range of 0.1-1.5 L/min and a low priming volume of 43 mL. Additionally, it is coated with X Coating, a biocompatible, hydrophilic polymer surface coating that reduces platelet adhesion and protein denaturation. The purpose of this study was to test the FX05 for gas transfer, blood path resistance, and blood handling characteristics in a standardized clinical setting. Heat exchange coefficients were also calculated during the cooling and warming period. Other data analyzed includes bypass circuit prime volumes and initial patient hematocrit along with the total operative homologous blood donor exposures. In summary, the FX05 offers good gas exchange capabilities and a low pressure drop during normal cardiopulmonary bypass parameters along with the safety of an integrated arterial line filter. Furthermore, the FX05 with integrated filter allows a reduction in overall bypass prime volume and surface area while promoting the reduction of homologous blood transfusions, optimizing hemostasis.

  9. Lactate clearance for initiating and weaning off extracorporeal membrane oxygenation in a child with regressed left ventricle after arterial switch operation. (United States)

    Singh, Sarvesh Pal; Chauhan, Sandeep; Bisoi, A K; Sahoo, Manoj


    We hereby report a child with transposition of great arteries and regressed ventricle who underwent arterial switch operation (ASO) with the aid of cardiopulmonary bypass and "integrated" extracorporeal membrane oxygenation (ECMO) circuit. The significance of lactate clearance as a guide to initiate and terminate veno-arterial ECMO in a post ASO child with regressed left ventricle is discussed.

  10. Lactate clearance for initiating and weaning off extracorporeal membrane oxygenation in a child with regressed left ventricle after arterial switch operation

    Directory of Open Access Journals (Sweden)

    Sarvesh Pal Singh


    Full Text Available We hereby report a child with transposition of great arteries and regressed ventricle who underwent arterial switch operation (ASO with the aid of cardiopulmonary bypass and "integrated" extracorporeal membrane oxygenation (ECMO circuit. The significance of lactate clearance as a guide to initiate and terminate veno-arterial ECMO in a post ASO child with regressed left ventricle is discussed.

  11. Changes in arterial oxygen tension and physiological status in resting, unrestrained Arctic charr Salvelinus alpinus (L.) exposed to mild hypoxia and hyperoxia. (United States)

    Karlsson, A; Rosseland, B O; Thorarensen, H; Kiessling, A


    In arctic charr Salvelinus alpinus, arterial blood partial pressures of oxygen (PaO2) and carbon dioxide increased with increasing water oxygen tension (PwO2), while the water to arterial PO2 difference (PwO2-PaO2) did not change in relation to PwO2.

  12. Inhaled Nitric Oxide for the Prevention of Impaired Arterial Oxygenation during Myocardial Revascularization with Extracorporeal Circulation

    Directory of Open Access Journals (Sweden)

    I. A. Kozlov


    Full Text Available Objective: to study the efficacy of inhaled nitric oxide used intraoperatively to prevent lung oxygenating dysfunction in patients with coronary heart disease after myocardial revascularization under extracorporeal circulation (EC. Subjects and methods. Thirty-two patients aged 55.0±2.0 years were examined. The inclusion criteria were the standard course of surgical intervention (the absence of hemorrhage, acute cardiovascular insufficiency, perioperative myocardial infarction, etc., a pulmonary artery wedge pressure of less than 15 – mm Hg throughout the study, and the baseline arterial partial oxygen tension/inspired mixture oxygen fraction (PaO2/FiO2 ratio of at least 350 mm Hg. There was a control group (n=21; Group 1 that used no special measures to prevent and/or to correct lung oxygenating dysfunction and Group 2 (n=11 that received inhaled nitric oxide. Ihe administration of inhaled nitric oxide at a concentration of 10 ppm was initiated after water anesthesia, stopped during EC, and resumed in the postperfusion period. Results. At the end, PaO2/FiO2 and intrapulmonary shunt fraction did not differ between the groups (p>0.05. Before EC, the patients receiving inhaled nitric oxide had a lower intrapulmonary blood shunting (8.9±0.7 and 11.7±1.0%; p<0.05. There were no intergroup differences in the values of PaO2/FiO2 at this stage. In the earliest postperfusion period, PaO2/FiO2 was higher in Group 2 than that in Group 1. At the end of operations, Groups 1 and 2 had a PaO2/FiO2 of 336.0±16.8 and 409.0±24.3 mm Hg, respectively (p<0.05 and an intrapulmonary shunt fraction of 14.5±1.0 and 10.4±1.0% (p<0.05. At the end of surgery, the rate of a reduction in PaO2/FiO2 to the level below 350 mm Hg was 52.4±11.1% in Group 1 and 18.2±11.6% in Group 2 (p<0.05. Six hours after surgery, PaO2/FiO2 values less than 300 mm Hg were diagnosed in 61.9±10.5% of Group 1 patients and in 27.3±13.4% of Group 2 ones (p<0.05. Conclusion. The

  13. T2 and T2* measurements of fetal brain oxygenation during hypoxia with MRI at 3T: correlation with fetal arterial blood oxygen saturation

    Energy Technology Data Exchange (ETDEWEB)

    Wedegaertner, Ulrike; Adam, Gerhard [Universitaetsklinikum Hamburg-Eppendorf, Department of Diagnostic and Interventional Radiology, Hamburg (Germany); Kooijman, Hendrik [Philips Medical Systems, Best (Netherlands); Andreas, Thomas; Beindorff, Nicola; Hecher, Kurt [University Hospital Hamburg-Eppendorf, Department of Obstetrics and Prenatal Medicine, Hamburg (Germany)


    The purpose of this prospective study was to determine the oxygen saturation of blood in the fetal brain based on T2 and T2* measurements in a fetal sheep model. Five sheep fetuses were investigated during normoxia and hypoxia by 3T MRI. Multi-echo gradient-echo and turbo-spin-echo sequences were performed on the fetal brain. MR-determined oxygen saturation (MR-sO{sub 2}) of blood in the fetal brain was calculated based on T2 and T2* values. Fetal arterial blood oxygen saturation (blood-sO{sub 2}) was measured during the two experimental phases. The slope of MR-sO{sub 2} as a function of blood-sO{sub 2} was estimated and tested for compatibility using the one-sample t-test. During normoxia, mean values for carotid blood oxygen saturation were 67%, 83 ms for T2*, 202 ms for T2 and 96% for MR-sO{sub 2}. During hypoxia, arterial blood oxygen saturation, T2* and calculated MR-sO{sub 2} decreased to 22%, 64 ms, and 68% respectively. The one-sample t-test revealed the slope to be significantly different from 0(T=5.023, df=4, P=0.007). It is feasible to perform quantitative T2 and T2* measurements in the fetal brain. MR-sO{sub 2} and fetal arterial blood oxygen saturation correlated significantly. However, based on these data a reliable quantification of fetal brain tissue oxygenation is not possible. (orig.)

  14. Variability in targeted arterial oxygenation levels in patients with severe sepsis or septic shock

    DEFF Research Database (Denmark)

    Dahl, R. M.; Grønlykke, L.; Haase, N.


    of arterial oxygen (PaO2 ) and mortality. METHODS: We extracted data from two Scandinavian clinical trials of ICU patients with severe sepsis or septic shock. We calculated average PaO2 and fraction of inspired oxygen (FiO2 ) from trial inclusion and the following 5 days, and assessed the association between...... PaO2 and 90-day mortality. RESULTS: The median PaO2 was 9.8 kPa [5-95% range 6.4-19.9] and FiO2 was 0.51 [5-95% range 0.27-1.00], respectively. Eight hundred and five of 1,770 patients (45%) died. The relative risk of mortality was 1.43 [95% CI: 1.19-1.65] in patients with average PaO2 ....29 [95% CI: 0.84-1.68] in patients with average PaO2 ≥ 16 kPa, as compared to patients with average PaO2 10-12 kPa. The relative risk of mortality was 1.38 [95% CI: 1.17-1.58] in patients with an average FiO2 0.60-0.80 and 2.10 [95% CI: 1.88-2.23] in patients with an average FiO2 ≥ 0.80 as compared...

  15. Application of exercise transcutaneous oxygen pressure measurements for detection of proximal lower extremity arterial disease: a case report. (United States)

    Mahe, Guillaume; Kalra, Manju; Abraham, Pierre; Liedl, David A; Wennberg, Paul W


    Proximal claudication is secondary to ischemia caused by peripheral artery disease (PAD), whereas proximal pseudo-claudication is secondary to other disease processes such as hip arthritis, spinal stenosis, neuropathy, and so forth. The differentiation between the two can be challenging. Exercise transcutaneous oxygen pressure measurement (exercise-TcPO2) allows noninvasive detection of flow-reducing lesions in the proximal arteries and tributaries of the lower extremity arterial tree. We present the first case report in the United States using an exercise-TcPO2 algorithm. A 71-year-old diabetic patient with proximal left-sided and right-calf claudication with indeterminate ankle-brachial indices underwent an exercise-TcPO2 study before and after endovascular intervention. Four TcPO2 probes were placed: one at chest level (reference probe), one on each buttock, and one on the symptomatic calf. The Delta from Resting Oxygen Pressure (DROP) index was calculated at each probe site using a previously validated protocol. Proximal left- and right-calf ischemia were confirmed by the initial exercise-TcPO2, and, after endovascular treatment of the left iliac artery lesion, improvements in proximal exercise-TcPO2 values were found. These data suggest that exercise-TcPO2 can be useful in PAD evaluation in patients with non-compressible arteries and/or proximal claudication.

  16. Optimal oxygen saturation in premature infants

    Directory of Open Access Journals (Sweden)

    Meayoung Chang


    Full Text Available There is a delicate balance between too little and too much supplemental oxygen exposure in premature infants. Since underuse and overuse of supplemental oxygen can harm premature infants, oxygen saturation levels must be monitored and kept at less than 95% to prevent reactive oxygen species-related diseases, such as retinopathy of prematurity and bronchopulmonary dysplasia. At the same time, desaturation below 80 to 85% must be avoided to prevent adverse consequences, such as cerebral palsy. It is still unclear what range of oxygen saturation is appropriate for premature infants; however, until the results of further studies are available, a reasonable target for pulse oxygen saturation (SpO2 is 90 to 93% with an intermittent review of the correlation between SpO2 and the partial pressure of arterial oxygen tension (PaO2. Because optimal oxygenation depends on individuals at the bedside making ongoing adjustments, each unit must define an optimal target range and set alarm limits according to their own equipment or conditions. All staff must be aware of these values and adjust the concentration of supplemental oxygen frequently.

  17. Reversibility of retinal ischemia due to central retinal artery occlusion by hyperbaric oxygen

    Directory of Open Access Journals (Sweden)

    Hadanny A


    Full Text Available Amir Hadanny,1,2 Amit Maliar,1 Gregory Fishlev,1 Yair Bechor,1 Jacob Bergan,1 Mony Friedman,1 Isaac Avni,2,3 Shai Efrati1,2,4,5 1Sagol Center for Hyperbaric Medicine and Research, Assaf Harofeh Medical Center, Zerifin, Israel; 2Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel; 3Opthalmology Department, Assaf Harofeh Medical Center, Zeirifin, Israel; 4Research and Development Unit, Assaf Harofeh Medical Center, Zerifin, Israel; 5Sagol School of Neuroscience, Tel-Aviv University, Tel-Aviv, Israel Purpose: Ischemic retinal damage can be reversed by hyperbaric oxygen therapy (HBOT as long as irreversible infarction damage has not developed. However, the time window till irreversible damage develops is still unknown. The study aim was to evaluate the effect of HBOT and determine possible markers for irreversible retinal damage.Materials and methods: Retrospective analysis of 225 patients treated with HBOT for central retinal artery occlusion (CRAO in 1999–2015. One hundred and twenty-eight patients fulfilled inclusion/exclusion criteria: age >18 years, symptoms <20 hours, and best-corrected visual acuity (BCVA <0.5 logMAR.Results: Time delay from symptoms to treatment was 7.8±3.8 hours. The BCVA was significantly improved after HBOT, from 2.14±0.50 to 1.61±0.78 (P<0.0001. The proportion of patients with clinically meaningful visual improvement was significantly higher in patients without cherry-red spot (CRS compared to patients with CRS at presentation (86.0% vs 57.6%, P<0.0001. The percentage of patients with final BCVA better than 1.0 was also significantly higher in patients without CRS vs patients with CRS at presentation (61.0% vs 7.1%, P<0.0001. There was no correlation between CRS and the time from symptoms. HBOT was found to be safe, and only 5.5% of patients had minor, reversible, adverse events.Conclusion: HBOT is an effective treatment for non-arteritic CRAO as long as CRS has not formed. The fundus findings, rather

  18. Veno-arterial extracorporeal membrane oxygenation for Streptococcus pyogenes toxic shock syndrome in pregnancy. (United States)

    Imaeda, Taro; Nakada, Taka-Aki; Abe, Ryuzo; Tateishi, Yoshihisa; Oda, Shigeto


    Streptococcal toxic shock syndrome (STSS), an invasive Streptococcus pyogenes (Group A streptococcus) infection with hypotension and multiple organ failure, is quite rare in pregnancy but is characterized by rapid disease progression and high fatality rates. We present a case of STSS with infection-induced cardiac dysfunction in a pregnant woman who was treated with veno-arterial extracorporeal membrane oxygenation (VA-ECMO). A 24-year-old multiparous woman in the third trimester had early symptoms of high fever and diarrhea 1 day prior to admission to the hospital emergency department. On admission, she had multiple organ failure including circulatory failure. Due to fetal distress, emergency Cesarean section was carried out and transferred to intensive care units. She had refractory circulatory failure with depressed myocardial contractility with progressive multiple organ failure, despite receiving significant hemodynamic supports including high-dose catecholamine. Thus, VA-ECMO was initiated 18 h after intensive care unit admission. Consequently, ECMO provided extra time to recover from infection and myocardial depression. She was successfully weaned from VA-ECMO on day 7 and was discharged home on day 53. VA-ECMO can be a therapeutic option for refractory circulatory failure with significant myocardial depression in STSS.

  19. Arterial oxygen saturation and hemoglobin mass in postmenopausal untrained and trained altitude residents. (United States)

    Cristancho, Edgar; Reyes, Orlando; Serrato, Mauricio; Mora, María Mercedes; Rojas, Joel Alberto; Robinson, Yohan; Böning, Dieter


    Because of lacking ventilatory stimulation by sex hormones in postmenopausal women (PW), one might expect a lowered arterial oxygen saturation (S(O(2))) in hypoxia and therefore a stronger erythropoietic reaction than in young women (YW). Nine untrained (UTRPW) and 11 trained (TRPW) postmenopausal altitude residents (2600 m) were compared to 16 untrained (UTRYW) and 16 trained young women (TRYW) to check this hypothesis and to study the combined response to hypoxia and training. S(O(2)) was decreased in PW (89.2% +/- 2.2 vs. 93.6 +/- 0.7% in YW, p < 0.01). Hb mass, however, was similar in UT (UTRYW: 9.2 +/- 0.9 g/kg(1), UTRPW: 8.7 +/- 1.0 g/kg). But if body fat rise with age was excluded by relation to fat-free mass, Hb mass was increased in UTRPW (+1.2 g/kg, p < 0.05) compared to UTRYW. Training caused a similar rise of Hb mass in PW and YW (0.3 g/kg per mL/kg x min(1) rise in V(O(2peak))). There was no difference in erythropoietin among the groups. Ferritin was higher in PW than YW. The results show that female hormones and fitness level have to be considered in studies on erythropoiesis at altitude. The role of erythropoietin during chronic hypoxia still has to be clarified.

  20. [Anesthetic management of coronary artery bypass grafting for unstable angina pectoris in a patient undergoing home oxygen therapy]. (United States)

    Arai, Takero; Enomoto, Yoshiro; Kuno, Yuichiro; Inoue, Hisashi; Okuda, Yasuhisa


    A 70-year-old man with pneumoconiosis receiving home oxygen therapy presented with chest pain. Coronary angiogram showed severe stenosis of his left main trunks and required emergency off-pump coronary artery bypass grafting. Anesthesia was induced and maintained with propofol, fentanyl and vecuronium. The trachea was intubated and the lungs were ventilated with oxygen and air maintaining the PaO2 between 80-100 mmHg and the PaCO2 between 55-65 mmHg. The operation was performed uneventfully. In the intensive care unit, the trachea was extubated after ensuring adequate respiratory function. The postoperative course was satisfactory.

  1. Quadratic function between arterial partial oxygen pressure and mortality risk in sepsis patients: an interaction with simplified acute physiology score


    Zhongheng Zhang; Xuqing Ji


    Oxygen therapy is widely used in emergency and critical care settings, while there is little evidence on its real therapeutic effect. The study aimed to explore the impact of arterial oxygen partial pressure (PaO2) on clinical outcomes in patients with sepsis. A large clinical database was employed for the study. Subjects meeting the diagnostic criteria of sepsis were eligible for the study. All measurements of PaO2 were extracted. The primary endpoint was death from any causes during hospita...

  2. Time-dependency of improvements in arterial oxygenation during partial liquid ventilation in experimental acute respiratory distress syndrome (United States)

    Max, Martin; Kuhlen, Ralf; Dembinski, Rolf; Rossaint, Rolf


    Background: The mechanisms by which partial liquid ventilation (PLV) can improve gas exchange in acute lung injury are still unclear. Therefore, we examined the time- and dose-dependency of the improvements in arterial oxygen tension (PaO2) due to PLV in eight pigs with experimental lung injury, in order to discriminate increases due to oxygen dissolved in perfluorocarbon before its intrapulmonary instillation from a persistent diffusion of the respiratory gas through the liquid column. Results: Application of four sequential doses of perfluorocarbon resulted in a dose-dependent increase in PaO2. Comparison of measurements 5 and 30 min after instillation of each dose revealed a time-dependent decrease in PaO2 for doses that approximated the functional residual capacity of the animals. Conclusion: Although oxygen dissolved in perfluorocarbon at the onset of PLV can cause a short-term improvement in arterial oxygenation, diffusion of oxygen through the liquid may not be sufficient to maintain the initially observed increase in PaO2. PMID:11056747

  3. Dapsone Induced Methaemoglobinemia: Early Intraoperative Detection by Pulse Oximeter Desaturation

    Directory of Open Access Journals (Sweden)

    Mahmood Rafiq


    Case signifies the importance of knowledge of any preoperative drug intake and its anaesthetic implications. Also patients on dapsone therapy especially children should be monitored for methaemoglobin levels. Since children with immune thrombocy-topenic purpura are being treated with dapsone these days and many of these patients would be planned for splenectomy, monitoring of preoperative methaemoglobin levels and methaemoglobinemia as a cause of intraoperative pulse oximeter desaturation should be kept in mind.

  4. "Awake Veno-arterial Extracorporeal Membrane Oxygenation" in Pediatric Cardiogenic Shock: A Single-Center Experience. (United States)

    Schmidt, F; Jack, T; Sasse, M; Kaussen, T; Bertram, H; Horke, A; Seidemann, K; Beerbaum, P; Koeditz, H


    In pediatric patients with acute refractory cardiogenic shock (CS), extracorporeal membrane oxygenation (ECMO) remains an established procedure to maintain adequate organ perfusion. In this context, ECMO can be used as a bridging procedure to recovery, VAD or transplantation. While being supported by ECMO, most centers tend to keep their patients well sedated and supported by invasive ventilation. This may be associated with an increased risk of therapy-related morbidity and mortality. In order to optimize clinical management in pediatric patients with ECMO therapy, we report our strategy of veno-arterial ECMO (VA-ECMO) in extubated awake and conscious patients. We therefore present data of six of our patients with CS, who were treated by ECMO being awake without continuous analgosedation and invasive ventilation. Of these six patients, four were 14 years of age. Median time on ECMO was 17.4 days (range 6.9-94.2 days). Median time extubated, while receiving ECMO support was 9.5 days. Mean time extubated was 78 % of the total time on ECMO. Three patients reached full recovery of cardiac function on "Awake-VA-ECMO," whereas the other three were successfully bridged to destination therapy (VAD, heart transplantation, withdrawal). Four out of our six patients are still alive. Complications related to ECMO therapy (i.e., severe bleeding, site infection or dislocation of cannulas) were not observed. We conclude that "Awake-VA-ECMO" in extubated, spontaneously breathing conscious pediatric patients is feasible and safe for the treatment of acute CS and can be used as a "bridging therapy" to recovery, VAD implantation or transplantation.

  5. Peripheral Veno-Arterial Extracorporeal Membrane Oxygenation as a Bridge to Decision for Pediatric Fulminant Myocarditis. (United States)

    Okada, Noritaka; Murayama, Hiroomi; Hasegawa, Hiroki; Kawai, Satoru; Mori, Hiromitsu; Yasuda, Kazushi


    It is essential to establish an appropriate initial treatment strategy for pediatric fulminant myocarditis. We reviewed eight cases of pediatric fulminant myocarditis that required extracorporeal membrane oxygenation (ECMO) from 2012 to 2015. The median age was 8 years (range 3 months-13 years), and the median body surface area was 0.89 m(2) (range 0.35-1.34 m(2) ). Peripheral veno-arterial ECMO was initially applied, and we evaluated whether heart decompression was sufficient. If the pump flow was insufficient, central cannulation was performed via median sternotomy (central ECMO). The need for subsequent ventricular assist device (VAD) support was determined 72 h after ECMO initiation. Six patients were bridged to recovery using peripheral ECMO support only (for 3-11 days), whereas two required VAD support. One patient was switched to central ECMO before VAD implantation. Three patients died of multiorgan failure, even though cardiac function recovered in two of those patients. The duration from hospital arrival to ECMO initiation was shorter in the survival (3.3 ± 1.3 h; range 1.6-4.7 h) than in the nonsurvival group (32 ± 28 h; range 0.7-55 h). Peripheral ECMO can be useful as a bridge to decision for pediatric fulminant myocarditis, which is frequently followed by a successful bridge to recovery. It is important to determine whether ECMO support should be initiated before organ dysfunction advances to preserve organ function, which provides a better bridge to subsequent VAD therapy and heart transplant or recovery.

  6. Impact of aquifer desaturation on steady-state river seepage (United States)

    Morel-Seytoux, Hubert J.; Miracapillo, Cinzia; Mehl, Steffen


    Flow exchange between surface and ground water is of great importance be it for beneficial allocation and use of the water resources or for the proper exercise of water rights. That exchange can take place under a saturated or unsaturated flow regime. Which regimes occur depend on conditions in the vicinity of the interactive area. Withdrawals partially sustained by seepage may not bring about desaturation but greater amounts eventually will. The problem considered in this paper deals only with the steady-state case. It is meant as a first step toward a simple, yet accurate and physically based treatment of the transient situation. The primary purpose of the article is to provide simple criteria for determination of the initiation of desaturation in an aquifer originally in saturated hydraulic connection with a river or a recharge area. The extent of the unsaturated zone in the aquifer will increase with increasing withdrawals while at the same time the seepage rate from the river increases. However the seepage increase will stop once infiltration takes place strictly by gravity in the aquifer and is no longer opposed by the capillary rise from the water table below the riverbed. Following desaturation simple criteria are derived and simple analytical formulae provided to estimate the river seepage based on the position of the water table mound below the clogging layer and at some distance away from the river bank. They fully account for the unsaturated flow phenomena, including the existence of a drainage entry pressure. Two secondary objectives were to verify that (1) the assumption of uniform vertical flow through a clogging layer and that (2) the approximation of the water table mound below the seepage area as a flat surface were both reasonably legitimate. This approach will be especially advantageous for the implementation of the methodology in large-scale applications of integrated hydrologic models used for management.

  7. An Obesity Paradox of Asian Body Mass Index after Cardiac Surgery: Arterial Oxygenations in Duration of Mechanic Ventilation

    Directory of Open Access Journals (Sweden)

    Chiu-Hsia Chang


    Full Text Available Background. Numerous studies have documented an obesity paradox that overweight of Caucasian patients has better prognosis after cardiac surgery. This study is to examine Asian patients’ BMI to see whether an obesity paradox exists in DMV after cardiac surgery. Methods. A retrospective study consisted of 428 patients after cardiac surgery from January 2006 to December 2010 in the medical center of Taiwan. The Asian BMI was divided into 3 groups: under-normal weight patients (; , overweight patients (BMI 24 to <27; , and obese patients (; . Multivariable analysis and paired were used to compare all variables. Results. Overweight patients were significantly associated with the shortest DMV. Under-normal weight patients had significantly better oxygenations of AaDO2 and P/F ratio in the DMV; however, they correlated with the longest DMV, older age, more female, lower LVSV, higher BUN, more dialysis-dependent, and poorer outcomes, namely, 1-year mortality, HAP, reintubation, tracheotomy, and LOS. Conclusions. Asian overweight patients after cardiac surgery have better prognosis. Under-normal weight patients have higher risk factors, longer DMV, and poorer outcomes; even though they have better arterial oxygenations, they seem to need better arterial oxygenations for successful weaning ventilator.

  8. The Use of the Ratio between the Veno-arterial Carbon Dioxide Difference and the Arterial-venous Oxygen Difference to Guide Resuscitation in Cardiac Surgery Patients with Hyperlactatemia and Normal Central Venous Oxygen Saturation

    Institute of Scientific and Technical Information of China (English)

    Wei Du; Yun Long; Xiao-Ting Wang; Da-Wei Liu


    Background:After cardiac surgery,central venous oxygen saturation (ScvO2) and serum lactate concentration are often used to guide resuscitation;however,neither are completely reliable indicators of global tissue hypoxia.This observational study aimed to establish whether the ratio between the veno-arterial carbon dioxide and the arterial-venous oxygen differences (P(v-a)CO2/C(a-v)O2) could predict whether patients would respond to resuscitation by increasing oxygen delivery (DO2).Methods:We selected 72 patients from a cohort of 290 who had undergone cardiac surgery in our institution between January 2012 and August 2014.The selected patients were managed postoperatively on the Intensive Care Unit,had a normal ScvO2,elevated serum lactate concentration,and responded to resuscitation by increasing DO2 by >10%.As a consequence,48 patients responded with an increase in oxygen consumption (VO2) while VO2 was static or fell in 24.Results:At baseline and before resuscitative intervention in postoperative cardiac surgery patients,a P(v-a)CO2/C(a-v)O2 ratio ≥1.6 mmHg/ml predicted a positive VO2 response to an increase in DO2 of>1 0% with a sensitivity of 68.8% and a specificity of 87.5%.Conclusions:P(v-a)CO2/C(a-v)O2 ratio appears to be a reliable marker of global anaerobic metabolism and predicts response to DO2 challenge.Thus,patients likely to benefit from resuscitation can be identified promptly,the P(v-a)CO2/C(a-v)O2 ratio may,therefore,be a useful resuscitation target.

  9. Effect of desflurane-remifentanil vs. Propofol-remifentanil anesthesia on arterial oxygenation during one-lung ventilation for thoracoscopic surgery: a prospective randomized trial


    Cho, Youn Joung; Kim, Tae Kyong; Hong, Deok Man; Seo, Jeong-Hwa; Bahk, Jae-Hyon; Jeon, Yunseok


    Background One-lung ventilation during thoracic surgery frequently disturbs normal systemic oxygenation. However, the effect of anesthetics on arterial oxygenation during one-lung ventilation has not been well established in human study. In this clinical trial, we investigated whether a difference between desflurane-remifentanil and propofol-remifentanil anesthesia can be observed with regard to oxygenation during one-lung ventilation for thoracoscopic surgery. Methods Adult patients with lun...

  10. Daily nursing care on patients undergoing venous-venous extracorporeal membrane oxygenation: a challenging procedure! (United States)

    Redaelli, Sara; Zanella, Alberto; Milan, Manuela; Isgrò, Stefano; Lucchini, Alberto; Pesenti, Antonio; Patroniti, Nicolò


    Daily nursing in critical care patients may alter vital parameters, especially in the most critically ill patients. The aim of our study was to evaluate feasibility and safety of daily nursing on patients undergoing venous-venous extracorporeal membrane oxygenation (vv-ECMO) for severe respiratory failure. Daily nursing was performed following defined phases (sponge bath, elevation with scooping stretcher, change position of endotracheal tube, dressing replacement). We recorded physiological and ECMO parameters before and during daily nursing in 5 patients for several days (total: 25 daily nursing) and adverse events: desaturation, hypertension, reduction of mixed venous oxygen saturation, arterial oxygen saturation or ECMO blood flow and elevation in minute ventilation. Sedative drug dosage and additional bolus were recorded. Daily nursing was performed in 92 % of cases (23/25), with a minimum of two adverse events per daily nursing. Hypertension and tachycardia were mostly recorded at the beginning, while desaturation, reduction in mixed venous oxygen saturation and blood flow were recorded during elevation with scooping stretcher. Increase in minute ventilation was frequent in spontaneous breathing patients. Additional bolus of sedation was required before and/or during nursing. Daily nursing significantly alters physiologic parameters; thus, it should be performed only when physicians are readily available to treat adverse events.

  11. Co mbination of sympto ms and oxygen desaturation index in predicting childhood obstructive sleep apnea%症状和氧减指数相结合的儿童阻塞性睡眠呼吸暂停综合征筛查模式探讨

    Institute of Scientific and Technical Information of China (English)

    崔菲菲; 方昕; 常丽


    Objective To develop a screening process of obstructive sleep apnea in children based on a combination of symptoms and oxygen desaturation index(ODI).Methods We performed a retrospective study of 141 Chinese patients who were referred to a pediatric sleep laboratory for possible obstructive sleep apnea(OSA).The parents of each patient answered a questionnaire before their child underwent polysomnography(PSG)in the laboratory.An apnea-hypopnea index(AHI)greater than five on nocturnal PSG was defined as OSA.The nocturnal PSG was interpreted by a sleep laboratory physician.The ODI and oc-currence ratio ofsleep problems such as snoring,observable apnea during sleep,mouth breathing,and restless sleep,among others were compared between the OSA and non-OSA groups using the chi-square test.Items that indicated statistically significant differ-ences were tested with non-parametric Spearman correlation tests to determine the correlation between these items and AHI.ODI and the items that indicated a statistically significant difference between the OSA and non-OSA groups were analyzed using binary logistic regression.The ODI cut-off point was determined through ODI receiver operating characteristic analysis to distinguish be-tween OSA and non-OSA.The sensitivity,specificity,positive predictive value(PPV),and negative predictive value(NPV)were calculated to determine the combination of OSA predictors that exhibited the best diagnostic performance.Results Among the 141 patients,78(55%)were diagnosed with OSA by PSG.The occurrences of observable apnea during sleep,mouth breathing, and restless sleep were significantly different between the OSA and non-OSA groups(20.5% vs.4.8%,85.9% vs.71.4%, 69.2% vs.52.4%,respectively,with P <0.05).The median of ODI in the OSA group was significantly higher than that in the non-OSA group.The ODI and the occurrences of observable apnea during sleep,mouth breathing,and restless sleep were correlated with AHI and were important diagnostic factors

  12. The Influence of Endothelial Function and Myocardial Ischemia on Peak Oxygen Consumption in Patients with Coronary Artery Disease

    Directory of Open Access Journals (Sweden)

    Simon L. Bacon


    Full Text Available Impaired endothelial function has been shown to limit exercise in coronary artery disease (CAD patients and has been implicated in myocardial ischemia. However, the association of endothelial function and ischemia on peak exercise oxygen consumption (VO2 has not been previously reported. A total of 116 CAD patients underwent standard exercise stress testing, during which VO2 was measured. On a separate day, endothelial-dependent and -independent function were assessed by ultrasound using flow-mediated arterial vasodilation (FMD and sublingual glyceryl trinitrate administration (GTNMD of the brachial artery. Patients with exercise-induced myocardial ischemia had lower FMD than nonischemic patients (3.64±0.57 versus 4.98±0.36, P=.050, but there was no difference in GTNMD (14.11±0.99 versus 15.47±0.63, P=.249. Analyses revealed that both FMD (P=.006 and GTNMD (P=.019 were related to peak VO2. However, neither the presence of ischemia (P=.860 nor the interaction of ischemia with FMD (P=.382 and GTNMD (P=.151 was related to peak VO2. These data suggest that poor endothelial function, potentially via impaired NO production and smooth muscle dysfunction, may be an important determinant of exercise capacity in patients with CAD, independent of myocardial ischemia.

  13. Sildenafil attenuates pulmonary arterial pressure but does not improve oxygenation during ARDS

    NARCIS (Netherlands)

    Cornet, A.D.; Hofstra, J.J.; Swart, E.L.; Girbes, A.R.J.; Juffermans, N.P.


    OBJECTIVE: Pulmonary hypertension is a characteristic feature of acute respiratory distress syndrome (ARDS) and contributes to mortality. Administration of sildenafil in ambulatory patients with pulmonary hypertension improves oxygenation and ameliorates pulmonary hypertension. Our aim was to determ

  14. The Effect of Arterial pH on Oxygenation Persists Even in Infants Treated with Inhaled Nitric Oxide

    Directory of Open Access Journals (Sweden)

    Aimee M. Barton


    Full Text Available Objective. To validate the empiric observation that pH has an important effect on oxygenation in infants receiving iNO. Study Design. Demographics, ventilator settings, arterial blood gases (ABG, and interventions for up to 96 hours of life were extracted from the charts of 51 infants receiving iNO. Need for ECMO and survival to discharge were noted. Mean blood pressure (MBP and mean airway pressure (MAP were recorded. The arterial/alveolar (a/A ratio was used as the primary outcome. Analysis was by simple linear regression and multiple linear regression analyses and Fisher's exact test. pH responsiveness was arbitrarily defined as a correlation coefficient (CC of >0.40 with 7.55. Of 11 patients requiring ECMO, only 3 exhibited responsiveness at any time in their course. Three responders required ECMO. Conclusion. This small study suggests that failure or inability to optimize pH may account for observed unresponsiveness to iNO. Maintaining a pH > 7.5 using hyperventilation is not recommended.

  15. Increasing mean arterial pressure in cardiogenic shock secondary to myocardial infarction: effects on hemodynamics and tissue oxygenation. (United States)

    Perez, Pierre; Kimmoun, Antoine; Blime, Vincent; Levy, Bruno


    There are very few data regarding the effects of norepinephrine uptitration on global and regional hemodynamics in cardiogenic shock. We studied 25 patients with shock secondary to myocardial infarction successfully treated with percutaneous coronary intervention. Before the inclusion, 16 of 25 patients presented a cardiac arrest in the presence of medical staff. Norepinephrine was titrated to increase mean arterial pressure (MAP) from 65 to 85 mmHg during 1 h. Swan-Ganz variables, arterial and mixed venous blood gases, lactate, and thenar near-infrared spectroscopy variables (muscle tissue oxygen saturation [StO2] and its changes during a vascular occlusion test) were measured before, 1 h after norepinephrine uptitration, and 1 h after norepinephrine downtitration. To obtain a MAP at 85 mmHg, norepinephrine was increased from 0.6 (0.28-1.2) to 1.53 µg · kg · min (0.76-2.6 µg · kg · min) (P cardiogenic shock complicated by postreperfusion disease is associated with better cardiac performance and improved microcirculatory variables.

  16. Safety and efficacy of distal perfusion catheterization to prevent limb ischemia after common femoral artery cannulation for extracorporeal membrane oxygenation

    Energy Technology Data Exchange (ETDEWEB)

    Jeon, Chang Ho; Seong, Nak Jong; Yoon, Chang Jin [Dept. of Radiology, Seoul National University Bundang Hospital, Seongnam (Korea, Republic of)


    The extracorporeal membrane oxygenation (ECMO) cannula has the potential for obstructing flow to the lower limb, thus causing severe ischemia and possible limb loss. We evaluated the safety and clinical efficacy of percutaneous distal perfusion catheterization in preventing limb ischemia. Between March 2013 and February 2015, 28 patients with distal perfusion catheterization after ECMO were included in this retrospective study. The technical success was evaluated by Doppler ultrasound at the popliteal level after saline injection via distal perfusion catheter. Clinical success was assessed when at least one of the following conditions was met: restoration of continuous peripheral limb oximetry value or presence of distal arterial pulse on Doppler ultrasound evaluation or resolution of early ischemic sign after connecting the catheter with ECMO. Twenty-six patients with early ischemia were successfully cannulated with a distal perfusion catheter (92.8%). Clinical success was achieved in 12/28 (42.8%) patients; 8/10 (80.0%) patients with survival duration exceeding 7 days and 4/18 (22.2%) patients with survival duration less than 7 days, respectively. A percutaneous distal perfusion catheter placement was a feasible tool with safety and efficacy in preventing lower limb ischemia for patients with prolonged common femoral arterial cannulation for ECMO.

  17. External carotid artery flow maintains near infrared spectroscopy-determined frontal lobe oxygenation during ephedrine administration

    DEFF Research Database (Denmark)

    Sørensen, H; Rasmussen, P; Sato, K;


    BACKGROUND: Phenylephrine and ephedrine affect frontal lobe oxygenation ([Formula: see text]) differently when assessed by spatially resolved near infrared spectroscopy. We evaluated the effect of phenylephrine and ephedrine on extra- vs intra-cerebral blood flow and on [Formula: see text]. METHODS...

  18. The Ratio of Partial Pressure Arterial Oxygen and Fraction of Inspired Oxygen 1 Day After Acute Respiratory Distress Syndrome Onset Can Predict the Outcomes of Involving Patients. (United States)

    Lai, Chih-Cheng; Sung, Mei-I; Liu, Hsiao-Hua; Chen, Chin-Ming; Chiang, Shyh-Ren; Liu, Wei-Lun; Chao, Chien-Ming; Ho, Chung-Han; Weng, Shih-Feng; Hsing, Shu-Chen; Cheng, Kuo-Chen


    The initial hypoxemic level of acute respiratory distress syndrome (ARDS) defined according to Berlin definition might not be the optimal predictor for prognosis. We aimed to determine the predictive validity of the stabilized ratio of partial pressure arterial oxygen and fraction of inspired oxygen (PaO2/FiO2 ratio) following standard ventilator setting in the prognosis of patients with ARDS.This prospective observational study was conducted in a single tertiary medical center in Taiwan and compared the stabilized PaO2/FiO2 ratio (Day 1) following standard ventilator settings and the PaO2/FiO2 ratio on the day patients met ARDS Berlin criteria (Day 0). Patients admitted to intensive care units and in accordance with the Berlin criteria for ARDS were collected between December 1, 2012 and May 31, 2015. Main outcome was 28-day mortality. Arterial blood gas and ventilator setting on Days 0 and 1 were obtained.A total of 238 patients met the Berlin criteria for ARDS were enrolled, and they were classified as mild (n = 50), moderate (n = 125), and severe (n = 63) ARDS, respectively. Twelve (5%) patients who originally were classified as ARDS did not continually meet the Berlin definition, and a total of 134 (56%) patients had the changes regarding the severity of ARDS from Day 0 to Day 1. The 28-day mortality rate was 49.1%, and multivariate analysis identified age, PaO2/FiO2 on Day 1, number of organ failures, and positive fluid balance within 5 days as significant risk factors of death. Moreover, the area under receiver-operating curve for mortality prediction using PaO2/FiO2 on Day 1 was significant higher than that on Day 0 (P = 0.016).PaO2/FiO2 ratio on Day 1 after applying mechanical ventilator is a better predictor of outcomes in patients with ARDS than those on Day 0.

  19. Intra-arterial tert-Butyl-hydroperoxide infusion induces an exacerbated sensory response in the rat hind limb and is associated with an impaired tissue oxygen uptake.

    NARCIS (Netherlands)

    Tan, E.C.T.H.; Goor, H. van; Bahrami, S.; Kozlov, A.V.; Leixnering, M.; Redl, H.; Goris, R.J.A.


    The objective of this study was to investigate oxidative stress and oxygen extraction mechanisms in an animal model of continuous intra-arterial infusion of a free radical donor and in an in vitro model using isolated mitochondria. tert-Butyl-hydroperoxide (tert-BuOOH, 25 mM) was infused for 24 h in

  20. Increased in vivo mitochondrial oxygenation with right ventricular failure induced by pulmonary arterial hypertension: Mitochondrial inhibition as driver of cardiac failure?

    NARCIS (Netherlands)

    G.M. Balestra (Gianmarco); E.G. Mik (Egbert); O. Eerbeek (Otto); P. Specht (Patricia); W.J. van der Laarse (Willem J.); C.J. Zuurbier (Coert J.)


    textabstractBackground: The leading cause of mortality due to pulmonary arterial hypertension (PAH) is failure of the cardiac right ventricle. It has long been hypothesized that during the development of chronic cardiac failure the heart becomes energy deprived, possibly due to shortage of oxygen at

  1. Physical Activity and Exertional Desaturation Are Associated with Mortality in Idiopathic Pulmonary Fibrosis (United States)

    Vainshelboim, Baruch; Kramer, Mordechai Reuven; Izhakian, Shimon; Lima, Ricardo M.; Oliveira, Jose


    Idiopathic pulmonary fibrosis (IPF) is a chronic lung disease that manifests in hypoxemia, inactivity, and poor prognosis. This study aimed to assess the prognostic role of physical activity (PA) and exertional desaturation (ED) with mortality in IPF. At baseline, 34 IPF patients (68 (50–81) years) were interviewed using the International Physical Activity Questionnaire (IPAQ), and SpO2 was assessed pre to post 6-min walking test (∆SpO2). Patients were prospectively followed up for 40 months. Receiver operating characteristics curve analysis determined cut-off points associated with mortality, and Cox proportional hazard ratio (HR) were conducted. Thresholds for increased mortality risk in IPF patients were determined as IPAQ ≤ 417 metabolic equivalent task (METS)-min/week, p = 0.004 (HR; 9.7, CI 95% (1.3–71.9), p = 0.027), and ∆SpO2 ≥ 10%, p = 0.002, (HR; 23.3, CI 95% (1.5–365), p = 0.025). This study demonstrated a significant association of PA and ED with mortality in IPF patients. The findings emphasize the clinical importance of PA and ED assessments to aid in IPF risk stratification, prognosis prediction, and in providing early appropriate treatments, such as pulmonary rehabilitation, PA consultation, oxygen supplementation, and lung transplantation referral. These results underscore that even low levels of PA corresponding to 100–105 min/week were associated with a reduced mortality risk and better survival in IPF. PMID:27548238

  2. Quadratic function between arterial partial oxygen pressure and mortality risk in sepsis patients: an interaction with simplified acute physiology score. (United States)

    Zhang, Zhongheng; Ji, Xuqing


    Oxygen therapy is widely used in emergency and critical care settings, while there is little evidence on its real therapeutic effect. The study aimed to explore the impact of arterial oxygen partial pressure (PaO2) on clinical outcomes in patients with sepsis. A large clinical database was employed for the study. Subjects meeting the diagnostic criteria of sepsis were eligible for the study. All measurements of PaO2 were extracted. The primary endpoint was death from any causes during hospital stay. Survey data analysis was performed by using individual ICU admission as the primary sampling unit. Quadratic function was assumed for PaO2 and its interaction with other covariates were explored. A total of 199,125 PaO2 samples were identified for 11,002 ICU admissions. Each ICU stay comprised 18 PaO2 samples in average. The fitted multivariable model supported our hypothesis that the effect of PaO2 on mortality risk was in quadratic form. There was significant interaction between PaO2 and SAPS-I (p = 0.007). Furthermore, the main effect of PaO2 on SOFA score was nonlinear. The study shows that the effect of PaO2 on mortality risk is in quadratic function form, and there is significant interaction between PaO2 and severity of illness.

  3. Percutaneous nocturnal oximetry in amyotrophic lateral sclerosis: periodic desaturation. (United States)

    de Carvalho, Mamede; Costa, João; Pinto, Susana; Pinto, Anabela


    Percutaneous nocturnal oximetry (PNO) is useful to screen respiratory function in amyotrophic lateral sclerosis (ALS). PNO recordings of some patients disclose a periodical pattern of O(2) desaturation (PP), whose significance is unknown. We aimed to characterize PP pattern, and we used a prospective study enrolling 261 consecutive ALS patients. Clinical, pulmonary and neurophysiological tests performed included: ALS functional rating scale, forced vital capacity (FVC), maximal inspiratory pressure (PImax), mouth occlusion pressure (MOP), phrenic nerve motor response, needle electromyography of the diaphragm, PNO, and sleep study. A total of 837 PNO recordings were analysed (3.2 recordings/patient) and 45 patients showed typical PP (17.2%). Four were excluded, 13 had normal diaphragm (group 1, G1), and in 28 the diaphragm was abnormal (G2). The two groups were comparable, apart from respiratory score, FVC and PImax which were lower in G2. In G1, REM sleep was absent and hypoventilation occurred at slow-wave sleep. Five patients in G1 were very spastic, had low MOP/FVC and a short survival. This study identified a subgroup of ALS patients (G1) with marked signs of upper motor neuron lesion, strong respiratory muscles, PP, low MOP/FVC ratio and poor prognosis. We speculate that they have a central respiratory dysfunction and deserve special care.

  4. Alkane desaturation by concerted double hydrogen atom transfer to benzyne. (United States)

    Niu, Dawen; Willoughby, Patrick H; Woods, Brian P; Baire, Beeraiah; Hoye, Thomas R


    The removal of two vicinal hydrogen atoms from an alkane to produce an alkene is a challenge for synthetic chemists. In nature, desaturases and acetylenases are adept at achieving this essential oxidative functionalization reaction, for example during the biosynthesis of unsaturated fatty acids, eicosanoids, gibberellins and carotenoids. Alkane-to-alkene conversion almost always involves one or more chemical intermediates in a multistep reaction pathway; these may be either isolable species (such as alcohols or alkyl halides) or reactive intermediates (such as carbocations, alkyl radicals, or σ-alkyl-metal species). Here we report a desaturation reaction of simple, unactivated alkanes that is mechanistically unique. We show that benzynes are capable of the concerted removal of two vicinal hydrogen atoms from a hydrocarbon. The discovery of this exothermic, net redox process was enabled by the simple thermal generation of reactive benzyne intermediates through the hexadehydro-Diels-Alder cycloisomerization reaction of triyne substrates. We are not aware of any single-step, bimolecular reaction in which two hydrogen atoms are simultaneously transferred from a saturated alkane. Computational studies indicate a preferred geometry with eclipsed vicinal C-H bonds in the alkane donor.

  5. Enhanced cellular responses and distinct gene profiles in human fetoplacental artery endothelial cells under chronic low oxygen. (United States)

    Jiang, Yi-Zhou; Wang, Kai; Li, Yan; Dai, Cai-Feng; Wang, Ping; Kendziorski, Christina; Chen, Dong-Bao; Zheng, Jing


    Fetoplacental endothelial cells are exposed to oxygen levels ranging from 2% to 8% in vivo. However, little is known regarding endothelial function within this range of oxygen because most laboratories use ambient air (21% O2) as a standard culture condition (SCN). We asked whether human umbilical artery endothelial cells (HUAECs) that were steadily exposed to the physiological chronic normoxia (PCN, 3% O2) for ∼20-25 days differed in their proliferative and migratory responses to FGF2 and VEGFA as well as in their global gene expression compared with those in the SCN. We observed that PCN enhanced FGF2- and VEGFA-stimulated cell proliferation and migration. In oxygen reversal experiments (i.e., when PCN cells were exposed to SCN for 24 h and vice versa), we found that preexposure to 21% O2 decreased the migratory ability, but not the proliferative ability, of the PCN-HUAECs in response to FGF2 and VEGFA. These PCN-enhanced cellular responses were associated with increased protein levels of HIF1A and NOS3, but not FGFR1, VEGFR1, and VEGFR2. Microarray analysis demonstrated that PCN up-regulated 74 genes and down-regulated 86, 14 of which were directly regulated by hypoxia-inducible factors as evaluated using in silico analysis. Gene function analysis further indicated that the PCN-regulated genes were highly related to cell proliferation and migration, consistent with the results from our functional assays. Given that PCN significantly alters cellular responses to FGF2 and VEGFA as well as transcription in HUAECs, it is likely that we may need to reexamine the current cellular and molecular mechanisms controlling fetoplacental endothelial functions, which were largely derived from endothelial models established under ambient O2.

  6. Severe cerebral desaturation during shoulder arthroscopy in the beach-chair position

    DEFF Research Database (Denmark)

    Dippmann, Christian; Winge, Søren; Nielsen, Henning Bay


    During shoulder arthroscopy in the beach-chair position, cerebral ischemia may be a serious complication because prolonged hypotension may affect regional cerebral oxygen supply. We present the cases of 2 patients in whom a reduction in mean arterial pressure after anesthesia provoked a decrease...

  7. Desaturation Patterns Detected by Oximetry in a Large Population of Athletes (United States)

    Garrido-Chamorro, Raul P.; Gonzalez-Lorenzo, Marta; Sirvent-Belando, Jose; Blasco-Lafarga, Cristina; Roche, Enrique


    Optimal exercise performance in well trained athletes can be affected by arterial oxygen saturation failure. Noninvasive detection of this phenomenon when performing a routine ergometric test can be a valuable tool for subsequent planning of the athlete's training, recovery, and nutrition. Oximetry has been used to this end. The authors studied…

  8. Effect of thoracic epidural anesthesia on oxygen delivery and utilization in cardiac surgical patients scheduled to undergo off-pump coronary artery bypass surgery: A prospective study

    Directory of Open Access Journals (Sweden)

    Suryaprakash Sharadaprasad


    Full Text Available To evaluate the effect of thoracic epidural anesthesia (TEA on tissue oxygen delivery and utilization in patients undergoing cardiac surgery. This prospective observational study was conducted in a tertiary referral heart hospital. A total of 25 patients undergoing elective off-pump coronary artery bypass surgery were enrolled in this study. All patients received thoracic epidural catheter in the most prominent inter-vertebral space between C7 and T3 on the day before operation. On the day of surgery, an arterial catheter and Swan Ganz catheter (capable of measuring cardiac index was inserted. After administering full dose of local anesthetic in the epidural space, serial hemodynamic and oxygen transport parameters were measured for 30 minute prior to administration of general anesthesia, with which the study was culminated. A significant decrease in oxygen delivery index with insignificant changes in oxygen extraction and consumption indices was observed. We conclude that TEA does not affect tissue oxygenation despite a decrease in arterial pressures and cardiac output.

  9. Systematic review of near-infrared spectroscopy determined cerebral oxygenation during non-cardiac surgery

    Directory of Open Access Journals (Sweden)

    Henning Bay Nielsen


    Full Text Available Near-infrared spectroscopy (NIRS is used to monitor regional cerebral oxygenation (rScO2 during cardiac surgery but is less established during non-cardiac surgery. This systematic review aimed i to determine the non-cardiac surgical procedures that provoke a reduction in rScO2 and ii to evaluate whether an intraoperative reduction in rScO2 influences postoperative outcome. The PubMed and Embase database were searched from inception until April 30, 2013 and inclusion criteria were intraoperative NIRS determined rScO2 in adult patients undergoing non-cardiac surgery. The type of surgery and number of patients included were recorded. There was included 113 articles and evidence suggests that rScO2 is reduced during thoracic surgery involving single lung ventilation, major abdominal surgery, hip surgery, and laparascopic surgery with the patient placed in anti-Tredelenburg’s position. Shoulder arthroscopy in the beach chair and carotid endarterectomy with clamped internal carotid artery also cause pronounced cerebral desaturation. A >20% reduction in rScO2 coincides with indices of regional and global cerebral ischemia during carotid endarterectomy. Following thoracic surgery, major orthopedic and abdominal surgery the occurrence of postoperative cognitive dysfunction might be related to intraoperative cerebral desaturation. In conclusion, certain non-cardiac surgical procedures is associated with an increased risk for the occurrence of regional cerebral oxygenation. Evidence for an association between cerebral desaturation and postoperative outcome parameters other than cognitive dysfunction needs to be established.

  10. A new fibre optic pulse oximeter probe for monitoring splanchnic organ arterial blood oxygen saturation. (United States)

    Hickey, M; Samuels, N; Randive, N; Langford, R; Kyriacou, P A


    A new, continuous method of monitoring splanchnic organ oxygen saturation (SpO(2)) would make the early detection of inadequate tissue oxygenation feasible, reducing the risk of hypoperfusion, severe ischaemia, and, ultimately, death. In an attempt to provide such a device, a new fibre optic based reflectance pulse oximeter probe and processing system were developed followed by an in vivo evaluation of the technology on seventeen patients undergoing elective laparotomy. Photoplethysmographic (PPG) signals of good quality and high signal-to-noise ratio were obtained from the small bowel, large bowel, liver and stomach. Simultaneous peripheral PPG signals from the finger were also obtained for comparison purposes. Analysis of the amplitudes of all acquired PPG signals indicated much larger amplitudes for those signals obtained from splanchnic organs than those obtained from the finger. Estimated SpO(2) values for splanchnic organs showed good agreement with those obtained from the finger fibre optic probe and those obtained from a commercial device. These preliminary results suggest that a miniaturized 'indwelling' fibre optic sensor may be a suitable method for pre-operative and post-operative evaluation of splanchnic organ SpO(2) and their health.

  11. Arterial input function of an optical tracer for dynamic contrast enhanced imaging can be determined from pulse oximetry oxygen saturation measurements (United States)

    Elliott, Jonathan T.; Wright, Eric A.; Tichauer, Kenneth M.; Diop, Mamadou; Morrison, Laura B.; Pogue, Brian W.; Lee, Ting-Yim; St. Lawrence, Keith


    In many cases, kinetic modeling requires that the arterial input function (AIF)—the time-dependent arterial concentration of a tracer—be characterized. A straightforward method to measure the AIF of red and near-infrared optical dyes (e.g., indocyanine green) using a pulse oximeter is presented. The method is motivated by the ubiquity of pulse oximeters used in both preclinical and clinical applications, as well as the gap in currently available technologies to measure AIFs in small animals. The method is based on quantifying the interference that is observed in the derived arterial oxygen saturation (SaO2) following a bolus injection of a light-absorbing dye. In other words, the change in SaO2 can be converted into dye concentration knowing the chromophore-specific extinction coefficients, the true arterial oxygen saturation, and total hemoglobin concentration. A simple error analysis was performed to highlight potential limitations of the approach, and a validation of the method was conducted in rabbits by comparing the pulse oximetry method with the AIF acquired using a pulse dye densitometer. Considering that determining the AIF is required for performing quantitative tracer kinetics, this method provides a flexible tool for measuring the arterial dye concentration that could be used in a variety of applications.

  12. Awake extracorporeal membrane oxygenation (ECMO) as bridge to recovery after left main coronary artery occlusion: a promising concept of haemodynamic support in cardiogenic shock. (United States)

    Alozie, Anthony; Kische, Stephan; Birken, Thomas; Kaminski, Alexander; Westphal, Bernd; Nöldge-Schomburg, Gabriele; Ince, Hüseyin; Steinhoff, Gustav


    Cardiogenic shock following acute myocardial infarction is associated with high mortality rate. Different management concepts including fluid management, inotropic support, intra aortic balloon counterpulsation (IABP) and extracorporeal membrane oxygenation (ECMO) mainly in mechanically ventilated patients have been used as cornerstones of management. However, success rates have been disappointing. Few reports suggested that ECMO when performed under circumvention of mechanical ventilation, may offer some survival benefits. We herein present our experience with the use of veno-arterial ECMO as bridge to recovery in an awake and spontaneously breathing patient after left main coronary artery occlusion complicated by cardiogenic shock.

  13. Prediction of inspired oxygen fraction for targeted arterial oxygen tension following open heart surgery in non-smoking and smoking patients. (United States)

    Bou-Khalil, Pierre; Zeineldine, Salah; Chatburn, Robert; Ayyoub, Chakib; Elkhatib, Farouk; Bou-Akl, Imad; El-Khatib, Mohamad


    Simple and accurate expressions describing the PaO2-FiO2 relationship in mechanically ventilated patients are lacking. The current study aims to validate a novel mathematical expression for accurate prediction of the fraction of inspired oxygen that will result in a targeted arterial oxygen tension in non-smoking and smoking patients receiving mechanical ventilation following open heart surgeries. One hundred PaO2-FiO2 data pairs were obtained from 25 non-smoking patients mechanically ventilated following open heart surgeries. One data pair was collected at each of FiO2 of 40, 60, 80, and 100% while maintaining same mechanical ventilation support settings. Similarly, another 100 hundred PaO2-FiO2 data pairs were obtained from 25 smoking patients mechanically ventilated following open heart surgeries. The utility of the new mathematical expression in accurately describing the PaO2-FiO2 relationship in these patients was assessed by the regression and Bland-Altman analyses. Significant correlations were seen between the true and estimated FiO2 values in non-smoking (r(2) = 0.9424; p < 0.05) and smoking (r(2) = 0.9466; p < 0.05) patients. Tight biases between the true and estimated FiO2 values for non-smoking (3.1%) and smoking (4.1%) patients were observed. Also, significant correlations were seen between the true and estimated PaO2/FiO2 ratios in non-smoking (r(2) = 0.9530; p < 0.05) and smoking (r(2) = 0.9675; p < 0.05) patients. Tight biases between the true and estimated PaO2/FiO2 ratios for non-smoking (-18 mmHg) and smoking (-16 mmHg) patients were also observed. The new mathematical expression for the description of the PaO2-FiO2 relationship is valid and accurate in non-smoking and smoking patients who are receiving mechanical ventilation for post cardiac surgery.

  14. Hyperbaric oxygenation effects determination in the therapy of chronic occlusive lower extremities arteries disease by the use of perfusion scintigraphy

    Directory of Open Access Journals (Sweden)

    Zoranović Uroš


    Full Text Available Background/Aim. Hyperbaric oxygenation (HBO is a medical treatment of a patient with 100% oxygen inspiration under the pressure higher than atmospheric in a special unit designed to let the whole patient's body rest in a chamber. The aim of the study was to determine the effect of the application of HBO treatment on the patient's lower extremities with chonic inoperabile occlusive disease by measning the parameters of perfusion scintigraphy (perfusion reserve, relative perfusion. Methods. This investigation included 22 patients (19 males and 3 famales. Following clinical assessment of lower extremities condition according to the skin appearance and its adnexa, claudication distance was performed. Clinical condition was graded by the use of 5-point nominal scale. In all of the patients 99mTctetraphosmine lower extremities scintigraphy was done ten days prior to the treatment start and ten days after the treatment with HBO. Lower legs were imaged from the posterior view. Prior to imaging the patients were obligatory lying approximately half an hour. Results. In 18 (86% of the patients there was an improvement manifested as better subjective condition and better skin and its adnexa appearance. Following HBO treatment there was a statistically significant change in collecting the radiopharmac at rest. This finding indicates an increased viability of muscles as well as an increased perfusion reserve. Perfusion reserve mean values increased from 39.99 to 50.86%, and from 38.46 to 49.33% for the right and the left lower leg, respectively. This parameter clearly indicates favorable effects of HBO treatment pertaining neoangiogenesis and, consequently, increased viability of the lower leg muscles. It was also obvious in visual analysis of the obtained images. Conclusion. The obtained results confirm that muscle perfusion measured by the parameters of perfusion scintigraphy using 99mTc-tetrophosmine (perfusion reserve, relative perfusion in patients with

  15. Oxygen Reserve Index (ORI): Validation of a new variable

    NARCIS (Netherlands)

    Scheeren, T.W.L.; Spanjersberg, R.; Struys, M.M.R.F.


    Conclusion: In the flat part of the haemoglobin-oxygen binding curve, where oxygen saturation is >97%, a decrease in ORI indicates a falling PaO2 prior to oxygen desaturation. As such, the non-invasive and continuously available ORI may offer additional information at maximum SpO2 values and help gu

  16. Repeatability of Blood Gas Parameters, Pco2 Gap, and Pco2 Gap to Arterial-to-Venous Oxygen Content Difference in Critically Ill Adult Patients (United States)

    Mallat, Jihad; Lazkani, Ali; Lemyze, Malcolm; Pepy, Florent; Meddour, Mehdi; Gasan, Gaëlle; Temime, Johanna; Vangrunderbeeck, Nicolas; Tronchon, Laurent; Thevenin, Didier


    Abstract The objective of this study was to examine the repeatability of blood gas (BG) parameters and their derived variables such as the central venous-to-arterial carbon dioxide tension difference (▵Pco2) and the ratio of ▵Pco2 over the central arteriovenous oxygen content difference (▵Pco2/C(a-cv)O2) and to determine the smallest detectable changes in individual patients. A total of 192 patients with arterial and central venous catheters were included prospectively. Two subsequent arterial and central venous blood samples were collected immediately one after the other and analyzed using the same point-of-care BG analyzer. The samples were analyzed for arterial and venous BG parameters, ▵Pco2, and ▵Pco2/C(a-cv)O2 ratio. Repeatability was expressed as the smallest detectable difference (SDD) and the least significant change (LSC). A change in value of these parameters exceeding the SDD or the LSC should be regarded as real. The SDDs for arterial carbon dioxide tension, arterial oxygen saturation, central venous oxygen saturation (ScvO2), and ▵Pco2 were small: ±2.06 mm Hg, ±1.23%, 2.92%, and ±1.98 mm Hg, respectively, whereas the SDDs for arterial oxygen tension (Pao2) and ▵Pco2/C(a-cv)O2 were high: ±9.09 mm Hg and ±0.57 mm Hg/mL, respectively. The LSCs (%) for these variables were 5.06, 1.27, 4.44, 32.4, 9.51, and 38.5, respectively. The repeatability of all these variables was good except for Pao2 and ▵Pco2/C(a-cv)O2 ratio for which we observed an important inherent variability. Expressed as SDD, a ScvO2 change value of at least ±3% should be considered as true. The clinician must be aware that an apparent change in these variables in an individual patient might represent only an inherent variation. PMID:25621691

  17. Angioplasty and stenting for severe vertebral artery oriifce stenosis:effects on cerebellar function remodeling veriifed by blood oxygen level-dependent functional magnetic resonance imaging

    Institute of Scientific and Technical Information of China (English)

    Bo Liu; Zhiwei Li; Peng Xie


    Vertebral artery oriifce stenting may improve blood supply of the posterior circulation of the brain to regions such as the cerebellum and brainstem. However, previous studies have mainly focused on recovery of cerebral blood lfow and perfusion in the posterior circulation after inter-ventional therapy. This study examined the effects of functional recovery of local brain tissue on cerebellar function remodeling using blood oxygen level-dependent functional magnetic reso-nance imaging before and after interventional therapy. A total of 40 Chinese patients with severe unilateral vertebral artery oriifce stenosis were enrolled in this study. Patients were equally and randomly assigned to intervention and control groups. The control group received drug treat-ment only. The intervention group received vertebral artery oriifce angioplasty and stenting+identical drug treatment to the control group. At 13 days after treatment, the Dizziness Handicap Inventory score was compared between the intervention and control groups. Cerebellar function remodeling was observed between the two groups using blood oxygen level-dependent function-al magnetic resonance imaging. The improvement in dizziness handicap and cerebellar function was more obvious in the intervention group than in the control group. Interventional therapy for severe vertebral artery oriifce stenosis may effectively promote cerebellar function remodeling and exert neuroprotective effects.

  18. Differential Sensitivities of Pulmonary and Coronary Arteries to Hemoglobin-Based Oxygen Carriers and Nitrovasodilators: Study in a Bovine Ex Vivo Model of Vascular Strips (United States)


    lsev ier.c omflocate/ vph Differential sensitivities of pulmonary and coronary arteries to hemoglobin-based oxygen carriers and nitrovasodilators...preparation has been used extensively in multiple studies that led to the discovery of NO as endothelium-derived relaxing factor (lgnarro et al., 1984...G.M .• Wood, K.S., Chaudhuri, G., 1988a. Pharmacological evidence that endothelium-derived relaxing factor is nitric oxide: use or pyrogallol and

  19. Circulação extracorpórea com desvio veno-arterial e baixa pressão parcial de oxigênio Extracorporeal circulation with venous-arterial shunt and low oxygen partial pressure

    Directory of Open Access Journals (Sweden)

    Mário Coli Junqueira de MORAES


    da perfusão. No estudo clínico verificou-se baixo pO2 arterial e fluxo de perfusão normal. Comparando-se os resultados clínicos constatou-se que não houve diferença de mortalidade nos 2 grupos, porém no grupo com baixo pO2 e desvio veno-arterial o sangramento pós-operatório foi significativamente menor, utilizando-se três vezes menos hemoderivados. Além disso, não foi necessário o uso de misturador de gases.PURPOSE: This study is divided into 2 parts, an experimental study to establish a technique of extracorporeal circulation with low oxygen partial pressure and a clinical study to show the feasibility in humans. MATERIAL AND METHODS: Experimental surgery with extracorporeal circulation was performed in 20 dogs divided into 2 groups of ten. In group I, cannulation was done first in the superior vena cava, then in the inferior vena cava, keeping normal heartbeat and breathing, controlled by a respirator and pure oxygen. After passing through a heat exchanger, the blood of each vena cava was injected in the femoral artery. Blood samples from the aorta were taken above the diaphragm in every 30 minutes to check gasometric values. In group II, the right atrium was drained and half of the blood injected in the pulmonary artery with another pump and picked up through the left ventricle to the reservoir that also works as a heat exchanger. The mixed blood (50% arterial and 50% venous was re-injected by another pump in the arterial circulation. The heart was maintained fibrillating and the breathing controlled by the respirator. In the clinical study, 40 patients were divided into 2 groups of 20 each. In group A the patients were bypassed in the conventional manner, that is, compressed air and oxygen in the oxigenator with high arterial pO2. In group B, pure oxygen was used in the membrane oxigenator and venous-arterial shunt, performed between 40% to 50%. RESULTS: In both groups, from a physiologic point of view there was shunting of 50% of venous blood to the

  20. Simultaneous mapping of temporally-resolved blood flow velocity and oxygenation in femoral artery and vein during reactive hyperemia

    Directory of Open Access Journals (Sweden)

    Langham Michael C


    Full Text Available Abstract Background Post-occlusive hyperemia is often used as a paradigm to evaluate vascular reactivity, for example by measuring post-ischemic flow-mediated dilation, arterial blood flow or temporally resolved venous blood oxygenation (HbO2. Here we demonstrate the feasibility of a simultaneous measurement of blood flow and HbO2 in the femoral circulation as part of a single procedure. Methods A multi-echo GRE pulse sequence was designed and implemented to collect velocity-encoded projections in addition to full-image echoes for field mapping as a means to quantify intravascular magnetic susceptibility. The method's feasibility was evaluated at 3T in a small pilot study involving two groups of healthy subjects (mean ages 26 ± 1.6 and 59 ± 7.3 years, N = 7 and 5, respectively in terms of six parameters characterizing the time-course of reactive hyperemia and their sensitivity to differentiate age effects. The reproducibility was assessed on two of the seven young healthy subjects with three repeated measurements. Results The physiological parameters agree with those obtained with current methods that quantify either velocity or HbO2 alone. Of the six measures of vascular reactivity, one from each group was significantly different in the two subject groups (p Conclusion The proposed method is able quantify multiple parameters that may lead to more detailed assessment of peripheral vascular reactivity in a single cuff paradigm rather than in separate procedures as required previously, thereby improving measurement efficiency and patient comfort.

  1. Cerebral desaturation during exercise reversed by O2 supplementation

    DEFF Research Database (Denmark)

    Nielsen, H B; Boushel, Robert Christopher; Madsen, P


    fraction of 0.21 or 0.30 in a crossover design. During exercise with an inspired O2 fraction of 0.21, the arterial CO2 pressure (35 +/- 1 mmHg; mean +/- SE) and O2 pressure (77 +/- 2 mmHg) as well as the hemoglobin saturation (91.9 +/- 0.7%) were reduced (P ... not affect ventilation (174 +/- 4 l/min), but arterial CO2 pressure (37 +/- 2 mmHg), O2 pressure (165 +/- 5 mmHg), and hemoglobin O2 saturation (99 +/- 0.1%) increased (P exercise (79 +/- 2 vs. 81 +/- 2%), and although the muscle DeltaHb (18 +/- 2...... microM) and DeltaHbO2 (-12 +/- 3 microM) were similar to those established without O2 supplementation, work capacity increased from 389 +/- 11 to 413 +/- 10 W (P exercise performance related to maintained cerebral...

  2. Long-term oxygen therapy: Are we prescribing appropriately?

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    Mª Rosa Güell Rous


    Full Text Available Mª Rosa Güell RousDepartament de Pneumologia, Hospital de la Santa Creu I de Sant Pau, Barcelona, SpainAbstract: Long-term oxygen therapy (LTOT is the treatment proven to improve survival in chronic obstructive pulmonary disease (COPD patients with chronic respiratory failure. It also appears to reduce the number of hospitalizations, increase effort capacity, and improve health-related quality of life. Standard LTOT criteria are related to COPD patients who have PaO2 <60 mmHg, are in a clinical stable situation, and are receiving optimal pharmacological treatment. According to LTOT guidelines, oxygen should be prescribed for at least 18 hours per day although some authors consider 24 hours would be more beneficial. The benefits of LTOT depend on correction of hypoxemia. Arterial blood gases should be measured at rest. During exercise, an effort test should be done to assure adequate SaO2. During sleep, continuous monitoring of SaO2 and PaCO2 should be performed to confirm correction of SaO2 overnight. An arterial blood gas sample should be taken at awakening to assess PaCO2 in order to prevent hypoventilation from the oxygen therapy. Several issues that need to be addressed are the use of LTOT in COPD patients with moderate hypoxemia, the efficacy of LTOT in patients who desaturate during exercise or during sleep, the optimal dosage of oxygen supplementation, LTOT compliance, and the LTOT prescription in diseases other than COPD.Keywords: long-term oxygen therapy, COPD, oxygen supplementation, chronic respiratory failure, hypoxemia

  3. Apnea test in the determination of brain death in patients treated with extracorporeal membrane oxygenation (ECMO). (United States)

    Saucha, Wojciech; Sołek-Pastuszka, Joanna; Bohatyrewicz, Romuald; Knapik, Piotr


    Extracorporeal Membrane Oxygenation (ECMO) is a well-established method of support in patients with severe respiratory and/or circulatory failure. Unfortunately, this invasive method of treatment is associated with a high risk of neurological complications including brain death. Proper diagnosis of brain death is crucial for the termination of futile medical care. Currently, the legal system in Poland does not provide an accepted protocol for apnea tests for patients on ECMO support. Veno-arterial ECMO is particularly problematic in this regard because it provides both gas exchange and circulatory support. CO₂ elimination by ECMO prevents hypercapnia, which is required to perform an apnea test. Several authors have described a safe apnea test procedure in patients on ECMO. Maximal reduction of the sweep gas flow to the oxygenator should maintain an acceptable haemoglobin oxygenation level and reduce elimination of carbon dioxide. Hypercapnia achieved via this method should allow an apnea test to be conducted in the typical manner. In the case of profound desaturation and an inadequate increase in the arterial CO₂ concentration, the sweep gas flow rate may be increased to obtain the desired oxygenation level, and exogenous carbon dioxide may be added to achieve a target carbon dioxide level. Incorporation of an apnea test for ECMO patients is planned in the next edition of the Polish guidelines on the determination of brain death.

  4. Pre-oxygenation and apnoea in pregnancy: changes during labour and with obstetric morbidity in a computational simulation. (United States)

    McClelland, S H; Bogod, D G; Hardman, J G


    Using the Nottingham Physiology Simulator, we investigated the effects on pre-oxygenation and apnoea during rapid sequence induction of labour, obesity, sepsis, pre-eclampsia, maternal haemorrhage and multiple pregnancy in term pregnancy. Pre-oxygenation with 100% oxygen was followed by simulated rapid sequence induction when end-tidal nitrogen tension was less than 1 kPa, and apnoea. Labour, morbid obesity and sepsis accelerated pre-oxygenation and de-oxygenation during apnoea. Fastest pre-oxygenation was in labour, with 95% of the maximum change in expired oxygen tension occurring in 47 s, compared to 97 s in a standard pregnant subject. The labouring subject with a body mass index of 50 kg x m(-2) demonstrated the fastest desaturation, the time taken to fall to an arterial saturation prolonged pre-oxygenation and tolerance to apnoea. Maternal haemorrhage and multiple pregnancy had minor effects. Our results inform the risk-benefit comparison of the anaesthetic options for Caesarean section.

  5. Carbogen inhalation increases oxygen transport to hypoperfused brain tissue in patients with occlusive carotid artery disease Increased oxygen transport to hypoperfused brain

    DEFF Research Database (Denmark)

    Ashkanian, Mahmoud; Gjedde, Albert; Mouridsen, Kim


    comparisons by an additive ANOVA model showed that carbogen significantly increased CBF by 7.51 + or - 1.62 ml/100 g/min while oxygen tended to reduce it by -3.22 + or - 1.62 ml/100 g/min. A separate analysis of the hemisphere contralateral to the hypoperfused hemisphere showed that carbogen significantly...... and Sa(O2) are readily obtained with carbogen, while oxygen increases only Sa(O2). Thus, carbogen improves oxygen transport to brain tissue more efficiently than oxygen alone. Further studies with more subjects are, however, needed to investigate the applicability of carbogen for long-term inhalation...

  6. Association between morphometric variables and nocturnal desaturation in sickle-cell anemia

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    Cristina Salles


    Full Text Available OBJECTIVE: to evaluate associations between morphometric variables, cervical circumference (CC, and abdominal circumference (AC with the presence of nocturnal desaturation in children and adolescents with sickle-cell anemia. METHODS: all patients were submitted to baseline polysomnography, oral cavity measurements (maxillary intermolar distance, mandibular intermolar distance, and overjet, and CC and AC measurements. RESULTS: a total of 85 patients were evaluated. A positive correlation was observed between the height/age Z-score and CC measurement (r = 0.233, p = 0.031. The presence of nocturnal desaturation was associated with CC (59.2± 9.3 vs. 67.5 ± 10.7, p = 0.006 and AC measurements (27.0 ± 2.0 vs. 29.0± 2.1, p = 0.028. There was a negative correlation between desaturation and maxillary intermolar distance (r = -0.365, p = 0.001 and mandibular intermolar distance (r = -0.233, p = 0.037. CONCLUSIONS: the morphometric variables of CC and AC may contribute to raise suspicion of nocturnal desaturation in children and adolescents with sickle-cell anemia.

  7. Positive end expiratory pressure during one-lung ventilation: Selecting ideal patients and ventilator settings with the aim of improving arterial oxygenation

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    Hoftman Nir


    Full Text Available The efficacy of positive end-expiratory pressure (PEEP in treating intraoperative hypoxemia during one-lung ventilation (OLV remains in question given conflicting results of prior studies. This study aims to (1 evaluate the efficacy of PEEP during OLV, (2 assess the utility of preoperative predictors of response to PEEP, and (3 explore optimal intraoperative settings that would maximize the effects of PEEP on oxygenation. Forty-one thoracic surgery patients from a single tertiary care university center were prospectively enrolled in this observational study. After induction of general anesthesia, a double-lumen endotracheal tube was fiberoptically positioned and OLV initiated. Intraoperatively, PEEP = 5 and 10 cmH 2 O were sequentially applied to the ventilated lung during OLV. Arterial oxygenation, cardiovascular performance parameters, and proposed perioperative variables that could predict or enhance response to PEEP were analysed. T-test and c2 tests were utilized for continuous and categorical variables, respectively. Multivariate analyses were carried out using a classification tree model of binary recursive partitioning. PEEP improved arterial oxygenation by ≥20% in 29% of patients (n = 12 and failed to do so in 71% (n = 29; however, no cardiovascular impact was noted. Among the proposed clinical predictors, only intraoperative tidal volume per kilogram differed significantly between responders to PEEP and non-responders (mean 6.6 vs. 5.7 ml/kg, P = 0.013; no preoperative variable predicted response to PEEP. A multivariate analysis did not yield a clinically significant model for predicting PEEP responsiveness. PEEP improved oxygenation in a subset of patients; larger, although still protective tidal volumes favored a positive response to PEEP. No preoperative variables, however, could be identified as reliable predictors for PEEP responders.

  8. Increased blood glycohemoglobin A1c levels lead to overestimation of arterial oxygen saturation by pulse oximetry in patients with type 2 diabetes

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    Pu Li


    Full Text Available Abstract Background Non-enzymatic glycation increases hemoglobin-oxygen affinity and reduces oxygen delivery to tissues by altering the structure and function of hemoglobin. Objectives We investigated whether an elevated blood concentration of glycosylated hemoglobin (HbA1c could induce falsely high pulse oximeter oxygen saturation (SpO2 in type 2 diabetic patients during mechanical ventilation or oxygen therapy. Methods Arterial oxygen saturation (SaO2 and partial pressure of oxygen (PO2 were determined with simultaneous monitoring of SpO2 in 261 type 2 diabetic patients during ventilation or oxygen inhalation. Results Blood concentration of HbA1c was >7% in 114 patients and ≤ 7% in 147 patients. Both SaO2 (96.2 ± 2.9%, 95% confidence interval [CI] 95.7-96.7% vs. 95.1 ± 2.8%, 95% CI 94.7-95.6% and SpO2 (98.0 ± 2.6%, 95% CI 97.6-98.5% vs. 95.3 ± 2.8%, 95% CI 94.9-95.8% were significantly higher in patients with HbA1c >7% than in those with HbA1c ≤ 7% (Data are mean ± SD, all p 2 did not significantly differ between the two groups. Bland-Altman analysis demonstrated a significant bias between SpO2 and SaO2 (1.83 ±0.55%, 95% CI 1.73% -1.94% and limits of agreement (0.76% and 2.92% in patients with HbA1c >7%. The differences between SpO2 and SaO2 correlated closely with blood HbA1c levels (Pearson’s r = 0.307, p  Conclusions Elevated blood HbA1c levels lead to an overestimation of SaO2 by SpO2, suggesting that arterial blood gas analysis may be needed for type 2 diabetic patients with poor glycemic control during the treatment of hypoxemia.

  9. Arterial oxygen saturation in healthy newborns delivered at term in Cerro de Pasco (4340 m) and Lima (150 m)


    Gonzales Gustavo F; Salirrosas Amelia


    Abstract Background High altitude is associated with both low pulse oxygen saturation at birth and more pre-term deliveries. The present study was performed to determine pulse oxygen saturation in newborns at term in Cerro de Pasco (4340 m) and Lima (150 m) to test the hypothesis that low pulse oxygen saturation at birth at high altitudes was not observed at term deliveries. Methods The present study was designed to determine pulse oxygen saturation values through 1 minute to 24 hours and val...

  10. Arterial oxygen content is precisely maintained by graded erythrocytotic responses in settings of high/normal serum iron levels, and predicts exercise capacity: an observational study of hypoxaemic patients with pulmonary arteriovenous malformations.

    Directory of Open Access Journals (Sweden)

    Vatshalan Santhirapala

    Full Text Available BACKGROUND: Oxygen, haemoglobin and cardiac output are integrated components of oxygen transport: each gram of haemoglobin transports 1.34 mls of oxygen in the blood. Low arterial partial pressure of oxygen (PaO2, and haemoglobin saturation (SaO2, are the indices used in clinical assessments, and usually result from low inspired oxygen concentrations, or alveolar/airways disease. Our objective was to examine low blood oxygen/haemoglobin relationships in chronically compensated states without concurrent hypoxic pulmonary vasoreactivity. METHODOLOGY: 165 consecutive unselected patients with pulmonary arteriovenous malformations were studied, in 98 cases, pre/post embolisation treatment. 159 (96% had hereditary haemorrhagic telangiectasia. Arterial oxygen content was calculated by SaO2 x haemoglobin x 1.34/100. PRINCIPAL FINDINGS: There was wide variation in SaO2 on air (78.5-99, median 95% but due to secondary erythrocytosis and resultant polycythaemia, SaO2 explained only 0.1% of the variance in arterial oxygen content per unit blood volume. Secondary erythrocytosis was achievable with low iron stores, but only if serum iron was high-normal: Low serum iron levels were associated with reduced haemoglobin per erythrocyte, and overall arterial oxygen content was lower in iron deficient patients (median 16.0 [IQR 14.9, 17.4]mls/dL compared to 18.8 [IQR 17.4, 20.1]mls/dL, p<0.0001. Exercise tolerance appeared unrelated to SaO2 but was significantly worse in patients with lower oxygen content (p<0.0001. A pre-defined athletic group had higher Hb:SaO2 and serum iron:ferritin ratios than non-athletes with normal exercise capacity. PAVM embolisation increased SaO2, but arterial oxygen content was precisely restored by a subsequent fall in haemoglobin: 86 (87.8% patients reported no change in exercise tolerance at post-embolisation follow-up. SIGNIFICANCE: Haemoglobin and oxygen measurements in isolation do not indicate the more physiologically relevant

  11. Markers of Myocardial Ischemia in Patients with Obstructive Sleep Apnea and Coronary Artery Disease

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    Misa Valo


    Full Text Available Obstructive sleep apnea (OSA is characterized by intermittent hypoxia during sleep. We tested the hypothesis that nocturnal myocardial ischemia is detectable by ST segment depression and elevation of high sensitive troponin T (hsTrop T and B-type natriuretic peptide (NT-proBNP in patients with OSA and coexisting coronary artery disease (CAD. Twenty-one patients with OSA and CAD and 20 patients with OSA alone underwent in-hospital polysomnography. Blood samples for hsTrop T and NT-proBNP measurements were drawn before and after sleep. ST segment depression was measured at the time of maximum oxygen desaturation during sleep. The apnea-hypopnea-index (AHI, oxygen saturation nadir, and time in bed with oxygen saturation of ≤80% were similar in both groups. Levels of hsTrop T and NT-proBNP did not differ significantly before and after sleep but NT-proBNP levels were significantly higher in patients suffering from OSA and CAD compared to patients with OSA alone. No significant ST depression was found at the time of oxygen saturation nadir in either group. Despite the fact that patients with untreated OSA and coexisting CAD experienced severe nocturnal hypoxemia, we were unable to detect myocardial ischemia or myocyte necrosis based on significant ST segment depression or elevation of hsTrop T and NT-proBNP, respectively.

  12. Dynamic mechanisms of cardiac oxygenation during brief ischemia and reperfusion

    Energy Technology Data Exchange (ETDEWEB)

    Parsons, W.J.; Rembert, J.C.; Bauman, R.P.; Greenfield, J.C. Jr.; Piantadosi, C.A. (Duke Univ., Durham (USA))


    Myocardial oxygenation may be altered markedly by changes in tissue blood flow. During brief ischemia and reperfusion produced by transient occlusion of the left anterior descending artery in 10 open-chest dogs, changes in the oxygenation of tissue hemoglobin (Hb) plus myoglobin (Mb) and the oxidation-reduction (redox) state of mitochondrial cytochrome aa3 were monitored continuously using near-infrared spectroscopy. The nondestructive optical technique indicated that coronary occlusion produced an abrupt drop in tissue oxygen stores (tHb02 + Mb02), tissue blood volume (tBV), and the oxidation level of cytochrome aa3. Changes in the cytochrome oxidation state were related inversely to transmural collateral blood flow within the ischemic region (r = 0.77) measured with radiolabeled microspheres. Furthermore, there was a direct relationship (r = 0.91) between collateral blood flow and the tissue level of desaturated Hb and Mb (tHb + Mb). Reperfusion after 2 min of ischemia led to a synchronous overshoot of baseline in coronary flow and tBV followed by supranormal increases in tHb + Mb02 and the oxidation level of cytochrome aa3. The tHb + Mb level increased transiently during reperfusion. This response correlated inversely with collateral flow during ischemia (r = 0.91). Accordingly, the time required to reach peak tHb + Mb levels was shortest in dogs with high collateral flows (r = 0.75). Thus collateral blood flow partially sustains myocardial oxygenation during coronary artery occlusion and influences tissue reoxygenation early during reperfusion.

  13. Reduced blood flow response to acetazolamide reflects pre-existing vasodilation and decreased oxygen metabolism in major cerebral arterial occlusive disease

    Energy Technology Data Exchange (ETDEWEB)

    Yamauchi, Hiroshi; Okazawa, Hidehiko; Kishibe, Yoshihiko; Sugimoto, Kanji; Takahashi, Masaaki [Research Institute, Shiga Medical Center, 5-4-30 Moriyama, Moriyama-city, Shiga 524-8524 (Japan)


    A decrease in the cerebral blood flow (CBF) response to acetazolamide may indicate an increase in cerebral blood volume (CBV) caused by reduced perfusion pressure in patients with major cerebral artery steno-occlusive lesions. However, a decrease in cerebral metabolic rate of oxygen (CMRO{sub 2}) caused by ischemic changes may also decrease the CBF response to acetazolamide by decreasing the production of carbon dioxide. The purpose of this study was to determine whether the values of CBV and CMRO{sub 2} are independent predictors of the CBF response to acetazolamide in major cerebral arterial occlusive disease. We used positron emission tomography to study 30 patients with major cerebral artery steno-occlusive lesions. The CBF response to acetazolamide was assessed by measuring baseline CBF and CBF 10 min after an intravenous injection of 1 g of acetazolamide. Multivariate analysis was used to test the independent predictive value of the CBV and CMRO{sub 2} at baseline with respect to the percent change in CBF during acetazolamide administration. Both increased CBV and decreased CMRO{sub 2} were significant and independent predictors of the reduced CBF response to acetazolamide. CBV accounted for 25% of the variance in the absolute change in CBF during acetazolamide administration and 42% of the variance in the percent change in CBF, whereas CMRO{sub 2} accounted for 19% and 4% of the variance, respectively. In patients with major cerebral arterial occlusive disease, a decrease in CMRO{sub 2} may contribute to the reduced CBF response to acetazolamide, although an increase in CBV appears to be the major contributing factor. (orig.)

  14. Relationship between hepatic fatty acid desaturation and lipid secretion in the estrogenized chicken. (United States)

    Hermier, D; Catheline, D; Legrand, P


    Desaturation of fatty acids is thought to facilitate their incorporation into glyceride and their subsequent secretion as lipoproteins. However, in the laying hen, the dramatic increase in hepatic lipogenesis is often paralleled by a liver steatosis that may affect egg production and even result in death. The balance between lipid secretion and storage, in relation to the fatty acid desaturation process, was therefore investigated in young male estrogenized chicken. Estrogen stimulation resulted in a dramatic increase in VLDL concentration (40.4 mg/ml versus 0.158 mg/ml in control) and hepatic lipid content (8.61 g/liver versus 1.47 g/liver in control). In estrogenized chickens, VLDL, total liver, and microsomes contained relatively more monounsaturated and less saturated and polyunsaturated fatty acids, whereas hepatic delta 9 desaturase activity was twofold higher. Moreover, in these birds, the proportion of monoenoic fatty acids was greater in VLDL (55%) than in the liver (50%), which was indicative of their preferential secretion. Therefore, under the influence of estrogen, fatty acid synthesis and desaturation are associated with and increased VLDL secretion, which limits the degree of hepatic accumulation of triglyceride and the risk of subsequent steatosis.

  15. Arterial oxygen saturation in healthy newborns delivered at term in Cerro de Pasco (4340 m and Lima (150 m

    Directory of Open Access Journals (Sweden)

    Gonzales Gustavo F


    Full Text Available Abstract Background High altitude is associated with both low pulse oxygen saturation at birth and more pre-term deliveries. The present study was performed to determine pulse oxygen saturation in newborns at term in Cerro de Pasco (4340 m and Lima (150 m to test the hypothesis that low pulse oxygen saturation at birth at high altitudes was not observed at term deliveries. Methods The present study was designed to determine pulse oxygen saturation values through 1 minute to 24 hours and values of Apgar score at 1 and 5 minutes in newborns delivered at term in Cerro de Pasco (4340 m and Lima (150 m. Pulse oxygen saturation was recorded in 39 newborns from Cerro de Pasco (4340 m and 131 from Lima (150 m at 1, 2, 3, 4, 5, 10, 15, 30 minutes and 1, 2, 8 and 24 hours after delivery. Apgar score was assessed at 1 and 5 minutes after birth. Neurological score was assessed at 24 h of birth by Dubowitz exam. Results Pulse oxygen saturation increased significantly from 1 to 15 min after birth at sea level and from 1 to 30 minutes at Cerro de Pasco. Thereafter, it increased slightly such that at 30 min at sea level and at 60 minutes in Cerro de Pasco it reached a plateau up to 24 hours after birth. At all times, pulse oxygen saturation was significantly higher at sea level than at high altitude (P Conclusion From these analyses may be concluded that pulse oxygen saturation at 4340 m was significantly low despite the fact that births occurred at term. Apgar scores at first minute and neurological scores were also lower at high altitudes.

  16. The use of veno-venous extracorporeal membrane oxygenation for perinatal support of an infant with d-transposition of the great arteries, intact atrial and ventricular septa, and flow-restricted ductus arteriosus. (United States)

    Sullivan, Kevin J; Lacey, Stephanie R; Schrum, Stefanie F; Freid, Eugene B; Collins, Steve V; Bouchard, Amy R; Burns, Scott E; Poulos, Nicholas D; Walsh, Danielle S; Ingyinn, Ma; Ettedgui, Jose A; Ceithaml, Eric L; Jerabek, Charles F; Herald, Tammy S; Castillo, Ramon A; Trogolo, Frank; Bleiweis, Mark S; Hudak, Mark L


    Prenatal assessment of a fetus with D-transposition of the great arteries demonstrated an absence of mixing between systemic and pulmonary circulations, and predicted lethal postnatal hypoxemia. A multidisciplinary meeting evaluated therapeutic options. After cesarean delivery, veno-venous extracorporeal membrane oxygenation was instituted in preparation for open atrial septectomy. The infant subsequently underwent an arterial switch procedure. Prenatal delineation of pulmonary and systemic circulations in the fetus with D-transposition of the great arteries influences postnatal management. Multidisciplinary planning enhanced the perinatal outcome.

  17. Short term non-invasive ventilation post-surgery improves arterial blood-gases in obese subjects compared to supplemental oxygen delivery - a randomized controlled trial

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    Zoremba Norbert


    Full Text Available Abstract Background In the immediate postoperative period, obese patients are more likely to exhibit hypoxaemia due to atelectasis and impaired respiratory mechanics, changes which can be attenuated by non-invasive ventilation (NIV. The aim of the study was to evaluate the duration of any effects of early initiation of short term pressure support NIV vs. traditional oxygen delivery via venturi mask in obese patients during their stay in the PACU. Methods After ethics committee approval and informed consent, we prospectively studied 60 obese patients (BMI 30-45 undergoing minor peripheral surgery. Half were randomly assigned to receive short term NIV during their PACU stay, while the others received routine treatment (supplemental oxygen via venturi mask. Premedication, general anaesthesia and respiratory settings were standardized. We measured arterial oxygen saturation by pulse oximetry and blood gas analysis on air breathing. Inspiratory and expiratory lung function was measured preoperatively (baseline and at 10 min, 1 h, 2 h, 6 h and 24 h after extubation, with the patient supine, in a 30 degrees head-up position. The two groups were compared using repeated-measure analysis of variance (ANOVA and t-test analysis. Statistical significance was considered to be P Results There were no differences at the first assessment. During the PACU stay, pulmonary function in the NIV group was significantly better than in the controls (p Conclusion Early initiation of short term NIV during in the PACU promotes more rapid recovery of postoperative lung function and oxygenation in the obese. The effect lasted 24 hours after discontinuation of NIV. Patient selection is necessary in order to establish clinically relevant improvements. Trial Registration# DRKS00000751;

  18. Left anterior descending coronary artery blood flow and left ventricular unloading during extracorporeal membrane oxygenation support in a swine model of acute cardiogenic shock. (United States)

    Brehm, Christoph; Schubert, Sarah; Carney, Elizabeth; Ghodsizad, Ali; Koerner, Michael; McCoach, Robert; El-Banayosy, Aly


    The impact of extracorporeal membrane oxygenation (ECMO) support on coronary blood flow and left ventricular unloading is still debated. This study aimed to further characterize the influence of ECMO on coronary artery blood flow and its ability to unload the left ventricle in a short-term model of acute cardiogenic shock. Seven anesthetized pigs were intubated and then underwent median sternotomy and cannulation for venoarterial (VA) ECMO. Flow in the left anterior descending (LAD) artery, left atrial pressure (LAP), left ventricular end-diastolic pressure (LVEDP), and mean arterial pressure (MAP) were measured before and after esmolol-induced cardiac dysfunction and after initiating VA-ECMO support. Induction of acute cardiogenic shock was associated with short-term increases in LAP from 8 ± 4 mm Hg to 18 ± 14 mm Hg (P = 0.9) and LVEDP from 5 ± 2 mm Hg to 13 ± 17 mm Hg (P = 0.9), and a decrease in MAP from 63 ± 16 mm Hg to 50 ± 24 mm Hg (P = 0.3). With VA-ECMO support, blood flow in the LAD increased from 28 ± 25 mL/min during acute unsupported cardiogenic shock to 67 ± 50 mL/min (P = 0.003), and LAP and LVEDP decreased to 8 + 5 mm Hg (P = 0.7) and 5 ± 3 mm Hg (P = 0.5), respectively. In this swine model of acute cardiogenic shock, VA-ECMO improved coronary blood flow and provided some degree of left ventricular unloading for the short duration of the study.

  19. Initial clinical experience with near-infrared spectroscopy in assessing cerebral tissue oxygen saturation in cerebral vasospasm before and after intra-arterial verapamil injection. (United States)

    Meng, Lingzhong; Settecase, Fabio; Xiao, Jifang; Yu, Zhaoxia; Flexman, Alana M; Higashida, Randall T


    Cerebral vasospasm is a devastating complication after subarachnoid hemorrhage. The use of cerebral tissue oxygen saturation (SctO2) to non-invasively assess changes in cerebral tissue perfusion induced by intra-arterial (IA) verapamil treatment has not been described to our knowledge. A total of 21 consecutive post-craniotomy patients scheduled for possible IA verapamil treatment of cerebral vasospasm were recruited. The effect of IA verapamil injection on SctO2 being continuously monitored on both the left and right forehead was investigated. Comparisons between changes in SctO2 monitored on the ipsilateral and contralateral forehead in relationship to the side of internal carotid artery (ICA) injection were performed. A total of 47 IA verapamil injections (15 left ICA, 18 right ICA, and 14 vertebral artery injections) during 18 neurointerventional procedures in 13 patients were analyzed. IA verapamil administration led to both increases and decreases in SctO2. Changes in SctO2 ipsilateral to the ICA injection side were more pronounced (p=0.02 and 0.07 for left and right ICA injections, respectively) and favored compared to contralateral SctO2 changes. We were unable to obtain reliable measurements on the side ipsilateral to the craniotomy during four procedures in three patients, presumably secondary to pneumocephalus. The local cerebral vasodilating effect of IA verapamil injection is suggested by the differential changes in SctO2 ipsilateral and contralateral to the ICA injection side. The inconsistent changes in SctO2 and the limitations of applying cerebral oximetry in this patient population needs to be recognized.

  20. Right heart function during simulated altitude in patients with pulmonary arterial hypertension (United States)

    Seccombe, Leigh M; Chow, Vincent; Zhao, Wei; Lau, Edmund M T; Rogers, Peter G; Ng, Austin C C; Veitch, Elizabeth M; Peters, Matthew J; Kritharides, Leonard


    Objective Patients with pulmonary arterial hypertension (PAH) are often recommended supplemental oxygen for altitude travel due to the possible deleterious effects of hypoxia on pulmonary haemodynamics and right heart function. This includes commercial aircraft travel; however, the direct effects and potential risks are unknown. Methods Doppler echocardiography and gas exchange measures were investigated in group 1 patients with PAH and healthy patients at rest breathing room air and while breathing 15.1% oxygen, at rest for 20 min and during mild exertion. Results The 14 patients with PAH studied were clinically stable on PAH-specific therapy, with functional class II (n=11) and III (n=3) symptoms when tested. Measures of right ventricular size and function were significantly different in the PAH group at baseline as compared to 7 healthy patients (p<0.04). There was no evidence of progressive right ventricular deterioration during hypoxia at rest or under exertion. Pulmonary arterial systolic pressure (PASP) increased in both groups during hypoxia (p<0.01). PASP in hypoxia correlated strongly with baseline PASP (p<0.01). Pressure of arterial oxygen correlated with PASP in hypoxia (p<0.03) but not at baseline, with three patients with PAH experiencing significant desaturation. The duration and extent of hypoxia in this study was tolerated well despite a mild increase in symptoms of breathlessness (p<0.01). Conclusions Non-invasive measures of right heart function in group 1 patients with PAH on vasodilator treatment demonstrated a predictable rise in PASP during short-term simulated hypoxia that was not associated with a deterioration in right heart function. PMID:28123765

  1. Changes in oxygen content and acid-base balance in arterial and portal blood in response to the dietary electrolyte balance in pigs during a 9-h period after a meal

    NARCIS (Netherlands)

    Dersjant-Li, Y.; Verstegen, M.W.A.; Jansman, A.; Schulze, H.; Schrama, J.W.; Verreth, J.A.J.


    The effect of two dietary electrolyte balance (dEB, Na K - Cl-) levels on arterial and portal blood oxygen content, blood pH, and acid-base status in pigs was studied during a 9-h period after a meal, using a crossover experimental design. The dEB levels were established by changing the Cl- level in

  2. Changes of blood flow, oxygen tension, action potential and vascular permeability induced by arterial ischemia or venous congestion on the spinal cord in canine model. (United States)

    Kobayashi, Shigeru; Yoshizawa, Hidezo; Shimada, Seiichiro; Guerrero, Alexander Rodríguez; Miyachi, Masaya


    It is generally considered that the genesis of myelopathy associated with the degenerative conditions of the spine may result from both mechanical compression and circulatory disturbance. Many references about spinal cord tissue ischemic damage can be found in the literature, but not detailed studies about spinal cord microvasculature damage related to congestion or blood permeability. This study investigates the effect of ischemia and congestion on the spinal cord using an in vivo model. The aorta was clamped as an ischemia model of the spinal cord and the inferior vena cava was clamped as a congestion model at the 6th costal level for 30 min using forceps transpleurally. Measurements of blood flow, partial oxygen pressure, and conduction velocity in the spinal cord were repeated over a period of 1 h after release of clamping. Finally, we examined the status of blood-spinal cord barrier under fluorescence and transmission electron microscope. Immediately after clamping of the inferior vena cava, the central venous pressure increased by about four times. Blood flow, oxygen tension and action potential were more severely affected by the aorta clamping; but this ischemic model did not show any changes of blood permeability in the spinal cord. The intramedullar edema was more easily produced by venous congestion than by arterial ischemia. In conclusions, venous congestion may be a preceding and essential factor of circulatory disturbance in the compressed spinal cord inducing myelopathy.

  3. Evaluation of Capiox FX05 oxygenator with an integrated arterial filter on trapping gaseous microemboli and pressure drop with open and closed purge line. (United States)

    Qiu, Feng; Peng, Sophia; Kunselman, Allen; Ündar, Akif


    Gaseous microemboli (GME) remain a challenge for cardiopulmonary bypass (CPB) because there is a positive correlation between microemboli exposure during CPB and postoperative neurological injury. Thus, minimizing the number of GME delivered to pediatric patients undergoing CPB procedures would lead to better clinical outcomes. In this study, we used a simulated CPB model to evaluate the effectiveness of capturing GME and the degree of membrane pressure drop for a new membrane oxygenator, Capiox Baby FX05 (Terumo Corporation,Tokyo, Japan), which has an integrated arterial filter with open and closed purge line.We used identical components in this study as our clinical CPB circuit. Three emboli detection and classification quantifier transducers were placed at prepump, preoxygenator, and postoxygenator sites in the circuit.Two flow probes as well as three pressure transducers were placed upstream and downstream of the oxygenator. The system was primed with human blood titrated to 30% hematocrit with Lactated Ringer’s solution.A bolus of air (1 mL) was injected in the prepump site under nonpulsatile perfusion mode at three flow rates (500,750, and 1000 mL/min) and with the purge line either open or closed. Six trials were performed for each unique set-up for a total of 36 trials.All trials were conducted at 35°C. The circuit pressure was kept constant at 100 mm Hg. Both the size and quantity of microemboli detected at postoxygenator site were recorded for 5 min postair injection. It was found that total counts of GME were significantly reduced with the purge line open when compared to keeping the purge line closed (P purge line closed compared to keeping the purge line open at flow rates of 750 mL/min and 1000 mL/min (P purge line open and closed, which is due to the small arteriovenous (A-V) shunt(P < 0.001). These results suggest that the integrated arterial filter of the Capiox FX05 oxygenator significantly improves the capturing of GME but has little impact on

  4. Effect of Mild Hypercapnia on Lung Oxygenation in Sitting Position During Shoulder Arthroscopy Under General Anesthesia (United States)

    Kwak, Hyun Jeong; Lee, Ji Yeon; Lee, Jong Wha; Kim, Hong Soon; Hur, Ho Jin; Kim, Ji Young


    Background Mild hypercapnia is permitted during surgeries in sitting position under general anesthesia to maintain cerebral regional oxygen saturation (rSO2). However, since hypoventilation may cause gas exchange impairment, we evaluated effects of mild hypercapnia on lung oxygenation during shoulder arthroscopy in sitting position. Material/Methods Forty patients were randomly allocated to a normocapnia group (ETCO2 35 mmHg, n=20) or a hypercapnia group (45 mmHg, n=20). The mean arterial pressure (MAP), heart rate (HR), and rSO2 were measured 5 min after intubation in supine position (T0), and at 2, 4, 6, 8, 10, 20, 30, 40, 50, and 60 min of remaining in sitting position (T1–10). Arterial blood gas was analyzed at T0 and T5. The oxygenation index (PaO2/FiO2) and dead-space ventilation ratio (Vd/Vt) were calculated. Results There were no differences in PaO2/FiO2 at T0 and T5 between the 2 groups. At T5, the Vd/Vt was higher in the normocapnia group than in the hypercapnia group (p=0.04). The Vd/Vt at T5 increased from T0 in the normocapnia group. The incidence of cerebral desaturation in the hypercapnia group (0/20) was lower than in the normocapnia group (5/20) (p=0.047). Among rSO2, MAP, and HR, only changes in rSO2 over time between the 2 groups differed significantly (p=0.048). Conclusions Mild hypercapnia did not decrease lung oxygenation in sitting position, probably due to attenuation of the increase in dead-space ventilation ratio. Since hypercapnia maintained rSO2 without changes in oxygenation index and hemodynamic parameters, mild hypercapnia should be maintained during shoulder arthroscopy in sitting position under general anesthesia. PMID:28202896

  5. Comparing Heparin-Coated and Non-Coated Oxygenators on Renal Functions in Coronary Artery Bypass Surgery

    Directory of Open Access Journals (Sweden)

    Bektaş Battaloğlu


    Full Text Available Background: Renal damage and subsequent acute renal failure is one of the most important complications in patients who had cardiac surgery. Multicenter studies with thousands of patients which exposed the risk factors for acute renal failure has been published especially in the last decade. This study is designed for evaluation of heparin-coated and non-coated oxygenators on the renal functions. Methods: This study has been performed prospectively with 50 patients who had undergone coronary bypass surgery in our clinic from March 2006 to September 2006. The patients have been divided into two groups as non-coated oxygenators (n = 25, Group 1 used and heparin-coated oxygenators (n = 25, Group 2 used. Blood samples were collected at the preoperative, and at 1st, 24th and 96th postoperative hours. The demographic data were similar in two groups. Results: There was no early mortality in both groups. Operative and postoperative parameters were similar in both groups. There were no statistical differences between the evaluated parameters like BUN, creatinine, sodium, potassium, calcium, chloride, phosphorus, urine protein, creatinine clearence, urine sodium, urine calcium and urine chloride tests at preoperative period in both groups. We did not detect renal dysfunction in any patients. There are no statistical differences in the creatinine clearance in preoperative and postoperative periods in both groups. In group one, creatinin levels were lower than group two at 24 hours after surgery and these differences were statistically important in two groups. We found no significant difference between two groups regarding the other parameters for renal function during the postoperative period. Conclusion: In this study, there were not any significant difference between coated and non-coated oxygenators’ effects over renal functions of patients whose renal functions were normal preoperatively.

  6. Oxygenation and release of inflammatory mediators after off-pump compared with after on-pump coronary artery bypass surgery

    DEFF Research Database (Denmark)

    Rasmussen, B.S.; Laugesen, Helle; Sollid, J.


    the use of CPB (OPCAB) would affect post-operative oxygenation and release of inflammatory mediators less compared with CABG. Methods: Low-risk patients scheduled for elective coronary revascularization were randomly assigned to one of two groups (CABG, n = 17 or OPCAB, n = 18). Two parameters...... of oxygenation, shunt (%) and ventilation-perfusions mismatch, described as ΔPO2 (kPa), were estimated for up to 5 days post-operatively. Systemic release of interleukin (IL)-6, -8 and -10, C-reactive protein (CRP) and neutrophils were measured in peripheral blood samples for up to 3 days post......-operatively. The lungs participation in the cytokine response was evaluated from mixed venous blood samples taken within the first 16 h post-operatively. Results: OPCAB was followed by a higher shunt (P = 0.047), with no difference (P = 0.47) in the deterioration of ΔPO2 between the groups. OPCAB was followed...

  7. Heart rate is associated with markers of fatty acid desaturation: the GOCADAN study

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    Sven O.E. Ebbesson


    Full Text Available Objectives: To determine if heart rate (HR is associated with desaturation indexes as HR is associated with arrhythmia and sudden death. Study design: A community based cross-sectional study of 1214 Alaskan Inuit. Methods: Data of FA concentrations from plasma and red blood cell membranes from those ≥35 years of age (n = 819 were compared to basal HR at the time of examination. Multiple linear regression with backward stepwise selection was employed to analyze the effect of the desaturase indexes on HR, after adjustment for relevant covariates. Results: The Δ5 desaturase index (Δ5-DI measured in serum has recently been associated with a protective role for cardiovascular disease. This index measured here in plasma and red blood cells showed a negative correlation with HR. The plasma stearoyl-CoA-desaturase (SCD index, previously determined to be related to cardiovascular disease (CVD mortality, on the other hand, was positively associated with HR, while the Δ6 desaturase index (Δ6-DI had no significant effect on HR. Conclusion: Endogenous FA desaturation is associated with HR and thereby, in the case of SCD, possibly with arrhythmia and sudden death, which would at least partially explain the previously observed association between cardiovascular mortality and desaturase activity.

  8. Desaturation Maneuvers and Precise Orbit Determination for the BepiColombo Mission

    CERN Document Server

    Alessi, Elisa Maria; Milani, Andrea; Tommei, Giacomo


    The purpose of this work is the analysis of the consequences that desaturation maneuvers can have in the precise orbit determination corresponding to the Radio Science Experiment (MORE) of the BepiColombo mission to Mercury. This mission is an ESA/JAXA joint project with very challenging objectives regarding geodesy, geophysics and fundamental physics. In the neighborhood of Mercury, the s/c will experience strong solar radiation pressure torques; the s/c attitude is controlled by inertial wheels that after some time reach their maximum rotation state. Then they have to be slowed down by means of thruster pulses, inducing a residual acceleration on the s/c, with a desaturation (or off-loading) maneuver. In this paper, we will show how such maneuvers affect the orbit of the s/c and the radio science measurements and, also, how to include them in the orbit determination and parameter estimation procedure. The non linear least squares fit we consider is applied on a set of observational arcs separated by interva...

  9. Inhibition of fatty acid desaturation in sycamore cells deprived of iron. (United States)

    Pascal, N; Dorne, A J


    The growth of isolated sycamore cells in a medium devoid of iron induced a marked reduction of the unsaturation level of fatty acids: the proportion of linolenic acid (C18:3) in polar lipids (phospholipids and galactolipids) decreased whereas a parallel increase in the proportions of oleic (C18:1) and linoleic (C18:2) acid was observed. In our experimental conditions, no direct effect of iron deprivation on fatty acid and glycerolipid biosynthesis could be observed. When sycamore cells were incubated in the presence of [14C]acetate, the level of unsaturation in fatty acids was very strongly reduced: no polyunsaturated fatty acids were synthesized in iron-deprived cells: only [14C]palmitic and [14C]oleic acids accumulated in glycerolipids. In contrast, sycamore cells grown in an iron-containing medium in the presence of [14C]acetate were able to synthesize glycerolipids containing 14C-labelled C18:2 and C18:3. We concluded that, in sycamore cells, iron is essential for C18:1-->C18:2-->C18:3 desaturations. In contrast, C18:0-->C18:1 desaturation is much less sensitive to iron deprivation under our experimental conditions.

  10. Oxygen-Sensitive Calcium Channels in Vascular Smooth Muscle and Their Possible Role in Hypoxic Arterial Relaxation (United States)

    Franco-Obregon, A.; Urena, J.; Lopez-Barneo, J.


    We have investigated the modifications of cytosolic [Ca2+] and the activity of Ca2+ channels in freshly dispersed arterial myocytes to test whether lowering O_2 tension (PO_2) directly influences Ca2+ homeostasis in these cells. Unclamped cells loaded with fura-2 AM exhibit oscillations of cytosolic Ca2+ whose frequency depends on extracellular Ca2+ influx. Switching from a PO_2 of 150 to 20 mmHg leads to a reversible attenuation of the Ca2+ oscillations. In voltage-clamped cells, hypoxia reversibly reduces the influx of Ca2+ through voltage-dependent channels, which can account for the inhibition of the Ca2+ oscillations. Low PO_2 selectively inhibits L-type Ca2+ channel activity, whereas the current mediated by T-type channels is unaltered by hypoxia. The effect of low PO_2 on the L-type channels is markedly voltage dependent, being more apparent with moderate depolarizations. These findings demonstrate the existence of O_2-sensitive, voltage-dependent, Ca2+ channels in vascular smooth muscle that may critically contribute to the local regulation of circulation.

  11. Comparison of the effectiveness of oral sildenafil versus oxygen administration as a test for feasibility of operation for patients with secondary pulmonary arterial hypertension. (United States)

    Ajami, Gholam Hossein; Borzoee, Mohammad; Radvar, Mohammad; Amoozgar, Hamid


    It is shown that phosphodiesterase type 5 (PDE5) inhibitors such as sildenafil can modulate pulmonary arterial hypertension (PAH) via increasing the level of guanosine-3,5-cyclic monophosphate (cGMP) and decreases pulmonary artery pressure (PAP). In this study we determined the effectiveness of sildenafil and compared its efficacy with inhaled nasal oxygen (O2) during cardiac catheterization in patients with congenital heart diseases (CHD) and PAH, as a test of feasibility for surgical repair of the patients. We studied 15 patients, 9 male and 6 female, with a mean age of 8.3 years. Hemodynamic measurements were made at baseline, after O2 administration for 20 min (5 L/min by mask), and then 45 min after administration of a single dose of sildenafil (0.5 mg/kg orally or via nasogastric tube). Mean PAP at baseline was 72.2 +/- 12.54 mm Hg and was reduced by sildenafil to 52.5 +/- 9.6 and by O2 to 61.3 +/- 10.39. Both sildenafil and O2 decreased PAP effectively (p = 0.08 and p = 0.04, respectively). Pulmonary vascular resistance (PVR) was calculated for 12 patients, with a baseline level of 9.08 +/- 1.09 mm Hg . L(-1) . min, which was significantly decreased by O2, to 3.74 +/- 0.43, and by sildenafil, to 5.93 +/- 0.75 (p = 0.005 and p = 0.05, respectively). Sildenafil, as a single oral dose, can effectively reduce PAP and PVR. This novel PDE5 inhibitor can be used for assessment of feasibility of operation for patients with CHD and PAH when inhaled NO is not available.

  12. Pulsatile compared with nonpulsatile perfusion using a centrifugal pump for cardiopulmonary bypass during coronary artery bypass grafting. Effects on systemic haemodynamics, oxygenation, and inflammatory response parameters. (United States)

    Driessen, J J; Dhaese, H; Fransen, G; Verrelst, P; Rondelez, L; Gevaert, L; van Becelaere, M; Schelstraete, E


    The present study investigated the influence of pulsatile or nonpulsatile flow delivery with a centrifugal pump for cardiopulmonary bypass (CPB) during coronary artery bypass grafting (CABG) in two randomized groups of 19 patients each. All patients received a standard anaesthetic and surgical protocol. Pulsatile perfusion during CPB was created by accelerating the baseline pump speed of the Sarns centrifugal pump at a rate of 50 cycles per minute. Measurements included perioperative systemic haemodynamics and oxygen exchange, total haemolytic complement (CH50), polymorphonuclear (neutrophil) granulocyte (PMN) count and plasma granulocyte elastase bound to alpha 1-proteinase inhibitor (E-alpha 1-PI). Laboratory measurements were corrected for haemodilution. During and after CPB there were only a few significant differences between the groups in systemic haemodynamics and oxygenation, i.e. a lower mean arterial blood pressure after the end of CPB in the nonpulsatile group (65 mmHg, SD = 11 vs 76 mmHg, SD = 11) and a lower SvO2 during rewarming on CPB in the nonpulsatile group (62%, SD = 8 vs 67%, SD = 8). The decrease in percentage of PMNs in the total white blood cell count during CPB was greater in the nonpulsatile group than in the pulsatile group (from 61 to 46% vs 63 to 53% of prebypass value). The steep increase of PMN count at the end of CPB and postoperatively was comparable in both groups. The maximal decrease of CH50 levels, occurring after surgery, was significantly higher in the nonpulsatile group (70% SD = 15 vs 79%, SD = 16, of baseline value), suggesting a greater complement activation. E-alpha 1-PI levels increased significantly in both groups during and after CPB with higher peak levels, obtained at one hour after admission to an intensive care unit, in the nonpulsatile group (316 micrograms/l, SD = 102) than in the pulsatile group (247 micrograms/l, SD = 106). There was a partly inverse correlation between the peak postoperative elastase levels and

  13. Short-term mechanical circulatory support by veno-arterial extracorporeal membrane oxygenation in the management of cardiogenic shock and end-stage heart failure. (United States)

    Brugts, Jasper J; Caliskan, Kadir


    Despite modern treatment modalities, cardiogenic shock is associated with a very high risk of mortality and morbidity. The short- and long-term survival in patients with cardiogenic shock or end-stage heart failure has improved considerably by recent technological advances in short and long-term mechanical circulatory support devices. For short-term mechanical support, veno-arterial extracorporeal membrane oxygenation (VA-ECMO) has been increasingly used as bridge-to-decision and bridge-to-recovery in cardiogenic shock patients. Long-term mechanical circulatory support devices such as left ventricular assist devices (LVADs) are widely available and play a central role in bridge-to-transplantation in those eligible for heart transplantation (HTX) and as destination therapy (DT) in those not eligible for heart transplantation. Nevertheless, patients with critical cardiogenic shock show a deleterious outcome after LVAD-implantation or HTX with higher mortality, more complications and higher burden on financial resources. These considerations underscore the importance of optimal timing and appropriate patient selection for eventual LVAD therapy. The current report will focus on the immediate management of patients with cardiogenic shock with inotropes, discuss the use of IABP and focus mainly on pivotal choices to be made in the period spanned by short term mechanical circulatory support in patients with refractory cardiogenic shock.

  14. Vascular Steal Explains Early Paradoxical Blood Oxygen Level-Dependent Cerebrovascular Response in Brain Regions with Delayed Arterial Transit Times

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    Julien Poublanc


    Full Text Available Introduction: Blood oxygen level-dependent (BOLD magnetic resonance imaging (MRI during manipulation of inhaled carbon dioxide (CO2 can be used to measure cerebrovascular reactivity (CVR and map regions of exhausted cerebrovascular reserve. These regions exhibit a reduced or negative BOLD response to inhaled CO2. In this study, we sought to clarify the mechanism behind the negative BOLD response by investigating its time delay (TD. Dynamic susceptibility contrast (DSC MRI with the injection of a contrast agent was used as the gold standard in order to provide measurement of the blood arrival time to which CVR TD could be compared. We hypothesize that if negative BOLD responses are the result of a steal phenomenon, they should be synchronized with positive BOLD responses from healthy brain tissue, even though the blood arrival time would be delayed. Methods: On a 3-tesla MRI system, BOLD CVR and DSC images were collected in a group of 19 patients with steno-occlusive cerebrovascular disease. For each patient, we generated a CVR magnitude map by regressing the BOLD signal with the end-tidal partial pressure of CO2 (PETCO2, and a CVR TD map by extracting the time of maximum cross-correlation between the BOLD signal and PETCO2. In addition, a blood arrival time map was generated by fitting the DSC signal with a gamma variate function. ROI masks corresponding to varying degrees of reactivity were constructed. Within these masks, the mean CVR magnitude, CVR TD and DSC blood arrival time were extracted and averaged over the 19 patients. CVR magnitude and CVR TD were then plotted against DSC blood arrival time. Results: The results show that CVR magnitude is highly correlated to DSC blood arrival time. As expected, the most compromised tissues with the longest blood arrival time have the lowest (most negative CVR magnitude. However, CVR TD shows a noncontinuous relationship with DSC blood arrival time. CVR TD is well correlated to DSC blood arrival time

  15. Sex pheromone biosynthesis in the processionary moth Thaumetopoea pityocampa by delta-13 desaturation. (United States)

    Arsequell, G; Fabriàs, G; Camps, F


    In vivo treatments of female sex pheromone glands of the processionary moth, Thaumetopoea pityocampa, with mass-labeled fatty acids showed that (Z)-13-hexadecen-11-ynyl acetate, the main sex pheromone component, is biosynthesized from palmitic acid by the combined action of delta-11 and delta-13 desaturases. The involvement of this unusual delta-13 has been proven by application of [16,16,16-2H3] [1,2-13C2]-hexadecanoic acid to the glands with a resultant incorporation of all labeled atoms into the pheromone and each one of the corresponding intermediates. These results seem to exclude alternative biosynthetic pathways, such as chain shortening and elongation combined with delta-11 desaturation. The delta-11 desaturase responsible for the formation of the triple bond in both the 11-hexadecynoyl and (Z)-13-hexadecen-11-ynoyl intermediates is also an unusual enzyme not previously reported in lepidopteran sex pheromone biosynthesis.

  16. Effect of oxygen breathing and perfluorocarbon emulsion treatment on air bubbles in adipose tissue during decompression sickness

    DEFF Research Database (Denmark)

    Randsoe, T; Hyldegaard, O


    for nitrogen causing faster nitrogen tissue desaturation. In anesthetized rats decompressed from a 60-min hyperbaric exposure breathing air at 385 kPa, we visually followed the resolution of micro-air bubbles injected into abdominal adipose tissue while the rats breathed either air, oxygen, or oxygen breathing...

  17. Usefulness of the 6-minute walk test as a screening test for pulmonary arterial enlargement in COPD

    Directory of Open Access Journals (Sweden)

    Oki Y


    Full Text Available Yutaro Oki,1,2 Masahiro Kaneko,3 Yukari Fujimoto,1 Hideki Sakai,2 Shogo Misu,1,2 Yuji Mitani,1,4 Takumi Yamaguchi,1,2 Hisafumi Yasuda,1 Akira Ishikawa1 1Department of Community Health Sciences, Kobe University Graduate School of Health Sciences, 2Department of Rehabilitation, 3Department of Respiratory Medicine, Kobe City Medical Center West Hospital, Kobe, 4Department of Rehabilitation, Sapporo Nishimaruyama Hospital, Sapporo, Japan Purpose: Pulmonary hypertension and exercise-induced oxygen desaturation (EID influence acute exacerbation of COPD. Computed tomography (CT-detected pulmonary artery (PA enlargement is independently associated with acute COPD exacerbations. Associations between PA to aorta (PA:A ratio and EID in patients with COPD have not been reported. We hypothesized that the PA:A ratio correlated with EID and that results of the 6-minute walk test (6MWT would be useful for predicting the risk associated with PA:A >1.Patients and methods: We retrospectively measured lung function, 6MWT, emphysema area, and PA enlargement on CT in 64 patients with COPD. The patients were classified into groups with PA:A ≤1 and >1. Receiver-operating characteristic curves were used to determine the threshold values with the best cutoff points to predict patients with PA:A >1.Results: The PA:A >1 group had lower forced expiratory volume in 1 second (FEV1, forced vital capacity (FVC, FEV1:FVC ratio, diffusion capacity of lung carbon monoxide, 6MW distance, and baseline peripheral oxygen saturation (SpO2, lowest SpO2, highest modified Borg scale results, percentage low-attenuation area, and history of acute COPD exacerbations ≤1 year, and worse BODE (Body mass index, airflow Obstruction, Dyspnea, and Exercise index results (P<0.05. Predicted PA:A >1 was determined for SpO2 during 6MWT (best cutoff point 89%, area under the curve 0.94, 95% confidence interval 0.88–1. SpO2 <90% during 6MWT showed a sensitivity of 93.1, specificity of 94

  18. Pre-treatment ferritin level and alveolar-arterial oxygen gradient can predict mortality rate due to acute/subacute interstitial pneumonia in dermatomyositis treated by cyclosporine a/glucocorticosteroid combination therapy: a case control study [corrected].

    Directory of Open Access Journals (Sweden)

    Kentaro Isoda

    Full Text Available BACKGROUND: Acute/subacute interstitial pneumonia in dermatomyositis (DM-A/SIP is a disease associated with a poor prognosis that resists treatment with glucocorticosteroids (GC and progresses rapidly in a period of weeks to months to death. We retrospectively studied outcomes, prognostic factors, and their relations with survival rate in patients with DM-A/SIP treated with early cyclosporine A (CSA/GC combination therapy and 2-hour postdose blood concentration monitoring. METHODS: This study comprised 32 DM-A/SIP patients who were simultaneously treated with CSA and prednisolone. Clinical and laboratory findings were compared between those who died due to DM-A/SIP and those surviving 24 weeks after beginning of therapy. Prognostic factors were extracted, and their relations with the survival rate were evaluated. RESULTS: Of the 32 DM-A/SIP patients, 25 survived, 5 died of DM-A/SIP, and 2 died of infections. In those who died due to DM-A/SIP, ferritin level and the alveolar-arterial oxygen gradient were significantly increased compared with the survivors (P<0.001 and P = 0.002, respectively. Multivariate analyses showed that ferritin and alveolar-arterial oxygen gradient were independent prognostic factors of poor outcome. The survival rate 24 weeks after beginning of treatment was significantly lower in those with a ferritin level of ≥ 600 ng/ml and alveolar-arterial oxygen gradient of ≥ 45 Torr (P<0.001 and P<0.001, respectively. All patients with both prognostic factors died, and the outcome was significantly poorer in these patients than in those with one or neither of the prognostic factors (P<0.001. CONCLUSIONS: We identified pre-treatment high serum ferritin level and high alveolar-arterial oxygen gradient as poor prognostic factors in DM-A/SIP patients undergoing early CSA/GC combination therapy and showed that the outcomes were poor in patients with both factors.


    Directory of Open Access Journals (Sweden)

    V. N. Poptsov


    Full Text Available Introduction. Acute antibody-mediated rejection (AMR is one of the severe complications of early and late period after heart transplantation (HT. Only few case reports and studies presented of mechanical circulatory support (MCS application for refractory acute rejection causing hemodynamic compromise. Aim. We report the case of a woman with cardiogenic shock caused by severe AMR that was successfully treatment by peripheral venoarterial extracorporeal membrane oxygenation (VA ECMO. Material and methods. In december 2014, a 60-year-old woman with dilated cardiomyopathy was operated for HT. The patient had a good initial cardiac allograft function and no and was discharged from ICU on the 4th day after HT. 1st endomyocardial biopsy (EMB (the 7th day after HT showed absence of acute cellular and antibody-mediated rejection. On the 11th day after HT patient aggravated and presented clinical signs of life-threatening acute cardiac allograft dysfunction: arterial blood pressure 78/49/38 mm Hg, HR 111 in min, CVP 20 mm Hg, PAP 47/34/25 mm Hg, PCWP 25 mm Hg, CI 1.5 l/min/m2, adrenalin 110 ng/kg/min, dopamine 15 mcg/kg/min. ECG showed impairment of systolic left (LVEF 25% and right (RVEF 15% ventricle function, left and right ventricle diffuse hypokinesis, thickness of IVS, LV and RV wall 1.7, 1.4 and 0.8 cm, tricuspid and mitral valve regurgitation 2–3 degrees. EMB presented AMR. In conscience peripheral VA ECMO was installed. We used peripheral transcutaneous cannulation technique via femoral vessels – arterial cannula 15 F, venous cannula – 23 F, vascular catheter 14 G for anterograde leg’s perfusion. ACT 130–150 sec. AMR therapy included: methylprednisolon pulse-therapy (10 mg/kg for 5 day, IgG, plasmapheresis (No 7, rituximab. Results. Under MCS by VA ECMO we noted quick improvement of hemodynamic, metabolic homeostasis and organ functions. On the 6th day of VA ECMO (blood flow 1.8 l/min: arterial blood pressure 133/81/54 mm Hg, CVP 5 mm

  20. Effect of desaturation and re-saturation on shale in underground galleries; Effets de la desaturation et de la resaturation sur l'argilite dans les ouvrages souterrains

    Energy Technology Data Exchange (ETDEWEB)

    Pham, Q.T


    The aim of this thesis is to characterize by experimental and numerical approaches the hydric, mechanical and hydro-mechanical effects due to the desaturation and re-saturation of the Eastern argillite, host rock of the Bure site, future underground radioactive waste disposal facility. Experimental and numerical approaches for the characterization of hydric transfers in argilites are presented. A simple identification method is proposed which uses the determination of the linearized hydric diffusivity from weight measurements performed on samples (thin tubes and plates) submitted to humidity steps according to a desaturation-re-saturation cycle. The hydric transfer is nonlinear. In order to interpret this phenomenon, a non-linear numerical model is established which takes into account the physical phenomena (hydraulic conduction, vapor diffusion, phase change..). The evolution of the physical and mechanical behaviour of the argillaceous rock with respect to the imposed humidity is then analyzed according to a desaturation-re-saturation cycle by successive steps. The hydric deformation, the velocity of ultrasonic waves propagation, the elastic properties, the rupture characteristics and the delayed phenomena depend on the hydric state of the material. The desaturation and re-saturation influence on a scale model of tunnel is analyzed. Thick tubes parallel or perpendicular to the stratification are used to show up the anisotropy of the rock. These tubes are submitted to hydric loads by blowing air with variable hygrometry through their center hole. A nonlinear poro-elastic model is used to interpret the anisotropic hydro-mechanical phenomena observed. It is shown that hydric loads can lead to the rupture of test samples which follow the anisotropic directions of the rock and which can be interpreted by the hydro-mechanical model as a violation of a rupture criterion in total pulling stress. Finally, numerical calculations for the phenomena generated by desaturation

  1. Blood-Oxygenation-Level-Dependent-(BOLD- Based R2′ MRI Study in Monkey Model of Reversible Middle Cerebral Artery Occlusion

    Directory of Open Access Journals (Sweden)

    Jing Zhang


    Full Text Available Objective. To investigate the value of BOLD-based reversible transverse relaxation rate (R2′ MRI in detecting ischemic penumbra (IP in a monkey model of reversible middle cerebral artery occlusion (MCAO and time evolution of relative R2′ (rR2′ in infarcted core, IP, and oligemia. Materials and Methods. 6 monkeys were used to make MCAO by the microcatheter method. MR scans were performed at 0 h (1 h after MCAO, 1 h, 3 h, 6 h, 12 h, 24 h, and 48 h after reperfusion. R2′ was calculated using quantitative T2 and T2∗ maps. Ischemic area was subdivided into infracted core, IP and oligemia. rR2′ was calculated respectively. Results. Reversible MCAO model for 4/6 monkeys was made successfully. rR2′ values were significantly different at each time point, being highest in oligemia followed by IP and infarcted core (<.05. With reperfusion time evolution, rR2′ in infarcted core showed a decreased trend: sharply decreased within 6 hours and maintained at 0 during 6–48 hours (<.05. rR2′ values in IP and oligemia showed similar increased trend: sharply increased within 6 hours, maintained a plateau during 6–24 hours, and slightly increased until 48 hours. Conclusion. BOLD-based R2′ MRI can be used to describe changes of cerebral oxygen extract in acute ischemic stroke, and it can provide additional information in detecting IP. The time evolution rR2′ in infarcted core, IP, and oligemia is in accordance with the underlying pathophysiology.

  2. Theoretical analysis of oxygen supply to contracted skeletal muscle. (United States)

    Groebe, K; Thews, G


    Honig and collaborators reported striking contradictions in current understanding of O2 supply to working skeletal muscle. Therefore we re-examined the problem by means of a new composite computer simulation. As inclusion of erythrocytic O2 desaturation and oxygen transport and consumption inside the muscle cell into a single model would entail immense numerical difficulties, we broke up the whole process into its several components: O2 desaturation of erythrocytes O2 transport and consumption in muscle fiber capillary transit time characterizing the period of contact between red cell and muscle fiber. "Erythrocyte model" as well as "muscle fiber model" both consist of a central core cylinder surrounded by a concentric diffusion layer representing the extracellular resistance to O2 diffusion (Fig. 1). Resistance layers in both models are to be conceived of as one and the same anatomical structure--even though in each model their shape is adapted to the respective geometry. By means of this overlap region a spatial connexion between both is given, whereas temporal coherence governing O2 fluxes and red cell spacing is derived from capillary transit time. Analysis of individual components is outlined as follows: Assuming axial symmetry of the problem a numerical algorithm was employed to solve the parabolic system of partial differential equations describing red cell O2 desaturation. Hb-O2 reaction kinetics, free and facilitated O2 diffusion in axial and radial directions, and red cell movement in capillary were considered. Resulting time courses of desaturation, which are considerably faster than the ones computed by Honig et al., are given in the following table (see also Fig. 3). (Formula: see text) Furthermore, we studied the respective importance of the several processes included in our model: Omission of longitudinal diffusion increased desaturation time by 15% to 23%, whereas effects of reaction kinetics and axial movement were 5% and 2% respectively. For time

  3. Oxygen therapy reduces postoperative tachycardia

    DEFF Research Database (Denmark)

    Stausholm, K; Kehlet, H; Rosenberg, J


    Concomitant hypoxaemia and tachycardia in the postoperative period is unfavourable for the myocardium. Since hypoxaemia per se may be involved in the pathogenesis of postoperative tachycardia, we have studied the effect of oxygen therapy on tachycardia in 12 patients randomly allocated to blinded...... air or oxygen by facemask on the second or third day after major surgery. Inclusion criteria were arterial hypoxaemia (oxygen saturation 90 beat.min-1). Each patient responded similarly to oxygen therapy: an increase in arterial oxygen saturation and a decrease...... in heart rate (p oxygen has a positive effect on the cardiac oxygen delivery and demand balance....

  4. Experimental study on nonmonotonicity of capillary desaturation curves in a 2-D pore-network

    Energy Technology Data Exchange (ETDEWEB)

    Rodriquez de Castro, Antonio [Univ. of Manchester (United Kingdom); Shokri, Nima [Univ. of Manchester (United Kingdom); Karadimitriou, Nikolaos [Univ. of Manchester (United Kingdom); Oostrom, Martinus [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Joekar-Niasar, Vahid [Univ. of Manchester (United Kingdom)


    Immiscible displacement in a porous medium is important in many applications such as soil remediation and enhanced oil recovery. When gravitational forces are negligible, two-phase immiscible displacement at the pore level is controlled by capillary and viscous forces whose relative importance is quantified through the dimensionless capillary number Ca and the viscosity ratio M between liquid phases. Depending on the values of Ca and M, capillary fingering, viscous fingering, or stable displacement may be observed resulting in a variety of patterns affecting the phase entrapment. The Capillary Desaturation Curve (CDC), which represents the relationship between the residual oils saturation and Ca, is an important relation to describe the phase entrapment at a given Ca. In the present study, we investigate the CDC as influenced by the viscosity ratio. A comprehensive series of experiments using a high-resolution microscope and state-of-the-art micromodels were conducted. The CDCs were calculated and the effects of Ca and M on phase entrapments were quantified. The results show that CDCs are not necessarily monotonic for all M.

  5. Carotenogenesis gene cluster and phytoene desaturase catalyzing both three- and four-step desaturations from Rhodobacter azotoformans. (United States)

    Zhang, Jinhua; Lu, Lili; Yin, Lijie; Xie, Shen; Xiao, Min


    A carotenogenesis gene cluster from the purple nonsulfur photosynthetic bacterium Rhodobacter azotoformans CGMCC 6086 was cloned. A total of eight carotenogenesis genes ( crtA , crtI , crtB , tspO , crtC , crtD , crtE , and crtF ) were located in two separate regions within the genome, a 4.9 kb region containing four clustered genes of crtAIB - tspO and a 5.3 kb region containing four clustered genes of crtCDEF . The organization was unusual for a carotenogenesis gene cluster in purple photosynthetic bacteria. A gene encoding phytoene desaturase ( CrtI ) from Rba. azotoformans was expressed in Escherichia coli. The recombinant CrtI could catalyze both three- and four-step desaturations of phytoene to produce neurosporene and lycopene, and the relative contents of neurosporene and lycopene formed by CrtI were approximately 23% and 75%, respectively. Even small amounts of five-step desaturated 3,4-didehydrolycopene could be produced by CrtI . This product pattern was novel because CrtI produced only neurosporene leading to spheroidene pathway in the cells of Rba. azotoformans. In the in vitro reaction, the relative content of lycopene in desaturated products increased from 19.6% to 62.5% when phytoene reduced from 2.6 to 0.13 μM. The results revealed that the product pattern of CrtI might be affected by the kinetics.

  6. [Anatomy and physiology of the heart and coronary arteries]. (United States)

    Leclercq, Florence


    The myocardium assures the supply of oxygen to the body. The provision of oxygen to the myocardium by the coronary arteries is dependent on two key parameters: the coronary blood flow and the ability to extract oxygen from the arterial blood. Coronary artery disease is almost always the consequence of atherosclerosis and can lead to myocardial infarction.

  7. Arterial hypoxaemia in cirrhosis

    DEFF Research Database (Denmark)

    Møller, S; Hillingsø, Jens; Christensen, E


    BACKGROUND: Although low arterial oxygen tension (Po2) has been claimed to occur in one to two thirds of patients with cirrhosis, hypoxaemia appears to be rare in clinical practice. AIMS: To assess the frequency of arterial hypoxaemia in cirrhosis in relation to clinical and haemodynamic......%, 96%, 96%, and 93% (NS). So2 was below the lower limit of 92% in 0%, 9%, 7%, and 24% (p arterial carbon dioxide tension, a low systemic vascular...... resistance, and a low indocyanine green clearance (p arterial hypoxaemia in cirrhosis is about 22% in patients without encephalopathy, but it varies from 10-40% depending on the degree of hepatic dysfunction. Arterial hypoxaemia in patients with cirrhosis of differing...

  8. [Transposition of Great Artery]. (United States)

    Konuma, Takeshi; Shimpo, Hideto


    Transposition of the great artery is one of common congenital cardiac disease resulting cyanosis. Death occurs easily in untreated patients with transposition and intact ventricular septal defect (VSD) in infancy at a few days of age when posterior descending coronary artery (PDA) closed. Since there are 2 parallel circulations, flow from pulmonary to systemic circulation is necessary for systemic oxygenation, and Balloon atrial septostomy or prostaglandin infusion should be performed especially if patient do not have VSD. Although the advent of fetal echocardiography, it is difficult to diagnose the transposition of the great arteries (TGA) as abnormality of great vessels is relatively undistinguishable. The diagnosis of transposition is in itself an indication for surgery, and arterial switch procedure is performed in the case the left ventricle pressure remains more than 2/3 of systemic pressure. Preoperative diagnosis is important as associated anomalies and coronary artery branching patterns are important to decide the operative indication and timing of surgery.

  9. Monitoring Cerebral Oxygenation in Neonates: An Update (United States)

    Dix, Laura Marie Louise; van Bel, Frank; Lemmers, Petra Maria Anna


    Cerebral oxygenation is not always reflected by systemic arterial oxygenation. Therefore, regional cerebral oxygen saturation (rScO2) monitoring with near-infrared spectroscopy (NIRS) is of added value in neonatal intensive care. rScO2 represents oxygen supply to the brain, while cerebral fractional tissue oxygen extraction, which is the ratio between rScO2 and systemic arterial oxygen saturation, reflects cerebral oxygen utilization. The balance between oxygen supply and utilization provides insight in neonatal cerebral (patho-)physiology. This review highlights the potential and limitations of cerebral oxygenation monitoring with NIRS in the neonatal intensive care unit. PMID:28352624

  10. Organ-Specific Alterations in Fatty Acid De Novo Synthesis and Desaturation in a Rat Model of Programmed Obesity

    Directory of Open Access Journals (Sweden)

    Desai Mina


    Full Text Available Abstract Background Small for gestational age (SGA leads to increased risk of adult obesity and metabolic syndrome. Offspring exposed to 50% maternal food restriction in utero are born smaller than Controls (FR, catch-up in growth by the end of the nursing period, and become obese adults. The objective of the study was to determine stearoyl-CoA desaturase activity (SCD1 and rates of de novo fatty acid synthesis in young FR and Control offspring tissues at the end of the nursing period, as possible contributors to catch-up growth. Methods From gestational day 10 to term, dams fed ad libitum (Control or were 50% food-restricted to produce small FR pups. Control dams nursed all pups. At postnatal day 1 (p1 and p21, offspring body tissues were analyzed by GC/MS, and desaturation indices of palmitoleate/palmitate and oleate/stearate were calculated. SCD1 gene expression was determined by real-time PCR on adipose and liver. Offspring were enriched with deuterium that was given to dams in drinking water during lactation and de novo synthesis of offspring body tissues was determined at p21. Primary adipocyte cell cultures were established at p21 and exposed to U13C-glucose. Results FR offspring exhibited higher desaturation index in p1 and p21 adipose tissue, but decreased desaturation index in liver at p21. SCD1 gene expression at p21 was correspondingly increased in adipose and decreased in liver. FR subcutaneous fat demonstrated increased de novo synthesis at p21. Primary cell cultures exhibited increased de novo synthesis in FR. Conclusions Adipose tissue is the first site to exhibit increased de novo synthesis and desaturase activity in FR. Therefore, abnormal lipogenesis is already present prior to onset of obesity during the period of catch-up growth. These abnormalities may contribute to future obesity development.

  11. What triggers the aerobic dive limit? Patterns of muscle oxygen depletion during dives of emperor penguins. (United States)

    Williams, Cassondra L; Meir, Jessica U; Ponganis, Paul J


    The physiological basis of the aerobic dive limit (ADL), the dive duration associated with the onset of post-dive blood lactate elevation, is hypothesized to be depletion of the muscle oxygen (O(2)) store. A dual wavelength near-infrared spectrophotometer was developed and used to measure myoglobin (Mb) O(2) saturation levels in the locomotory muscle during dives of emperor penguins (Aptenodytes forsteri). Two distinct patterns of muscle O(2) depletion were observed. Type A dives had a monotonic decline, and, in dives near the ADL, the muscle O(2) store was almost completely depleted. This pattern of Mb desaturation was consistent with lack of muscle blood flow and supports the hypothesis that the onset of post-dive blood lactate accumulation is secondary to muscle O(2) depletion during dives. The mean type A Mb desaturation rate allowed for calculation of a mean muscle O(2) consumption of 12.4 ml O(2) kg(-1) muscle min(-1), based on a Mb concentration of 6.4 g 100 g(-1) muscle. Type B desaturation patterns demonstrated a more gradual decline, often reaching a mid-dive plateau in Mb desaturation. This mid-dive plateau suggests maintenance of some muscle perfusion during these dives. At the end of type B dives, Mb desaturation rate increased and, in dives beyond the ADL, Mb saturation often reached near 0%. Thus, although different physiological strategies may be used during emperor penguin diving, both Mb desaturation patterns support the hypothesis that the onset of post-dive lactate accumulation is secondary to muscle O(2) store depletion.

  12. Automated frequency domain analysis of oxygen saturation as a screening tool for SAHS. (United States)

    Morillo, Daniel Sánchez; Gross, Nicole; León, Antonio; Crespo, Luis F


    Sleep apnea-hypopnea syndrome (SAHS) is significantly underdiagnosed and new screening systems are needed. The analysis of oxygen desaturation has been proposed as a screening method. However, when oxygen saturation (SpO(2)) is used as a standalone single channel device, algorithms working in time domain achieve either a high sensitivity or a high specificity, but not usually both. This limitation arises from the dependence of time-domain analysis on absolute SpO(2) values and the lack of standardized thresholds defined as pathological. The aim of this study is to assess the degree of concordance between SAHS screening using offline frequency domain processing of SpO(2) signals and the apnea-hypopnea index (AHI), and the diagnostic performance of such a new method. SpO(2) signals from 115 subjects were analyzed. Data were divided in a training data set (37) and a test set (78). Power spectral density was calculated and related to the desaturation index scored by physicians. A frequency desaturation index (FDI) was then estimated and its accuracy compared to the classical desaturation index and to the apnea-hypopnea index. The findings point to a high diagnostic agreement: the best sensitivity and specificity values obtained were 83.33% and 80.44%, respectively. Moreover, the proposed method does not rely on absolute SpO(2) values and is highly robust to artifacts.

  13. Fatty acid desaturation links germ cell loss to longevity through NHR-80/HNF4 in C. elegans.

    Directory of Open Access Journals (Sweden)

    Jérôme Goudeau


    Full Text Available BACKGROUND: Preventing germline stem cell proliferation extends lifespan in nematodes and flies. So far, studies on germline-longevity signaling have focused on daf-16/FOXO and daf-12/VDR. Here, we report on NHR-80/HNF4, a nuclear receptor that specifically mediates longevity induced by depletion of the germ line through a mechanism that implicates fatty acid monodesaturation. METHODS AND FINDINGS: nhr-80/HNF4 is induced in animals lacking a germ line and is specifically required for their extended longevity. Overexpressing nhr-80/HNF4 increases the lifespan of germline-less animals. This lifespan extension can occur in the absence of daf-16/FOXO but requires the presence of the nuclear receptor DAF-12/VDR. We show that the fatty acid desaturase, FAT-6/SCD1, is a key target of NHR-80/HNF4 and promotes germline-longevity by desaturating stearic acid to oleic acid (OA. We find that NHR-80/HNF4 and OA must work in concert to promote longevity. CONCLUSIONS: Taken together, our data indicate that the NHR-80 pathway participates in the mechanism of longevity extension through depletion of the germ line. We identify fat-6 and OA as essential downstream elements although other targets must also be present. Thus, NHR-80 links fatty acid desaturation to lifespan extension through germline ablation in a daf-16/FOXO independent manner.

  14. Fatty Acid Desaturation Links Germ Cell Loss to Longevity Through NHR-80/HNF4 in C. elegans (United States)

    Goudeau, Jérôme; Bellemin, Stéphanie; Toselli-Mollereau, Esther; Shamalnasab, Mehrnaz; Chen, Yiqun; Aguilaniu, Hugo


    Background Preventing germline stem cell proliferation extends lifespan in nematodes and flies. So far, studies on germline-longevity signaling have focused on daf-16/FOXO and daf-12/VDR. Here, we report on NHR-80/HNF4, a nuclear receptor that specifically mediates longevity induced by depletion of the germ line through a mechanism that implicates fatty acid monodesaturation. Methods and Findings nhr-80/HNF4 is induced in animals lacking a germ line and is specifically required for their extended longevity. Overexpressing nhr-80/HNF4 increases the lifespan of germline-less animals. This lifespan extension can occur in the absence of daf-16/FOXO but requires the presence of the nuclear receptor DAF-12/VDR. We show that the fatty acid desaturase, FAT-6/SCD1, is a key target of NHR-80/HNF4 and promotes germline-longevity by desaturating stearic acid to oleic acid (OA). We find that NHR-80/HNF4 and OA must work in concert to promote longevity. Conclusions Taken together, our data indicate that the NHR-80 pathway participates in the mechanism of longevity extension through depletion of the germ line. We identify fat-6 and OA as essential downstream elements although other targets must also be present. Thus, NHR-80 links fatty acid desaturation to lifespan extension through germline ablation in a daf-16/FOXO independent manner. PMID:21423649

  15. Changes In Arterial Hemoglobin Oxygen Saturation During Transport From the Operating Room to the Postanesthesia Care Unit In Healthy Patients Breathing Room Air (United States)


    Propafol ___ Ketamine __ Etomidate Other’ ______ _ Inhalational: Isoflurane ___ Halothane ___ Desflurane Sevoflurane Narcotics: ___ Fentanyl...This occurs because nitrous oxide is 31 times more soluble in blood than nitrogen. If nitrogen was more soluble in blood than nitrous oxide this would...lack of data on pat i ent oxygenation during postoperative transfer, explainable in part by the difficulty of measuring blood gases under s uch

  16. Position Paper: The Feasibility of Lowering Oxygen Concentrations Aboard Submarines in Order to Improve Fire Safety. (United States)


    of oxygen when reductions of alveolar P0 2 fail to drop arterial oxygen tension below 40 torr. Reductions of arterial oxygen tension to the steep...concentration of total bilirubin; Increased turnover of iron. 44,46,47 Blood gases Increased oxygen carrying capacity; Lower arterial oxy- gen tension ; No im...during the first few days of sudden exposure to aerohypoxia. A reduction of arterial oxygen tension must precede the symptoms of hypoxia (52) and many

  17. Non-conjugated cis/trans 18:2 in Beef Fat are Mainly Δ-9 Desaturation Products of trans-18:1 Isomers. (United States)

    Vahmani, P; Rolland, D C; Gzyl, K E; Dugan, M E R


    Human liver cells (HepG2) were cultured with individual trans (t) 18:1 including t6-, t12-, t13-, t14-, t15- and t16-18:1, and retention times of their Δ-9 desaturation products were determined using 100-m biscyanopropyl-polysiloxane and SLB-IL111 columns. Corresponding peaks were found in beef adipose tissues known to have different delta-9 desaturase activities. Further lines of evidence indicating the presence of Δ-9 desaturation products of t-18:1 isomers in beef fat were developed by analysis of fatty acid methyl esters (FAME) fractionated using Ag(+)-TLC, and by GC/MS. Some of the Δ-9 desaturation products of t-18:1 have been previously identified in ruminant fat (c9, t12- and c9, t13-18:2). Some of the Δ-9 desaturation products of t-18:1 (c9, t14- and c9, t15-18:2) have been previously tentatively identified as different fatty acids, and for the first time we provide evidence of the presence of c9, t16-18:2, and where t6, c9-18:2 may elute during analysis of FAME from beef fat.

  18. Comparison the Effects of Shallow and Deep Endotracheal Tube Suctioning on Respiratory Rate, Arterial Blood Oxygen Saturation and Number of Suctioning in Patients Hospitalized in the Intensive Care Unit: A Randomized Controlled Trial

    Directory of Open Access Journals (Sweden)

    Mohammad Abbasinia


    Full Text Available Introduction: Endotracheal tube suctioning is essential for improve oxygenation in the patients undergoing mechanical ventilation. There are two types of shallow and deep endotracheal tube suctioning. This study aimed to evaluate the effect of shallow and deep suctioning methods on respiratory rate (RR, arterial blood oxygen saturation (SpO2 and number of suctioning in patients hospitalized in the intensive care units of Al-Zahra Hospital, Isfahan, Iran. Methods: In this randomized controlled trial, 74 patients who hospitalized in the intensive care units of Isfahan Al-Zahra Hospital were randomly allocated to the shallow and deep suctioning groups. RR and SpO2 were measured immediately before, immediately after, 1 and 3 minute after each suctioning. Number of suctioning was also noted in each groups. Data were analyzed using repeated measures analysis of variance (RMANOVA, chi-square and independent t-tests. Results: RR was significantly increased and SpO2 was significantly decreased after each suctioning in the both groups. However, these changes were not significant between the two groups. The numbers of suctioning was significantly higher in the shallow suctioning group than in the deep suctioning group. Conclusion: Shallow and deep suctioning had a similar effect on RR and SpO2. However, shallow suctioning caused further manipulation of patient’s trachea than deep suctioning method. Therefore, it seems that deep endotracheal tube suctioning method can be used to clean the airway with lesser manipulation of the trachea.

  19. Desaturation and chain elongation of essential fatty acids in isolated liver cells from rat and rainbow trout

    Energy Technology Data Exchange (ETDEWEB)

    Hagve, T.A.; Christophersen, B.O.; Dannevig, B.H.


    Isolated hepatocytes from rainbow trout and rat were incubated with /sup 14/C-labeled linoleic acid, linolenic acid, dihomogammalinolenic acid or eicosapentaenoic acid. The most striking difference in the desaturase activity was the lower level of delta 5 desaturase in trout than in rat. No delta 4 desaturation of 22:4(n-6) to 22:5(n-6) was observed in either of the two species, while the conversion of 22:5(n-3) to 22:6(n-3) was significant in both groups and highest in rainbow trout. The chain-elongating activity was remarkably similar in the two species, except for the dead-end elongation which was distinctly more important in fish.

  20. Cardiac arrhythmias during fiberoptic bronchoscopy and relation with oxygen saturation

    Directory of Open Access Journals (Sweden)

    Hassan G


    Full Text Available To evaluate the occurrence of electrocardiographic abnormalities during fiberoptic bronchoscopy, in relation to specific stages of the procedures, patients′ age, sex, smoking, pre-existing lung disease, premedication and oxygen saturation, a prospective study was conducted on 56 patients aged 35 to 75 (mean 62 years without pre-existing cardiovascular disease. Patients were connected to a 12-lead computerized electrocardiographic recorder and pulse oximeter. Fall of oxygen saturation from mean of 95.12% before the procedure to below 80% was observed in 12 (21.4% patients and below 75% in 5 (8.9% patients, at various stages. Statistically highly significant (p < 0.001 fall of oxygen saturation was observed during the procedures while bronchoscope was introduced into the airways and tracheobronchial tree examined. Major disturbances of cardiac rhythm (i.e. atrial, ventricular or both developed in 23 (41.07% patients. Out of these, sinus tachycardia was noted in 16 (69.5%, ventricular premature complexes in 5 (21.7% and paroxysmal supraventricular tachycardia in 2 (8.6% patients. Arrhythmias were most frequent in association with periods of maximum oxygen desaturation in 18 (78.2% of these 23 patients. Oxygen desaturation persisted for more than half an hour in 38 (67.8% of the 56 patients. However, no correlation was observed between the frequency of arrhythmias during bronchoscopy and patients′ age, sex pre-medication or pre-existing pulmonary disease.

  1. Acute arterial occlusion - kidney (United States)

    Acute renal arterial thrombosis; Renal artery embolism; Acute renal artery occlusion; Embolism - renal artery ... kidney can often result in permanent kidney failure. Acute arterial occlusion of the renal artery can occur after injury or trauma to ...

  2. Characterization of three novel desaturases involved in the delta-6 desaturation pathways for polyunsaturated fatty acid biosynthesis from Phytophthora infestans. (United States)

    Sun, Quanxi; Liu, Jiang; Zhang, Qin; Qing, Xiaohe; Dobson, Gary; Li, Xinzheng; Qi, Baoxiu


    Phytophthora infestans is the causative agent of potato blight that resulted in the great famine in Ireland in the nineteenth century. This microbe can release large amounts of the C20 very long-chain polyunsaturated fatty acids arachidonic acid (ARA; 20:4Δ(5, 8, 11, 14)) and eicosapentaenoic acid (EPA; 20:5Δ(5, 8, 11, 14, 17)) upon invasion that is known to elicit a hypersensitive response to their host plant. In order to identify enzymes responsible for the biosynthesis of these fatty acids, we blasted the recently fully sequenced P. infestans genome and identified three novel putatively encoding desaturase sequences. These were subsequently functionally characterized by expression in Saccharomyces cerevisiae and confirmed that they encode desaturases with Δ12, Δ6 and Δ5 activity, designated here as PinDes12, PinDes6 and PinDes5, respectively. This, together with the combined fatty acid profiles and a previously identified Δ6 elongase activity, implies that the ARA and EPA are biosynthesized predominantly via the Δ6 desaturation pathways in P. infestans. Elucidation of ARA and EPA biosynthetic mechanism may provide new routes to combating this potato blight microbe directly or by means of conferring resistance to important crops.

  3. CCAAT/enhancer-binding protein CEBP-2 controls fat consumption and fatty acid desaturation in Caenorhabditis elegans. (United States)

    Xu, Xiao-Ying; Hu, Jian-Ping; Wu, Meng-Meng; Wang, Li-Shun; Fang, Ning-Yuan

    Mammalian CCAAT/enhancer-binding proteins (C/EBPs) are generally known as regulators in adipocyte differentiation. However, more understanding of the role of C/EBPs in lipid and glucose metabolism remains to be discovered. In this study, we verified the effect of CEBP-2, the homolog of CEBPs, on fat storage in Caenorhabditis elegans. Expressions of 85 genes that encode the major enzymes in energy metabolic pathways were then screened in cebp-2-deficient worms using a quantitative real-time polymerase chain reaction (QRT-PCR). Our data implied that loss of function of CEBP-2 displayed a low-fat phenotype in C. elegans owing to increased expression of ech-1.1 and decreased expression of fat-5. Our findings indicated that cebp-2 controls total body fat content by governing fatty acid mitochondrial β-oxidation and desaturation in C. elegans. These data provide insights into how C/EBPs may affect lipid metabolism in mammals in addition to regulating adipocyte differentiation.

  4. Effect of epidural blockade and oxygen therapy on changes in subcutaneous oxygen tension after abdominal surgery

    DEFF Research Database (Denmark)

    Rosenberg, J; Pedersen, U; Erichsen, C J


    oxygen tension, arterial oxygen saturation, heart rate, and skin temperature on the day after operation, and arterial blood for gas analysis was drawn every 15 min during the study. A fluid challenge (10 ml saline/kg body wt) did not alter any of the measured values. The epidural blockade did not change...... any of the measured values. Oxygen therapy before epidural blockade increased median subcutaneous oxygen tension from 60 to 71 mmHg (P tension with oxygen therapy was 30 (15-55) min...... without epidural blockade and 15 (10-20) min with blockade (P tension with or without oxygen therapy after elective uncomplicated major abdominal surgery....

  5. MAPA em portadores de DPOC com dessaturação no sono MAPA en portadores de EPOC con desaturación durante el sueño ABPM in COPD patients with sleep desaturation

    Directory of Open Access Journals (Sweden)

    Neila Anders Aidar


    Full Text Available FUNDAMENTO: A hipoxemia no período de sono pode, por mecanismo de ativação simpática, alterar a pressão arterial. Poucos estudos demonstram os parâmetros pressóricos em portadores de DPOC, que não têm apnéia do sono, mas que dessaturam nesse período. OBJETIVOS: Analisar os parâmetros pressóricos em pacientes com DPOC e dessaturação no sono, não causada por apnéia. MÉTODOS: Treze pacientes com DPOC foram submetidos à espirometria, gasometria arterial, polissonografia e MAPA para avaliação pressórica. Quatorze pacientes sem DPOC foram submetidos à espirometria, oximetria e MAPA. As análises pressóricas foram feitas tanto na vigília quanto no sono. Os dois grupos foram constituídos por pacientes sem antecedentes hipertensivos. RESULTADOS: Os dois grupos eram semelhantes em relação à idade, altura, peso e índice de massa corporal. Houve diferença significativa (p FUNDAMENTO: La hipoxemia en el período de sueño puede, por mecanismo de activación simpática, alterar la presión arterial. Pocos estudios demuestran los parámetros de presión en portadores de EPOC, que no tiene apnea del sueño, y que desaturan en ese período. OBJETIVO: Analizar los parámetros de presión en pacientes con EPOC y desaturación en el sueño, no causada por apnea. MÉTODOS: Trece pacientes con EPOC se sometieron a la espirometría, la gasometría arterial, la polisonografía y al MAPA para la evaluación de presión. Un total de 14 pacientes sin EPOC se sometieron a la espirometría, la oximetría y MAPA. Los análisis de presión se hicieron tanto en la vigilia como en el sueño. Los dos grupos estaban conformados por pacientes sin antecedentes hipertensivos. RESULTADOS: Los dos grupos se asemejaban respecto a la edad, la altura, el peso e el índice de masa corporal. Hubo diferencia significativa (p BACKGROUND: Sleep hypoxemia may change blood pressure by sympathetic activation. Few studies have analyzed blood pressure parameters in

  6. 20 CFR 718.105 - Arterial blood-gas studies. (United States)


    ... gas exchange. This defect will manifest itself primarily as a fall in arterial oxygen tension either... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Arterial blood-gas studies. 718.105 Section... DEATH DUE TO PNEUMOCONIOSIS Criteria for the Development of Medical Evidence § 718.105 Arterial...

  7. Oxygen Therapy (United States)

    Oxygen therapy is a treatment that provides you with extra oxygen. Oxygen is a gas that your body needs to function. Normally, your lungs absorb oxygen from the air you breathe. But some conditions ...

  8. Nocturnal myocardial ischemic events and sleep-disordered breathing in patients with coronary artery disease

    Institute of Scientific and Technical Information of China (English)

    Wenli ZHANG; Shiwen WANG; Caiyi LU; Peng LIU; Rui CHEN; Xian JI; Yusheng ZHAO


    Objective To investigate the occurrence of nocturnal myocardial ischemia and its relationship with sleep-disordered breathing (apneas and oxygen desaturations) in patients with angina pectoris undergoing coronary angiography.Methods Eighty-two men and 14 women referred for consideration of coronary intervention were randomly selected. Observation by an overnight sleep monitor and Holter recording were performed to study sleep-disordered breathing (oxyhemoglobin desaturations≥4% and apnea-hypopneas),heart rates, and ST-segment depressions (≥ 1mm, ≥1 min).Results Nocturnal ST-segment depressions occurred in 37 % of the patients. ST-segment depression within 2 min after an apnea-hypopnea or desaturation occurred in 17% of the patients. This temporal association was seen in 21% of the patients with nocturnal ST-segment depressions, more frequently in men (P<0.05) and more frequently in those with severe disordered breathing (P<0.05).Most of these ST-segment depressions were preceded by a series of breathing events: repeated apnea-hypopneas or desaturations or both in 73% of the patients. Conclusions Episodes of nocturnal myocardial ischemia are common in patients with angina pectoris. A temporal relationship between sleep-disordered breathing and myocardial ischemia was present in some of our patients, and occurs more frequently in men and in those with severely disordered breathing. (J Geriatr Cardiol 2004;1(2):90-94.)

  9. Extracorporeal membrane oxygenation circuitry. (United States)

    Lequier, Laurance; Horton, Stephen B; McMullan, D Michael; Bartlett, Robert H


    The extracorporeal membrane oxygenation circuit is made of a number of components that have been customized to provide adequate tissue oxygen delivery in patients with severe cardiac and/or respiratory failure for a prolonged period of time (days to weeks). A standard extracorporeal membrane oxygenation circuit consists of a mechanical blood pump, gas-exchange device, and a heat exchanger all connected together with circuit tubing. Extracorporeal membrane oxygenation circuits can vary from simple to complex and may include a variety of blood flow and pressure monitors, continuous oxyhemoglobin saturation monitors, circuit access sites, and a bridge connecting the venous access and arterial infusion limbs of the circuit. Significant technical advancements have been made in the equipment available for short- and long-term extracorporeal membrane oxygenation applications. Contemporary extracorporeal membrane oxygenation circuits have greater biocompatibility and allow for more prolonged cardiopulmonary support time while minimizing the procedure-related complications of bleeding, thrombosis, and other physiologic derangements, which were so common with the early application of extracorporeal membrane oxygenation. Modern era extracorporeal membrane oxygenation circuitry and components are simpler, safer, more compact, and can be used across a wide variety of patient sizes from neonates to adults.

  10. Carotid artery surgery (United States)

    Carotid endarterectomy; CAS surgery; Carotid artery stenosis - surgery; Endarterectomy - carotid artery ... through the catheter around the blocked area during surgery. Your carotid artery is opened. The surgeon removes ...

  11. General Anesthesia Combined With Epidural Anesthesia on Elderly Patients With Single Lung Ventilation Intrapulmonary Shunt and Arterial Oxygenation%全麻复合硬膜外麻醉对老年患者单肺通气肺内分流及动脉氧合的影响

    Institute of Scientific and Technical Information of China (English)

    王福杰; 周英娟


    Objective Discuss on general anesthesia combined with epidural anesthesia on elderly patients with single lung ventilation pulmonary artery shunt and oxygenation.Methods Randomly selected from May 2013 to December 2015 in our hospital 60 elderly patients with clinical data,depending on the anesthesia,60 patients were divided into two groups, ]one group for the general anesthesia. Group 2 to 1.0% lidocaine anesthesia combined with epidural anesthesia group,30 cases in each. Compared the two groups before the single-lung ventilation lung,single lung ventilation 10 min,20 min,30 min, 40 min of arterial blood gases and arterial oxygenation.Results Arterial oxygen pressure and flow and ventilation points when comparing the two groups,had declined. Epidural anesthesia group decreased more efective than general anesthesia group,compared to the diference was statisticaly significant(P<0.05).Conclusion Anesthesia combined with epidural anesthesia in elderly patients with reduced single-lung ventilation pulmonary shunt,reduced arterial oxygen tension.%目的:探讨全麻复合硬膜外麻醉对老年患者单肺通气肺内分流及动脉氧合的影响。方法随机选择我院2013年5月~2015年12月我院收治的60例行开胸手术的老年患者临床资料,根据不同麻醉方式把60例患者分成2组,1组为全麻组,2组为全麻复合1.0%利多卡因硬膜外麻醉组,每组各30例。比较2组单肺肺通气前、单肺通气10 min、20 min、30 min、40 min的动脉血气及动脉氧合。结果两组单肺通气时动脉氧分压与分流量与通气前对比,均有所下降,全麻复合组下降效果优于单纯全麻组,对比差异有统计学意义(P<0.05)。结论全麻复合硬膜外麻醉减少老年患者单肺通气肺内分流,降低动脉血氧分压。

  12. Zusammenhang zwischen maximaler Sauerstoffaufnahme und arterieller Gefäßsteifigkeit in Ruhe und während eines Cold Pressure Tests // Relationship between Maximal Oxygen Consumption and Arterial Stiffness at Rest and during Cold Pressor Stress Testing

    Directory of Open Access Journals (Sweden)

    Milatz F


    Full Text Available iIntroduction:/i The favorable influence of endurance exercise on arterial stiffness (AS is widely known. It is also well accepted that stress contributes the development of arterial stiffness and predict the risk of cardiovascular events. The aim of this study was to investigate the relationship between maximal oxygen consumption (VO2max and arterial stiffness (AS, quantified by aortic pulse wave velocity (aPWV and augmentation index (AIx, at rest, but in par- ticular during stress iMethods:/i 32 recreationally active men completed a cardiopulmonary exercise testing. aPWV and AIx were measured non-invasively at rest and during a 2 minute cold pressor test (CPT using Mobil-O-Graph®. After applying partial correlation analysis, the cohort was divided into tertiles of VO2max. Thereafter, ANCOVAs adjusted for age, body mass index and height were performed. br iResults:/i In the total cohort VO2max showed negative correlations with AIx (r = –0.49, p = 0.006 at rest and with AIx (r = –0.51, p = 0.005 as well as aPWV (r = –0.55, r = 0.001 stress test-related. Subjects in the highest tertile of VO2max showed significantly lower stiffness parameters than subjects in the lowest tertile. This was true for AIx (1.1% vs 10.2%, p = 0.012 at rest and for AIx (3.3% vs 13.9%, p = 0.015 as well as aPWV (6.0 m/s vs 6.9 m/s, p = 0.006 during CPT, iDiscussion:/i The study provides evidence for an inverse relationship between VO2max and stress test-related AS. Furthermore higher VO2max values seem to be associated with more favorable effects on arterial compliance during stress testing irrespective of known factors influencing AS. p bKurzfassung: /biEinleitung:/i Ausdauertraining besitzt bekanntermaßen günstige Effekte auf die arterielle Gefäßsteifigkeit (AS. Evidenzen aus der kardiovaskulären Forschung sprechen jedoch dafür, dass das kardiovaskuläre Risiko insbesondere durch die Gefäßcompliance während körperlicher und

  13. The natural diyne-furan fatty acid EV-086 is an inhibitor of fungal delta-9 fatty acid desaturation with efficacy in a model of skin dermatophytosis. (United States)

    Knechtle, Philipp; Diefenbacher, Melanie; Greve, Katrine B V; Brianza, Federico; Folly, Christophe; Heider, Harald; Lone, Museer A; Long, Lisa; Meyer, Jean-Philippe; Roussel, Patrick; Ghannoum, Mahmoud A; Schneiter, Roger; Sorensen, Alexandra S


    Human fungal infections represent a therapeutic challenge. Although effective strategies for treatment are available, resistance is spreading, and many therapies have unacceptable side effects. A clear need for novel antifungal targets and molecules is thus emerging. Here, we present the identification and characterization of the plant-derived diyne-furan fatty acid EV-086 as a novel antifungal compound. EV-086 has potent and broad-spectrum activity in vitro against Candida, Aspergillus, and Trichophyton spp., whereas activities against bacteria and human cell lines are very low. Chemical-genetic profiling of Saccharomyces cerevisiae deletion mutants identified lipid metabolic processes and organelle organization and biogenesis as targets of EV-086. Pathway modeling suggested that EV-086 inhibits delta-9 fatty acid desaturation, an essential process in S. cerevisiae, depending on the delta-9 fatty acid desaturase OLE1. Delta-9 unsaturated fatty acids-but not saturated fatty acids-antagonized the EV-086-mediated growth inhibition, and transcription of the OLE1 gene was strongly upregulated in the presence of EV-086. EV-086 increased the ratio of saturated to unsaturated free fatty acids and phosphatidylethanolamine fatty acyl chains, respectively. Furthermore, EV-086 was rapidly taken up into the lipid fraction of the cell and incorporated into phospholipids. Together, these findings demonstrate that EV-086 is an inhibitor of delta-9 fatty acid desaturation and that the mechanism of inhibition might involve an EV-086-phospholipid. Finally, EV-086 showed efficacy in a guinea pig skin dermatophytosis model of topical Trichophyton infection, which demonstrates that delta-9 fatty acid desaturation is a valid antifungal target, at least for dermatophytoses.

  14. Transcutaneous oxygen tension in imminent foot gangrene

    DEFF Research Database (Denmark)

    Tønnesen, K H


    with moderate obstruction, the oxygen tension reached zero at a toe systolic blood pressure of 5--10 mmHg (tilt toe up) and reached arterial oxygen tension at about 50 to 70 mmHg (tilt toe down). In legs withsevere arterial obstruction and ischaemic rest pain, oxygen tension rose from zero not before systolic......Transcutaneous oxygen tension at 44 degree C and maximal isotope clearance (90m Tc-pretechnetate + histramine) just proximal to the 1st toe and systolic toe blood pressure (strain gauge) were studied on a tilt table in patients with various degrees of obstructive arteriosclerotic disease. In legs...

  15. Palmitic acid (16:0) competes with omega-6 linoleic and omega-3 ɑ-linolenic acids for FADS2 mediated Δ6-desaturation. (United States)

    Park, Hui Gyu; Kothapalli, Kumar S D; Park, Woo Jung; DeAllie, Christian; Liu, Lei; Liang, Allison; Lawrence, Peter; Brenna, J Thomas


    Sapienic acid, 16:1n-10 is the most abundant unsaturated fatty acid on human skin where its synthesis is mediated by FADS2 in the sebaceous glands. The FADS2 product introduces a double bond at the Δ6, Δ4 and Δ8 positions by acting on at least ten substrates, including 16:0, 18:2n-6, and 18:3n-3. Our aim was to characterize the competition for accessing FADS2 mediated Δ6 desaturation between 16:0 and the most abundant polyunsaturated fatty acids (PUFA) in the human diet, 18:2n-6 and 18:3n-3, to evaluate whether competition may be relevant in other tissues and thus linked to metabolic abnormalities associated with FADS2 or fatty acid levels. MCF7 cells stably transformed with FADS2 biosynthesize 16:1n-10 from exogenous 16:0 in preference to 16:1n-7, the immediate product of SCD highly expressed in cancer cell lines, and 16:1n-9 via partial β-oxidation of 18:1n-9. Increasing availability of 18:2n-6 or 18:3n-3 resulted in decreased bioconversion of 16:0 to 16:1n-10, simultaneously increasing the levels of highly unsaturated products. FADS2 cells accumulate the desaturation-elongation products 20:3n-6 and 20:4n-3 in preference to the immediate desaturation products 18:3n-6 and 18:4n-3 implying prompt/coupled elongation of the nascent desaturation products. MCF7 cells incorporate newly synthesized 16:1n-10 into phospholipids. These data suggest that excess 16:0 due to, for instance, de novo lipogenesis from high carbohydrate or alcohol consumption, inhibits synthesis of highly unsaturated fatty acids, and may in part explain why supplemental preformed EPA and DHA in some studies improves insulin resistance and other factors related to diabetes and metabolic syndrome aggravated by excess calorie consumption.

  16. Effects of water temperature and diets containing palm oil on fatty acid desaturation and oxidation in hepatocytes and intestinal enterocytes of rainbow trout (Oncorhynchus mykiss). (United States)

    Tocher, Douglas R; Fonseca-Madrigal, Jorge; Dick, James R; Ng, Wing-Keong; Bell, J Gordon; Campbell, Patrick J


    Food grade fisheries have reached their sustainable limits while aquaculture production has increased to meet consumer demands. However, for growth in aquaculture to continue and utilise sustainable, feeding ingredients, alternatives to fish oil (FO), the predominant lipid component of fish diets, must be developed. Therefore, there is currently considerable interest in the regulation of fatty acid metabolism in fish in order to determine strategies for the best use of plant oils in diets for commercially important cultured fish species. Plant oils are characteristically rich in C18 polyunsaturated fatty acids (PUFA) but devoid of C20 and C22 highly unsaturated fatty acids (HUFA) found in FO. The fatty acyl desaturase enzyme activities involved in the biosynthesis of HUFA from PUFA are known to be under nutritional regulation and can be increased in fish fed diets rich in plant oils. However, fatty acid desaturase activity is also known to be modulated by water temperature in fish. The present study aimed to investigate the interaction between water temperature and diet in the regulation of fatty acid metabolism in rainbow trout. Trout, acclimatized to 7, 11 or 15 degrees C, were fed for 4 weeks on diets in which the FO was replaced in a graded manner by palm oil. At the end of the trial, fatty acyl desaturation/elongation and beta-oxidation activities were determined in isolated hepatocytes and intestinal enterocytes using [1-14C]18:3n-3 as substrate, and samples of liver were collected for analysis of lipid and fatty acid composition. The most obvious effect of temperature was that fatty acid desaturation/elongation and beta-oxidation were reduced in both hepatocytes and intestinal enterocytes from fish maintained at the highest water temperature (15 degrees C). There were differences between the two tissues with the highest desaturation/elongation and beta-oxidation activities tending to be in fish held at 11 degrees C in the case of hepatocytes, but 7 degrees C

  17. Anomalous Origin of the Left Coronary Artery From the Pulmonary Artery

    Directory of Open Access Journals (Sweden)

    Venkat Gangadharan MD


    Full Text Available A 36-year-old woman was seen with complaints of exertional chest pain and shortness of breath. Her medical history included atrial fibrillation and diabetes. Physical examination was unremarkable except for an irregular cardiac rhythm. Myocardial perfusion imaging revealed the presence of a large area of infarction involving the entire anterior and apical walls and part of the anteroseptal wall with minimal periinfarct ischemia. Computed tomography coronary angiogram revealed an anomalous left main coronary artery arising from the main pulmonary artery. Right and left heart catheterizations demonstrated moderate pulmonary hypertension with a slight step-up in oxygen saturation between the right ventricle and main pulmonary artery. Coronary angiography showed a large tortuous right coronary artery with collaterals to the left anterior descending artery that drained into the main pulmonary artery. She was referred for surgery. This case demonstrates a rare coronary artery anomaly in an adult where survival is dependent on collateral circulation.

  18. Coronary artery fistula (United States)

    Congenital heart defect - coronary artery fistula; Birth defect heart - coronary artery fistula ... A coronary artery fistula is often congenital, meaning that it is present at birth. It generally occurs when one of the coronary arteries ...

  19. Effect of oxygen treatment on heart rate after abdominal surgery

    DEFF Research Database (Denmark)

    Rosenberg-Adamsen, S; Lie, C; Bernhard, A;


    . METHODS: The authors studied the effect of oxygen therapy on arterial oxygen saturation and heart rate in 100 consecutive unselected patients randomly and double blindly allocated to receive air or oxygen therapy between the first and fourth day after major abdominal surgery. RESULTS: The median arterial...... supplementation were found between patients with or without an epidural catheter or between the postoperative day studied. CONCLUSION: Postoperative oxygen therapy increased arterial oxygen saturation and decreased heart rate after uncomplicated abdominal surgery in a consecutive unselected group of patients who......BACKGROUND: Cardiac complications are common during the postoperative period and may be associated with hypoxemia and tachycardia. Preliminary studies in high-risk patients after operation have shown a possible beneficial effect of oxygen therapy on arterial oxygen saturation and heart rate...

  20. Continuous blood gas monitoring in femoral arteries (United States)

    Schlain, Les A.; Spar, Steven M.; Dellinger, Bart


    Continuous intra-arterial blood gas monitoring is a potentially valuable tool in the surgical and intensive care arenas. Patient oxygenation and acid base status can change rapidly and without warning. The ability to monitor pHa, PaCO2 and PaO2 in arterial blood will be a major medical advance for the anesthesiologist and intensivist. Intra-arterial blood gas sensors are typically placed in radial arteries. In certain patient populations accurate monitoring is not possible in radial arteries due to arterial environmental factors such as hypotension, vasoconstriction and atherosclerotic disease. These same factors can make radial cannulation difficult resulting in traumatic catheter insertion, thereby further compromising flow conditions. In situations where radial artery flow is expected to be compromised, selecting a large vessel for sensor placement is desirable. We report an initial feasibility study of our blood gas monitoring system using the femoral artery as the sensing site. Clinical results are presented as well as potential advantages and disadvantages associated with monitoring in the femoral artery.

  1. Using oxygen at home (United States)

    Oxygen - home use; COPD - home oxygen; Chronic obstructive airways disease - home oxygen; Chronic obstructive lung disease - home oxygen; Chronic bronchitis - home oxygen; Emphysema - home oxygen; Chronic respiratory ...

  2. Arterial hypoxaemia in cirrhosis: fact or fiction?

    DEFF Research Database (Denmark)

    Møller, S; Hillingsø, J; Christensen, E


    BACKGROUND: Although low arterial oxygen tension (Po2) has been claimed to occur in one to two thirds of patients with cirrhosis, hypoxaemia appears to be rare in clinical practice. AIMS: To assess the frequency of arterial hypoxaemia in cirrhosis in relation to clinical and haemodynamic......%, 96%, 96%, and 93% (NS). So2 was below the lower limit of 92% in 0%, 9%, 7%, and 24% (p arterial carbon dioxide tension, a low systemic vascular...... resistance, and a low indocyanine green clearance (p arterial hypoxaemia in cirrhosis is about 22% in patients without encephalopathy, but it varies from 10-40% depending on the degree of hepatic dysfunction. Arterial hypoxaemia in patients with cirrhosis of differing...

  3. Skin perfusion pressure measured by isotope washout in legs with arterial occlusive disease. Evaluation of different tracers, comparison to segmental systolic pressure, angiography and transcutaneous oxygen tension and variations during changes in systemic blood pressure

    DEFF Research Database (Denmark)

    Holstein, P; Trap-Jensen, J; Bagger, H


    The skin perfusion pressure (SPP) measured as the isotope washout cessation external pressure is valuable in selection of major amputation level. Five methodological investigations important to clinical use were carried out: (1) In five normal legs and 10 legs with arterial occlusive disease (AOD...... in legs with arterial occlusions at two levels or more; (4) In 47 legs with AOD, the SPP on the calf or on the thigh was compared with transcutaneously measured pO2. The two different methods correlated statistically significant, but the scatter was great; (5) During induced variations in systemic blood...... pressure in seven patients (12 legs with AOD), the segmental SPP and the segmental systolic blood pressure were found on average to vary in proportion with intra-arterial mean and systolic pressure respectively; however, this proportional relationship was not valid for the individual leg. It is concluded...

  4. 经皮氧和二氧化碳分压与动脉血氧和二氧化碳分压的相关性%Correlation of transcutaneous partial pressures of oxygen and carbon dioxide and arterial partial pressures of oxygen and carbon dioxide

    Institute of Scientific and Technical Information of China (English)

    刘璇; 刘世江; 刘存明


    目的 探讨经皮氧(PTCO2)和二氧化碳分压(PTCCO2)监测值与动脉血氧(PaO2)和二氧化碳分压(PaCO2)的相关性.方法 拟行开放胰十二指肠切除手术的患者16例,年龄38-68岁,ASA Ⅰ-Ⅱ级.在麻醉前(T1)、麻醉诱导后1 h(T2)、2 h(T3)、3 h(T4)、4 h(T5)同时记录并分析PTCO2、PTCCO2、呼气末二氧化碳分压(PETCO2)和PaO2、PaCO2值的相关性.结果 PTC CO2、PETCO2和PaCO2以及PTCO2与PaO2在T1-T5各时间点均存在良好的相关性.PTCCO2与PaCO总体线性回归关系:PTCCO2=17.70+0.42×PaCO2(r=0.644,P<0.01).PETCO2与PaCO2总体线性回归关系:PETCO2 =23.44+0.30×PaCO2 (r=0.569,P<0.01).PTCO与PaO2线性回归关系:PTCO2=10.07+0.99×PaO2(r=0.941,P<0.01).结论 在长时间手术患者,PTCCO2和PTCO2可以及时准确地反映动脉血PaO2和PaCO2.%Objective To investigate the correlation of transcutaneous partial pressures of oxygen(PTCO2) and carbon dioxide(PTCCO2) and the arterial partial pressures of oxygen(PaO2) and carbon dioxide(PaCO2).Methods Sixteen patients undergoing duodenopancreatectomy(aged 38-68 years old,ASA Ⅰ-Ⅱ) were enrolled in our study.The PTC O2,PTCCO2,end-expired partial pressure of carbon dioxide(PETCO2) and PaO2,PaCO2 (by blood gas analysis) were recorded at the same time points of before anesthesia (T1),at 1 h (T2),2 h (T3),3 h (T4),4 h (T5) during anesthesia.The correlations among PTCCO2,PETCO2 and PaCO2 were analyzed.Results The PTCCO2,PETCO2 and PaCO2 were closely correlated at all time points of T1 to T5 (P<0.01).The equations of linear regression were as follows.PTCCO2 =17.70+0.42 × PaCO2 (r=0.644,P<0.01),PET CO2 =23.44+ 0.30× PaCO2 (r=0.569,P<0.01),and PTC O2 =-10.07 + 0.99 × PaO2 (r=0.941,P<0.01).Conclusion PTCCO2 and PTCO2 can reflect PaCO2 and PaO2 timely and accurately in the patients undergoing surgery for a long time.

  5. Peripheral arterial line (image) (United States)

    A peripheral arterial line is a small, short plastic catheter placed through the skin into an artery of the arm or leg. The purpose of a peripheral arterial line is to allow continuous monitoring of ...

  6. Delta-8 desaturation activity varies among fatty acyl desaturases of teleost fish: high activity in delta-6 desaturases of marine species. (United States)

    Monroig, Oscar; Li, Yuanyou; Tocher, Douglas R


    The benefits of dietary fish and fish oil are derived from n-3 long-chain polyunsaturated fatty acids (LC-PUFA) that have beneficial effects in a range of human diseases and pathologies such as cardiovascular and other inflammatory disorders, neural development and neurological pathologies. The precursor of n-3 LC-PUFA, 18:3n-3 does not have the same beneficial effects prompting interest in the pathways of endogenous synthesis of LC-PUFA in vertebrates. The LC-PUFA biosynthesis pathway classically involves Δ6 and Δ5 fatty acyl desaturases (Fad), but it was recently shown that Δ6 Fad in mammals also displayed Δ8 activity demonstrating a possible alternative "Δ8-pathway" for the synthesis of LC-PUFA. Our primary hypothesis was that Δ8 desaturase activity would be a common feature of vertebrate Δ6 Fads, and so the aim of the present study was to determine the ability of teleostei Fads for Δ8 desaturation activity. To this end, cDNAs for Fads from a range of freshwater, diadromous and marine teleost fish species were assayed for Δ8 activity in the heterologous yeast expression system. In summary, the present study has demonstrated that Δ8 desaturation activity was also a characteristic of fish orthologs, although the activity varied notably between freshwater/diadromous and marine fish species, with the latter possessing Fads2-like proteins with Δ8 activity far higher than mammalian FADS2. The data showed that, generally, the fish Fad are technically υ-3 desaturases, with new double bonds introduced 3C beyond a pre-existing double bond. However, the ability of zebrafish and rabbitfish Fads, previously characterised as Δ6/Δ5 bifunctional desaturases, to introduce non-methylene interrupted double bonds in 20:3n-3 and 20:2n-6 suggested that a novel combination of regioselectivity modes operates within these enzymes.

  7. Reduction in the desaturation capacity of the liver in mice subjected to high fat diet: Relation to LCPUFA depletion in liver and extrahepatic tissues. (United States)

    Valenzuela, Rodrigo; Barrera, Cynthia; Espinosa, Alejandra; Llanos, Paola; Orellana, Paula; Videla, Luis A


    α-Linolenic (ALA) and linoleic (LA) acids are precursors of long chain polyunsaturated fatty acids (LCPUFAs), FAs with important biochemical and physiological functions. In this process, desaturation reactions catalyzed by Δ5- and Δ6-desaturase play a major role, enzymes that are subjected to hormonal and dietary regulation. The aim of this study was to assess the influence of a high fat diet (HFD) on activity of liver Δ5 and Δ6 desaturases, in relation to LCPUFA composition in liver and extrahepatic tissues. Male C57BL/6J mice received control diet (CD) (10% fat, 20% protein and 70% carbohydrate) or high fat diet (HFD) (60% fat, 20% protein, and 20% carbohydrate) for 12 weeks. After this time, blood and liver samples were taken for metabolic, morphologic, inflammatory, oxidative stress and desaturase activity assessment, besides FA phospholipid analysis in erythrocytes, heart, adipose tissue and brain. HFD significantly increased hepatic total fat, triacylglycerides and free FA content with macrovesicular steatosis and oxidative stress enhancement, concomitantly with higher fasting serum glucose and insulin levels, HOMA, and serum cholesterol, triacylglycerols, TNF-α, and IL-6. Diminution in liver Δ5- and Δ6-desaturase activities and LCPUFA depletion were induced by HFD, the later finding being also observed in extrahepatic tissues. In conclusion, HFD-induced reduction in the bioavailability of liver LCPUFA is associated with defective desaturation of ALA and LA, with Δ5- and Δ6-desaturase activities being correlated with insulin resistance development. Data analyzed point to the liver as a major organ responsible for extrahepatic LCPUFA homeostasis, which is markedly deranged by HFD.

  8. [Apneic oxygenation]. (United States)

    Alekseev, A V; Vyzhigina, M A; Parshin, V D; Fedorov, D S


    Recent technological advances in thoracic and tracheal surgery make the anaesthesiologist use different respiratory techniques during the operation. Apneic oxygenation is a one of alternative techniques. This method is relatively easy in use, does not require special expensive equipment and is the only possible technique in several clinical situations when other respiratory methods are undesirable or cannot be used. However there is no enough information about apneic oxygenation in Russian. This article reviews publications about apneic oxygenation. The review deals with experiments on diffusion respiration in animals, physiological changes during apneic oxygenation in man and defines clinical cases when apneic oxygenation can be used.

  9. Cerebral Tissue Oxygenation during Immediate Neonatal Transition and Resuscitation (United States)

    Pichler, Gerhard; Schmölzer, Georg M.; Urlesberger, Berndt


    This article provides a review of cerebral tissue oxygenation during immediate transition after birth in human neonates. Recommended routine monitoring, especially if resuscitation is needed, during this period includes arterial oxygen saturation and heart rate measured by pulse oximetry and electrocardiogram. However, there is increasing interest to monitor in addition with near-infrared spectroscopy (NIRS) the oxygenation of the brain. There is a different pattern of increase between cerebral tissue oxygenation and arterial oxygen saturation during the immediate transition, with cerebral tissue oxygenation reaching a plateau faster than arterial oxygen saturation. Differences can be explained, since cerebral tissue oxygenation is not only affected by arterial oxygen saturation but also by cerebral blood flow, hemoglobin content, and cerebral oxygen consumption. Normal values have already been established for different devices, gestational ages, and modes of delivery in neonates without any medical support. Cerebral hypoxia during immediate transition might cause brain damage. In preterm neonates with cerebral hemorrhage evolving in the first week after birth, the cerebral tissue oxygenation is already lower in the first minutes after birth compared to preterm neonates without cerebral hemorrhage. Using cerebral NIRS in combination with intervention guidelines has been shown to reduce the burden of cerebral hypoxia in preterm neonates. Cerebral tissue oxygenation during immediate transition seems to have an impact on outcome, whereby NIRS monitoring is feasible and has the advantage of continuous, non-invasive recording. The impact of NIRS monitoring and interventions on short- and long-term outcomes still need to be evaluated. PMID:28280719

  10. Haemodynamic influences on kidney oxygenation : Clinical implications of integrative physiology

    NARCIS (Netherlands)

    Evans, Roger G.; Ince, Can; Joles, Jaap A.; Smith, David W.; May, Clive N.; O'Connor, Paul M.; Gardiner, Bruce S.


    Renal blood flow, local tissue perfusion and blood oxygen content are the major determinants of oxygen delivery to kidney tissue. Arterial pressure and segmental vascular resistance influence kidney oxygen consumption through effects on glomerular filtration rate and sodium reabsorption. Diffusive s

  11. 53. Bilateral ductal stenting for nonconfluent pulmonary arteries in a newborn

    Directory of Open Access Journals (Sweden)

    K. Al Dhahri


    Full Text Available Bilateral PDA dependent pulmonary circulation with right and left pulmonary artery discontinuity is very rare. Limited data available for bilateral PDA stenting. Bilateral PDA stenting in nonconfluent pulmonary arteries is challenging procedure but can be considered as an option in the management of complex conditions like this. 12 days old Preterm (36 weeks gestation male baby with birth weight of 2.6 kg developed respiratory distress with severe cyanosis and desaturation upto 50%. Baby was intubated and started on Prostaglandin 0.05 mic/kg/mt. His saturation improved to 80%. Echocardiogram showed complex cyanotic heart disease, Situs ambiguous, dextrocardia, complete unbalanced AV septal defect, pulmonary atresia , nonconfluent small branch pulmonary arteries supplied by the bilateral patent ductus arteriosus (PDA from right aortic arch and all four pulmonary veins form a confluence and drain into superior vena cava(SVC through vertical vein with no obstruction. Baby was taken up for PDA stenting. descending aortogram showed right aortic arch with vertical tortuous duct to right pulmonary artery (RPA and another short duct with acute angle from left subclavian artery to left pulmonary artery (LPA . Both ducti stented with coronary stents. Vertical vein angiogram showed both lungs drain to a confluence and then to SVC via ascending vertical vein with no obstruction. After stenting lung perfusion improved and the baby was stable and maintained 80% saturation on room air. Bilateral PDA dependent pulmonary circulation with right and left pulmonary artery discontinuity is very rare. Our case is unique with Heterotaxy, TAPVC, Dextrocardia and double ducti. Eventhough bilateral ductal stenting is technically challenging it is successful through femoral artery approach.

  12. 右美托咪啶对单肺通气时肺内分流及血液氧合的影响%Effects of Dexmedetomidine on Intrapulmonary Shunt and Arterial Oxygenation During One~lung Ven-tilation

    Institute of Scientific and Technical Information of China (English)

    李琦; 沈颖彦; 周清河; 周红梅


    N(P<0.01). Conclusion Dexmedetomidine administration may increase the intrapulmo⁃nary shunt and decrease the arterial oxygenation during one~lung ventilation; so Dexmedetomidine should be used with caution in patients with pulmonary insufficiency during one~lung ventilation.

  13. Appreciating Oxygen (United States)

    Weiss, Hilton M.


    Photosynthetic flora and microfauna utilize light from the sun to convert carbon dioxide and water into carbohydrates and oxygen. While these carbohydrates and their derivative hydrocarbons are generally considered to be fuels, it is the thermodynamically energetic oxygen molecule that traps, stores, and provides almost all of the energy that…

  14. Acoustic detection of coronary artery disease. (United States)

    Semmlow, John; Rahalkar, Ketaki


    Coronary artery disease (CAD) occurs when the arteries to the heart (the coronary arteries) become blocked by deposition of plaque, depriving the heart of oxygen-bearing blood. This disease is arguably the most important fatal disease in industrialized countries, causing one-third to one-half of all deaths in persons between the ages of 35 and 64 in the United States. Despite the fact that early detection of CAD allows for successful and cost-effective treatment of the disease, only 20% of CAD cases are diagnosed prior to a heart attack. The development of a definitive, noninvasive test for detection of coronary blockages is one of the holy grails of diagnostic cardiology. One promising approach to detecting coronary blockages noninvasively is based on identifying acoustic signatures generated by turbulent blood flow through partially occluded coronary arteries. In fact, no other approach to the detection of CAD promises to be as inexpensive, simple to perform, and risk free as the acoustic-based approach. Although sounds associated with partially blocked arteries are easy to identify in more superficial vessels such as the carotids, sounds from coronary arteries are very faint and surrounded by noise such as the very loud valve sounds. To detect these very weak signals requires sophisticated signal processing techniques. This review describes the work that has been done in this area since the 1980s and discusses future directions that may fulfill the promise of the acoustic approach to detecting coronary artery disease.

  15. Effects of trans n-6 fatty acids on the fatty acid profile of tissues and liver microsomal desaturation in the rat

    Directory of Open Access Journals (Sweden)

    Berdeaux, Olivier


    Full Text Available 18:2Δ 9c,12t and 18:2 Δ9t,12c are present in our diet, as result of heat treatment of vegetable oils. A nutritional study was carried out in order to obtain more precise information on the conversion of these two isomers into long chain polyunsaturated fatty acids (PUFA by rat tissues. This in vivo study performed using rat fed with small quantities of mono trans linoleic acid isomers (0.6% of total energy showed that 18:2 Δ9c,12t was converted into 20:4 Δ5c,8c,11c,14t while 18:2 Δ9t,12c was only slightly converted into 20:4 Δ5c,8c,11t,14c. Furthermore 18:2 Δ9t,12c was preferentially elongated into 20:2 Δ11t,14c. Each C20 metabolite of these mono trans 18:2 isomers was isolated as methyl ester by semi-preparative high-performance liquid chromatography (HPLC followed by silver nitrate thin layer chromatography (AgNO3-TLC.The structure of the components was identified using partial hydrazine reduction, AgNO3-TLC of the resulting monoenes and gas-liquid chromatography coupled with mass spectrometry (GC-MS of the 4,4-dimethyloxazoline (DMOX derivatives. Fourier-transform-infrared spectroscopy (GC-FTIR confirmed the frans geometry. Gas-liquid chromatography (GC analyses showed that 18:2 Δ9c,12t and 18:2 Δ9t,12c were present in different tissue lipids (liver, heart, testes, brain and adipose tissue, and without any modification in the amount of 20:4n-6. 20:4 Δ5c, 8c,11c,14t was incorporated in different rat tissues except in brain. Furthermore, its incorporation followed that of its structural analogue, 20:3n-9 in liver phospholipid classes (phosphatidylethanolamine, phosphatidylinositol and phosphatidylcholine. Finally, an in vitro study carried out with rat liver microsomes showed that dietary trans 18:2 isomers could inhibit the Δ6- desaturation of 18:2n-6 to 18:3n-6 and the Δ5-desaturation of 20:3n-6 to 20:4n-6.

  16. Arterial stiffness: pathophysiology and clinical impact. (United States)

    London, Gérard M; Marchais, Sylvain J; Guerin, Alain P; Pannier, Bruno


    The ill effects of hypertension are usually attributed to a reduction in the caliber or the number of arterioles, resulting in an increase in total peripheral resistance (TPR). This definition does not take into account the fact that BP is a cyclic phenomenon with systolic and diastolic BP being the limits of these oscillations. The appropriate term to define the arterial factor(s) opposing LV ejection is aortic input impedance which depends on TPR, arterial distensibility (D), and wave reflections (WR). D defines the capacitive properties of arterial stiffness, whose role is to dampen pressure and flow oscillations and to transform pulsatile flow and pressure in arteries into a steady flow and pressure in peripheral tissues. Stiffness is the reciprocal value of D. These parameters are BP dependent, and arteries become stiffer at high pressure. In to D which provides information about the elasticity> of artery as a hollow structure, the elastic incremental modulus (Einc) characterizes the properties of the arterial wall biomaterials, independently of vessel geometry. As an alternative, arterial D can be evaluated by measuring the pulse wave velocity (PWV) which increases with the stiffening of arteries. Arterial stiffening increases left ventricular (LV) afterload and alters the coronary perfusion. With increased PWV, the WR impacts on the aorta during systole, increasing systolic pressures and myocardial oxygen consumption, and decreasing diastolic BP and coronary flow. The arterial stiffness is altered primarily in association with increased collagen content and alterations of extracellular matrix (arteriosclerosis) as classically observed during aging or in arterial hypertension. The arterial stiffening estimated by changes in aortic PWV and intensity of WR are independent predictors of survival in end stage renal disease (ESRD) and general population. Improvement of arterial stiffening could be obtained by antihypertensive treatmen as observed with the calcium

  17. Inadequate cerebral oxygen delivery and central fatigue during strenuous exercise

    DEFF Research Database (Denmark)

    Nybo, Lars; Rasmussen, Peter


    Under resting conditions, the brain is protected against hypoxia because cerebral blood flow increases when the arterial oxygen tension becomes low. However, during strenuous exercise, hyperventilation lowers the arterial carbon dioxide tension and blunts the increase in cerebral blood flow, which...

  18. Extra-corporeal membrane oxygenation during the beating heart coronary artery bypass grafting for ;high risk patients-a single center experience%体外膜肺氧合在高危重症冠心病患者心脏不停跳冠状动脉旁路移植术中的应用

    Institute of Scientific and Technical Information of China (English)

    段大为; 刘迎午; 胡晓旻; 刘博江; 吴鹏; 张强; 李彤


    目的:总结体外膜肺氧合( extra-corporeal membrane oxygenation,ECMO)在高危重症冠心病患者心脏不停跳冠状动脉旁路移植术( coronary artery bypass grafting,CABG)中的应用方法和效果。方法选取2007年11月至2014年6月天津市第三中心医院心脏外科的高危重症冠心病行CABG术患者21例,年龄70~83(75.7±3.6)岁,在ECMO辅助下实施择期心脏不停跳CABG术。结果21例患者中,8例术后即刻顺利脱离ECMO辅助;8例桥血管吻合后ECMO不能立即撤离,继续辅助2.0~4.5 h 后撤离;5例在手术室时 ECMO 不能撤离,关胸后返回冠心病重症监护病房( CCU),考虑ECMO辅助时间较长,为克服ECMO非搏动性灌注,联合主动脉内球囊反搏( intra-aortic balloon pump,IABP)支持,IABP辅助时间76~147(115.2±25.9)h。5例CCU内ECMO辅助患者中:股动静脉插管部位渗血1例,经止血及加压包扎后好转;下肢缺血1例,安装旁路循环后缺血改善;均顺利脱机。21例患者均康复出院,住院时间11~28(17.4±2.8) d。结论 ECMO用于心脏不停跳CABG术可为高危重症冠心病患者提供手术治疗的支持和保护。%Objective To summarize clinical application, method and result of extra-corporeal membrane oxygenation ( ECMO) used during beating heart coronary artery bypass grafting ( CABG) in high risk patients. Methods Twenty one patients [ mean age ( 75. 7 ± 3. 6 ) years old ] who received beating-heart CABG surgery assisted with ECMO were included in the study. We observed the condition when ECMO weaned off, the duration on mechanical rentilato time of ICU stay and the occurance of related complications. Results Among the 21 patients, ECMO was weaned off uneventfully after surgery in 8 patients. Immediate weaning was failed in another 8 patients and required gradual weaning in 2. 0-4. 5 hrs. Five patients could not wean off the ECMO in operation room needing continuous ECMO support in CCU. ECMO was weaned off in CCU gradually with

  19. Oxygen Therapy (United States)

    ... oxygen at very high altitudes (like in the mountains or in an airplane) even if you do ... Med Vol 171. P1-P2, 2005 ATS Patient Education Series © 2016 American Thoracic Society www. thoracic. org ...

  20. Breast tumor oxygenation in response to carbogen intervention assessed simultaneously by three oxygen-sensitive parameters (United States)

    Gu, Yueqing; Bourke, Vincent; Kim, Jae Gwan; Xia, Mengna; Constantinescu, Anca; Mason, Ralph P.; Liu, Hanli


    Three oxygen-sensitive parameters (arterial hemoglobin oxygen saturation SaO2, tumor vascular oxygenated hemoglobin concentration [HbO2], and tumor oxygen tension pO2) were measured simultaneously by three different optical techniques (pulse oximeter, near infrared spectroscopy, and FOXY) to evaluate dynamic responses of breast tumors to carbogen (5% CO2 and 95% O2) intervention. All three parameters displayed similar trends in dynamic response to carbogen challenge, but with different response times. These response times were quantified by the time constants of the exponential fitting curves, revealing the immediate and the fastest response from the arterial SaO2, followed by changes in global tumor vascular [HbO2], and delayed responses for pO2. The consistency of the three oxygen-sensitive parameters demonstrated the ability of NIRS to monitor therapeutic interventions for rat breast tumors in-vivo in real time.

  1. Skin perfusion pressure measured by isotope washout in legs with arterial occlusive disease. Evaluation of different tracers, comparison to segmental systolic pressure, angiography and transcutaneous oxygen tension and variations during changes in systemic blood pressure

    DEFF Research Database (Denmark)

    Holstein, P; Trap-Jensen, J; Bagger, H;


    digit (strain gauge technique). The two different methods correlated statistically significant at all four levels, but the systolic blood pressures were higher than the SPP in particular in diabetic legs; (3) Angiograms in 35 legs with AOD showed that the SPP on the ankle was only consistently decreased......The skin perfusion pressure (SPP) measured as the isotope washout cessation external pressure is valuable in selection of major amputation level. Five methodological investigations important to clinical use were carried out: (1) In five normal legs and 10 legs with arterial occlusive disease (AOD......Hg (range 18-98) (P less than 0.02). The average washout constant for the three different tracers were approximately equal and correlated statistically significant with the SPP; (2) In 59 legs with AOD, segmental SPP was compared to segmental systolic blood pressures on the thigh, calf, ankle and first...

  2. Crosstalk between nitrite, myoglobin and reactive oxygen species to regulate vasodilation under hypoxia. (United States)

    Totzeck, Matthias; Hendgen-Cotta, Ulrike B; Kelm, Malte; Rassaf, Tienush


    The systemic response to decreasing oxygen levels is hypoxic vasodilation. While this mechanism has been known for more than a century, the underlying cellular events have remained incompletely understood. Nitrite signaling is critically involved in vessel relaxation under hypoxia. This can be attributed to the presence of myoglobin in the vessel wall together with other potential nitrite reductases, which generate nitric oxide, one of the most potent vasodilatory signaling molecules. Questions remain relating to the precise concentration of nitrite and the exact dose-response relations between nitrite and myoglobin under hypoxia. It is furthermore unclear whether regulatory mechanisms exist which balance this interaction. Nitrite tissue levels were similar across all species investigated. We then investigated the exact fractional myoglobin desaturation in an ex vivo approach when gassing with 1% oxygen. Within a short time frame myoglobin desaturated to 58±12%. Given that myoglobin significantly contributes to nitrite reduction under hypoxia, dose-response experiments using physiological to pharmacological nitrite concentrations were conducted. Along all concentrations, abrogation of myoglobin in mice impaired vasodilation. As reactive oxygen species may counteract the vasodilatory response, we used superoxide dismutase and its mimic tempol as well as catalase and ebselen to reduce the levels of reactive oxygen species during hypoxic vasodilation. Incubation of tempol in conjunction with catalase alone and catalase/ebselen increased the vasodilatory response to nitrite. Our study shows that modest hypoxia leads to a significant nitrite-dependent vessel relaxation. This requires the presence of vascular myoglobin for both physiological and pharmacological nitrite levels. Reactive oxygen species, in turn, modulate this vasodilation response.

  3. Mesenteric artery ischemia (United States)

    ... Mesenteric artery ischemia To use the sharing features on this page, please enable JavaScript. Mesenteric artery ischemia occurs when there is a narrowing or blockage ...

  4. Upper limb arterial thromboembolism

    DEFF Research Database (Denmark)

    Andersen, L V; Lip, Gregory Y.H.; Lindholt, J S;


    The aim of this review is to focus on risk factors, risk-modifying drugs and prognosis for upper limb arterial thromboembolism, and the relationship between upper limb arterial thromboembolism and atrial fibrillation (AF).......The aim of this review is to focus on risk factors, risk-modifying drugs and prognosis for upper limb arterial thromboembolism, and the relationship between upper limb arterial thromboembolism and atrial fibrillation (AF)....

  5. Intraoperative blood oxygenation continuous pulmonary artery perfusion lung protection of ventricular septal defect combined children with pulmonary hypertension%术中氧合血持续肺动脉灌注对室间隔缺损合并肺动脉高压患儿的肺保护作用

    Institute of Scientific and Technical Information of China (English)

    章晔; 李春玲; 胡建明; 林庆; 陈艰


    目的:研究在体外循环手术中使用氧合血进行持续肺动脉灌注对合并肺动脉高压的室间隔缺损患儿的肺保护作用。方法30例室间隔缺损合并肺动脉高压的患儿,随机均分为试验组和对照组。均在体外循环下进行室间隔缺损修补手术。试验组在体外循环中采用氧合血持续肺动脉灌注,对照组未行肺动脉灌注。两组患儿在体外循环前,主动脉开放后6、12、24h时抽取动脉血3ml.采用酶联免疫吸附法(ELISA法)检测丙二醛(MDA)的水平。并抽取动脉血进行血气分析,计算体外循环前,主动脉开放后6、12、24h时的氧合指数(QI),并记录气道峰压和呼吸机辅助时间,进行统计分析。结果试验组术后12、24h的 QI高于对照组(P<0.05),试验组术后6、12h的气道峰压明显低于对照组(P<0.05)。试验组术后呼吸机辅助时间明显低于对照组(P<0.05)。试验组术后6、12、24h时MDA水平均低于对照组(P<0.05)。结论氧合血持续肺动脉灌注能减轻室间隔缺损合并肺动脉高压患儿在体外循环中的肺损伤。%Objective To study the effects of blood oxygenation in extracorporeal circulation operation on continuous pul-monary artery perfusion of merger pulmonary hypertension of ventricular septal defect with pulmonary protection. Methods 30 cases of ventricular septal defect combined pulmonary hypertension were randomly divided into experimental group and control group,15 cases in each group. Both ventricular septal defect repair surgery under extracorporeal circulation. Patients with blood oxygenation in extracorporeal circulation continuous pulmonary artery perfusion, the control group no pulmonary artery perfusion. Two groups of children in front of the extracorporeal circulation, aorta open after 6,12 and 24 h when extracting arterial blood 3 ml. By using enzyme-linked immunosorbent (ELISA) to detect malondialdehyde (MDA

  6. Effects of Shenfu injection on hemodynamics and oxygen metabolism in off-pump coronary artery bypass grafting%非体外循环冠脉搭桥术中参附注射液对血流动力学和氧代谢的影响

    Institute of Scientific and Technical Information of China (English)

    李向宇; 柳垂亮; 潘飞鹏; 黎涌; 招伟贤


    Objective To investigate the effect of Shenfu injection on hemodynamics and systemic oxygen metabolism during off-pump coronary artery bypass grafting (OPCABG).Methods Fifty-six patients with coronary heart disease undergoing selective OPCABG (ASA Ⅱ -Ⅲ )were randomly assigned to Shenfu group (SF,n=29) and normal saline control group (NS,n=27).Patients in SF group received Shenfu 40 ml via intravenous injection prior to dermal preparation and graft anastamosis,respectively.In contrast,an equivalent volume of normal saline was injected in subjects of NS group.Hemodynamics and systemic oxygen metabolism was monitored using Swan-Ganz catheter,arterial and mixed venous blood gas analysis during anesthesia and surgery at nine time points of post anesthetic induction with stable hemodynamics (T1),after stemotomy (T2),before vascular anastomosis (T3),anterior drop branch anastomosis (T4),posterior descending artery or right coronary artery anastamosis(T5),left circumflex coronary artery or diagonal branch anastamosis (T6),cardiac at original position after vascular anastomosis (T7),before sternum closur(T8)and the end of operation(T9).Results Cardiac index (CI) and stroke index (SI) were significantly lower after posterior descending artery or right coronary artery anastamosis (T5) and left circumflex coronary artery or diagonal branch anastamosis (T6) as compared with post anesthetic induction with stable hemodynamics (T1)[(2.1 ±0.6) and (2.0 ±0.5) vs (2.3±0.5) L·min-1·m-2,(1.7 ±0.6) and (1.8 ±0.6) vs (2.1±0.5) L·min-1·m-2;(24±10) and (23 ±8) vs (32±7) ml·beat-1·m-2,(22 ±9) and (22 ±8) vs (32±9) ml·beat-1·m-2,P<0.05].As compared with NS group,CI in SF group after sternotomy (T2) or T5 was slightly higher[ (2.5 ±0.7) vs (2.1 ±0.6) L·min-1·m-2,(2.1 ±0.6) vs (1.7 ±0.6) L·min-1·m-2,P<0.05].During the operation,HR,MAP,LVWI and RVWI in SF group were slightly higher as compared with NS group (P<0.05).pH decreased with time in both groups and

  7. Arterial Elasticity, Strength, Fatigue, and Endurance in Older Women

    Directory of Open Access Journals (Sweden)

    Gary R. Hunter


    Full Text Available Arterial health may influence muscle function in older adults. Study purpose was to determine whether arterial elasticity is related to strength, central and peripheral fatigue, fatigue at rest, and treadmill endurance. Subjects were 91 healthy women aged >60. Treadmill endurance and maximal oxygen uptake (VO2 max were measured. Peripheral and central fatigue for the knee extensors were evaluated using two isometric fatigue tests (one voluntary and one adding electrical stimulation. Arterial elasticity was determined using radial artery pulse wave analysis. Linear multiple regression was used in statistical analysis. Large artery elasticity was associated with central fatigue (P<0.01 and treadmill endurance (P<0.02 after adjusting for VO2 max and knee extension strength. Subjective fatigue at rest was related to large artery elasticity after adjusting for ethnic origin (<0.02. Strength was significantly related to small artery elasticity after adjusting for ethnic origin, leg lean tissue, age, and blood pressure. Arterial elasticity is independently related to strength and fatigue in older women, especially in the central nervous system where arterial elasticity is independently related to perceptions of fatigue at rest and central fatigue. These results suggest that arterial health may be involved with the ability of the central nervous system to activate muscle in older women.

  8. The Impact of Moderate-Altitude Staging on Pulmonary Arterial Hemodynamics after Ascent to High Altitude (United States)


    pressure ( Pao2 ) and arterial oxygenation saturation (Sao2) were measured at each time point. Compared to mean PAP at SL (mean SD, 14 3 mmHg), mean PAP...increased after DA to 37 8 mmHg (D¼ 24 10 mmHg, p< 0.001) and was negatively correlated with both Pao2 (r 2¼ 0.57, p¼ 0.011) and Sao2 (r2¼ 0.64, p...subcostal view. Assessment of oxygenation The primary indexes of oxygenation in this study were alveolar oxygen pressure ( Pao2 ) and arterial oxygen

  9. [Upper extremity arterial diseases]. (United States)

    Becker, F


    Compared to lower limb arterial diseases, upper limb arterial diseases look rare, heterogeneous with various etiologies and a rather vague clinical picture, but with a negligible risk of amputation. Almost all types of arterial diseases can be present in the upper limb, but the anatomical and hemodynamic conditions particular to the upper limb often confuse the issue. Thus, atherosclerosis affects mainly the subclavian artery in its proximal segment where the potential of collateral pathway is high making the symptomatic forms not very frequent whereas the prevalence of subclavian artery stenosis or occlusion is relatively high. The clinical examination and the etiologies are discussed according to the clinical, anatomical and hemodynamic context.

  10. Nasal pulse oximetry overestimates oxygen saturation

    DEFF Research Database (Denmark)

    Rosenberg, J; Pedersen, M H


    Ten surgical patients were monitored with nasal and finger pulse oximetry (Nellcor N-200) for five study periods with alternating mouth and nasal breathing and switching of cables and sensors. Nasal pulse oximetry was found to overestimate arterial oxygen saturation by 4.7 (SD 1.4%) (bias...

  11. Transradial artery coronary angioplasty. (United States)

    Kiemeneij, F; Laarman, G J; de Melker, E


    This study explored the feasibility and safety of percutaneous coronary balloon angioplasty (PTCA) with miniaturized PTCA equipment via the radial artery. Coronary angioplasty (PTCA) via the femoral or brachial arteries may be associated with rare vascular complications such as bleeding and damage to the artery and adjacent structures. It was postulated that PTCA via the radial artery with miniaturized angioplasty equipment is feasible and that no major puncture site-related complications occur because hemostasis is obtained easily and because no major structures are near the radial artery. With double blood supply to the hand, radial artery occlusion is well tolerated. In 100 patients with collateral blood supply to the right hand, PTCA was attempted with 6F guiding catheters and rapid-exchange balloon catheters for exertional angina (87 patients) or nonexertional angina (13 patients). Angioplasty was attempted in 122 lesions (type A n = 67 [55%], Type B n = 37 [30%], and type C n = 18 [15%]). Pre- and post-PTCA computerized quantitative coronary analysis was performed. Radial artery function and structure were assessed clinically and with Doppler and two-dimensional ultrasound on the day of discharge. Coronary catheterization via the radial artery was successful in 94 patients (94%). The 6 remaining patients had successful PTCA via the femoral artery (n = 5) or the brachial artery (n = 1). Procedural success (120 of 122 lesions) was achieved in 92 patients (98%) via the radial artery and in 98 patients of the total study population.(ABSTRACT TRUNCATED AT 250 WORDS)

  12. Relating oxygen partial pressure, saturation and content: the haemoglobin–oxygen dissociation curve

    Directory of Open Access Journals (Sweden)

    Julie-Ann Collins


    The delivery of oxygen by arterial blood to the tissues of the body has a number of critical determinants including blood oxygen concentration (content, saturation (SO2 and partial pressure, haemoglobin concentration and cardiac output, including its distribution. The haemoglobin–oxygen dissociation curve, a graphical representation of the relationship between oxygen satur­ation and oxygen partial pressure helps us to understand some of the principles underpinning this process. Historically this curve was derived from very limited data based on blood samples from small numbers of healthy subjects which were manipulated in vitro and ultimately determined by equations such as those described by Severinghaus in 1979. In a study of 3524 clinical specimens, we found that this equation estimated the SO2 in blood from patients with normal pH and SO2 >70% with remarkable accuracy and, to our knowledge, this is the first large-scale validation of this equation using clinical samples. Oxygen saturation by pulse oximetry (SpO2 is nowadays the standard clinical method for assessing arterial oxygen saturation, providing a convenient, pain-free means of continuously assessing oxygenation, provided the interpreting clinician is aware of important limitations. The use of pulse oximetry reduces the need for arterial blood gas analysis (SaO2 as many patients who are not at risk of hypercapnic respiratory failure or metabolic acidosis and have acceptable SpO2 do not necessarily require blood gas analysis. While arterial sampling remains the gold-standard method of assessing ventilation and oxygenation, in those patients in whom blood gas analysis is indicated, arterialised capillary samples also have a valuable role in patient care. The clinical role of venous blood gases however remains less well defined.

  13. Frequency of apnea, bradycardia, and desaturations following first diphtheria-tetanus-pertussis-inactivated polio-Haemophilus influenzae type B immunization in hospitalized preterm infants

    Directory of Open Access Journals (Sweden)

    Spady Donald W


    Full Text Available Abstract Background Adverse cardiorespiratory events including apnea, bradycardia, and desaturations have been described following administration of the first diphtheria-tetanus-pertussis-inactivated polio-Haemophilus influenzae type B (DTP-IPV-Hib immunization to preterm infants. The effect of the recent substitution of acellular pertussis vaccine for whole cell pertussis vaccine on the frequency of these events requires further study. Methods Infants with gestational age of ≤ 32 weeks who received their first DTP-IPV-Hib immunization prior to discharge from two Edmonton Neonatal Intensive Care Units January 1, 1996 to November 30, 2000 were eligible for the study. Each immunized infant was matched by gestational age to one control infant. The number of episodes of apnea, bradycardia, and/or desaturations (ABD and the treatment required for these episodes in the 72 hours prior to and 72 hours post-immunization (for the immunized cohort or at the same post-natal age (for controls was recorded. Results Thirty-four infants who received DTP-IPV-Hib with whole cell pertussis vaccine, 90 infants who received DTP-IPV-Hib with acellular pertussis vaccine, and 124 control infants were entered in the study. Fifty-six immunized infants (45.1% and 36 control infants (29.0% had a resurgence of or increased ABD in the 72 hours post-immunization in the immunized infants and at the same post-natal age in the controls with an adjusted odds ratio for immunized infants of 2.41 (95% CI 1.29,4.51 as compared to control infants. The incidence of an increase in adverse cardiorespiratory events post-immunization was the same in infants receiving whole cell or acellular pertussis vaccine (44.1% versus 45.6%. Eighteen immunized infants (14.5% and 51 control infants (41.1% had a reduction in ABD in the 72 hours post- immunization or at the equivalent postnatal age in controls for an odds ratio of 0.175 (95%CI 0.08, 0.39. The need for therapy of ABD in the immunized

  14. Acute occlusion of the left subclavian artery with artery dissection

    Institute of Scientific and Technical Information of China (English)


    @@ Subclavian steal syndrome is cerebral or brain stem ischemia resulting from diversion of blood flow from the basilar artery to the subclavian artery, which is caused by occlusive disease of either the subclavian artery or the innominate artery before they branch off at the vertebral artery. In the patients with subclavian steal syndrome the subclavian artery is fed by retrograde flow from the vertebral artery via the carotids and the circle of Willis.

  15. 题目:基于微生物诱导减饱和作用降低地基液化风险的研究%Mitigation of soil liquefaction using microbially induced desaturation

    Institute of Scientific and Technical Information of China (English)

    Jia HE; Jian CHU; Shi-fan WU; Jie PENG


    induced soil desaturation is proposed and tested. The desaturation effect in soil is achieved by the generation of nitrogen gas produced from the microbial denitrification process. Some major issues related to this method are experimentally investigated. These include soil desaturation procedures, shapes and distribution of gas bubbles in soil, mechanical responses and liquefaction resistance of desaturated soils, and stability of gas in soils. The desaturation treatment of soils is made simply by introducing denitrifying bacteria and a desaturation solution into soil pores by mixing, flushing, or injec-tion. The degree of saturation can be reduced as the microbial reaction proceeds. Experimental results show that the final degree of saturation is related to the initial nitrate concentration added to the soil: the higher the concentration of nitrate in the desaturation solution, the lower the degree of saturation that can be achieved. The existence of gas bubbles in soil is evidenced by computer tomography (CT) technology. The CT images reveal that gas is in the form of small pockets which has a size a little larger than the mean size of sand grains. It is shown in the shaking table tests that microbially induced desaturation can effectively improve the liquefaction resistance of soil by showing a much lower pore pressure generation, much smaller volumetric strain, and much smaller settlement of the structure in desaturated soil, as compared with those in saturated soil. Triaxial consolidated undrained tests reveal that the desaturation treatment of soil can improve the undrained shear strength of loose sand. The stability of gas is tested under hydrostatic and water flow conditions. The gas phase is stable under the hydrostatic condition, but unstable under water flow conditions. So measures ought to be taken to prevent steady flow in practice.

  16. Cerebral oxygenation and hyperthermia

    Directory of Open Access Journals (Sweden)

    Anthony Richard Bain


    Full Text Available Hyperthermia is associated with marked reductions in cerebral blood flow (CBF. Increased distribution of cardiac output to the periphery, increases in alveolar ventilation and resultant hypocapnia each contribute to the fall in CBF during passive hyperthermia; however, their relative contribution remains a point of contention, and probably depends on the experimental condition (e.g. posture and degree of hyperthermia. The hyperthermia-induced hyperventilatory response reduces arterial CO2 pressure (PaCO2 causing cerebral vasoconstriction and subsequent reductions in flow. During supine passive hyperthermia, the majority of recent data indicate that reductions in PaCO2 may be the primary, if not sole, culprit for reduced CBF. On the other hand, during more dynamic conditions (e.g. hemorrhage or orthostatic challenges, an inability to appropriately decrease peripheral vascular conductance presents a condition whereby adequate cerebral perfusion pressure may be compromised secondary to reductions in systemic blood pressure. Although studies have reported maintenance of pre-frontal cortex oxygenation (assessed by near-infrared spectroscopy during exercise and severe heat stress, the influence of cutaneous blood flow is known to contaminate this measure. This review discusses the governing mechanisms associated with changes in CBF and oxygenation during moderate to severe (i.e. 1.0°C to 2.0°C increase in body core temperature levels of hyperthermia. Future research directions are provided.

  17. Bilateral accessory thoracodorsal artery. (United States)

    Natsis, Konstantinos; Totlis, Trifon; Tsikaras, Prokopios; Skandalakis, Panagiotis


    The subscapular artery arises from the third part of the axillary artery and gives off the circumflex scapular and the thoracodorsal arteries. Although anatomical variations of the axillary artery are very common, the existence of a unilateral accessory thoracodorsal artery has been described in the literature only once. There are no reports of bilateral accessory thoracodorsal artery, in the literature. In the present study, a bilateral accessory thoracodorsal artery, originating on either side of the third part of the axillary artery, is described in a 68-year-old female cadaver. All the other branches of the axillary artery had a typical origin, course, distribution and termination. This extremely rare anatomical variation apart from the anatomical importance also has clinical significance for surgeons in this area. Especially, during the dissection or mobilization of the latissimus dorsi that is partly used for coverage problems in many regions of the body and also in dynamic cardiomyoplasty, any iatrogenic injury of this accessory artery may result in ischemia and functional loss of the graft.

  18. Effect of thoracic epidural anesthesia with bupivacaine on arterial oxygenation during one-lung ventilation%食管癌术中硬膜外阻滞对单肺通气期间动脉氧合的影响∗

    Institute of Scientific and Technical Information of China (English)

    蒋大明; 王丽君; 顾连兵


    目的:探讨食管癌手术采取全麻复合硬膜外阻滞麻醉时对单肺通气( OLV)期间动脉氧合的影响。方法选择60例行经左胸食管癌根治术患者( ASAIII级),随机分为静脉全麻复合硬膜外阻滞麻醉组( A组,30例)和仅静脉全麻组( B组,30例)。两组患者分别于OLV前( T1)、OLV 15min( T2)、OLV 30min( T3)抽取桡动脉血和混合静脉血行血气分析,计算通气/血流比(Qs/Qt)值。结果在T2和T3时,A组氧分压(PaO2)分别为(219�3±48�2)mmHg和(174�7±37�6)mmHg,显著低于B组的(268�1±81�2)mmHg和(221�6±87�0)mmHg。在OLV期间,A组的Qs/Qt显著高于B组(P<0�05),各时间点A组血压均显著低于B组( P<0�05)。结论全麻复合硬膜外阻滞麻醉时会引起食管癌患者术中血压下降,而且会引起OLV期间肺内分流的增加和氧分压的降低。%Objective To study the effects of thoracic epidural anesthesia(TEA) with bupivacaine on oxygenation, shunt fraction during one-lung ventilation( OLV) . Methods Sixty patients who had prolonged periods of OLV for elective thoracic surgery for esophageal cancer were randomized into two groups. Thirty patients ( group A) were anesthetized with propofol/atracurium/epidural thoracic bupivacaine 0�5%. In another 30 patients ( group B) , fentanyl/propofol/atracurium anesthesia was used. A double-lumen en-dotracheal tube was inserted, and mechanical ventilation with 100% oxygen was used during the entire study. Arterial and venous blood gases were recorded before surgery in a lateral position with two-lung ventilation, 15 and 30 min after OLV ( OLV+15 and OLV+30, respectively) in all patients. PaO2, venous central oxygen tension, arterial and central venous oxygen saturation, venous admixture per-centage (Qs/Qt) were measured. Results The mean values for PaO2 during OLV in the group A after 15min with (219�3±48�2)mm-Hg and 30min with

  19. Anesthetic management of a patient undergoing liver transplantation who had previous coronary artery bypass grafting using an in situ right gastroepiploic artery.


    Murata, Hiroaki; Inoue, Haruka; Sumikawa, Koji


    We describe successful anesthetic management during living-donor liver transplantation in a 63-year-old man with previous coronary artery bypass grafting (CABG) that employed an in situ right gastroepiploic artery (RGEA). Anesthesia was maintained with 1.5% isoflurane in air/oxygen and fentanyl. A five-lead electrocardiogram, transesophageal echocardiogram, and pacing pulmonary artery catheter evaluated cardiac function. A pacing wire was inserted through the catheter to prepare for intraoper...

  20. Functional optimization of the arterial network

    CERN Document Server

    Mauroy, Benjamin


    We build an evolutionary scenario that explains how some crucial physiological constraints in the arterial network of mammals - i.e. hematocrit, vessels diameters and arterial pressure drops - could have been selected by evolution. We propose that the arterial network evolved while being constrained by its function as an organ. To support this hypothesis, we focus our study on one of the main function of blood network: oxygen supply to the organs. We consider an idealized organ with a given oxygen need and we optimize blood network geometry and hematocrit with the constraint that it must fulfill the organ oxygen need. Our model accounts for the non-Newtonian behavior of blood, its maintenance cost and F\\aa hr\\ae us effects (decrease in average concentration of red blood cells as the vessel diameters decrease). We show that the mean shear rates (relative velocities of fluid layers) in the tree vessels follow a scaling law related to the multi-scale property of the tree network, and we show that this scaling la...

  1. Celiac Artery Compression Syndrome

    Directory of Open Access Journals (Sweden)

    Mohammed Muqeetadnan


    Full Text Available Celiac artery compression syndrome is a rare disorder characterized by episodic abdominal pain and weight loss. It is the result of external compression of celiac artery by the median arcuate ligament. We present a case of celiac artery compression syndrome in a 57-year-old male with severe postprandial abdominal pain and 30-pound weight loss. The patient eventually responded well to surgical division of the median arcuate ligament by laparoscopy.

  2. Popliteal artery entrapment syndrome.

    LENUS (Irish Health Repository)

    O'Leary, D P


    Popliteal artery entrapment syndrome is a rare abnormality of the anatomical relationship between the popliteal artery and adjacent muscles or fibrous bands in the popliteal fossa. The following is a case report of a 19 year old female, in whom popliteal artery entrapment syndrome was diagnosed, and successfully treated surgically. A review of literature is also presented and provides details on how PAES is classified, diagnosed both clinically and radiologically, and treated surgically.

  3. Effects of fish oil and starch added to a diet containing sunflower-seed oil on dairy goat performance, milk fatty acid composition and in vivo delta9-desaturation of [13C]vaccenic acid. (United States)

    Bernard, Laurence; Mouriot, Julien; Rouel, Jacques; Glasser, Frédéric; Capitan, Pierre; Pujos-Guillot, Estelle; Chardigny, Jean-Michel; Chilliard, Yves


    The potential benefits on human health have prompted an interest in developing nutritional strategies for specifically increasing rumenic acid (RA) in ruminant milk. The aims of the present study were to (i) compare two dietary treatments with lipid supplements on milk yield and composition, (ii) measure the in vivo delta9-desaturation of vaccenic acid (VA) to RA using 13C-labelled VA and (iii) determine the effect of the dietary treatments on this variable. Treatments were 90 g sunflower-seed oil (SO) per d or 60 g sunflower-seed oil and 30 g fish oil per d plus additional starch (SFO), in a grassland hay-based diet given to eight Alpine goats in a 2 x 2 cross-over design with 21 d experimental periods. Milk yield and composition were similar between treatments. Goats fed SFO had higher milk 6 : 0-16 : 0 concentration, lower milk sigmaC18 concentrations and showed no effect on milk VA and RA, compared with SO. At the end of the experiment, intravenous injection of 1.5 g [13C]VA followed by measurements of milk lipid 13C enrichment showed that in vivo 31.7 and 31.6 % of VA was delta9-desaturated into milk RA in the caprine with the SO and SFO treatments, respectively. The expression of genes encoding for delta9-desaturase (or stearoyl-CoA desaturase; SCD1, SCD5) in mammary tissues and four milk delta9-desaturation ratios were similar between treatments. In conclusion, the present study provides the first estimates of in vivo endogenous synthesis of RA (63-73 % of milk RA) from VA in goats, and shows no difference between the two lipid supplements compared.

  4. Arterial waveform analysis. (United States)

    Esper, Stephen A; Pinsky, Michael R


    The bedside measurement of continuous arterial pressure values from waveform analysis has been routinely available via indwelling arterial catheterization for >50 years. Invasive blood pressure monitoring has been utilized in critically ill patients, in both the operating room and critical care units, to facilitate rapid diagnoses of cardiovascular insufficiency and monitor response to treatments aimed at correcting abnormalities before the consequences of either hypo- or hypertension are seen. Minimally invasive techniques to estimate cardiac output (CO) have gained increased appeal. This has led to the increased interest in arterial waveform analysis to provide this important information, as it is measured continuously in many operating rooms and intensive care units. Arterial waveform analysis also allows for the calculation of many so-called derived parameters intrinsically created by this pulse pressure profile. These include estimates of left ventricular stroke volume (SV), CO, vascular resistance, and during positive-pressure breathing, SV variation, and pulse pressure variation. This article focuses on the principles of arterial waveform analysis and their determinants, components of the arterial system, and arterial pulse contour. It will also address the advantage of measuring real-time CO by the arterial waveform and the benefits to measuring SV variation. Arterial waveform analysis has gained a large interest in the overall assessment and management of the critically ill and those at a risk of hemodynamic deterioration.

  5. Presión parcial de oxígeno, pH, hematocrito, hemoglobina e índice cardíaco en pollos de engorde a 2.600 metros sobre el nivel del mar Arterial blood oxygen partial pressure, hematocrit, haemoglobin, and cardiac index in broilers at 2600 m above sea level

    Directory of Open Access Journals (Sweden)



    Full Text Available La incidencia de hipertensión arterial pulmonar (HP en pollosparrilleros constituye un problema económico importante. Dentrode los mecanismos de adaptación del organismo a la altitud se encuentran,además del aumento de la tensión arterial pulmonar, el incremento de la masa muscular ventricular derecha, la policitemía y posiblemente la hiperventilación con la subsecuente alcalosis respiratoria. Es factible que el alto nivel de energía en la ración incremente la hipoxemia derivada de la hipoxia; con lo anterior, el grado de policitemia se puede elevar y producirse un efecto agravante de la HP. Para establecer valores de pO2, Ht, Hb e IC en pollos parrilleros residentes a 2.600 m de altura sobre el nivel del mar, se estudiaron 24 aves de ambos sexos, de una población de 400 animales. Los valores promedios obtenidos fueron los siguientes: a pO2: 67.21 mmHg ± 5.21. Hubo diferencias estadísticas (pWideman y Buss (1985y Julian y col. (1985. La correlación inversa entre el IC y la pO2 arterial indican el efecto de la hipoxia de las vías aéreas en la hipoxemia y en el grado de hipertrofia e hiperplasia ventricular derecha.High incidence of cardiac failure in broilers due to hypoxic pulmonaryhypertension (PH, produces huge economical losses. Adaptive responsesinclude right ventricular hypertrophy and polycythemia. High energy levelin feed could increase hypoxemia and therefore the degree of polycythemia,thus increasing PH. To establish normal values in arterial oxygen partialpressure (pO2, pH, hematocrit (Ht, haemoglobin (Hb, and cardiacindex (CI, 24 broilers (12 males and 12 females, chosen at random, froma population of 400 birds, were studied in Bogotá, Colombia, 2600m above sea level. Mean values obtained were as follows: a pO2:67.21 ± 5.21 mmHg; statistical differences between sexes and among ages were found (p<0.05; b pH: 7.5 ± 0.05; c Ht: 37.13 ± 3.27%. In males, Ht values were higher at 24 and 37 days. In females, therewas a

  6. The unresolved issue of oxygen therapy in lung fibrosis: Some clues from a Spanish cohort

    Directory of Open Access Journals (Sweden)

    Irene Martin-Robles


    Full Text Available Indication of oxygen therapy in fibrotic interstitial lung diseases is not standardized and its specific requirements are not well defined. The objective of this study was to evaluate ambulatory oxygen therapy features in lung fibrotic patients. Clinical and exploratory data, including 6-minute walking test and pulmonary hypertension, from one hundred and seven patients with fibrotic interstitial lung disease that received ambulatory oxygen treatment were studied. In up to 40% of cases the prescription of oxygen therapy was made after performing a 6-minute walking test. Patients who required ambulatory oxygen only during exercise presented a mild to moderate reduction of the predicted % FVC (62.1 ± 19 and DLCO (49 ± 14.4 while patients who had respiratory failure at rest (mean PaO2 51.9 ± 6.7 presented a moderate reduction of %FVC (56.8 ± 15.6 but a severe decrease of %DLCO (31.67 ± 12. Pulmonary hypertension (PH was evaluated in 47.7% of patients and occurred in 60.8% of them. In conclusion, there is no pulmonary functional predictor of oxyhaemoglobin desaturation during exercise. PH is frequently associated with interstitial lung diseases, mainly when respiratory failure at rest appears. The heterogeneity of the patients and limitation of retrospective studies could be the cause of the tributes for potential benefits of oxygen treatment in interstitial lung diseases.

  7. Reversible Oxygenation of Oxygen Transport Proteins. (United States)

    Drain, C. M.; Corden, Barry B.


    Describes a lecture demonstration which illustrates changes in the visible spectra of oxygen transport proteins upon reversible oxygen binding. Provides a comparison of the physical characteristics of oxygen storage and transport proteins. Reviews essentials for preparation of the materials. (ML)

  8. Anomalous origin of right coronary artery from pulmonary artery

    Directory of Open Access Journals (Sweden)

    Rajat Gupta


    Full Text Available Anomalous origin of coronary artery from the pulmonary artery is a rare anomaly that most frequently involves the left coronary artery and very rarely the right coronary artery. These lesions can be missed on echocardiography unless carefully looked for. We describe a case of isolated anomalous origin of right coronary artery from pulmonary artery diagnosed on echocardiography and confirmed by computed tomography (CT angiography.

  9. Near Infrared Spectroscopy for the Detection of Desaturations in Vulnerable Ischemic Brain Tissue A Pilot Study at the Stroke Unit Bedside

    NARCIS (Netherlands)

    Aries, M.J.H.; Coumou, Adriaan D.; Elting, Jan Willem J.; van der Harst, Joep J.; Kremer, Berry P. H.; Vroomen, Patrick C. A. J.


    Background and Purpose-There is uncertainty whether bilateral near infrared spectroscopy (NIRS) can be used for monitoring of patients with acute stroke. Methods-The NIRS responsiveness to systemic and stroke-related changes was studied overnight by assessing the effects of brief peripheral arterial

  10. Coronary bypass revascularization with radial artery and internal mammary artery grafts

    Institute of Scientific and Technical Information of China (English)

    甄文俊; 佟宏峰; 王永忠; 孙耀光; 黄文; 马玉健; 田家政; 吴良洪


    Objective To evaluate radial artery (RA) and internal mammary artery (IMA) grafts in coronary artery bypass and the use of color Doppler ultrasound in the peri-operative evaluation of IMA and radial-ulnar collateral circulation.Methods From June 1998 to June 2000, sixty cases of coronary bypass revascularization with RA and IMA were performed. Preoperatively, the radial-ulnar collateral circulation was evaluated with the modified Allen's test, color Doppler ultrasound and noninvasive oxygen saturation measurement. The IMA lumen and blood flow were measured at the first intercostal space with color Doppler ultrasound preoperatively and postoperatively.Results One patient (1.7%) died of serious cardiac arrhythmia on the fourth postoperative day. There were no arterial graft harvest related complications. Before harvesting, the ulnar artery blood flow was 30.78±9.71?ml/min, and it increased to 43.36±13.98?ml/min (40.87% increase, P0.05), but the systolic/diastolic flow ratio markedly decreased from 8.57±3.98?ml/min to 3.41±4.87?ml/min (P<0.01).Conclusions Arterial grafts can be safely used for coronary bypass revascularization with good results. The ulnar artery blood flow can increase compensatively after RA harvesting. The diastolic blood flow of grafted IMA markedly increased postoperatively. Color Doppler ultrasound was very helpful both in evaluating the radial-ulnar collateral circulation before RA harvesting and in assessing the patency of the grafted IMA after coronary artery bypass grafting (CABG).

  11. Artery by Neuropeptides

    Directory of Open Access Journals (Sweden)

    Esmeralda Sofia Costa Delgado


    Methods. Isolated rabbit eyes (n=12 were perfused in situ with tyrode through the external ophthalmic artery. Effects of intra-arterial injections of NPY 200 μg/ml (Group A; n=6 and VIP 200 μg/ml (Group B; n=6 on the recorded pressure were obtained. For statistical analysis, Student's paired t-test and Fast Fourier Transform were used. Results. Spontaneous oscillations were observed before any drug administration in the 12 rabbit models. NPY produced an increase in total vascular resistance and a higher frequency and amplitude of oscillations, while VIP evoked the opposite effects. Conclusions. This study provides evidence of vasomotion in basal conditions in rabbit external ophthalmic artery. Concerning drug effects, NPY increased arterial resistance and enhanced vasomotion while VIP produced opposite effects which demonstrates their profound influence in arterial vasomotion.

  12. Hyperbaric Oxygen Therapy (United States)

    ... before your first hyperbaric oxygen therapy session. During hyperbaric oxygen therapy Hyperbaric oxygen therapy typically is performed ... and the therapy unit throughout your treatment. After hyperbaric oxygen therapy You may feel somewhat tired or ...

  13. Effects of different mean arterial pressure levels on hemodynamics, tissue perfusion and oxygen metabolism in elderly patients with septic shock%不同动脉压水平对老年感染性休克患者血流动力学组织灌注和代谢的影响

    Institute of Scientific and Technical Information of China (English)

    李茂琴; 王惠敏; 许继元; 李家琼; 许艳军; 莫逊; 卢飞; 李琳; 张舟; 李松梅


    目的 观察应用去甲肾上腺素联合多巴酚丁胺(NE+Dobu)在小同平均动脉压(MAP)水平对老年感染件休克患者血流动力学、组织灌注和代谢的影响. 方法 感染性休克患者18例,充分液体复苏后为基础状态,应用NE+Dobu并随机调节剂量,使MAP分别维持在65、75、85mm Hg 3种水平状态,持续4 h,观察不同MAP水平的血流动力学、氧合指标、血乳酸、肾功能和胃黏膜二氧化碳分压变化. 结果 当MAP达75 mm Hg和85 mm Hg时,心脏指数(4.7±0.6和5.1±0.7)、体循环阻力指数(1162±278和1276±319)、氧输送[(697±53)ml·min-1·m-2和(711±68)ml·min-1·m-2]、氧摄取率[(0.28±0.02)%和(0.27±0.02)%],均较MAP为65 mm Hg时[4.0±0.6、1011±225、(634±70)ml·min-1·m-2、(0.25±0.02)%]明显增加(P. min Norepinephrine was titrated to maintain MAP at levels of 65 mm Hg, 75 mm Hg and 85 mmHg. Four hours later, the changes of hemodynamics, oxygenation index, blood lactate, renal function and gastric pCO at every MAP level were observed. Results There were no significant differences in heart rate (HR), pulmonary arterial wedge pressure (PAWP), volume of oxygen (VO), Blood lactate, pH value, △pCO and creatinine clearance rate (CCr) among the MAP levels of 65 mm Hg, 75 mm Hg and 85 mm Hg ( all P>0.05). Compared with MAP 65 mm Hg, cardiac index (CI), systemic vascular resistance index (SVRI), oxygen delivery over oxygen extraction ratio were obviously higher at MAP 75 mm Hg and 85 mm Hg [4.7±0.6, 5.1±0.7 vs. 4.0±0.6; 1162±278, 1276±319 vs. 1011±225; (697±53) ml. min. m,(711±68)ml. min. m vs. (634±70) ml · min · m; (0.28±0.02)%,(0.27±0.02)% vs. (0.25±0.02) %, respectively, all P<0.05). The urinary output at MAP levels of 65 mm Hg, 75 mm Hg and 85 mm Hg were (98±43)ml/h, (91±54) ml/h and(74±49)ml/h repectively, and only the differences between MAP 75 mm Hg and MAP 65 mm Hg had statistical significance (P<0.05). Conclusions After aggressive fluid resuscitation

  14. Hemodynamic support during vein-vein or vein-artery extracorporeal membrane oxygenation weaning%撤离静脉-静脉体外膜肺氧合和静脉-动脉体外膜肺氧合的血流动力学支持策略

    Institute of Scientific and Technical Information of China (English)

    周飞虎; 胡婕; 薛超


    体外膜肺氧合(extra corporeal membrane oxygenation, ECMO)已广泛应用于成年人、儿童、新生儿难治性心力衰竭、呼吸衰竭及心肺复苏,最常见的模式是静脉-静脉体外膜肺氧合(vein vein extra corporeal membrane oxygenation,VV-ECMO)和静脉-动脉体外膜肺氧合(vein artery extra corporeal membrane oxygenation,VA-ECMO),作为短期器官功能支持的手段,一般在数小时至一周内需要撤离。在ECMO,特别是VA-ECMO撤机时患者血流动力学会发生巨大变化,可能出现全身血管舒张、左心功能不全、左心室流出道梗阻及右心功能不全。ECMO撤离过程需要严密的血流动力学监测和反复心脏超声(经胸或经食管)的检查,药物(如左西孟旦等)和其他器官支持技术(主动脉球囊反搏和持续肾脏替代治疗)可能改善撤机时的血流动力学,但仍需进一步前瞻性临床研究评估上述措施的有效性。%Extracorporeal membrane oxygenation (ECMO) is broadly used to provide respiratory and cardiac support in patients with refractory respiratory or cardiac failure and during cardiopulmonary resuscitation in neonates, children and adults. The most common used modes include venous-venous ECMO (VV-ECMO) and venous-arterial ECMO (VA-ECMO). The utility of ECMO is usually limited to a short period of time but can sometimes be extended up to a week. During the weaning process of ECMO, especially under the VA-ECMO mode, the hemodynamics may become unstable due to a variety of factors such as systemic vasodilation, left ventricular (LV) dysfunction, LV outflow obstruction and right ventricular (RV) failure. Frequent and reliable assessments of hemodynamics as well as repeated performances of either transthoracic echocardiogram (TTE) or transesophageal echocardiogram (TEE) should be performed during the weaning of ECMO. Pharmacological support such as Levosimendan and other therapeutic tools including intra

  15. Coronary artery aneurysms

    Energy Technology Data Exchange (ETDEWEB)

    Koischwitz, D.; Harder, T.; Schuppan, U.; Thurn, P.


    Seven saccular coronary artery aneurysms have been demonstrated in the course of 1452 selective coronary artery angiograms. In six patients they were arterio-sclerotic; in one patient the aneurysm must have been congenital or of mycotic-embolic origin. The differential diagnosis between true aneurysms and other causes of vascular dilatation is discussed. Coronary artery aneurysms have a poor prognosis because of the possibility of rupture with resultant cardiac tamponade, or the development of thrombo-embolic myocardial infarction. These aneurysms can only be diagnosed by means of coronary angiography and require appropriate treatment.

  16. Coronary Artery Bypass

    Directory of Open Access Journals (Sweden)

    Kadri Ceberut


    Full Text Available Ancient schwannoma is a rare variant of neural tumors though rarely seen in the thorax. The combination with coronary artery diseases is also rare. Here we describe a 66 year-old male who had undergone one-stage combined surgery for thoracic ancient schwannomas removal and coronary artery disease. The masses were, respectively, 13 cm in the middle mediastinum and 5 cm in diameter originating from the intercostal nerve. The tumors were successfully removed using sternotomy, and then a coronary artery bypass grafting was performed. Here we discuss this rare tumor in relation to the relevant literature.

  17. Clinical significance of ventricular premature contraction in patients with coronary artery disease combined with obstructive sleep apnea%室性期前收缩频率在阻塞性睡眠呼吸暂停的冠心病者中的临床意义

    Institute of Scientific and Technical Information of China (English)



    Objective To investigate the clinical significance of ventricular premature contraction (VPC) frequen-cy and sympathetic activity in the patients with coronary artery disease combined with obstructive sleep apnea. Methods 125 patients were categorized by apnea-hypopnea index (AHI) into moderate (AHI15) group. Sleep stage was divided into five stages (Wake, S1, S2, S34, and REM). Parameters of heart rate turbulence were calculated. Results VPC frequency was affected significantly by sleep stage (Wake, S2 and REM, F=5.8, P<0.01) and by AHI(F = 8.7, P < 0.01). In Severe group, VPC frequency was higher in REM than in Wake (P=0.011).In contrast, patients in moderate group had fewer VPCs and exhibited sleep stage independence (P=0. 19). Oxygen desat-uration duration per apnea episode was correlated positively with AHI (r2=. 71, P<0.01), and was longer in REM than in non-REM (P <0.01). The heart rate turbulence parameter TS was correlated negatively with oxygen desaturation dura-tion in REM (r2=.06, P=0.014). Conclusion Higher VPC frequency coupled with higher sympathetic activity caused by longer apnea episodes in REM sleep may be one of the reasons for increased nocturnal death in apnca patients.%目的 评价室性期前收缩(VPC)频率及交感活性在惠有阻塞性睡眠呼吸暂停综合征(OSAS)的冠心病患者中的意义.方法 125例中有OSAS的冠心病患者,均行多导睡眠图检查,将患者按AHI值进行分组.睡眠阶段分为清醒组、S1、S2、S34及REM.并对患者心率震荡(HRT)参数进行测量对比.结果 VPC频率受睡眠阶段(清醒期、S2及REM,F=5.8,P<0.005)及AHI(F=8.7,P<0.005)影响;在严重OSAS患者,REM期VPC频率较清醒期为高(P=0.011),相反,中等OSAS患者VPC频率较低,且没有睡眠阶段依赖性(P=0.19).氧失饱和持续间期与AHI成正相关(r2=0.71,P<0.001),且在REM期较非REM期为长(P<0.0001),在REM期HRT参数TS与氧失饱和持续间期成负相关(r2=0.06,P=0.014).结论 REM期高VPC频率可

  18. Renal arteries (image) (United States)

    A renal angiogram is a test used to examine the blood vessels of the kidneys. The test is performed ... main vessel of the pelvis, up to the renal artery that leads into the kidney. Contrast medium ...

  19. Coronary Artery Bypass Surgery (United States)

    ... t help, you may need coronary artery bypass surgery. The surgery creates a new path for blood to flow ... more than one bypass. The results of the surgery usually are excellent. Many people remain symptom-free ...

  20. Carotid Artery Disease (United States)

    ... make them more vulnerable to damage. Tobacco use. Nicotine can irritate the inner lining of your arteries. ... your physical and mental capabilities such as strength, memory and speech. After that, your doctor may recommend: ...

  1. Pulmonary Arterial Hypertension (United States)

    Pulmonary Arterial Hypertension What Is Pulmonary Hypertension? To understand pulmonary hypertension (PH) it helps to understand how blood ows throughout your body. While the heart is one organ, it ...

  2. Oxygen Tension in the Aqueous Humor of Human Eyes under Different Oxygenation Conditions

    Directory of Open Access Journals (Sweden)

    Farideh Sharifipour


    Full Text Available Purpose: To measure oxygen tension in the aqueous humor of human eyes under different oxygenation conditions. Methods: This prospective comparative interventional case series consisted of two parts. In the first part, 120 consecutive patients scheduled for cataract surgery were randomized into group I (control group in which surgery was performed under local anesthesia inhaling 21% oxygen; group II in whom general anesthesia using 50% oxygen was employed; and group III receiving general anesthesia with 100% oxygen. After aspirating 0.2 ml aqueous humor under sterile conditions, the aqueous sample and a simultaneously drawn arterial blood sample were immediately analyzed using a blood gas analyzer. In part II the same procedures were performed in 10 patients after fitting a contact lens and patching the eye for 20 minutes (group IV and in 10 patients after transcorneal delivery of oxygen at a flow rate of 5 L/min (group V. Results: Mean aqueous PO2 in groups I, II and III was 112.3±6.2, 141.1±20.4, and 170.1±27 mmHg, respectively (P values <0.001 and mean arterial PO2 was 85.7±7.9, 184.6±46, and 379.1±75.9 mmHg, respectively (P values <0.001. Aqueous PO2 was 77.2±9.2 mmHg in group IV and 152.3±10.9 mmHg in group V (P values <0.001. There was a significant correlation between aqueous and blood PO2 (r=0.537, P<0.001. The contribution of atmospheric oxygen to aqueous PO2 was 23.7%. Conclusion: Aqueous oxygen tension is mostly dependent on the systemic circulation and in part on the atmosphere. Increasing inspiratory oxygen and transcorneal oxygen delivery both increase aqueous PO2 levels.

  3. Heritability of cilioretinal arteries

    DEFF Research Database (Denmark)

    Taarnhøj, Nina Charlotte; Munch, Inger C; Kyvik, Kirsten O;


    PURPOSE: To determine whether the presence of one or more cilioretinal arteries, a distinct element of the pattern of fundus vessels, is genetically programmed, influenced by environmental factors, or the result of random mechanisms of vascular development. METHODS: The fundi of 112 pairs...... environmental factors. CONCLUSIONS: The presence or absence of one or more cilioretinal arteries in healthy persons is markedly influenced by genetic factors....

  4. Mathematical arterialization of venous blood in emergency medicine patients

    DEFF Research Database (Denmark)

    Tygesen, Gitte Boier; Matzen, Helle; Grønkjær, Karen;


    .83; and Bland-Altman limits of agreement well within the limits of acceptable laboratory and clinical performance. The calculated values of arterial PO2 followed a set of predefined rules relating calculated and measured PO2 levels in all cases. The method represents an improvement on the use of venous blood......OBJECTIVES: Arterial punctures represent a painful and unpleasant experience. Acid-base and oxygenation status can be assessed from peripheral venous blood, but agreement with arterial values is not always clinically acceptable. This study evaluates a method for mathematically transforming...... alone where the correlation coefficients were as follows: group A, pH 0.85, PCO2 0.88; group B, pH 0.79, PCO2 0.59; and limits of agreement for PCO2 at the border of (group A) or beyond (group B) acceptable clinical limits. CONCLUSION: Application of the mathematical arterialization method may reduce...

  5. A comparison of blood gases and acid-base measurements in arterial, arterialized venous, and venous blood during short-term maximal exercise. (United States)

    Linderman, J; Fahey, T D; Lauten, G; Brooker, A S; Bird, D; Dolinar, B; Musselman, J; Lewis, S; Kirk, L


    The purpose of this study was to determine the relationship between blood gases and acid-base measurements in arterial, arterialized venous, and venous blood measured simultaneously during short-term maximal exercise. Ten well-trained male cyclists performed a graded maximal exercise test on a cycle ergometer to determine the power output corresponding to their peak oxygen consumption (test I), and a short-term maximal test on a cycle ergometer at peak power output (test II). During test II arterial, arterialized venous and venous blood were sampled simultaneously for determination of partial pressures of oxygen and carbon dioxide, pH, bicarbonate (HCO3-), base excess (BE), and lactate (La). Samples were taken at rest, the end of 1 min of exercise (1 ME), at the end of exercise (EE), and at 2 min of recovery (REC). During test II, subjects maintained a peak power output of 370.6 (62.1) W [mean (SD)] for 4.5, SD 1.6 min. Except at rest venous and arterialized venous measurements tended to be the same at all sampling intervals, but differed significantly from measurements in arterial blood (P less than 0.05). BE was the only variable that rendered consistently significant correlations between arterial and arterialized venous blood at each sampling interval. The pooled correlation coefficient between arterial and arterialized venous BE was r = 0.83 [regression equation: BEa = (0.84 BEav)-0.51]. Arterial La was significantly higher than venous La at 1 ME (2.8, 0.7 vs 0.8, 0.3 mmol.l-1) and higher than both venous and arterialized venous La at EE.(ABSTRACT TRUNCATED AT 250 WORDS)

  6. Crosstalk between oxidative and nitrosative stress and arterial stiffness. (United States)

    Mozos, Ioana; Luca, Constantin Tudor


    Arterial stiffness, the expression of reduced arterial elasticity, is an effective predictor of cardiovascular disorders. Oxidative stress is an imbalance between exposure to toxic reactive oxygen species (ROS) and antioxidant systems. The increase in reactive nitrogen species (RNS) is termed nitrosative stress. We review the main mechanisms and products linking arterial stiffness with oxidative and nitrosative stress in several disorders, focusing on recent experimental and clinical data, and the mechanisms explaining benefits of antioxidant therapy. Oxidative and nitrosative stress play important roles in arterial stiffness elevation in several disorders, including diabetes mellitus, hypertension, metabolic syndrome, obesity, peripheral arterial disease, chronic obstructive pulmonary disease, systemic lupus erythematosus, thalassemia, Kawasaki disease and malignant disorders. Oxidative and nitrosative stress are responsible for endothelial dysfunction due to uncoupling of the nitric oxide synthase, oxidative damage to lipids, proteins and DNA in vascular endothelial cells, associated with inflammation, arteriosclerosis and atherosclerosis. Regular physical exercise, caloric restriction, red wine, statins, sartans, metformin, oestradiol, curcumin and combinations of antioxidant vitamins are therapeutic strategies that may decrease arterial stiffness and oxidative stress thus reducing the risk of cardiovascular events. ROS and RNS represent potential therapeutic targets for preventing progression of arterial stiffness.

  7. Coronary anomaly: the single coronary artery

    Institute of Scientific and Technical Information of China (English)

    QIN Xu-guang; XIONG Wei-guo; LU Chun-peng; GONG Cheng-jie; SHANG Li-hua


    @@ Single coronary artery (SCA), defined as an artery that arises from the arterial trunk and nourishes the entire myocardium, is rare. We report two cases of SCA, one is the right coronary artery (RCA) originating from the middle of left descending artery (LAD), and the other is the left main coronary artery (LMCA) arising from the proximal right coronary artery.

  8. Coronary Artery and Pulmonary Artery Fistula Originated from Significant Stenosis in the Left Anterior Descending Artery

    Directory of Open Access Journals (Sweden)

    Alper Sami Kunt


    Full Text Available Coronary artery fistula (CAF is defined as a rare anomalous connection between a coronary artery and a major vessel or a cardiac chamber. We report a case of a left anterior descending coronary (LAD stenosis and coronary artery fistula between the LAD coronary artery and the pulmonary artery (PA. CAF is often diagnosed by coronary angiogram. We describe our diagnostic approach and review the literature on the epidemiology, the pathophysiology, the diagnostic modalities, and the treatment options.

  9. Extracorporeal membrane oxygenation support in acardia. (United States)

    Marinakis, Sotirios; Ferrari, Enrico; Delay, Dominique; Tozzi, Piergiorgio; Berdajs, Denis; Niclauss, Lars; Rolf, Tanina; von Segesser, Ludwig Karl


    In extreme situations, such as hyperacute rejection of heart transplant or major heart trauma, heart preservation may not be possible. Our experimental team works on a project of peripheral extracorporeal membrane oxygenation (ECMO) support in acardia as a bridge to heart transplantation or artificial heart implantation. An ECMO support was established in five calves (58.6 ± 6.9 kg) by the transjugular insertion to the caval axis of a self-expanded cannula, with carotid artery return. After baseline measurements, ventricular fibrillation was induced, great arteries were clamped, heart was excised, and right and left atria remnants, containing pulmonary veins, were sutured together leaving an atrial septal defect over the caval axis cannula. Measurements of pump flow and arterial pressure were taken with the pulmonary artery clamped and anastomosed with the caval axis for a total of 6 hours. Pulmonary artery anastomosis to the caval axis provided an acceptable 6 hour hemodynamic stability, permitting a peripheral access ECMO support in extreme scenarios indicating a heart explantation.

  10. Boron PLA for oxygen sensing & hypoxia imaging

    Directory of Open Access Journals (Sweden)

    Cassandra L. Fraser


    Full Text Available Oxygen is essential for many forms of life and its depletion in the body and the environment can lead to deleterious effects. Low oxygen conditions, even anoxia, are associated with eutrophication of lakes and rivers, wherein an over abundance of nutrients often caused by pollution result in excessive plant growth and decay, threatening water quality, ecosystem balance, and aquatic life. In the body, low oxygen conditions or hypoxia may be generalized, as can occur at high altitude or during strenuous exercise, or localized in particular tissues, when there is a mismatch between oxygen supply and demand. Hypoxia is present in many important diseases as well. Low oxygen levels in tumors are often associated with biochemical changes, increased invasiveness, cancer progression, and resistance to radiation and chemotherapies. Vascular blockage in strokes, heart attacks, and peripheral artery disease, which is common in diabetes, are other situations where oxygen levels can drop precipitously and cause great damage to affected tissues. Clearly, innovative sensing technologies that provide new insight into these many oxygen dependent processes can impact global society in significant ways.

  11. Hemorheological abnormalities in human arterial hypertension (United States)

    Lo Presti, Rosalia; Hopps, Eugenia; Caimi, Gregorio


    Blood rheology is impaired in hypertensive patients. The alteration involves blood and plasma viscosity, and the erythrocyte behaviour is often abnormal. The hemorheological pattern appears to be related to some pathophysiological mechanisms of hypertension and to organ damage, in particular left ventricular hypertrophy and myocardial ischemia. Abnormalities have been observed in erythrocyte membrane fluidity, explored by fluorescence spectroscopy and electron spin resonance. This may be relevant for red cell flow in microvessels and oxygen delivery to tissues. Although blood viscosity is not a direct target of antihypertensive therapy, the rheological properties of blood play a role in the pathophysiology of arterial hypertension and its vascular complications.

  12. Cerebral oxygen delivery and consumption during evoked neural activity

    Directory of Open Access Journals (Sweden)

    Alberto L Vazquez


    Full Text Available Increases in neural activity evoke increases in the delivery and consumption of oxygen. Beyond observations of cerebral tissue and blood oxygen, the role and properties of cerebral oxygen delivery and consumption during changes in brain function are not well understood. This work overviews the current knowledge of functional oxygen delivery and consumption and introduces recent and preliminary findings to explore the mechanisms by which oxygen is delivered to tissue as well as the temporal dynamics of oxygen metabolism. Vascular oxygen tension measurements have shown that a relatively large amount of oxygen exits pial arterioles prior to capillaries. Additionally, increases in cerebral blood flow (CBF induced by evoked neural activation are accompanied by arterial vasodilation and also by increases in arteriolar oxygenation. This increase contributes not only to the down-stream delivery of oxygen to tissue, but also to delivery of additional oxygen to extra-vascular spaces surrounding the arterioles. On the other hand, the changes in tissue oxygen tension due to functional increases in oxygen consumption have been investigated using a method to suppress the evoked CBF response. The functional decreases in tissue oxygen tension induced by increases in oxygen consumption are slow to evoked changes in CBF under control conditions. Preliminary findings obtained using flavoprotein autofluorescence imaging suggest cellular oxidative metabolism changes at a faster rate than the average changes in tissue oxygen. These issues are important in the determination of the dynamic changes in tissue oxygen metabolism from hemoglobin-based imaging techniques such as blood oxygenation-level dependent functional magnetic resonance imaging (fMRI.

  13. Dense pulmonary opacification in neonates treated with extracorporeal membrane oxygenation

    Energy Technology Data Exchange (ETDEWEB)

    Schlesinger, A.E.; Cornish, J.D.; Null, D.M.


    Chest radiographic findings in three neonates with respiratory failure secondary to meconium aspiration treated with extracorporeal membrane oxygenation (ECMO) are described. The degree of pulmonary opacification on the chest radiographs failed to correlate with the patients' clinical status as measured by the arterial oxygen levels but correlated well with the peak airway pressure (PAP) and continuous positive airway pressure (CPAP) settings on the mechanical ventilator. Because a variable portion of the arterial blood oxygenation is performed by the extracorporeal membrane oxygenator and unusually large fluctuations in airway pressure settings can occur in these patients while on ECMO, it is important to realize that the chest radiography may not be an accurate predictor of the patients' clinical status.

  14. Prediction of arterial blood gas values from arterialized earlobe blood gas values in patients treated with mechanical ventilation

    Directory of Open Access Journals (Sweden)

    Honarmand Azim


    Full Text Available Background/Objective: Arterial blood gas (ABG analysis is useful in evaluation of the clinical condition of critically ill patients; however, arterial puncture or insertion of an arterial catheter may sometimes be difficult and cause many complications. Arterialized ear lobe blood samples have been described as adequate to gauge gas exchange in acute and chronically ill pediatric patients. Purpose: This study evaluates whether pH, partial pressure of oxygen (PO 2 , partial pressure of carbon dioxide (PCO 2 , base excess (BE, and bicarbonate (HCO 3 values of arterialized earlobe blood samples could accurately predict their arterial blood gas analogs for adult patients treated by mechanical ventilation in an intensive care unit (ICU. Setting: A prospective descriptive study Methods: Sixty-seven patients who were admitted to ICU and treated with mechanical ventilation were included in this study. Blood samples were drawn simultaneously from the radial artery and arterialized earlobe of each patient. Results: Regression equations and mean percentage-difference equations were derived to predict arterial pH, PCO 2 , PO 2 , BE, and HCO 3 -values from their earlobe analogs. pH, PCO 2 , BE, and HCO 3 all significantly correlated in ABG and earlobe values. In spite of a highly significant correlation, the limits of agreement between the two methods were wide for PO 2 . Regression equations for prediction of pH, PCO 2 , BE, and HCO3- values were: arterial pH (pHa = 1.81+ 0.76 x earlobe pH (pHe [r = 0.791, P < 0.001]; PaCO 2 = 1.224+ 1.058 x earlobePCO 2 (PeCO 2 [r = 0.956, P < 0.001]; arterial BE (BEa = 1.14+ 0.95 x earlobe BE (BEe [r= 0.894, P < 0.001], and arterial HCO 3 - (HCO 3 -a = 1.41+ earlobe HCO 3 (HCO 3 -e [r = 0.874, P < 0.001]. The predicted ABG values from the mean percentage-difference equations were derived as follows: pHa = pHe x 1.001; PaCO 2 = PeCO 2 x 0.33; BEa = BEe x 0.57; and HCO 3 -a = HCO 3 -e x 1.06. Conclusions: Arterialized

  15. Correlation Between Capnography and Arterial Carbon Dioxide Before, During, and After Severe Chest Injury in Swine (United States)


    During phase 2, animals developed decreased oxygenation ( PaO2 :FiO2 [fraction of inspired oxygen] ratio G200) and hy- potension (mean arterial...mercury), ABG, and ratio of arterial oxygen content ( PaO2 ) to FIO2 (PFR). All data col lection was during three phases (1, 2, and 3) of the experiment...did not show an increase in correlation and was therefore left out of the final model. Ratio of PaO2 to FIO2 was not associated with PaCO2. Using

  16. Trans-10,cis-12-CLA-caused lipodystrophy is associated with profound changes of fatty acid profiles of liver, white adipose tissue and erythrocytes in mice: possible link to tissue-specific alterations of fatty acid desaturation. (United States)

    Jaudszus, Anke; Moeckel, Peter; Hamelmann, Eckard; Jahreis, Gerhard


    Dietary supplementation with conjugated linoleic acid (CLA) has been shown to reduce body fat mass. To investigate the effects of individual CLA isomers on the fatty acid profiles of lipogenic (liver and white adipose) and lipid sensitive (erythrocyte) tissues, BALB/c mice were fed with 1 of 2 diets supplemented with either a c9,t11-CLA-enriched and t10,c12-CLA-free or a CLA-mixture containing both isomers in equal amounts (1% w/w of the diet) for 5 weeks. A control group was fed with a diet enriched in sunflower oil to energy balance the CLA. Compared to the t10,c12-CLA-free and the control diets, we observed a significant reduction of adipose tissue accompanied by fatty livers in the CLA-mix-fed group. These alterations in body fat distribution entailed a conspicuous shift of the fatty acid profiles of adipose tissue and livers. Liver enlargement was mainly caused by accumulation of C18 monoenes that accounted for 67 ± 1% of total fatty acid methyl esters. The significant reduction of the 18:0/18:1 desaturation index in the liver upon CLA-mix diet indicated high stearoyl-CoA desaturase activity. In contrast, reduction in white adipose tissue was largely driven by percental reduction of monounsaturated fatty acids (p ≤ 0.001). 16:0/ 16:1 and 18:0/18:1 desaturation indices for white adipose tissue significantly increased, suggesting an inhibition of stearoyl-CoA desaturase upon CLA-mix diet. The fatty acid profile of the erythrocytes widely reflected that of livers, depending on the supplemented diet. These profound changes in fatty acid composition of lipogenic organs due to t10,c12-CLA intake may be the consequence of functional alterations of lipid metabolism.

  17. Retinopathy of prematurity outcome in infants with Prethreshold Retinopathy of Prematurity and oxygen saturation > 94% in room air : The High Oxygen Percentage in Retinopathy of Prematurity study

    NARCIS (Netherlands)

    McGregor, ML; Bremer, DL; Cole, C; McClead, RE; Phelps, DL; Fellows, RR; Oden, N


    Objectives. To determine the rate of progression from prethreshold to threshold retinopathy of prematurity (ROP) in infants excluded from Supplemental Therapeutic Oxygen for Prethreshold Retinopathy of Prematurity (STOP-ROP) because their median arterial oxygen saturation by pulse oximetry (Spo(2))

  18. Monitoring of the Adult Patient on Venoarterial Extracorporeal Membrane Oxygenation

    Directory of Open Access Journals (Sweden)

    Mabel Chung


    Full Text Available Venoarterial extracorporeal membrane oxygenation (VA ECMO provides mechanical support to the patient with cardiac or cardiopulmonary failure. This paper reviews the physiology of VA ECMO including the determinants of ECMO flow and gas exchange. The efficacy of this therapy may be determined by assessing patient hemodynamics and device flow, overall gas exchange support, markers of adequate oxygen delivery, and pulsatility of the arterial blood pressure waveform.

  19. Left Coronary Artery-Pulmonary Artery Fistula in Coronary Artery Disease

    Directory of Open Access Journals (Sweden)

    Orhan Veli Doğan


    Full Text Available Coroner artery fistula which is rare and congenital or acquired arise from whole coroner artery drainage all of cardiac chamber and great artery. Although coroner artery fistula is uncommon, it can cause significant mortality and morbidity rates. The article is presented which coroner artery disease and coroner-pulmonary artery fistula was accomplishment committed. Sixty three year-old male patient admitted to the hospital with chest pain. Non-ST myocardial infarction was diagnosed in the examinations. After coroner angiography, it was found coronary artery disease in addition between LAD proximal portion and main pulmonary artery fistula. Fistula repair and coronary bypass were performed successfully under cardiopulmonary bypass. Without hemodynamic problem in intensive care and service follow-up, the patient was discharged from the hospital in the seventh postoperative day. We think that surgical treatment of coronary fistulas in patients with coronary artery lesion is done at the earliest time would enable improvement in mortality and morbidity rates.


    Daland, G A; Isaacs, R


    1. The oxygen consumption of blood of normal individuals, when the hemoglobin is saturated with oxygen, is practically zero within the limits of experimental error of the microspirometer used. 2. The oxygen consumed in a microspirometer by the blood of patients with chronic myelogenous leucemia with a high white blood cell count, and of one with leucocytosis from sepsis, was proportional to the number of adult polymorphonuclear neutrophils in the blood. 3. No correlation could be made between the rate of oxygen absorption and the total number of white blood cells in the blood, or the total number of immature cells, or the number of red blood cells, or the amount of oxyhemoglobin. 4. The blood of patients with chronic myelogenous leucemia continued to use oxygen in the microspirometer longer than that of normal individuals, and the hemoglobin, in the leucemic bloods, became desaturated even though exposed to air. 5. In blood in which the bulk. of the cells were immature and the mature cells few, the oxygen consumption was lower than in blood in which the mature cells predominated. The rate of oxygen consumption of the immature cells was relatively low as compared to the mature. 6. The slower rate of oxygen absorption by the immature leucocytes in chronic myelogenous leucemia as compared to the mature cells, places them, in accord with Warburg's reports, in the class of the malignant tissues in this respect rather than in the group of young or embryonic cells.

  1. Arterial hypertension and cancer. (United States)

    Milan, Alberto; Puglisi, Elisabetta; Ferrari, Laura; Bruno, Giulia; Losano, Isabel; Veglio, Franco


    Arterial hypertension and cancer are two of the most important causes of mortality in the world; correlations between these two clinical entities are complex and various. Cancer therapy using old (e.g., mitotic spindle poisons) as well as new (e.g., monoclonal antibody) drugs may cause arterial hypertension through different mechanisms; sometimes the increase of blood pressure levels may be responsible for chemotherapy withdrawal. Among newer cancer therapies, drugs interacting with the VEGF (vascular endothelial growth factors) pathways are the most frequently involved in hypertension development. However, many retrospective studies have suggested a relationship between antihypertensive treatment and risk of cancer, raising vast public concern. The purposes of this brief review have then been to analyse the role of chemotherapy in the pathogenesis of hypertension, to summarize the general rules of arterial hypertension management in this field and finally to evaluate the effects of antihypertensive therapy on cancer disease.

  2. Comparative efficiency of oxygen therapy in patients (smokers and non-smokers with chronic obstructive pulmonary disease

    Directory of Open Access Journals (Sweden)

    E.G. Zarubina and I.O. Prokhorenko


    Full Text Available The decrease in clinical efficacy of oxygen therapy takes place in patients suffering from chronic pulmonary obstructive disease who continue smoking even if the intensity of smoking is getting lower. It is explained by the damage of oxygen utilization regardless of normalization of arterial blood saturation indices and perfusion oxygen saturation indices in blood flow.

  3. Comparative efficacy of oxygen therapy in patients (smokers and non-smokers with chronic pulmonary obstructive disease

    Directory of Open Access Journals (Sweden)

    Starodumov N.I.


    Full Text Available The decrease in clinical efficacy of oxygen therapy takes place in patients suffering from chronic pulmonary obstructive disease who continue smoking even if the intensity of smoking is getting lower. It is explained by the damage of oxygen utilization regardless of normalization of arterial blood saturation indices and perfusion oxygen saturation indices in blood flow

  4. Losartan protects mesenteric arteries from ROS-associated decrease in myogenic constriction following 5/6 nephrectomy

    NARCIS (Netherlands)

    Vavrinec, Peter; van Dokkum, Richard P. E.; Goris, Maaike; Buikema, Hendrik; Henning, Robert H.


    Background: Chronic renal failure (CRF) is associated with hypertension, proteinuria, loss of myogenic constriction (MC) of mesenteric arteries and increased production of reactive oxygen species (ROS) under experimental conditions. Previous results showed that ACE (angiotensin-converting enzyme act

  5. Idiopathic pulmonary artery aneurysm. (United States)

    Kotwica, Tomasz; Szumarska, Joanna; Staniszewska-Marszalek, Edyta; Mazurek, Walentyna; Kosmala, Wojciech


    Pulmonary artery aneurysm (PAA) is an uncommon lesion, which may be associated with different etiologies including congenital cardiovascular diseases, systemic vasculitis, connective tissue diseases, infections, and trauma. Idiopathic PAA is sporadically diagnosed by exclusion of concomitant major pathology. We report a case of a 56-year-old female with an idiopathic pulmonary artery dilatation identified fortuitously by echocardiography and confirmed by contrast-enhanced computed tomography. Neither significant pulmonary valve dysfunction nor pulmonary hypertension and other cardiac abnormalities which might contribute to the PAA development were found. Here, we describe echocardiographic and computed tomography findings and review the literature on PAA management.

  6. Left Anterior Descending Artery-Pulmonary Artery Fistula

    Directory of Open Access Journals (Sweden)

    Turan Ege


    Full Text Available Despite the fact that coronary arteriovenous fistulas constitute approximately half (48% of coronary artery anomalies, they are rarely seen anomalies. In this report,we aim to present a coronary arteriovenous fistula case detected during a coronary angiography between left anterior descending artery and pulmonary artery.

  7. Pulmonary arterial hypertension in children after neonatal arterial switch operation

    NARCIS (Netherlands)

    Zijlstra, Willemijn Mh; Elmasry, Ola; Pepplinkhuizen, Shari; Ivy, D Dunbar; Bonnet, Damien; Lévy, Marilyne; Gavilan, Jose Luis; Torrent-Vernetta, Alba; Mendoza, Alberto; Del Cerro, Maria Jesus; Moledina, Shahin; Berger, Rolf M. F.


    OBJECTIVES: Paediatric pulmonary arterial hypertension (PAH) after neonatal arterial switch operation (ASO) for transposition of the great arteries (TGA) is a clinically recognised entity with an estimated incidence of 0.6%-1.0%. Nevertheless, a clinical characterisation is lacking. We present an in

  8. Systemic arterial air embolism after percutaneous lung biopsy

    Energy Technology Data Exchange (ETDEWEB)

    Hare, S.S., E-mail: [Ottawa Hospital, Ontario (Canada); Gupta, A.; Goncalves, A.T.C.; Souza, C.A.; Matzinger, F.; Seely, J.M. [Ottawa Hospital, Ontario (Canada)


    Systemic arterial air embolism is a rarely encountered but much feared complication of percutaneous lung biopsy. We present a comprehensive review of iatrogenic air embolism post-lung biopsy, a complication that is often suboptimally managed. This review was inspired by our own institutional experience and we use this to demonstrate that excellent outcomes from this complication can be seen with prompt treatment using hyperbaric oxygen chamber therapy, after initial patient stabilization has been achieved. Pathophysiology, clinical features, and risk factors are reviewed and misconceptions regards venous versus arterial air embolism are examined. An algorithm is provided for radiologists to ensure suspected patients are appropriately managed with more favourable outcomes.

  9. Pharmacological modulation of arterial stiffness.

    LENUS (Irish Health Repository)

    Boutouyrie, Pierre


    Arterial stiffness has emerged as an important marker of cardiovascular risk in various populations and reflects the cumulative effect of cardiovascular risk factors on large arteries, which in turn is modulated by genetic background. Arterial stiffness is determined by the composition of the arterial wall and the arrangement of these components, and can be studied in humans non-invasively. Age and distending pressure are two major factors influencing large artery stiffness. Change in arterial stiffness with drugs is an important endpoint in clinical trials, although evidence for arterial stiffness as a therapeutic target still needs to be confirmed. Drugs that independently affect arterial stiffness include antihypertensive drugs, mostly blockers of the renin-angiotensin-aldosterone system, hormone replacement therapy and some antidiabetic drugs such as glitazones. While the quest continues for \\'de-stiffening drugs\\

  10. Diaphragm paralysis causing ventilatory failure in an adult with the rigid spine syndrome. (United States)

    Efthimiou, J; McLelland, J; Round, J; Gribbin, H R; Loh, L; Spiro, S G


    A syndrome consisting of a rigid spine and myopathy predominantly affecting proximal limb muscles has been previously described in children, and as with most neuromuscular disorders, the respiratory muscles appear to be affected only at an advanced stage in the disease. We describe an adult male with this syndrome who presented with ventilatory failure caused by severe respiratory muscle weakness and who demonstrated profound nocturnal arterial oxygen desaturation, particularly during rapid eye movement sleep. Treatment with negative pressure ventilation initially resulted in only modest improvements in symptoms, blood gas tensions, and nocturnal desaturation. The cause of this only partial improvement was upper airway obstruction provoked by the mode of ventilatory support used. After tracheostomy there was a dramatic and sustained improvement in symptoms and blood gas tensions and complete abolition of nocturnal arterial oxygen desaturation. This is the first report of an adult with the rigid spine syndrome presenting with ventilatory failure and cor pulmonale due to severe respiratory muscle weakness.

  11. Artificial oxygen transport protein (United States)

    Dutton, P. Leslie


    This invention provides heme-containing peptides capable of binding molecular oxygen at room temperature. These compounds may be useful in the absorption of molecular oxygen from molecular oxygen-containing atmospheres. Also included in the invention are methods for treating an oxygen transport deficiency in a mammal.

  12. Hemoglobin, hematocrit, and changes in cerebral blood flow : The Second Manifestations of ARTerial disease-Magnetic Resonance study

    NARCIS (Netherlands)

    van der Veen, Pieternella H.; Muller, Majon; Vincken, Koen L.; Westerink, Jan; Mali, Willem P. T. M.; van der Graaf, Yolanda; Geerlings, Mirjam I.; Doevendans, PAFM


    Hemoglobin and hematocrit are important determinants of blood viscosity and arterial oxygen content and may therefore influence cerebral blood flow (CBF). We examined cross-sectional and prospective associations of hemoglobin and hematocrit with CBF in 569 patients with manifest arterial disease (me

  13. Pulmonary artery sling: Case report

    Energy Technology Data Exchange (ETDEWEB)

    Shin, Gil Hyun; Lee, Sun Wha; Cha, Sung Ho [Kyunghee University College of Medicine, Seoul (Korea, Republic of)


    Aberrant left-sided pulmonary artery(pulmonary artery sling) is an uncommon anomaly,which may cause significant respiratory abnormality. We report a case of pulmonary artery sling which is combined with persistent left superior vena cava and dextrocardia. This case were identified by esophagogram and CT and confirmed by MRI and angiography. We consider that MRI is a valuable new method for the diagnosis of aberrant left-sided pulmonary artery.

  14. Oxygen sensing and signaling. (United States)

    van Dongen, Joost T; Licausi, Francesco


    Oxygen is an indispensable substrate for many biochemical reactions in plants, including energy metabolism (respiration). Despite its importance, plants lack an active transport mechanism to distribute oxygen to all cells. Therefore, steep oxygen gradients occur within most plant tissues, which can be exacerbated by environmental perturbations that further reduce oxygen availability. Plants possess various responses to cope with spatial and temporal variations in oxygen availability, many of which involve metabolic adaptations to deal with energy crises induced by low oxygen. Responses are induced gradually when oxygen concentrations decrease and are rapidly reversed upon reoxygenation. A direct effect of the oxygen level can be observed in the stability, and thus activity, of various transcription factors that control the expression of hypoxia-induced genes. Additional signaling pathways are activated by the impact of oxygen deficiency on mitochondrial and chloroplast functioning. Here, we describe the molecular components of the oxygen-sensing pathway.

  15. Intracranial artery dissection

    NARCIS (Netherlands)

    Sikkema, T.; Uyttenboogaart, Maarten; Eshghi, O.; De Keyser, J.; Brouns, R.; van Dijk, J.M.C.; Luijckx, G. J.


    The aim of this narrative review is to evaluate the pathogenesis, clinical features, diagnosis, treatment and prognosis of intracranial artery dissection (IAD). IAD is a rare and often unrecognized cause of stroke or subarachnoid haemorrhage (SAH), especially in young adults. Two types of IAD can be

  16. Popliteal artery entrapment syndrome

    DEFF Research Database (Denmark)

    Altintas, Ümit; Helgstrand, Ulf Johan Vilhelm; Hansen, Marc A;


    The purpose of this study was to report our experience with popliteal artery entrapment syndrome (PAES) with special emphasis on the applicability of duplex ultrasound scanning (DUS) when diagnosing PAES. In addition to examining the correlation between DUS and intraoperative findings...

  17. Arterial Emboli Complicating Cisplatin Therapy


    Tait, Campbell D.; Rankin, Elaine M


    We report three cases of arterial emboli in patients with lung cancer treated with cisplatin chemotherapy. All three patients were managed without surgical intervention but subsequent oncological treatment was complicated by the sequelae of arterial emboli. We discuss the issues surrounding these patients and the importance of identifying patients at risk of arterial embolic phenomena with cisplatin treatment.

  18. Vein graft adaptation and fistula maturation in the arterial environment. (United States)

    Lu, Daniel Y; Chen, Elizabeth Y; Wong, Daniel J; Yamamoto, Kota; Protack, Clinton D; Williams, Willis T; Assi, Roland; Hall, Michael R; Sadaghianloo, Nirvana; Dardik, Alan


    Veins are exposed to the arterial environment during two common surgical procedures, creation of vein grafts and arteriovenous fistulae (AVF). In both cases, veins adapt to the arterial environment that is characterized by different hemodynamic conditions and increased oxygen tension compared with the venous environment. Successful venous adaptation to the arterial environment is critical for long-term success of the vein graft or AVF and, in both cases, is generally characterized by venous dilation and wall thickening. However, AVF are exposed to a high flow, high shear stress, low-pressure arterial environment and adapt mainly via outward dilation with less intimal thickening. Vein grafts are exposed to a moderate flow, moderate shear stress, high-pressure arterial environment and adapt mainly via increased wall thickening with less outward dilation. We review the data that describe these differences, as well as the underlying molecular mechanisms that mediate these processes. Despite extensive research, there are few differences in the molecular pathways that regulate cell proliferation and migration or matrix synthesis, secretion, or degradation currently identified between vein graft adaptation and AVF maturation that account for the different types of venous adaptation to arterial environments.

  19. Peripheral arterial disease and revascularization of the diabetic foot. (United States)

    Forsythe, R O; Brownrigg, J; Hinchliffe, R J


    Diabetes is a complex disease with many serious potential sequelae, including large vessel arterial disease and microvascular dysfunction. Peripheral arterial disease is a common large vessel complication of diabetes, implicated in the development of tissue loss in up to half of patients with diabetic foot ulceration. In addition to peripheral arterial disease, functional changes in the microcirculation also contribute to the development of a diabetic foot ulcer, along with other factors such as infection, oedema and abnormal biomechanical loading. Peripheral arterial disease typically affects the distal vessels, resulting in multi-level occlusions and diffuse disease, which often necessitates challenging distal revascularisation surgery or angioplasty in order to improve blood flow. However, technically successful revascularisation does not always result in wound healing. The confounding effects of microvascular dysfunction must be recognised--treatment of a patient with a diabetic foot ulcer and peripheral arterial disease should address this complex interplay of pathophysiological changes. In the case of non-revascularisable peripheral arterial disease or poor response to conventional treatment, alternative approaches such as cell-based treatment, hyperbaric oxygen therapy and the use of vasodilators may appear attractive, however more robust evidence is required to justify these novel approaches.

  20. Vein graft adaptation and fistula maturation in the arterial environment (United States)

    Lu, Daniel Y; Chen, Elizabeth Y; Wong, Daniel J; Yamamoto, Kota; Protack, Clinton D; Williams, Willis T; Assi, Roland; Hall, Michael R; Sadaghianloo, Nirvana; Dardik, Alan


    Veins are exposed to the arterial environment during two common surgical procedures, creation of vein grafts and arteriovenous fistulae (AVF). In both cases veins adapt to the arterial environment that is characterized by different hemodynamic conditions and increased oxygen tension compared to the venous environment. Successful venous adaptation to the arterial environment is critical for long term success of the vein graft or AVF, and in both cases is generally characterized by venous dilation and wall thickening. However, AVF are exposed to a high flow, high shear stress, low pressure arterial environment, and adapt mainly via outward dilation with less intimal thickening. Vein grafts are exposed to a moderate flow, moderate shear stress, high pressure arterial environment, and adapt mainly via increased wall thickening with less outward dilation. We review the data that describe these differences, as well as the underlying molecular mechanisms that mediate these processes. Despite extensive research, there are few differences in the molecular pathways that regulate cell proliferation and migration or matrix synthesis, secretion, or degradation currently identified between vein graft adaptation and AVF maturation that account for the different types of venous adaptation to arterial environments. PMID:24582063

  1. Oxygen-enhanced combustion

    CERN Document Server

    Baukal, Charles E


    Combustion technology has traditionally been dominated by air/fuel combustion. However, two developments have increased the significance of oxygen-enhanced combustion-new technologies that produce oxygen less expensively and the increased importance of environmental regulations. Advantages of oxygen-enhanced combustion include less pollutant emissions as well as increased energy efficiency and productivity. Oxygen-Enhanced Combustion, Second Edition compiles information about using oxygen to enhance industrial heating and melting processes. It integrates fundamental principles, applications, a

  2. Retinal oxygen saturation evaluation by multi-spectral fundus imaging (United States)

    Khoobehi, Bahram; Ning, Jinfeng; Puissegur, Elise; Bordeaux, Kimberly; Balasubramanian, Madhusudhanan; Beach, James


    Purpose: To develop a multi-spectral method to measure oxygen saturation of the retina in the human eye. Methods: Five Cynomolgus monkeys with normal eyes were anesthetized with intramuscular ketamine/xylazine and intravenous pentobarbital. Multi-spectral fundus imaging was performed in five monkeys with a commercial fundus camera equipped with a liquid crystal tuned filter in the illumination light path and a 16-bit digital camera. Recording parameters were controlled with software written specifically for the application. Seven images at successively longer oxygen-sensing wavelengths were recorded within 4 seconds. Individual images for each wavelength were captured in less than 100 msec of flash illumination. Slightly misaligned images of separate wavelengths due to slight eye motion were registered and corrected by translational and rotational image registration prior to analysis. Numerical values of relative oxygen saturation of retinal arteries and veins and the underlying tissue in between the artery/vein pairs were evaluated by an algorithm previously described, but which is now corrected for blood volume from averaged pixels (n > 1000). Color saturation maps were constructed by applying the algorithm at each image pixel using a Matlab script. Results: Both the numerical values of relative oxygen saturation and the saturation maps correspond to the physiological condition, that is, in a normal retina, the artery is more saturated than the tissue and the tissue is more saturated than the vein. With the multi-spectral fundus camera and proper registration of the multi-wavelength images, we were able to determine oxygen saturation in the primate retinal structures on a tolerable time scale which is applicable to human subjects. Conclusions: Seven wavelength multi-spectral imagery can be used to measure oxygen saturation in retinal artery, vein, and tissue (microcirculation). This technique is safe and can be used to monitor oxygen uptake in humans. This work

  3. Cerebral Arterial Fenestrations (United States)

    Cooke, Daniel L; Stout, Charles E; Kim, Warren T; Kansagra, Akash P; Yu, John Paul; Gu, Amy; Jewell, Nicholas P; Hetts, Steven W; Higashida, Randall T; Dowd, Christopher F; Halbach, Van V


    Summary Arterial fenestrations are an anatomic variant with indeterminate significance. Given the controversy surrounding fenestrations we sought their prevalence within our practice along with their association with other cerebrovascular anomalies. We retrospectively reviewed 10,927 patients undergoing digital subtraction angiography between 1992 and 2011. Dictated reports were searched for the terms “fenestration” or “fenestrated” with images reviewed for relevance, yielding 228 unique cases. A Medline database search from February 1964 to January 2013 generated 304 citations, 127 cases of which were selected for analysis. Cerebral arterial fenestrations were identified in 228 patients (2.1%). At least one aneurysm was noted in 60.5% of patients, with an aneurysm arising from the fenestration in 19.6% of patients. Aneurysmal subarachnoid hemorrhage or non-aneurysmal subarachnoid hemorrhage were present in 60.1% and 15.8%, respectively. For the subset of patients with an aneurysm arising directly from a fenestration relative to those patients with an aneurysm not immediately associated with a fenestration, the prevalence of aneurysmal subarachnoid hemorrhage was 66.7% vs. 58.6% (p = 0.58). Fenestrations were more often within the posterior circulation (73.2%) than the anterior circulation (24.6%), though there was no difference in the prevalence of aneurysms within these groups (61.1% vs. 60.7%, p = 1.0). Cerebral arterial fenestrations are an anatomic variant more often manifesting at the anterior communicating arterial complex and basilar artery and with no definite pathological relationship with aneurysms. PMID:24976087

  4. Comparison Between the Acute Pulmonary Vascular Effects of Oxygen with Nitric Oxide and Sildenafil

    Directory of Open Access Journals (Sweden)

    Ronald W. Day


    Full Text Available Objective. Right heart catheterization is performed in patients with pulmonary arterial hypertension to determine the severity of disease and their pulmonary vascular reactivity. The acute pulmonary vascular effect of inhaled nitric oxide is frequently used to identify patients who will respond favorably to vasodilator therapy. This study sought to determine whether the acute pulmonary vascular effects of oxygen with nitric oxide and intravenous sildenafil are similar. Methods. A retrospective, descriptive study of 13 individuals with pulmonary hypertension who underwent heart catheterization and acute vasodilator testing was performed. The hemodynamic measurements during five phases (21% to 53% oxygen, 100% oxygen, 100% oxygen with 20 ppm nitric oxide, 21% to 51% oxygen, and 21% to 51% oxygen with 0.05 mg/kg to 0.29 mg/kg intravenous sildenafil of the procedures were compared.Results. Mean pulmonary arterial pressure and pulmonary vascular resistance acutely decreased with 100% oxygen with nitric oxide, and 21% to 51% oxygen with sildenafil. Mean pulmonary arterial pressure (mm Hg, mean ± standard error of the mean was 38 ± 4 during 21% to 53% oxygen, 32 ± 3 during 100% oxygen, 29 ± 2 during 100% oxygen with nitric oxide, 37 ± 3 during 21% to 51% oxygen, and 32 ± 2 during 21% to 51% oxygen with sildenafil. There was not a significant correlation between the percent change in pulmonary vascular resistance from baseline with oxygen and nitric oxide, and from baseline with sildenafil (r2 = 0.011, p = 0.738. Conclusions. Oxygen with nitric oxide and sildenafil decreased pulmonary vascular resistance. However, the pulmonary vascular effects of oxygen and nitric oxide cannot be used to predict the acute response to sildenafil. Additional studies are needed to determine whether the acute response to sildenafil can be used to predict the long-term response to treatment with an oral phosphodiesterase V inhibitor.

  5. Cerebral perfusion, oxygenation and metabolism during exercise in young and elderly individuals

    DEFF Research Database (Denmark)

    Fisher, James P; Hartwich, Doreen; Seifert, Thomas


    artery blood velocity (MCA V(mean)), mean arterial pressure (MAP), cardiac output (CO) and the partial pressure of arterial carbon dioxide (PaCO(2)) were measured. Blood samples were obtained from the right internal jugular vein and brachial artery to determine concentration differences for oxygen (O(2......)), glucose and lactate across the brain. The molar ratio between the cerebral uptake of O(2) versus carbohydrate (O(2)-carbohydrate index; O(2) / [glucose + 0.5 lactate]; OCI), the cerebral metabolic rate of O(2) (CMRO(2)) and changes in mitochondrial O(2) tension (P(mito)O(2)) were calculated. W...

  6. Hyperbaric Oxygen Therapy Registry (United States)


    Air or Gas Embolism; Carbon Monoxide Poisoning; Clostridial Myositis and Myonecrosis (Gas Gangrene); Crush Injury, Compartment Syndrome & Other Acute Traumatic Ischemias; Decompression Sickness; Peripheral Arterial Insufficiency and Central Retinal Artery Occlusion; Severe Anemia; Intracranial Abscess; Necrotizing Soft Tissue Infections; Osteomyelitis (Refractory); Delayed Radiation Injury (Soft Tissue and Bony Necrosis); Compromised Grafts and Flaps; Acute Thermal Burn Injury; Idiopathic Sudden Sensorineural Hearing Loss

  7. Arterial Blood Gases, Electrolytes and Metabolic Indices Associated with Hemorrhagic Shock: Inter-and Intrainbred Rat Strain Variation (United States)


    cellular changes and compensatory responses. Such ABM include arterial blood gases ( PaO2 , PaCO2, oxygen content); electrolytes (potassium, sodium, cal...1.34 SaO2) (0.003 PaO2 ) where PaO2 arterial oxygen pressure, and SaO2 arterial oxygen saturation. Oxygen content reflects the total volume...TCO2, 2.4%, 2.3%; pH, 0.02%, 0.08%; BE, 10.8%, 21.6%; Na, 0.0%, 0.4%; K, 2.0%, 0.9%; glucose, 1.4%, 2.3%; Ca, 0.8%, 1.2%; PaO2 , 3.4%, 1.3%; oxygen

  8. Using broadband spatially resolved NIRS to assess muscle oxygenation during altered running protocols (United States)

    Koukourakis, Georg; Vafiadou, Maria; Steimers, André; Geraskin, Dmitri; Neary, Patrick; Kohl-Bareis, Matthias


    We used spatially resolved near-infrared spectroscopy (SRS-NIRS) to assess calf and thigh muscle oxygenation during running on a motor-driven treadmill. Two protocols were used: An incremental speed protocol (velocity = 6 - 12 km/h, ▵v = 2 km/h) was performed in 3 minute stages, while a pacing paradigm modulated step frequency alternatively (2.3 Hz [SLow]; 3.3 Hz [SHigh]) during a constant velocity for 2 minutes each. A SRS-NIRS broadband system (600 - 1000 nm) was used to measure total haemoglobin concentration and oxygen saturation (SO2). An accelerometer was placed on the hip joints to measure limb acceleration through the experiment. The data showed that the calf (SO2 58 to 42%) desaturated to a significantly lower level than the thigh (61 to 54%). During the pacing protocol, SO2 was significantly different between the SLow vs. SHigh trials. Additionally, physiological data as measured by spirometry were different between the SLow vs. SHigh pacing trials (VO2 (2563+/- 586 vs. 2503 +/- 605 mL/min). Significant differences in VO2 at the same workload (speed) indicate alterations in mechanical efficiency. These data suggest that SRS broadband NIRS can be used to discern small changes in muscle oxygenation, making this device useful for metabolic exercise studies in addition to spirometry and movement monitoring by accelerometers.

  9. Frontal lobe oxygenation is maintained during hypotension following propofol-fentanyl anesthesia

    NARCIS (Netherlands)

    P. Nissen; J.J. van Lieshout; H.B. Nielsen; N.H. Secher


    Near-infrared spectroscopy (NIRS) assesses cerebral oxygen saturation (Sco2) as a balance between cerebral oxygen delivery and consumption. In 71 patients, we evaluated whether marked reduction in mean arterial pressure (MAP) during propofol-fentanyl anesthesia induction affects frontal lobe Sco2. T

  10. Muscle oxygen kinetics at onset of intense dynamic exercise in humans

    DEFF Research Database (Denmark)

    Bangsbo, J; Krustrup, P; González-Alonso, J;


    , and 4.7 +/- 0.5 s at the end of exercise. Arterial venous O(2) difference (a-v(diff) O(2)) of 18 +/- 5 ml/l before the exercise was unchanged after 2 s, but it increased (P ... of exercise. The limited oxygen utilization in the initial phase of intense exercise is not caused by insufficient oxygen availability....

  11. Oxygen therapy for sepsis patients in the emergency department : a little less?

    NARCIS (Netherlands)

    Stolmeijer, Renate; ter Maaten, Jan C.; Zijlstra, Jan G.; Ligtenberg, Jack J. M.


    Liberal oxygen therapy has been a cornerstone in the treatment of critically ill patients. Recently, awareness of hyperoxia toxicity has emerged. We investigated the partial pressure of oxygen in arterial blood (PaO2) in sepsis patients admitted to the emergency department treated with a reduced ins

  12. Extra corporeal membrane oxygenation in newborns : implications for brain and lung

    NARCIS (Netherlands)

    Heijst, Adrianus Franciscus Jacobus van


    Extracorporeal membrane oxygenation (ECMO) is a rescue treatment for newborns with severe respiratory insufficiency. In veno-arterial ECMO, venous blood is drained from the right atrium, oxygenated in an artificial lung and reinfused in the aorta. For vascular access the right internal jugular vein

  13. Trophoblast invasion and oxygenation of the placenta: measurements versus presumptions. (United States)

    Huppertz, Berthold; Weiss, Gregor; Moser, Gerit


    Invasion of extravillous trophoblast into maternal tissues has a profound effect on the oxygenation of the placenta and hence the fetus. The main route of trophoblast invasion is interstitial invasion into the tissues of the decidua and myometrium. From this main route side branches reach the spiral arteries (endovascular trophoblast) as well as the uterine glands (endoglandular trophoblast) to open both structures toward the intervillous space. This enables histiotrophic nutrition in the first trimester and hemotrophic nutrition in the second and third trimesters of pregnancy. Failure of endovascular trophoblast invasion has profound effects on the oxygenation of the placenta. Interestingly, this does not lead to hypoxia as has long been presumed. Rather, all measurements available today point to increased oxygen levels within the placenta in patients with a failure of spiral artery transformation. This should lead to a rethink regarding pathological conditions such as intrauterine growth restriction and preeclampsia.

  14. Minimally invasive compared to conventional approach for coronary artery bypass grafting improves outcome

    Directory of Open Access Journals (Sweden)

    Jitumoni Baishya


    Full Text Available Introduction: Minimally invasive (MI cardiac surgery is a rapidly gaining popularity, globally as well as in India. We aimed to compare the outcome of MI to the conventional approach for coronary artery bypass graft (CABG surgery. Methods: This prospective, comparative study was conducted at a tertiary care cardiac surgical center. All patients who underwent CABG surgery via MI approach (MI group from July 2015 to December 2015 were enrolled and were compared against same number of EuroSCORE II matched patients undergoing CABG through conventional mid-sternotomy approach (CON group. Demographic, intra- and post-operative variables were collected. Results: In MI group, duration of the surgery was significantly longer (P = 0.029. Intraoperative blood loss lesser (P = 0.002, shorter duration of ventilation (P = 0.002, shorter Intensive Care Unit stay (P = 0.004, shorter hospital stay (P = 0.003, lesser postoperative analgesic requirements (P = 0.027, and lower visual analog scale scores on day of surgery (P = 0.032 and 1 st postoperative day (P = 0.025. No significant difference in postoperative blood loss, blood transfusion, or duration of inotrope requirement observed. There was no conversion to mid-sternotomy in any patients, 8% of patients had desaturation intraoperatively. There was no operative mortality. Conclusion: MI surgery is associated with lesser intraoperative blood loss, better analgesia, and faster recovery.

  15. Caliber-Persistent Artery

    Directory of Open Access Journals (Sweden)

    Sabrina Araújo Pinho Costa


    Full Text Available Caliber-persistent artery (CPLA of the lip is a common vascular anomaly in which a main arterial branch extends to the surface of the mucous tissue with no reduction in its diameter. It usually manifests as pulsatile papule, is easily misdiagnosed, and is observed more frequently among older people, suggesting that its development may involve a degenerative process associated with aging; CPLA is also characterized by the loss of tone of the adjacent supporting connective tissue. Although the diagnosis is clinical, high-resolution Doppler ultrasound is a useful noninvasive tool for evaluating the lesion. This report describes the case of a 58-year-old male patient who complained of a lesion of the lower lip with bleeding and recurrent ulceration. The patient was successfully treated in our hospital after a diagnosis of CPLA and is currently undergoing a clinical outpatient follow-up with no complaints.

  16. Renal Artery Stent Outcomes (United States)

    Murphy, Timothy P.; Cooper, Christopher J.; Matsumoto, Alan H.; Cutlip, Donald E.; Pencina, Karol M.; Jamerson, Kenneth; Tuttle, Katherine R.; Shapiro, Joseph I.; D’Agostino, Ralph; Massaro, Joseph; Henrich, William; Dworkin, Lance D.


    BACKGROUND Multiple randomized clinical trials comparing renal artery stent placement plus medical therapy with medical therapy alone have not shown any benefit of stent placement. However, debate continues whether patients with extreme pressure gradients, stenosis severity, or baseline blood pressure benefit from stent revascularization. OBJECTIVES The study sought to test the hypothesis that pressure gradients, stenosis severity, and/or baseline blood pressure affects outcomes after renal artery stent placement. METHODS Using data from 947 patients with a history of hypertension or chronic kidney disease from the largest randomized trial of renal artery stent placement, the CORAL (Cardiovascular Outcomes in Renal Atherosclerotic Lesions) study, we performed exploratory analyses to determine if subsets of patients experienced better outcomes after stent placement than the overall cohort. We examined baseline stenosis severity, systolic blood pressure, and translesion pressure gradient (peak systolic and mean) and performed interaction tests and Cox proportional hazards analyses for the occurrence of the primary endpoint through all follow-up, to examine the effect of these variables on outcomes by treatment group. RESULTS There were no statistically significant differences in outcomes based on the examined variables nor were there any consistent nonsignificant trends. CONCLUSIONS Based on data from the CORAL randomized trial, there is no evidence of a significant treatment effect of the renal artery stent procedure compared with medical therapy alone based on stenosis severity, level of systolic blood pressure elevation, or according to the magnitude of the transstenotic pressure gradient. (Benefits of Medical Therapy Plus Stenting for Renal Atherosclerotic Lesions [CORAL]; NCT00081731) PMID:26653621

  17. The relation between oxygen saturation level and retionopathy of prematurity

    Directory of Open Access Journals (Sweden)

    Mohammad Gharavi Fard


    Full Text Available Introduction: Oxygen therapy used for preterm infant disease might be associated with oxygen toxicity or oxidative stress. The exact oxygen concentration to control and maintain the arterial oxygen saturation balance is not certainly clear. We aimed to compare the efficacy of higher or lower oxygen saturations on the development of severe retinopathy of prematurity which is a major cause of blindness in preterm neonates. Methods: PubMed was searched for obtaining the relevant articles. A total of seven articles were included after studying the titles, abstracts, and the full text of retrieved articles at initial search. Inclusion criteria were all the English language human clinical randomized controlled trials with no time limitation, which studied the efficacy of low versus high oxygen saturation measured by pulse oximetry in preterm infants.Result: It can be suggested that lower limits of oxygen saturations have higher efficacy at postmesetural age of ≤28 weeks in preterm neonates. This relation has been demonstrated in five large clinical trials including three Boost trials, COT, and Support.Discussion: Applying higher concentrations of oxygen supplementations at mesentural age ≥32 weeks reduced the development of retinopathy of prematurity. Lower concentrations of oxygen saturation decreased the incidence and the development of retinopathy of prematurity in preterm neonates while applied soon after the birth.Conclusions: Targeting levels of oxygen saturation in the low or high range should be performed cautiously with attention to the postmesentural age in preterm infants at the time of starting the procedures.

  18. Case Report: Coronary arterial spasm in single right coronary artery

    Institute of Scientific and Technical Information of China (English)

    En-zhi JIA; Qi-jun SHAN; Zhi-jian YANG; Tie-bing ZHU; Lian-sheng WANG; Ke-jiang CAO; Wen-zhu MA


    We presented a case of anomalous single-coronary artery detected incidentally during routine coronary angiography. A 32-year-old male Chinese patient presented with recurrent pre-syncope and six episodes of syncope. Coronary angiography and coronary-computed tomography (CT)-angiography performed by a dual-source computed tomography (DSCT) revealed that the patient had a single large right coronary artery. A moderately large branch originated from the proximal part of the single right coronary artery and extended to the left, passing the anterior to the pulmonary artery, and divided into the anterior descending artery branch and circumflex branch at the base of the left auricular appendage. The episodes of the syncope were suspected to be caused by coronary arterial spasm, so this patient was on a regimen of 30 mg of diltiazem every 6 h and had no recurrence of syncope during follow-up.

  19. Oxygen transport membrane

    DEFF Research Database (Denmark)


    The present invention relates to a novel composite oxygen transport membrane as well as its preparation and uses thereof.......The present invention relates to a novel composite oxygen transport membrane as well as its preparation and uses thereof....

  20. Hyperbaric oxygen therapy (United States)

    ... page: // Hyperbaric oxygen therapy To use the sharing features on this page, please enable JavaScript. Hyperbaric oxygen therapy uses a special pressure chamber to increase ...

  1. Home Oxygen Therapy (United States)

    ... Teenagers Living With Lung Disease Articles written by Respiratory Experts Home Oxygen Therapy More and more people are using oxygen therapy ... April 12, 2012 Revised: © 2017 American Association for Respiratory Care

  2. Biogeochemistry: Oxygen burrowed away

    NARCIS (Netherlands)

    Meysman, F.J.R.


    Multicellular animals probably evolved at the seafloor after a rise in oceanic oxygen levels. Biogeochemical model simulations suggest that as these animals started to rework the seafloor, they triggered a negative feedback that reduced global oxygen.

  3. Blood oxygenation during hyperpressure intraperitoneal fluid administration in a rabbit model of severe liver injury: Evaluation of a novel concept for control of pre-hospital liver bleeding. (United States)

    Ahmadi-Noorbakhsh, Siavash; Azizi, Saeed; Dalir-Naghadeh, Bahram; Maham, Masoud


    Oxygen is an essential part of the most important metabolic pathways in aerobic organisms. Oxygen delivery is merely dependent on blood, rendering blood loss a devastating event. Traumatic pre-hospital liver bleeding is a major cause of early trauma deaths in human and animals, with no established therapeutic method yet. Increasing intra-abdominal pressure (IAP) has been shown to reduce liver bleeding by half. Although reduction of blood loss could be in favor of blood oxygen delivery, however, the complex interaction between increased IAP and respiratory mechanics during severe hemorrhagic shock remained unclear. We used a novel model of liver trauma in 16 rabbits and randomly assigned them to either normotensive abdomen group or increased IAP by fluid infusion (HA) groups (n=8 each). Liver size and the amount of liver injury were evaluated. Various blood oxygenation parameters were recorded. Both groups were identical in terms of the liver size and injury. The HA group had significantly lower shock index. Arterial oxygen capacity and oxygen content were higher in the HA group. No significant statistical difference was seen between groups in terms of abdominal perfusion pressure; alveolar pressure of oxygen; dissolved oxygen in blood plasma; alveolar to arterial oxygen tension gradient; arterial to alveolar oxygen pressure ratio; the ratio between partial pressure of arterial oxygen and fraction of inspired oxygen; and respiratory index. In conclusion, the novel therapeutic method of increasing IAP by fluid infusion in a rabbit model of liver hemorrhage preserved blood oxygenation better than the classic therapeutic method.

  4. Blood oxygenation during hyperpressure intraperitoneal fluid administration in a rabbit model of severe liver injury: Evaluation of a novel concept for control of pre-hospital liver bleeding

    Directory of Open Access Journals (Sweden)

    Siavash Ahmadi-Noorbakhsh


    Full Text Available Oxygen is an essential part of the most important metabolic pathways in aerobic organisms. Oxygen delivery is merely dependent on blood, rendering blood loss a devastating event. Traumatic pre-hospital liver bleeding is a major cause of early trauma deaths in human and animals, with no established therapeutic method yet. Increasing intra-abdominal pressure (IAP has been shown to reduce liver bleeding by half. Although reduction of blood loss could be in favor of blood oxygen delivery, however, the complex interaction between increased IAP and respiratory mechanics during severe hemorrhagic shock remained unclear. We used a novel model of liver trauma in 16 rabbits and randomly assigned them to either normotensive abdomen group or increased IAP by fluid infusion (HA groups (n=8 each. Liver size and the amount of liver injury were evaluated. Various blood oxygenation parameters were recorded. Both groups were identical in terms of the liver size and injury. The HA group had significantly lower shock index. Arterial oxygen capacity and oxygen content were higher in the HA group. No significant statistical difference was seen between groups in terms of abdominal perfusion pressure; alveolar pressure of oxygen; dissolved oxygen in blood plasma; alveolar to arterial oxygen tension gradient; arterial to alveolar oxygen pressure ratio; the ratio between partial pressure of arterial oxygen and fraction of inspired oxygen; and respiratory index. In conclusion, the novel therapeutic method of increasing IAP by fluid infusion in a rabbit model of liver hemorrhage preserved blood oxygenation better than the classic therapeutic method.

  5. Oxygen evolution reaction catalysis (United States)

    Haber, Joel A.; Jin, Jian; Xiang, Chengxiang; Gregoire, John M.; Jones, Ryan J.; Guevarra, Dan W.; Shinde, Aniketa A.


    An Oxygen Evolution Reaction (OER) catalyst includes a metal oxide that includes oxygen, cerium, and one or more second metals. In some instances, the cerium is 10 to 80 molar % of the metals in the metal oxide and/or the catalyst includes two or more second metals. The OER catalyst can be included in or on an electrode. The electrode can be arranged in an oxygen evolution system such that the Oxygen Evolution Reaction occurs at the electrode.

  6. Massive cerebral arterial air embolism following arterial catheterization

    Energy Technology Data Exchange (ETDEWEB)

    Yang, C.W. [Northwestem University Feinberg School of Medicine, Department of Radiology, Chicago, IL (United States); Yang, B.P. [Northwestern University Feinberg School of Medicine, Department of Neurological Surgery, Chicago, IL (United States)


    Microscopic cerebral arterial air embolism (CAAE) has been described in many patients undergoing cardiac surgery as well as other invasive diagnostic and therapeutic procedures. However, massive CAAE is rare. We report a 42-year-old woman who initially presented with thalamic and basal ganglia hemorrhages. Shortly after a radial arterial catheter was inserted, the patient suffered a generalized seizure and CT demonstrated intra-arterial air in bilateral cerebral hemispheres. (orig.)

  7. Importância da ventilação pulmonar no transporte de 0(2 e equilíbrio ácido-base após desclampeamento intermitente de aorta na revascularização cirúrgica do miocárdio: desclamping in coronary artery bypass graft Importance of lung ventilation on oxygen transport and acid-base balance after intermittent aortic cross

    Directory of Open Access Journals (Sweden)

    Marilde de Albuquerque Piccioni


    controversy of the need of lung ventilation on prevention of the hypoxemia. The purpose of this work was to verify the importance of lung ventilation on oxygen transport and acidbase balance in blood that will reperfuse the myocardium following aortic desclamping. Ten patients undergoing coronary artery bypass graft under moderate hypothermia were divided in two groups: I - Lung ventilation was carried out after aortic desclamping. II - Lung ventilation wasn't done following aortic desclamping. Blood samples were collected from the left right atrium, aorta, radial and pulmonary artery and the both sides of bypass circuit (venous and arterial. Oxygem saturation, oxygen tension, carbon dioxide tension, and blood pH were evaluated in the both groups. The results showed no statistical difference between groups concerning oxygen saturation. The pH decreases significantly in patients of Group II, due to a sharp elevation of PCO2. Although no significative hypoxemia could be observed, the respiratory acidosis that appeared in Group II suggests the importance of ventilation of the lungs as soon as possible after aortic desclamping. It is important to remember that myocardial contractility may be depressed by hydrogen ions (H+ in excess.

  8. Arterial stiffness as a risk factor for coronary artery disease. (United States)

    Liao, Josh; Farmer, John


    Hypertension is a major modifiable risk factor, and clinical trials have demonstrated that successful reduction of elevated blood pressure to target levels translates into decreased risk for the development of coronary artery disease, stroke, heart failure, and renal failure. The arterial system had previously been regarded as a passive conduit for the transportation of arterial blood to peripheral tissues. The physiologic role the arterial system was greatly expanded by the recognition of the central role of the endothelial function in a variety of physiologic processes. The role of arterial function and structure in cardiovascular physiology was expanded with the development of a variety of parameters that evaluate arterial stiffness. Markers of arterial stiffness have been correlated with cardiovascular outcomes, and have been classified as an emerging risk factor that provides prognostic information beyond standard stratification strategies involving hypertension, diabetes, obesity, dyslipidemia and smoking. Multiple epidemiologic studies have correlated markers of arterial stiffness such as pulse-wave velocity, augmentation index and pulse pressure with risk for the development of fatal and nonfatal cardiovascular events. Additionally, measurements of arterial stiffness had clarified the results of clinical trials that demonstrated differing impacts on clinical outcomes, despite similar reductions in blood pressure, as measured by brachial and sphygmomanometry.

  9. Aerobic exercise training increases plasma Klotho levels and reduces arterial stiffness in postmenopausal women. (United States)

    Matsubara, Tomoko; Miyaki, Asako; Akazawa, Nobuhiko; Choi, Youngju; Ra, Song-Gyu; Tanahashi, Koichiro; Kumagai, Hiroshi; Oikawa, Satoshi; Maeda, Seiji


    The Klotho gene is a suppressor of the aging phenomena, and the secretion as well as the circulation of Klotho proteins decrease with aging. Although habitual exercise has antiaging effects (e.g., a decrease in arterial stiffness), the relationship between Klotho and habitual exercise remains unclear. In the present study, we investigated the effect of habitual exercise on Klotho, with a particular focus on arterial stiffness. First, we examined the correlation between plasma Klotho concentration and arterial stiffness (carotid artery compliance and β-stiffness index) or aerobic exercise capacity [oxygen uptake at ventilatory threshold (VT)] in 69 healthy, postmenopausal women (50-76 years old) by conducting a cross-sectional study. Second, we tested the effects of aerobic exercise training on plasma Klotho concentrations and arterial stiffness. A total of 19 healthy, postmenopausal women (50-76 years old) were divided into two groups: control group and exercise group. The exercise group completed 12 wk of moderate aerobic exercise training. In the cross-sectional study, plasma Klotho concentrations positively correlated with carotid artery compliance and VT and negatively correlated with the β-stiffness index. In the interventional study, aerobic exercise training increased plasma Klotho concentrations and carotid artery compliance and decreased the β-stiffness index. Moreover, the changes in plasma Klotho concentration and arterial stiffness were found to be correlated. These results suggest a possible role for secreted Klotho in the exercise-induced modulation of arterial stiffness.

  10. Application of hyperbaric oxygen in liver transplantation

    Directory of Open Access Journals (Sweden)

    Hu Lv


    Full Text Available In recent years, hyperbaric oxygen (HBO has been used in the treatment of a lot of diseases such as decompression sickness, arterial gas embolism, carbon dioxide poisoning, soft tissue infection, refractory osteomyelitis, and problematic wound, but little is known about its application in liver transplantation. Although several studies have been conducted to investigate the protective effects of HBO on liver transplantation and liver preservation, there are still some controversies on this issue, especially its immunomodulatory effect. In this short review, we briefly summarize the findings supporting the application of HBO during liver transplantation (including donors and recipients.

  11. Arterial responses during migraine headache

    DEFF Research Database (Denmark)

    Iversen, Helle Klingenberg; Nielsen, T H; Olesen, J


    The superficial temporal artery has been thought to be the main focus of pain during migraine attacks, but its diameter has never been measured directly. The use of a new, high-resolution ultrasound machine to measure arterial size in 25 migraine patients with unilateral head pain showed...... that the lumen was wider on the painful than on the non-painful side during a migraine attack. The diameters of both radial arteries and the temporal artery on the non-painful side were smaller during than between attacks. The generalised vasoconstriction was not shared by the temporal artery on the affected...... side, which suggests a local vasodilatory response. The findings suggest that cephalic arteries may play a role in migraine pathogenesis....

  12. True aneurysm of brachial artery. (United States)

    Hudorović, Narcis; Lovričević, Ivo; Franjić, Dario Bjorn; Brkić, Petar; Tomas, Davor


    True upper extremity peripheral artery aneurysms are a rarely encountered arterial disorder. Following computer-tomography angiographic (CT-a) imaging examination, true saccular aneurysm, originating from the left brachial artery was diagnosed in the 77-year-old female without history of trauma. The aneurysm was resected by surgical intervention, and primary repair of the brachial artery was performed by interposition of a part of great saphenous vein harvested from the left groin and creation of two end-to-end anastomoses between interposition graft and previously resected part of brachial artery. No complication was observed during the follow-up. Surgical intervention for upper extremity aneurysms should be initiated without delay. Factors combined with minimal morbidity associated with repair suggest that surgical repair should be performed routinely for true upper extremity arterial aneurysms.

  13. Age, hypertension and arterial function. (United States)

    McEniery, Carmel M; Wilkinson, Ian B; Avolio, Albert P


    1. Ageing exerts a marked effect on the cardiovascular system and, in particular, the large arteries. Using a variety of techniques to assess arterial stiffness, many cross-sectional studies have demonstrated a significant relationship between age and aortic stiffness, although the age-related changes observed in peripheral arteries appear to be less marked. 2. The relationship between arterial stiffness and hypertension is more complex. The distending, or mean arterial, pressure is an important confounder of measurements of arterial stiffness and, therefore, must be taken into consideration when assessing arterial stiffness in hypertensive subjects or investigating the effect of antihypertensive agents. Current methods for correcting for differences in distending pressure involve pharmacological manipulation, statistical correction or mathematical manipulation of stiffness indices. 3. Many studies have provided evidence that both peripheral (muscular) and central (elastic) arteries are stiffer in subjects with mixed (systolic/diastolic) hypertension compared with normotensive subjects. However, it is unclear to what extent differences in mean arterial pressure explain the observed differences in hypertensive subjects. In contrast, isolated systolic hypertension is associated with increased aortic, but not peripheral artery, stiffness, although the underlying mechanisms are somewhat unclear. 4. Traditional antihypertensive agents appear to reduce arterial stiffness, but mostly via an indirect effect of lowering mean pressure. Therefore, therapies that target the large arteries to reduce stiffness directly are urgently required. Agents such as nitric oxide donors and phosphodiesterase inhibitors may be useful in reducing stiffness via functional mechanisms. In addition, inhibitors or breakers of advanced glycation end-product cross-links between proteins, such as collagen and elastin, hold substantial promise.

  14. The right hepatic artery syndrome

    Institute of Scientific and Technical Information of China (English)

    Kazumi Miyashita; Katsuya Shiraki; Takeshi Ito; Hiroki Taoka; Takeshi Nakano


    Various benign and malignant conditions could cause biliary obstruction. Compression of extrahepatic bile duct (EBD) by right hepatic artery was reported as a right hepatic artery syndrome but all cases were compressed EBD from stomach side. Our case compressed from dorsum was not yet reported, so it was thought to be a very rare case. We present here the first case of bile duct obstruction due to the compression of EBD from dorsum by right hepatic artery.

  15. Management of Sepsis in Patients with Pulmonary Arterial Hypertension in the Intensive Care Unit. (United States)

    Tartavoulle, Todd M


    Pulmonary arterial hypertension is a lethal condition, and the management of sepsis in patients with pulmonary arterial hypertension is challenging. As the disease progresses, the right ventricle is susceptible to failure due to a high pulmonary vascular resistance. The limited ability of the right ventricle to increase cardiac output in septic shock makes it difficult to deliver oxygen to the organ and tissues. Intravascular volume replacement and vasoactive drugs should only be considered after a thorough assessment. Priorities of care include improving cardiac output and oxygen delivery by optimizing preload, reducing afterload, and improving contractility.

  16. Countercurrent aortography via radial artery

    Energy Technology Data Exchange (ETDEWEB)

    Sohn, Hyung Kuk; Lee, Young Chun; Lee, Seung Chul; Jeon, Seok Chol; Joo, Kyung Bin; Lee, Seung Ro; Kim, Soon Yong [College of Medicine, Hanyang University, Seoul (Korea, Republic of)


    Countercurrent aortography via radial artery was performed for detection of aortic arch anomalies in 4 infants with congenital heart disease. Author's cases of aortic arch anomalies were 3 cases of PDA, 1 case of coarctation of aorta, and 1 case of occlusion of anastomosis site on subclavian artery B-T shunt. And aberrant origin of the right SCA, interrupted aortic arch, hypoplastic aorta, anomalous origin of the right pulmonary artery from the ascending aorta can be demonstrated by this method. Countercurrent aortography affords an safe and simple method for detection of aortic arch anomalies without retrograde arterial catheterization, especially in small infants or premature babies.

  17. Arterial Abnormalities Leading to Tinnitus. (United States)

    Miller, Timothy R; Serulle, Yafell; Gandhi, Dheeraj


    Tinnitus is a common symptom that usually originates in the middle ear. Vascular causes of pulsatile tinnitus are categorized by the location of the source of the noise within the cerebral-cervical vasculature: arterial, arteriovenous, and venous. Arterial stenosis secondary to atherosclerotic disease or dissection, arterial anatomic variants at the skull base, and vascular skull base tumors are some of the more common causes of arterial and arteriovenous pulsatile tinnitus. Noninvasive imaging is indicated to evaluate for possible causes of pulsatile tinnitus, and should be followed by catheter angiography if there is a strong clinical suspicion for a dural arteriovenous fistula.

  18. Pulmonary arterial hypertension in pregnancy. (United States)

    Običan, Sarah G; Cleary, Kirsten L


    Pulmonary hypertension is a medical condition characterized by elevated pulmonary arterial pressure and secondary right heart failure. Pulmonary arterial hypertension is a subset of pulmonary hypertension, which is characterized by an underlying disorder of the pulmonary arterial vasculature. Pulmonary hypertension can also occur secondarily to structural cardiac disease, autoimmune disorders, and toxic exposures. Although pregnancies affected by pulmonary hypertension and pulmonary arterial hypertension are rare, the pathophysiology exacerbated by pregnancy confers both high maternal and fetal mortality and morbidity. In light of new treatment modalities and the use of a multidisciplinary approach to care, maternal outcomes may be improving.

  19. Use of extracorporeal membrane oxygenation in adults. (United States)

    Lafç, Gökhan; Budak, Ali Baran; Yener, Ali Ümit; Cicek, Omer Faruk


    Since the first successful application of the heart-lung machine in 1953 by John Gibbon [1], great efforts have been made to modify the bypass techniques and devices in order to allow prolonged extracorporeal circulation in the intensive care unit (ICU), commonly referred to as extracorporeal membrane oxygenation (ECMO). ECMO uses classic cardiopulmonary bypass technology to support circulation. It provides continuous, non-pulsatile cardiac output and extracorporeal oxygenation [2]. Veno-venous ECMO (VV ECMO) provides respiratory support, while veno-arterial ECMO (VA ECMO) provides cardio-respiratory support to patients with severe but potentially reversible cardiac or respiratory deterioration refractory to standard therapeutic modalities. ECMO is a temporary form of life support providing a prolonged biventricular circulatory and pulmonary support for patients experiencing both pulmonary and cardiac failure unresponsive to conventional therapy. Despite the advent of newer ventricular assist devices that are more suitable for long term support, ECMO is simple to establish, cost-effective to operate.

  20. [Measurement of arterial pressure]. (United States)

    Rorive, G


    The casual determination of blood pressure remains the basis of the diagnosis of arterial hypertension and the criteria for usefulness of drug therapy. The reference values usually in use concern determinations by the doctor in very well defined conditions, rest, size of the bladder, etc.... The poor reproductibility of the determinations made by the doctor in casual conditions has produced a large interest for new approaches: autodetermination by the patient at home, and ambulatory blood pressure determinations using automatic devices. These new approaches have their own reference values, specific indications and limitations.

  1. Iatrogenic systemic air embolism treated with hyperbaric oxygen therapy

    DEFF Research Database (Denmark)

    Jørgensen, Thomas Bech; Sørensen, Allan Martini Ibsen; Jansen, Erik C.


    Air embolism is a rare and potentially severe complication of surgical and invasive procedures. Emboli large enough to produce symptoms require immediate treatment because of the risk of 'gas lock' in the right side of the heart and subsequent circulatory failure. If air is transmitted to the art...... to the arterial circulation through a shunt, it may cause cerebral emboli with neurological symptoms. We present two cases with venous air emboli and concurrent cerebral arterial emboli. Both patients were successfully treated with hyperbaric oxygen therapy Udgivelsesdato: 2008/4...

  2. Reference values for local arterial stiffness. Part B : femoral artery

    NARCIS (Netherlands)

    Bossuyt, Jelle; Engelen, Lian; Ferreira, Isabel; Stehouwer, Coen D; Boutouyrie, Pierre; Laurent, Stéphane; Segers, Patrick; Reesink, Koen; Van Bortel, Luc M


    OBJECTIVE: Carotid-femoral pulse wave velocity (PWV) is considered the gold standard measure of arterial stiffness, representing mainly aortic stiffness. As compared with the elastic carotid and aorta, the more muscular femoral artery may be differently associated with cardiovascular risk factors (C

  3. Dual anterior descending coronary artery associated with coronary artery disease

    Directory of Open Access Journals (Sweden)

    Siqueira Luciane da L. V.


    Full Text Available The patient is a male with risk factors for coronary artery disease, who was referred for cardiac catheterization after acute myocardial infarction in the inferior wall. The patient underwent transluminal coronary angioplasty in the right coronary artery with successful stent implantation.

  4. Association between internal carotid artery dissection and arterial tortuosity

    Energy Technology Data Exchange (ETDEWEB)

    Saba, Luca; Piga, Mario [Azienda Ospedaliero Universitaria (A.O.U.), Department of Radiology, Monserrato, Cagliari (Italy); Argiolas, Giovanni Maria; Siotto, Paolo [Azienda Ospedaliero Brotzu (A.O.B.), Department of Radiology, di Cagliari (Italy); Sumer, Suna; Wintermark, Max [Neuroradiology Division, Neuroradiology, UVA Department of Radiology, Charlottesville, VA (United States); Raz, Eytan [New York University School of Medicine, Department of Radiology, New York, NY (United States); Sapienza University of Rome, Department of Neurology and Psychiatry, Rome (Italy); Sanfilippo, Roberto; Montisci, Roberto [Azienda Ospedaliero Universitaria (A.O.U.), Department of Vascular Surgery, di Cagliari (Italy)


    Carotid artery dissection is an important cause of ischemic stroke in all age groups, particularly in young patients. The purpose of this work was to assess whether there is an association between the presence of an internal carotid artery dissection (ICAD) and the arterial tortuosity. This study considered 124 patients (72 males and 52 females; median age 57 years) with CT/MR diagnosis of ICAD of the internal carotid artery were considered in this multi-centric retrospective study. The arterial tortuosity was evaluated and, when present, was categorized as elongation, kinking, or coiling. For each patient, both the right and left sides were considered for a total number of 248 arteries in order to have the same number of cases and controls. Fisher's exact test was applied to test the association between elongation, kinking, coiling, dissection, and the side affected by CAD. Fisher's exact test showed a statistically significant association between the ICAD and kinking (p = 0.0089) and coiling (p = 0.0251) whereas no statistically significant difference was found with arterial vessel elongation (p = 0.444). ICAD was more often seen on the left side compared to the right (p = 0.0001). These results were confirmed using both carotid arteries of the same patient as dependent parameter with p = 0.0012, 0.0129, and 0.3323 for kinking, coiling, and elongation, respectively. The presence of kinking and coiling is associated with ICAD. (orig.)

  5. 42 CFR 414.226 - Oxygen and oxygen equipment. (United States)


    ... 42 Public Health 3 2010-10-01 2010-10-01 false Oxygen and oxygen equipment. 414.226 Section 414... Equipment and Prosthetic and Orthotic Devices § 414.226 Oxygen and oxygen equipment. (a) Payment rules—(1) Oxygen equipment. Payment for rental of oxygen equipment is made based on a monthly fee schedule...

  6. Genetics Home Reference: pulmonary arterial hypertension (United States)

    ... Home Health Conditions pulmonary arterial hypertension pulmonary arterial hypertension Enable Javascript to view the expand/collapse boxes. ... PDF Open All Close All Description Pulmonary arterial hypertension is a progressive disorder characterized by abnormally high ...

  7. Pulmonary artery perfusion versus no pulmonary perfusion during cardiopulmonary bypass in patients with COPD

    DEFF Research Database (Denmark)

    Buggeskov, Katrine B; Sundskard, Martin M; Jonassen, Thomas;


    INTRODUCTION: Absence of pulmonary perfusion during cardiopulmonary bypass (CPB) may be associated with reduced postoperative oxygenation. Effects of active pulmonary artery perfusion were explored in patients with chronic obstructive pulmonary disease (COPD) undergoing cardiac surgery. METHODS: 90...... starting CPB and longitudinally in a mixed-effects model (MEM). Secondary outcomes were tracheal intubation time, serious adverse events, mortality, days alive outside the intensive care unit (ICU) and outside the hospital. RESULTS: 21 hours after starting CPB patients receiving pulmonary artery perfusion...... with normothermic oxygenated blood had a higher oxygenation index compared with no pulmonary perfusion (mean difference (MD) 0.94; 95% CI 0.05 to 1.83; p=0.04). The blood group had also a higher oxygenation index both longitudinally (MEM, p=0.009) and at 21 hours (MD 0.99; CI 0.29 to 1.69; p=0.007) compared...

  8. Isolated superior mesenteric artery dissection

    Directory of Open Access Journals (Sweden)

    Lalitha Palle


    Full Text Available Isolated superior mesenteric artery (SMA dissection without involvement of the aorta and the SMA origin is unusual. We present a case of an elderly gentleman who had chronic abdominal pain, worse after meals. CT angiography, performed on a 64-slice CT scanner, revealed SMA dissection with a thrombus. A large artery of Drummond was also seen. The patient was managed conservatively.

  9. Epigenetics and Peripheral Artery Disease. (United States)

    Golledge, Jonathan; Biros, Erik; Bingley, John; Iyer, Vikram; Krishna, Smriti M


    The term epigenetics is usually used to describe inheritable changes in gene function which do not involve changes in the DNA sequence. These typically include non-coding RNAs, DNA methylation and histone modifications. Smoking and older age are recognised risk factors for peripheral artery diseases, such as occlusive lower limb artery disease and abdominal aortic aneurysm, and have been implicated in promoting epigenetic changes. This brief review describes studies that have associated epigenetic factors with peripheral artery diseases and investigations which have examined the effect of epigenetic modifications on the outcome of peripheral artery diseases in mouse models. Investigations have largely focused on microRNAs and have identified a number of circulating microRNAs associated with human peripheral artery diseases. Upregulating or antagonising a number of microRNAs has also been reported to limit aortic aneurysm development and hind limb ischemia in mouse models. The importance of DNA methylation and histone modifications in peripheral artery disease has been relatively little studied. Whether circulating microRNAs can be used to assist identification of patients with peripheral artery diseases and be modified in order to improve the outcome of peripheral artery disease will require further investigation.

  10. Pulmonary arterial hypertension : an update

    NARCIS (Netherlands)

    Hoendermis, E. S.


    Pulmonary arterial hypertension (PAH), defined as group 1 of the World Heart Organisation (WHO) classification of pulmonary hypertension, is an uncommon disorder of the pulmonary vascular system. It is characterised by an increased pulmonary artery pressure, increased pulmonary vascular resistance a

  11. Ambient oxygen promotes tumorigenesis.

    Directory of Open Access Journals (Sweden)

    Ho Joong Sung

    Full Text Available Oxygen serves as an essential factor for oxidative stress, and it has been shown to be a mutagen in bacteria. While it is well established that ambient oxygen can also cause genomic instability in cultured mammalian cells, its effect on de novo tumorigenesis at the organismal level is unclear. Herein, by decreasing ambient oxygen exposure, we report a ∼50% increase in the median tumor-free survival time of p53-/- mice. In the thymus, reducing oxygen exposure decreased the levels of oxidative DNA damage and RAG recombinase, both of which are known to promote lymphomagenesis in p53-/- mice. Oxygen is further shown to be associated with genomic instability in two additional cancer models involving the APC tumor suppressor gene and chemical carcinogenesis. Together, these observations represent the first report directly testing the effect of ambient oxygen on de novo tumorigenesis and provide important physiologic evidence demonstrating its critical role in increasing genomic instability in vivo.

  12. Integrated turbomachine oxygen plant (United States)

    Anand, Ashok Kumar; DePuy, Richard Anthony; Muthaiah, Veerappan


    An integrated turbomachine oxygen plant includes a turbomachine and an air separation unit. One or more compressor pathways flow compressed air from a compressor through one or more of a combustor and a turbine expander to cool the combustor and/or the turbine expander. An air separation unit is operably connected to the one or more compressor pathways and is configured to separate the compressed air into oxygen and oxygen-depleted air. A method of air separation in an integrated turbomachine oxygen plant includes compressing a flow of air in a compressor of a turbomachine. The compressed flow of air is flowed through one or more of a combustor and a turbine expander of the turbomachine to cool the combustor and/or the turbine expander. The compressed flow of air is directed to an air separation unit and is separated into oxygen and oxygen-depleted air.

  13. Arterial Stiffness: Recommendations and Standardization (United States)

    Townsend, Raymond R.


    The use of arterial stiffness measurements in longitudinal cohorts of normal populations, hypertensive patients, diabetic patients, healthy elderly, and patients on hemodialysis have confirmed the value of this important measure of arterial health, and established its complementary role to measures of blood pressure. Its contribution to understanding cardiovascular and mortality risk beyond blood pressure measurements has moved measures of arterial stiffness into the ranks of factors such as elevated cholesterol, diabetes, and left ventricular hypertrophy in considering cardiovascular risk. The recent international collaboration's publication of reference ranges for normal people and those with hypertension, along with the American Heart Association's recent scientific statement on standardizing arterial stiffness measurements are important aspects to consider in future studies employing these valuable methods, particularly as interventions that not only lower blood pressure but improve arterial function are tested in the clinical arena. PMID:28275588

  14. Liver cirrhosis and arterial hypertension

    DEFF Research Database (Denmark)

    Henriksen, Jens Henrik; Møller, Søren


    blood pressure. This review considers the alterations in systemic hemodynamics in patients with cirrhosis in relation to essential hypertension and arterial hypertension of the renal origin. Subjects with arterial hypertension (essential, secondary) may become normotensive during the development...... of cirrhosis, and arterial hypertension is rarely manifested in patients with cirrhosis, even in cases with renovascular disease and high circulating renin activity. There is much dispute as to the understanding of homoeostatic regulation in cirrhotic patients with manifest arterial hypertension. This most......Characteristic findings in patients with cirrhosis are vasodilatation with low overall systemic vascular resistance, high arterial compliance, increased cardiac output, secondary activation of counter-regulatory systems (renin-angiotensin-aldosterone system, sympathetic nervous system, release...

  15. Liver cirrhosis and arterial hypertension

    DEFF Research Database (Denmark)

    Henriksen, Jens Henrik; Møller, Søren


    blood pressure. This review considers the alterations in systemic hemodynamics in patients with cirrhosis in relation to essential hypertension and arterial hypertension of the renal origin. Subjects with arterial hypertension (essential, secondary) may become normotensive during the development...... of cirrhosis, and arterial hypertension is rarely manifested in patients with cirrhosis, even in cases with renovascular disease and high circulating renin activity. There is much dispute as to the understanding of homoeostatic regulation in cirrhotic patients with manifest arterial hypertension. This most...... likely includes the combination of vasodilatation and vasoconstriction in parallel. Arterial compliance; Central vascular filling; Chyperdynamic circulation; Kidney function, Nitric oxide; Blood pressure regulation; Renin–angiotensin–aldosterone system; Sympathetic nervous system; Vasodilatation...

  16. Obesity and arterial compliance alterations. (United States)

    Seifalian, Alexander M; Filippatos, Theodosios D; Joshi, Jatin; Mikhailidis, Dimitri P


    Obesity is associated with increased cardiovascular disease (CVD) risk, especially when excess body fat is distributed preferentially within the abdominal region. Obese subjects usually have increased arterial stiffness compared with non-obese subjects of similar age. The factors associated with increased arterial stiffness in obesity include endothelial dysfunction (decreased nitric oxide bioavailability), impaired smooth muscle cell function, insulin resistance, as well as elevated cholesterol and C-peptide levels. Furthermore, visceral fat, the adipose tissue-related renin-angiotensin-aldosterone system and hyperleptinaemia contribute to the obesity-associated impaired arterial compliance. Weight loss improves CVD risk factors and arterial compliance. Because increased arterial stiffness is a marker of CVD risk these findings support the concept that the presence of obesity has vascular implications.

  17. Solid state oxygen sensor (United States)

    Garzon, F.H.; Brosha, E.L.


    A potentiometric oxygen sensor is formed having a logarithmic response to a differential oxygen concentration while operating as a Nernstian-type sensor. Very thin films of mixed conducting oxide materials form electrode services while permitting diffusional oxygen access to the interface between the zirconia electrolyte and the electrode. Diffusion of oxygen through the mixed oxide is not rate-limiting. Metal electrodes are not used so that morphological changes in the electrode structure do not occur during extended operation at elevated temperatures. 6 figs.

  18. Measuring tissue oxygenation (United States)

    Soyemi, Olusola O. (Inventor); Soller, Babs R. (Inventor); Yang, Ye (Inventor)


    Methods and systems for calculating tissue oxygenation, e.g., oxygen saturation, in a target tissue are disclosed. In some embodiments, the methods include: (a) directing incident radiation to a target tissue and determining reflectance spectra of the target tissue by measuring intensities of reflected radiation from the target tissue at a plurality of radiation wavelengths; (b) correcting the measured intensities of the reflectance spectra to reduce contributions thereto from skin and fat layers through which the incident radiation propagates; (c) determining oxygen saturation in the target tissue based on the corrected reflectance spectra; and (d) outputting the determined value of oxygen saturation.

  19. Fatal dissection of the pulmonary artery in pulmonary arterial hypertension

    Directory of Open Access Journals (Sweden)

    B. Degano


    Full Text Available A 41-yr-old patient with chronic stable idiopathic pulmonary arterial hypertension (PAH presented with sudden chest pain and unusual dyspnoea during physical exertion. The patient had been diagnosed with PAH at the age of 12 yrs and was in New York Heart Association functional class I/II. The patient was being treated with an anticoagulant regimen, low-dose diuretics and continuous intravenous epoprostenol therapy. A computed tomography scan showed ancient massive thrombi in dilated central pulmonary arteries, which were not haemodynamically significant (perfusion lung scans did not demonstrate segmental or larger defects, and extensive dissection of the right pulmonary artery starting from the intermediate branch. Due to the extensiveness of the dissection, the patient was immediately considered for heart–lung transplantation, but died 72 h after the onset of symptoms. Permission for post mortem examination was denied. Pulmonary artery dissection should be suspected in PAH patients presenting with chest pain and worsening dyspnoea. In the current case, the factors possibly associated with increased risk for dissection may include dilatation of the pulmonary artery, local inflammation favoured by in situ thrombosis, and acute increase of pulmonary pressure secondary to physical exertion. Extensive pulmonary artery dissection is a life-threatening complication of PAH, and urgent heart/lung transplantation might be the treatment of choice in eligible patients. In addition, better identification of the risk factors for pulmonary artery dissection may help in considering transplantation for selected patients at risk.

  20. Chronic hypoxia during gestation enhances uterine arterial myogenic tone via heightened oxidative stress.

    Directory of Open Access Journals (Sweden)

    Daliao Xiao

    Full Text Available Chronic hypoxia during gestation has profound adverse effects on the adaptation of uteroplacental circulation in pregnancy. Yet, the underlying mechanisms are not fully understood. The present study tested the hypothesis that enhanced production of reactive oxygen species (ROS in uterine arteries plays a critical role in the maladaptation of uterine circulation associated with chronic hypoxia. Uterine arteries were isolated from nonpregnant and near-term pregnant sheep maintained at sea level (~300 m or exposed to high-altitude (3801 m hypoxia for 110 days. Hypoxia significantly increased ROS production in uterine arteries of pregnant, but not nonpregnant, sheep. This was associated with a significant increase in NADPH oxidase (Nox 2, but not Nox1 or Nox4, protein abundance and total Nox activity in uterine arteries of pregnant animals. Chronic hypoxia significantly increased pressure-dependent uterine arterial myogenic tone in pregnant sheep, which was abrogated by a Nox inhibitor apocynin. Additionally, the hypoxia-induced increase in myogenic reactivity of uterine arteries to phorbol 12,13-dibutyrate in pregnant sheep was blocked by apocynin and tempol. In consistence with the myogenic responses, the hypoxia-mediated down-regulation of BKCa channel activity in uterine arteries of pregnant animals was reversed by apocynin. The findings suggest that heightened oxidative stress in uterine arteries plays a key role in suppressing the BKCa channel activity, resulting in increased myogenic reactivity and maladaptation of uteroplacental circulation caused by chronic hypoxia during gestation.

  1. Blood oxygenation level dependent effect of cerebral ischemic penumbra in monkey reversible middle cerebral artery occlusion model%猴可复性大脑中动脉闭塞模型脑缺血半暗带的血氧水平依赖效应

    Institute of Scientific and Technical Information of China (English)

    张敬; 陈英敏; 张云亭


    Objective To investigate the value of blood oxygenation level dependent (BOLD) MRI in detecting monkey cerebral ischemic penumbra (IP). Methods Six monkeys were used to make reversible middle cerebral artery occlusion (MCAO) model by an interventional microcatheter method. MR DWI, PWI mean transit time (MTT), T_2WI and quantitative T_2 map, T_2~* map were performed at MCAO (0 h) and 1,3,6,12,24,48 h after reperfusion. Reversible transverse relaxation rate (R_2') BOLD imaging was calculated using quantitative T_2 and T_2~* maps. Lesion volume percentage (lesion volume/bilateral hemispheres volume) were measured on 0 h DWI,48 h T_2WI and TTC staining. Ischemic area was subdivided into infracted core (high signal area on both 0 h DWI and 48 h T_2 WI), IP (high signal on 0 h DWI, iso on 48 h T_2 WI) and oligemia (0 h delayed MTT, iso signal on both 0 h DWI and 48 h T_2 WI). Relative R_2' (rR_2') was calculated to get ratio between the lesion and mirror area in contralateral healthyhemisphere. Paired t test and correlation analysis were used for comparison of lesion volume percentage. rR_2' values at each time point were compared by ANOVA. Results Reversible MCAO models were made successfully in 4 of 6 monkeys. Lesion volume porcentage on 48 h T_2 WI was reduced compared to that on Oh DWI [ (8.16±0.55)% vs (11.37±1.41)% ,t=6.472,P0.05], which showed significant positive correlation (r=0.98, P0.05),两者呈明显正相关(r=0.98,P<0.05).梗死核心、IP、低灌注区rR_2'在各时间点差异均有统计学意义,梗死核心低于IP,IP低于低灌注区(P<0.05),三者rR_2'值:0 h时分别为1.129±0.108、1.329±0.081、1.584±0.103(F=36.19,P<0.05).1 h分别为0.668±0.082、1.237±0.072、1.435±0.066(F=134.09,P<0.05).3 h分别为0.536±0.075、1.453±0.081、1.770±0.141(F=256.30,P<0.05).6 h分别为0.259±0.050、2.435±0.131、2.957±0.177(F=803.25,P<0.05).12 h分别为0.385±0.054、2.447±0.148、3.254±0.184(F=743.74,P<0.05).24 h分别为0.083±0.026、1

  2. Use of NIRS to assess effect of training on peripheral muscle oxygenation changes in elite rugby players performing repeated supramaximal cycling tests. (United States)

    Jones, Benjamin; Cooper, C E


    In most team sports, intermittent high intensity sprint efforts combined with short recovery periods have been identified as a key factor of physical performance; the ability to repeat these efforts at a sustained level is of great importance. Near-infrared spectroscopy (NIRS) has been proposed as a tool to monitor muscle oxygenation changes during such sprint efforts. The purpose of this study was to observe muscle reoxygenation rate (reoxy rate) (% s⁻¹) between sprint efforts in a repeat sprint cycle test. A two wavelength spatially resolved NIR spectrometer (Portamon, Artinis Inc.) was used to assess reoxy rate changes in the vastus lateralis of the dominant leg before and after a training stimulus. Eight UK premiership academy level rugby players were assessed (age 20.6 ± 0.9) years; height 187 ± 0.6 cm; weight 109.5 ± 8.6 kg; quadriceps skin fold 16.6 ± 4.5 mm); the subjects completed ten repeated 10-s cycle sprints interspersed with 40 s recovery, upon a Wattbike Pro cycle. Hemoglobin variables (ΔHHb, ΔtHb, ΔO₂Hb, ΔTSI %) during the sprint and the post-sprint reoxygenation rate (%TSI s⁻¹) were measured. During both cycle tests all subjects experienced a drop in muscle oxygen saturation (Pre-Δ - 12.39 ± 6.01 %), Post-Δ - 14.83 ± 3.88 %). Post-training, there was an increase in the extent of desaturation (drop in TSI %) in the group means, both for the biggest single change and the average of all ten changes. Seven out of eight players showed an increase based on the maximum change and six based on the average of their ten tests. Additionally, seven out of eight players showed a significant increase in ΔHHb (Pre-Δ + 76.80 ± 61.92, Post-Δ + 121.28 ± 69.76) (p < 0.01) (including the one player who did not show a significant effect on the TSI measure). Players who exercised at the highest power tended to decrease their muscle oxygenation to a greater extent. The number of bike training sessions undertaken correlated with improvements in

  3. [Grafting of carotid arteries]. (United States)

    Belov, Iu V; Stepanenko, A B; Gens, A P; Bazylev, V V; Seleznev, M N; Savichev, D D


    Over 5-years, 167 reconstructive surgeries for stenosis of internal carotid arteries (ICA) were performed in 124 patients. Mean age of the patients was 63.5 years. One hundred and twenty-nine carotid endarterectomies (CEAE) in 86 patients and 38 reconstructive operations of ICA in 38 patients were performed. There were no lethal outcomes in short- and long-term postoperative period. In short-term period after prosthesis of ICA restenosis was revealed in 3% patients, after eversion CEAE in 3% patients the embolism was seen, after standard CEAE restenosis were diagnosed in 8% patients and thrombosis -- in 3%. In long-term period after grafting of ICA the strokes were seen in 3%, stenosis -- in 6% patients, after eversion endarterectomy -- in 0 and 3% patients, and after standard CEAE -- in 3 and 24% patients, respectively. It is concluded that grafting of ICA is adequate surgical method of reconstruction and stroke prevention in specific variants of carotid atherosclerosis.

  4. Spontaneous Coronary Artery Dissection. (United States)

    Tweet, Marysia S; Gulati, Rajiv; Hayes, Sharonne N


    Spontaneous coronary artery dissection is an important etiology of nonatherosclerotic acute coronary syndrome, myocardial infarction, and sudden death. Innovations in the catheterization laboratory including optical coherence tomography and intravascular ultrasound have enhanced the ability to visualize intimal disruption and intramural hematoma associated with SCAD. Formerly considered "rare," these technological advances and heightened awareness suggest that SCAD is more prevalent than prior estimates. SCAD is associated with female sex, young age, extreme emotional stress, or extreme exertion, pregnancy, and fibromuscular dysplasia. The clinical characteristics and management strategies of SCAD patients are different than for atherosclerotic heart disease and deserve specific consideration. This review will highlight recent discoveries about SCAD as well as describe current efforts to elucidate remaining gaps in knowledge.

  5. Cerebral oxygenation is reduced during hyperthermic exercise in humans

    DEFF Research Database (Denmark)

    Rasmussen, P.; Nybo, Lars; Volianitis, Stefanos;


    Abstract Aim: Cerebral mitochondrial oxygen tension (P(mito)O(2)) is elevated during moderate exercise, while it is reduced when exercise becomes strenuous, reflecting an elevated cerebral metabolic rate for oxygen (CMRO(2)) combined with hyperventilation-induced attenuation of cerebral blood flow...... (CBF). Heat stress challenges exercise capacity as expressed by increased rating of perceived exertion (RPE). Methods: This study evaluated the effect of heat stress during exercise on P(mito)O(2) calculated based on a Kety-Schmidt-determined CBF and the arterial-to-jugular venous oxygen differences...... in eight males [27 +/- 6 years (mean +/- SD) and maximal oxygen uptake (VO(2max)) 63 +/- 6 mL kg(-1) min(-1)]. Results: The CBF, CMRO(2) and P(mito)O(2) remained stable during 1 h of moderate cycling (170 +/- 11 W, approximately 50% of VO(2max), RPE 9-12) in normothermia (core temperature of 37.8 +/- 0...

  6. Pulsation-limited oxygen diffusion in the tumour microenvironment (United States)

    Milotti, Edoardo; Stella, Sabrina; Chignola, Roberto


    Hypoxia is central to tumour evolution, growth, invasion and metastasis. Mathematical models of hypoxia based on reaction-diffusion equations provide seemingly incomplete descriptions as they fail to predict the measured oxygen concentrations in the tumour microenvironment. In an attempt to explain the discrepancies, we consider both the inhomogeneous distribution of oxygen-consuming cells in solid tumours and the dynamics of blood flow in the tumour microcirculation. We find that the low-frequency oscillations play an important role in the establishment of tumour hypoxia. The oscillations interact with consumption to inhibit oxygen diffusion in the microenvironment. This suggests that alpha-blockers–a class of drugs used to treat hypertension and stress disorders, and known to lower or even abolish low-frequency oscillations of arterial blood flow –may act as adjuvant drugs in the radiotherapy of solid tumours by enhancing the oxygen effect.

  7. Middle meningeal artery arising from the basilar artery. (United States)

    Salem, Mohamed M; Fusco, Matthew R; Dolati, Parviz; Reddy, Arra S; Gross, Bradley A; Ogilvy, Christopher S; Thomas, Ajith J


    Various anomalies for the origin of the middle meningeal artery (MMA) have been described in the literature. However, origin of the MMA from the basilar trunk is an extremely rare variant. We report on a 54-year-old female who presented with frequent headaches; magnetic resonance imaging showed a right parietal meningioma. The abnormal origin of the middle meningeal artery from the basilar artery was diagnosed by angiography performed for preoperative embolization of the tumor. We report on the case with a review of the embryologic basis, possible explanations for this aberrant origin, and its clinical implications.

  8. Phenylephrine decreases frontal lobe oxygenation at rest but not during moderately intense exercise

    DEFF Research Database (Denmark)

    Brassard, Patrice; Seifert, Thomas; Wissenberg, Mads


    -infrared spectroscopy-derived frontal lobe oxygenation (ScO2) at rest and during exercise. At rest, nine healthy male subjects received bolus injections of phenylephrine (0.1, 0.25, and 0.4 mg), and changes in mean arterial pressure (MAP), MCA Vmean, internal jugular venous O2 saturation (SjvO2), ScO2), and arterial....... At rest, MAP and MCA Vmean increased approximately 20% (P

  9. Automated oxygen titration and weaning with FreeO2 in patients with acute exacerbation of COPD: a pilot randomized trial

    Directory of Open Access Journals (Sweden)

    Lellouche F


    Full Text Available François Lellouche,1 Pierre-Alexandre Bouchard,1 Maude Roberge,1 Serge Simard,1,2 Erwan L’Her,1,3 François Maltais,1 Yves Lacasse1 1Research Centre, 2Biostatistics Department, Quebec Heart and Lung Institute, Laval University, 3Emergency Medicine, Hôtel-Dieu de Lévis, Laval University, Quebec City, QC, Canada Introduction: We developed a device (FreeO2 that automatically adjusts the oxygen flow rates based on patients’ needs, in order to limit hyperoxia and hypoxemia and to automatically wean them from oxygen. Objective: The aim of this study was to evaluate the feasibility of using FreeO2 in patients hospitalized in the respiratory ward for an acute exacerbation of COPD. Methods: We conducted a randomized controlled trial comparing FreeO2 vs manual oxygen titration in the respiratory ward of a university hospital. We measured the perception of appropriateness of oxygen titration and monitoring in both groups by nurses and attending physicians using a Likert scale. We evaluated the time in the target range of oxygen saturation (SpO2 as defined for each patient by the attending physician, the time with severe desaturation (SpO2 <85%, and the time with hyperoxia (SpO2 >5% above the target. We also recorded length of stay, intensive care unit admissions, and readmission rate. Fifty patients were randomized (25 patients in both groups; mean age: 72±8 years; mean forced expiratory volume in 1 second: 1.00±0.49 L; and mean initial O2 flow 2.0±1.0 L/min. Results: Nurses and attending physicians felt that oxygen titration and monitoring were equally appropriate with both O2 administration systems. The percentage of time within the SpO2 target was significantly higher with FreeO2, and the time with severe desaturation and hyperoxia was significantly reduced with FreeO2. Time from study inclusion to hospital discharge was 5.8±4.4 days with FreeO2 and 8.4±6.0 days with usual oxygen administration (P=0.051. Conclusion: FreeO2 was deemed as an

  10. Total Arterial Revascularization with Internal Mammary Artery or Radial Artery Graft Configuration

    Institute of Scientific and Technical Information of China (English)


    To investigate the clinical use of π graft in total arterial revascularization and its outcomes, a retrospective analysis of 23 patients out of 1000 patients undergoing total arterial coronary bypass surgery with a π graft between September 1994 and December 2004 was performed. In the selected patients for the management of triple vessel disease with middle diagonal/intermediate ramus disease such that a skip with the left internal mammary artery (LIMA) or radial artery (RA),the main stem of π graft, to the left anterior descending coronary artery (LAD) will not work and the right internal mammary artery (RIMA) or right gastroepiploic artery (RGEA) cannot pick up the diagonal/intermediate ramus, hence the LAD and diagonal/intermediate ramus were grafted with a mini Y graft using the distal segment of LIMA, RIMA, RA or RGEA, together with the bilateral internal mammary artery (BIMA) or LIMA-RA T graft to compose π graft. Twenty-three patients (18 males, 5 females) underwent the π graft procedure. There were no deaths or episodes of myocardial infarction, stroke, and deep sternal wound infection. One patient required reopening for controlling bleeding. Until the end of 2004, during a mean follow-up of 81.0 ±28.4 months, no angina needing re-intervention or operative therapy or coronary related death occurred. In conclusion, in patients with specific coronary artery anatomy/stenosis, the BIMA (sometimes LIMA with RA or RGEA) π graft can be successfully performed for total arterial revascularization with good midterm outcomes.

  11. Thenar oxygen saturation and invasive oxygen delivery measurements in critically ill patients in early septic shock. (United States)

    Mesquida, Jaume; Gruartmoner, Guillem; Martínez, Maria Luisa; Masip, Jordi; Sabatier, Caroline; Espinal, Cristina; Artigas, Antonio; Baigorri, Francisco


    This prospective study was aimed to test the hypothesis that tissue hemoglobin oxygen saturation (StO₂) measured noninvasively using near-infrared spectroscopy is a reliable indicator of global oxygen delivery (DO₂) measured invasively using a pulmonary artery catheter (PAC) in patients with septic shock. The study setting was a 26-bed medical-surgical intensive care unit at a university hospital. Subjects were adult patients in septic shock who required PAC hemodynamic monitoring for resuscitation. Interventions included transient ischemic challenge on the forearm. After blood pressure normalization, hemodynamic and oximetric PAC variables and, simultaneously, steady-state StO₂ and its changes from ischemic challenge (deoxygenation and reoxygenation rates) were measured. Fifteen patients were studied. All the patients had a mean arterial pressure above 65 mmHg. The DO₂ index (iDO₂) range in the studied population was 215 to 674 mL O₂/min per m. The mean mixed venous oxygen saturation value was 61% ± 10%, mean cardiac index was 3.4 ± 0.9 L/min per m, and blood lactate level was 4.6 ± 2.7 mmol/L. Steady-state StO₂ significantly correlated with iDO₂, arterial and venous O₂ content, and O₂ extraction ratio. A StO₂ cutoff value of 75% predicted iDO₂ below 450, with a sensitivity of 0.9 and a specificity of 0.9. In patients in septic shock and normalized MAP, low StO₂ reflects extremely low iDO₂. Steady-state StO₂ does not correlate with moderately low iDO₂, indicating poor sensitivity of StO₂ to rule out hypoperfusion.

  12. Two levels of the inspired oxygen fraction in propofol-anesthetized dogs with high intracranial pressure: cardiopulmonary function

    Directory of Open Access Journals (Sweden)

    P.C. Ferro Lopes


    Full Text Available In the initial stage of traumatic brain injury, the use of 1.0 inspired oxygen fraction (FiO2 is indicated. However, high FiO2 has been correlated with atelectasis. Thus, the effects of FiO2 = 1.0 and FiO2 = 0.6 on the cardiopulmonary function in propofol-anesthetized dogs with high intracranial pressure (ICP were evaluated. Eight dogs were anesthetized on two occasions, receiving, during controlled ventilation, an FiO2 = 1 (G100 or an FiO2 = 0.6 (G60. Propofol was used for induction ( followed by a continuous rate infusion ( An increase in the ICP was induced by temporary obliteration of the right jugular vein (OJv 50 minutes after induction of anesthesia. The measurement was taken twenty minutes after OJv (T0 and then at 15-minute intervals (T15 to T60. Alveolar oxygen partial pressure in G60 was lower than in G100 during the whole procedure. Alveolar-arterial oxygen gradient in G100 was greater than in G60 at T0 and at T60. No differences were observed for arterial oxygen partial pressure/inspired oxygen fraction ratio, arterial-to-alveolar oxygen pressure ratio, respiratory index, venous admixture, oxygen delivery, oxygen consumption, oxygen extraction, heart rate, mean pulmonary arterial pressure, pulmonary arterial occlusion pressure, cardiac index, stroke index and systemic vascular resistance index. In G100, mean arterial pressure at T0 was higher than at T45. In dogs with high ICP, the cardiopulmonary function was not influenced by the different FiO2 used.

  13. Oxygen therapy - infants (United States)

    ... may not work well and may die. Your baby may not grow properly. Many of the developing organs, including the brain and heart, may be injured. Too much oxygen can also cause injury. Breathing too much oxygen can damage the lung. ...

  14. Proterozoic atmospheric oxygen

    DEFF Research Database (Denmark)

    Canfield, Donald Eugene


    This article is concerned with the evolution of atmospheric oxygen concentrations through the Proterozoic Eon. In particular, this article will seek to place the history of atmospheric oxygenation through the Proterozoic Eon in the context of the evolving physical environment including the histor...

  15. Highest Oxygen Bar

    Institute of Scientific and Technical Information of China (English)


    The world’s highest altitude Lhalu Wetland in Tibet is rebounding from past environmental damage In Lhasa, where the oxygen content is just 60 percent of that of the plain area, a place known as the "natural oxygen bar"is highly prized by residents.

  16. Cerebellar arteries originating from the internal carotid artery: angiographic evaluation and embryologic explanations

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jae Young; Han, Moon Hee; Yu, In Gyu; Chang, Ki Hyun [Seoul National Univ. College of Medicine, Seoul (Korea, Republic of); Kim, Eui Jong [Kyunghee Univ. College of Medicine, Seoul (Korea, Republic of); Kim, Dae Ho [Soonchunhyang Univ. College of Medicine, Asan(Korea, Republic of)


    To find and describe the cerebellar arteries arising from the internal carotid artery, explain them embryologically, and evaluate their clinical implication. To determine the point in the internal carotid artery from which the cereballar artery arose anomalously, consecutive angiographic studies performed in the last three years were reviewed. The distribution of such anomalous cerebellar arteries, the point in the internal carotid artery from which the anomalous vessels originated, and associated findings were analyzed. Five anomalous origins of cerebellar arteries arising arising directly from the internal carotid artery were found in five patients. Three anterior inferior cerebellar arteries (AICA) and one common trunk of an AICA and a posterior inferior cerebellar artery (PICA) were found to originate from the internal carotid artery at a point close to the origin of the primitive trigeminal artery. A PICA arose from an artery presenting a course similar to the proatlantal intersegmental artery. Intracranial aneurysms in two patients, Moyamoya disease in one, and facial arteriovenous malformation in one. In our series, AICAs supplied from the arteries considered to be persistent trigeminal artery variants were the most common type. A correlation between type of anomalous cerebellar artery and type of carotid-vertebrobasilar anastomosis may exist. Cerebellar arteries originating anomalously from the internal carotid artery seem to occur as a result of the persistence of carotid-vertebrobasilar anastomoses associated with incomplete fusion of the longitudinal neural arteries. An understanding of these anomalous cerebellar arteries may help prevent accidents during therapeutic embolization and surgical treatment, as well as misinterpretation.

  17. Analysis of Arterial and Venous Blood Gases in Healthy Gyr Falcons ( Falco rusticolus ) Under Anesthesia. (United States)

    Raghav, Raj; Middleton, Rachael; BSc, Rinshiya Ahamed; Arjunan, Raji; Caliendo, Valentina


    Arterial and venous blood gas analysis is useful in the assessment of tissue oxygenation and ventilation and in diagnosis of metabolic and respiratory derangements. It can be performed with a relatively small volume of blood in avian patients under emergency situations. Arterial and venous blood gas analysis was performed in 30 healthy gyr falcons ( Falco rusticolus ) under anaesthesia to establish temperature-corrected reference intervals for arterial blood gas values and to compare them to temperature-corrected venous blood gas values with a portable point-of-care blood gas analyzer (i-STAT 1, Abbott Laboratories, Abbott Park, IL, USA). Statistically significant differences were observed between the temperature-corrected values of pH, partial pressure of carbon dioxide (Pco2), and partial pressure of oxygen (Po2) and the corresponding nontemperature-corrected values of these parameters in both arterial and venous blood. Values of temperature-corrected pH, temperature-corrected Pco2, bicarbonate concentrations, and base excess of extra cellular fluid did not differ significantly between arterial and venous blood, suggesting that, in anesthetized gyr falcons, venous blood gas analysis can be used in place of arterial blood gas analysis in clinical situations. Values for hematocrit, measured by the point-of-care analyzer, were significantly lower compared with those obtained by the microhematocrit method.

  18. Embolisation of the splenic artery

    Energy Technology Data Exchange (ETDEWEB)

    Essler, G.; Duex, A.


    In bleeding of oesophageal varices with resistance to common treatment embolisation of the splenic artery causes depression of the portal hypertension by forty per cent. Thrombosis of the splenic or portal vein as in splenectomies are not to be expected. The splenic vein remains open for later spleno-renal anastomosis. By occlusion of the splenic artery we were successful in stopping oesophageal bleeding. In a patient with dominant hypersplenism in portal hypertension the severity of the syndrome decreased after embolisation of the splenic artery. Thrombocytes, leukocytes and gammaglobulin increased.

  19. Access to the ophthalmic artery by retrograde approach through the posterior communicating artery for intra-arterial chemotherapy of retinoblastoma

    Energy Technology Data Exchange (ETDEWEB)

    Pham, Chi-Tuan; Blanc, Raphael; Pistocchi, Silvia; Bartolini, Bruno; Piotin, Michel [Fondation Rothschild Hospital, Department of Interventional Neuroradiology, Paris (France); Lumbroso-Le Rouic, Livia [Institut Curie, Department of Ocular Oncology, Paris (France)


    Intra-arterial infusion of chemotherapy into the ophthalmic artery for treatment of retinoblastoma has been realized after catheterization of the internal carotid and temporary balloon occlusion beyond the orifice of the ophthalmic artery, or more recently after superselective canulation of the ophthalmic artery by a microcatheter. The superselective catheterization of the ophthalmic artery could be cumbersome because of the implantation of the ostium on the carotid siphon or because of the tortuosity of the carotid siphon. We report our experience of using a retrograde approach through the posterior communicating artery that allows a more direct angle of access to the origin of the ophthalmic artery. (orig.)

  20. Transient cortical blindness after intradiscal oxygen-ozone therapy. (United States)

    Vaiano, Agostino Salvatore; Valente, Cristiana; De Benedetti, Giacomo; Caramello, Guido


    A 54-year-old caucasian male developed bilateral blindness during an oxygen-ozone injection for disc herniation. The visual loss (VL) was immediately followed by severe frontal headache, vomiting, and nausea. The patient underestimated the VL showing Anton's syndrome, with a complete visual recovery after 2-month follow-up. Magnetic resonance data were consistent with recent ischemic lesions in bilateral vascular territories of posterior cerebral arteries.

  1. Calibrated MRI to evaluate cerebral hemodynamics in patients with an internal carotid artery occlusion

    NARCIS (Netherlands)

    De Vis, Jill B.; Petersen, Esben T.; Bhogal, Alex; Hartkamp, Nolan S.; Klijn, Catharina J. M.; Kappelle, L. J.; Hendrikse, J.


    The purpose of this study was to assess whether calibrated magnetic resonance imaging (MRI) can identify regional variances in cerebral hemodynamics caused by vascular disease. For this, arterial spin labeling (ASL)/blood oxygen level-dependent (BOLD) MRI was performed in 11 patients (65 +/- 7 years

  2. A method to calculate arterial and venous saturation from near infrared spectroscopy (NIRS)

    NARCIS (Netherlands)

    Menssen, J.J.M.; Colier, W.N.J.M.; Hopman, J.C.W.; Liem, D.; Korte, C.L. de


    For adequate development and functioning of the neonatal brain, sufficient oxygen (O2) should be available. With a fast sampling (f(s) > 50 Hz) continuous wave NIRS device, arterial (SaO2) and venous (SvO2) saturation can be measured using the physiological fluctuations in the oxyhemoglobin (O2Hb) a

  3. Phenylephrine increases near-infrared spectroscopy determined muscle oxygenation in men

    DEFF Research Database (Denmark)

    Sørensen, H; Thomsen, J H; Meyer, A S P


    Phenylephrine increases mean arterial pressure (MAP) by enhanced total peripheral resistance (TPR) but near-infrared spectroscopy (NIRS) determined muscle oxygenation (SmO2) increases. We addressed that apparent paradox during supine rest and head-up tilt (HUT). Variables were determined ± phenyl......Phenylephrine increases mean arterial pressure (MAP) by enhanced total peripheral resistance (TPR) but near-infrared spectroscopy (NIRS) determined muscle oxygenation (SmO2) increases. We addressed that apparent paradox during supine rest and head-up tilt (HUT). Variables were determined...

  4. Calculating acid-base and oxygenation status during COPD exacerbation using mathematically arterialised venous blood

    DEFF Research Database (Denmark)

    Rees, Stephen Edward; Rychwicka-Kielek, Beate A; Andersen, Bjarne F


    Abstract Background: Repeated arterial puncture is painful. A mathematical method exists for transforming peripheral venous pH, PCO2 and PO2 to arterial eliminating the need for arterial sampling. This study evaluates this method to monitor acid-base and oxygenation during admission for exacerbat......Abstract Background: Repeated arterial puncture is painful. A mathematical method exists for transforming peripheral venous pH, PCO2 and PO2 to arterial eliminating the need for arterial sampling. This study evaluates this method to monitor acid-base and oxygenation during admission...... were assessed with previously defined rules. Differences between maximal changes of calculated and measured values were compared using a t-test, with trends analysed by inspection of plots. Results: Fifty-four patients, median age 67 years (range 62-75), were studied on average 3 days. Mean values of p......H, PCO2 and PO2 were 7.432±0.047, 6.8±1.7 kPa and 9.2±1.5 kPa, respectively. Calculated and measured arterial pH and PCO2 agreed well, differences having small bias and SD (0.000±0.022 pH, -0.06±0.50 kPa PCO2), significantly better than venous blood alone. Calculated PO2 obeyed the clinical rules...

  5. Oxygen foreshock of Mars (United States)

    Yamauchi, M.; Lundin, R.; Frahm, R. A.; Sauvaud, J.-A.; Holmström, M.; Barabash, S.


    Mars Express (MEX) has operated for more than 10 years in the environment of Mars, providing solar wind ion observations from the Analyzer of Space Plasmas and Energetic Atoms experiment's Ion Mass Analyser (IMA). On 21 September 2008, MEX/IMA detected foreshock-like discrete distributions of oxygen ions at around 1 keV in the solar wind attached to the bow shock and this distribution was observed continuously up to more than 2000 km from the bow shock. Foreshock-like protons are also observed but at a shifted location from the oxygen by about 1000 km, at a slightly higher energy, and flowing in a slightly different direction than the oxygen ions. Both protons and oxygen ions are flowing anti-sunward at different angles with respect to the solar wind direction. This is the first time that a substantial amount of planetary oxygen is observed upstream of the bow shock. Although rare, this is not the only IMA observation of foreshock-like oxygen: oxygen ions are sometimes observed for a short period of time (<5 min) inside the foreshock region. These observations suggest a new escape channel for planetary ions through the acceleration in the bow shock-magnetosheath region.

  6. Idiopathic arterial calcification in childhood

    Energy Technology Data Exchange (ETDEWEB)

    Patel, Maya [Department of Paediatric Radiology, Red Cross Children' s Hospital, Cape Town (South Africa); Red Cross Children' s Hospital, School of Child and Adolescent Health, University of Cape Town, Klipfontein Road, Rondebosch, Cape Town (South Africa); Andronikou, Savvas; Solomon, Rustum; Sinclair, Paul; McCulloch, Mignon [Department of Paediatric Radiology, Red Cross Children' s Hospital, Cape Town (South Africa)


    Idiopathic arterial calcification in infancy is usually fatal with death in early life and diagnosis at post mortem. This report describes a unique, late presentation with hypertension and cardiac failure in a child aged 33 months, found to have widespread arterial calcification at radiological imaging. The calcium-phosphate axis was normal and there was no other demonstrable cause for calcification. Additionally, the histological features of arterial calcification at renal biopsy paralleled the findings in infants with this disorder. The late presentation in this case is unusual and has not been previously reported. Ultrasound and CT are sensitive for calcification, and the disease should be suspected in children presenting with cardiac or respiratory manifestations and features of arterial calcification, where no metabolic cause is established. (orig.)

  7. Peripheral Artery Disease and Diabetes (United States)

    ... Venous Thromboembolism Aortic Aneurysm More Peripheral Artery Disease & Diabetes Updated:Jan 26,2016 People with diabetes are ... life. This content was last reviewed January 2016. Diabetes • Home • About Diabetes • Why Diabetes Matters Introduction Cardiovascular ...

  8. Robotics and coronary artery surgery. (United States)

    Magee, Mitchell J; Mack, Michael J


    Significant progress in cardiac surgery, and specifically the surgical management of coronary artery disease, has been due in large part to enabling technology. Robotic systems have been recently developed and refined for use in cardiac surgery to facilitate, among other procedures, a totally endoscopic approach to coronary artery bypass surgery. These systems enhance precision through endoscopic approaches by specifically addressing the inherent limitations of conventional endoscopic coronary microsurgical instrumentation via computerized, digital interface, telemanipulation technology. With a combined experience of 125 patients, several groups have independently demonstrated the clinical feasibility of totally endoscopic coronary artery bypass with two commercially available robotic telemanipulation systems. Additional enabling technology is needed to overcome the challenges currently limiting development and widespread application of totally endoscopic off-pump multivessel coronary artery bypass surgery.

  9. Update in pulmonary arterial hypertension. (United States)

    Mejía Chew, C R; Alcolea Batres, S; Ríos Blanco, J J


    Pulmonary arterial hypertension is a rare and progressive disease that mainly affects the pulmonary arterioles (precapillary), regardless of the triggering aetiology. The prevalence of pulmonary hypertension and pulmonary arterial hypertension in Spain is estimated at 19.2 and 16 cases per million inhabitants, respectively. The diagnosis of pulmonary arterial hypertension is based on haemodynamic criteria (mean pulmonary artery pressure ≥25mmHg, pulmonary capillary wedge pressure ≤15mmHg and pulmonary vascular resistance >3 Wood units) and therefore requires the implementation of right cardiac catheterisation. Sequential therapy with a single drug has been used in clinical practice. However, recent European guidelines recommend combined initial therapy in some situations. This review conducts a critical update of our knowledge of this disease according to the latest guidelines and recommendations.


    Directory of Open Access Journals (Sweden)

    E. A. Spirina


    Full Text Available Aim of our clinical study was evaluation own initial experience of high-urgency ortotopic heart transplantation (OHT in recipients, who were bridged on peripheral Vena-Arterial Extracorporeal Membrane Oxygenation (VA ECMO. Materials and methods. In this study was included 17 patients (14/3 M/F, age 16–66 (40.1 ± 4.2 yrs who underwent OHT while on peripheral ECMO support. In all cases we used peripheral surgical can- nulation technique via femoral vessels – arterial cannula 15–19 Fr, venous cannula – 21–25 Fr, arterial cannula or vascular catheter 8–10 Fr for anterograde leg’s perfusion. Results. Duration Vena-Arterial Extracorporeal Membrane Oxygenation before OHT was 81 ± 17 h. VA ECMO support was blood flow 4.8 ± 0.6 l/min or 2.63 ± 0/04 l/min/m2, gas flow 4.8 ± 0.6 l/min, FiO2 0.86 ± 0.07. Vena-Arterial Extracorporeal Membrane Oxygenation support was continued in “protective mode” (blood flow 1.9 ± 0.2 l/min 4.3 ± 0.5 days after OHT. Thirteen pa- tients (76.4% were weaned from VA ECMO successfully and survived to be discharged. ICU and hospital LOS after orthotopic heart transplantation was respectively 6.7 ± 0.8 and 32.3 ± 4.6 days in group of survived patients. The reasons of a lethal outcome (n = 4, 23.5% were sepsis and multiorgan failure (n = 3, sudden cardiac arrest (n = 1. Conclusion. Vena-Arterial Extracorporeal Membrane Oxygenation is a favorable short-term method of circulatory support in patients who needed in high-urgency heart transplantation. 

  11. Heart transplantation and arterial elasticity

    Directory of Open Access Journals (Sweden)

    Colvin-Adams M


    Full Text Available Monica Colvin-Adams,1 Nonyelum Harcourt,1 Robert LeDuc,2 Ganesh Raveendran,1 Yassir Sonbol,3 Robert Wilson,1 Daniel Duprez11Cardiovascular Division, University of Minnesota, Minneapolis, MN, USA; 2Division of Biostatistics University of Minnesota, Minneapolis, MN, USA; 3Cardiovascular Division, St Luke's Hospital System, Sugar Land, TX, USAObjective: Arterial elasticity is a functional biomarker that has predictive value for cardiovascular morbidity and mortality in nontransplant populations. There is little information regarding arterial elasticity in heart transplant recipients. This study aimed to characterize small (SAE and large (LAE artery elasticity in heart transplant recipients in comparison with an asymptomatic population free of overt cardiovascular disease. A second goal was to identify demographic and clinical factors associated with arterial elasticity in this unique population.Methods: Arterial pulse waveform was registered noninvasively at the radial artery in 71 heart transplant recipients between 2008 and 2010. SAEs and LAEs were derived from diastolic pulse contour analysis. Comparisons were made to a healthy cohort of 1,808 participants selected from our prevention clinic database. Multiple regression analyses were performed to evaluate associations between risk factors and SAE and LAE within the heart transplant recipients.Results: LAE and SAE were significantly lower in heart transplant recipients than in the normal cohort (P <0.01 and P < 0.0001, respectively. Female sex and history of ischemic cardiomyopathy were significantly associated with reduced LAE and SAE. Older age and the presence of moderate cardiac allograft vasculopathy were also significantly associated with reduced SAE. Transplant duration was associated with increased SAE.Conclusion: Heart transplants are associated with peripheral endothelial dysfunction and arterial stiffness, as demonstrated by a significant reduction in SAE and LAE when compared with a

  12. Severe Hypoxemia in Muskoxen ( Ovibos moschatus ) Immobilized with Etorphine and Xylazine Corrected with Supplemental Nasal Oxygen. (United States)

    Lian, Marianne; Björck, Sven; Arnemo, Jon M; Esteruelas, Núria Fandos; Angel, Martine; Minsaas, Solveig C; Jones, Krista L; L Evans, Alina


    Twenty-three muskoxen ( Ovibos moschatus ) housed in a captive facility for rewilding in Sweden were chemically immobilized for annual health evaluations and hoof trimming. The muskoxen were darted in May to September (2012-2015) in their holding pen with etorphine (0.015 mg/kg) and xylazine (0.1 mg/kg) intramuscularly. Twenty-two of the 23 animals were immobilized with a single dart injection. The mean (SD) induction time was 4 (2) min. Arterial blood gases were collected from 18 animals. All animals were severely hypoxemic with varying degrees of respiratory acidosis. The hypoxemia resolved in 17 of 18 animals with intranasal oxygen supplementation at 1 L/min per 100 kg. Relative arterial oxygen saturation (SpO2) measured by pulse oximetry was significantly higher than the arterial oxygen saturation calculated from the partial pressure of arterial oxygen (SaO2) obtained by a blood gas analyzer. Based on these findings, muskox can be immobilized successfully with etorphine (0.015 mg/kg) and xylazine (0.1 mg/kg) but should receive supplemental oxygen.

  13. Coronary artery bypass grafting in a patient with organophosphate poisoning. (United States)

    Pieris, Rajeeva R; Fernando, Ravindra


    A 43-year-old male, with no previous history of mental illness, was diagnosed with coronary heart disease, after which he became acutely depressed and attempted suicide by ingesting an organophosphate pesticide. He was admitted to an intensive care unit and treated with pralidoxime, atropine, and oxygen. His coronary occlusion pattern required early coronary artery bypass grafting (CABG) surgery. His family, apprehensive of a repeat suicidal attempt, requested surgery be performed as soon as possible. He recovered well from the OP poisoning and was mentally fit to express informed consent 2 weeks after admission. Seventeen days after poisoning, he underwent coronary artery bypass grafting and recovered uneventfully. Six years later, he remains in excellent health. We report this case because to the best of our knowledge there is no literature regarding CABG performed soon after organophosphate poisoning.

  14. Non-endothelial endothelin counteracts hypoxic vasodilation in porcine large coronary arteries

    DEFF Research Database (Denmark)

    Hedegaard, Elise Røge; Stankevicius, Edgaras; Simonsen, Ulf


    of large coronary arteries. RESULTS: In prostaglandin F2α (PGF2α, 10 μM)-contracted segments with endothelium, gradual lowering of oxygen tension from 95 to 1% O2 resulted in vasodilation. The vasodilation to O2 lowering was rightward shifted in segments without endothelium at all O2 concentrations except...... at 1% O2. The endothelin receptor antagonist SB217242 (10 μM) markedly increased hypoxic dilation despite the free tissue ET-1 concentration in the arterial wall was unchanged in 1% O2 versus 95% O2. Exogenous ET-1 reversed hypoxic dilation in segments with and without endothelium, and the hypoxic...... arteries showed an increased sensitivity towards ET-1 compared to the normoxic controls. Without affecting basal NO, hypoxia increased NO concentration in PGF2α-contracted arteries, and an NO synthase inhibitor, L-NOARG,(300 μM, NG-nitro-L-Arginine) reduced hypoxic vasodilation. NO-induced vasodilation...

  15. A neonate with left pulmonary artery thrombosis and left lung hypoplasia: a case report

    Directory of Open Access Journals (Sweden)

    ElHassan Nahed O


    Full Text Available Abstract Introduction Spontaneous intrauterine arterial thrombosis and congenital pulmonary hypoplasia are rare conditions and have not been reported to occur together. The literature rather includes two reports of babies with neonatal pulmonary artery occlusion and post-infarction cysts of the lungs. Case presentation We report a case of a live Caucasian male newborn with left lung hypoplasia that occurred in association with left pulmonary artery thrombosis. Despite a critical neonatal course, including extracorporeal membrane oxygenation, this infant is alive and well at 18 months of age without any neurodevelopmental sequelae or reactive airway disease. Conclusion This association suggests the possibility of an intrauterine vascular event between the fifth and eighth weeks of gestation during early pulmonary artery and lung development.

  16. Heat stress redistributes blood flow in arteries of the brain during dynamic exercise. (United States)

    Sato, Kohei; Oue, Anna; Yoneya, Marina; Sadamoto, Tomoko; Ogoh, Shigehiko


    We hypothesized that heat stress would decrease anterior and posterior cerebral blood flow (CBF) during exercise, and the reduction in anterior CBF would be partly associated with large increase in extracranial blood flow (BF). Nine subjects performed 40 min of semirecumbent cycling at 60% of the peak oxygen uptake in hot (35°C; Heat) and thermoneutral environments (25°C; Control). We evaluated BF and conductance (COND) in the external carotid artery (ECA), internal carotid artery (ICA), and vertebral artery (VA) using ultrasonography. During the Heat condition, ICA and VA BF were significantly increased 10 min after the start of exercise (P brain arteries to exercise, which resulted in an alteration in the distribution of cardiac output. Moreover, a hyperthermia-induced increase in extracranial BF might compromise anterior CBF during exercise with heat stress.

  17. Arterial stiffness response to exercise in persons with and without Down syndrome. (United States)

    Hu, Min; Yan, Huimin; Ranadive, Sushant M; Agiovlasitis, Stamatis; Fahs, Christopher A; Atiq, Muhammed; Atique, Nazia; Fernhall, Bo


    This study compared arterial stiffness and wave reflection at rest and following maximal exercise between individuals with and without Down syndrome (DS), and the influence of body mass index (BMI), peak oxygen uptake (VO2 peak) on changes in arterial stiffness. Twelve people with DS (26.6 ± 2.6 yr) and 15 healthy controls (26.2 ± 0.6 yr) completed this study. Intima-media thickness (IMT) and stiffness of common carotid artery was examined. Hemodynamic and arterial variables were measured before and 3-min after exercise. Persons with DS had higher BMI and lower VO 2 peak than controls. IMT did not differ between groups. At rest, carotid β stiffness was significantly higher in persons with DS (PObesity and particularly VO 2 peak influenced these findings. These results suggest impaired vascular function in people with DS.

  18. Liver cirrhosis and arterial hypertension

    Institute of Scientific and Technical Information of China (English)

    Jens H Henriksen; Soren Moller


    Characteristic findings in patients with cirrhosis are vasodilatation with low overall systemic vascular resistance, high arterial compliance, increased cardiac output, secondary activation of counter-regulatory systems (renin-angiotensin-aldosterone system,sympathetic nervous system, release of vasopressin),and resistance to vasopressors. The vasodilatory state is mediated through adrenomedullin, calcitonin generelated peptide, nitric oxide, and other vasodilators,and is most pronounced in the splanchnic area.This constitutes an effective (although relative)counterbalance to increased arterial blood pressure.This review considers the alterations in systemic hemodynamics in patients with cirrhosis in relation to essential hypertension and arterial hypertension of the renal origin. Subjects with arterial hypertension (essential, secondary) may become normotensive during the development of cirrhosis, and arterial hypertension is rarely manifested in patients with cirrhosis, even in cases with renovascular disease and high circulating renin activity. There is much dispute as to the understanding of homoeostatic regulation in cirrhotic patients with manifest arterial hypertension. This most likely includes the combination of vasodilatation and vasoconstriction in parallel.

  19. Severe stenosis of a long tracheal segment, with agenesis of the right lung and left pulmonary arterial sling. (United States)

    Munro, Hamish M; Sorbello, Andrea M C; Nykanen, David G


    A baby presented at term with respiratory distress was managed with extracorporeal membrane oxygenation. Bronchoscopy revealed tracheal hypoplasia, complete tracheal rings, and agenesis of the right main bronchus. Echocardiography showed a left pulmonary arterial sling arising from the proximal part of the right pulmonary artery. Cardiac catheterization demonstrated abnormal pulmonary vasculature in the left lung which would have prevented survival, even after surgical repair. Diagnostic catheterization was important in delineating the anatomy, and aided in the decision not to proceed with surgical repair.

  20. Arterial function of carotid and brachial arteries in postmenopausal vegetarians

    Directory of Open Access Journals (Sweden)

    Su T


    Full Text Available Ta-Chen Su1, Pao-Ling Torng2, Jiann-Shing Jeng3, Ming-Fong Chen1, Chiau-Suong Liau1,41Division of Cardiology, Department of Internal Medicine, 2Department of Obstetrics and Gynecology, 3Department of Neurology, National Taiwan University Hospital, National Taiwan University College of Medicine, 4Cardiovascular Center, Taipei Buddist Tzu-Chi Hospital, Hsin-Dian, Taipei, TaiwanBackground: Vegetarianism is associated with a lower risk of cardiovascular disease. However, studies of arterial function in vegetarians are limited.Methods: This study investigated arterial function in vegetarianism by comparing 49 healthy postmenopausal vegetarians with 41 age-matched omnivores. The arterial function of the common carotid artery was assessed by carotid duplex, while the pulse dynamics method was used to measure brachial artery distensibility (BAD, compliance (BAC, and resistance (BAR. Fasting blood levels of glucose, lipids, lipoprotein (a, high-sensitivity C-reactive protein, homocysteine, and vitamin B12 were also measured.Results: Vegetarians had significantly lower serum cholesterol, high-density and low-density lipoprotein, and glucose compared with omnivores. They also had lower vitamin B12 but higher homocysteine levels. Serum levels of lipoprotein (a and high-sensitivity C-reactive protein were no different between the two groups. There were no significant differences in carotid beta stiffness index, BAC, and BAD between the two groups even after adjustment for associated covariates. However, BAR was significantly lower in vegetarians than in omnivores. Multiple linear regression analysis revealed that age and pulse pressure were two important determinants of carotid beta stiffness index and BAD. Vegetarianism is not associated with better arterial elasticity.Conclusion: Apparently healthy postmenopausal vegetarians are not significantly better in terms of carotid beta stiffness index, BAC, and BAD, but have significantly decreased BAR than

  1. Optic nerve oxygen tension

    DEFF Research Database (Denmark)

    la Cour, M; Kiilgaard, Jens Folke; Eysteinsson, T


    To investigate the influence of acute changes in intraocular pressure on the oxygen tension in the vicinity of the optic nerve head under control conditions and after intravenous administration of 500 mg of the carbonic anhydrase inhibitor dorzolamide....

  2. High Selectivity Oxygen Delignification

    Energy Technology Data Exchange (ETDEWEB)

    Lucian A. Lucia


    Project Objective: The objectives of this project are as follows: (1) Examine the physical and chemical characteristics of a partner mill pre- and post-oxygen delignified pulp and compare them to lab generated oxygen delignified pulps; (2) Apply the chemical selectivity enhancement system to the partner pre-oxygen delignified pulps under mill conditions (with and without any predetermined amounts of carryover) to determine how efficiently viscosity is preserved, how well selectivity is enhanced, if strength is improved, measure any yield differences and/or bleachability differences; and (3) Initiate a mill scale oxygen delignification run using the selectivity enhancement agent, collect the mill data, analyze it, and propose any future plans for implementation.

  3. Effects of acetazolamide on cerebral blood flow and brain tissue oxygenation

    DEFF Research Database (Denmark)

    Lassen, N A; Friberg, L; Kastrup, J


    Oral administration of 1 g of acetazolamide to 8 normal subjects studied at sea level and in normoxia caused an acute increase in cerebral blood flow (CBF). During the subsequent prolonged oral treatment with 1 g of acetazolamide daily, CBF returned to normal within 2 days. The alveolar CO2 tension...... decreased gradually to 70% of the control value, indicating hyperventilation. At sea level hyperventilation will not increase brain oxygenation significantly in normal man, as the arterial oxygen content only increases minimally, while CBF is unchanged. At high altitude the beneficial effects...... of acetazolamide on the symptoms of acute mountain sickness may well be due to an improved oxygen supply to the brain, as hyperventilation will, at the low ambient PO2, cause a significant increase of the arterial oxygen content, while CBF presumably is unaffected by the drug. During hypoxia at high altitude...

  4. De-oxygenation

    Digital Repository Service at National Institute of Oceanography (India)

    Naqvi, S.W.A; Kortzinger, A

    of fixed nitrogen that keeps the atmospheric nitrogen content constant over geological time scales. An important aspect of redox chemistry of nitrogen is the production of nitrous oxide (N2O), a potent greenhouse gas both as an intermediate during... denitrification and as a byproduct during the 30 oxidation of ammonium to nitrate (nitrification). Denitrification is confined to low-oxygen waters, but even during nitrification, the yield of N2O is greatly enhanced as the waters get depleted with oxygen...

  5. Recurrent ischemia resulting from left internal mammary artery-to-pulmonary artery fistula. (United States)

    Madu, E C; Hanumanthu, S K; Kim, C; Prudoff, A


    This report describes a case series of recurrent ischemia after coronary artery bypass grafting resulting from left internal mammary artery-to-pulmonary artery fistula. An angiographic demonstration of this fistula is presented.

  6. First experiences with a combined usage of veno-arterial and veno-venous ECMO in therapy-refractory cardiogenic shock patients with cerebral hypoxemia. (United States)

    Moravec, R; Neitzel, T; Stiller, M; Hofmann, B; Metz, D; Bucher, M; Silber, R; Bushnaq, H; Raspé, C


    The use of extracorporeal membrane oxygenation (ECMO) is becoming a popular tool in the treatment of cardiogenic shock. We present two case reports where classical veno-arterial peripherally cannulated ECMO therapy proved insufficient with profuse cerebral hypoxemia. After augmenting the setting into veno-veno-arterial ECMO, we achieved a remarkable improvement of all oxygenation parameters. The simultaneous use of veno-venous and veno-arterial ECMO might display as a novel strategy to counteract the coronary and cerebral hypoxemia in veno-arterial ECMO therapy in patients with therapy-refractory cardiogenic shock or in combined cardiopulmonary failure. In this manuscript, the veno-veno-arterial ECMO setup is described in full detail and different venous cannulas are discussed.

  7. Capsaicin- resistant arterial baroreceptors

    Directory of Open Access Journals (Sweden)

    Andresen Michael C


    Full Text Available Abstract Background Aortic baroreceptors (BRs comprise a class of cranial afferents arising from major arteries closest to the heart whose axons form the aortic depressor nerve. BRs are mechanoreceptors that are largely devoted to cardiovascular autonomic reflexes. Such cranial afferents have either lightly myelinated (A-type or non-myelinated (C-type axons and share remarkable cellular similarities to spinal primary afferent neurons. Our goal was to test whether vanilloid receptor (TRPV1 agonists, capsaicin (CAP and resiniferatoxin (RTX, altered the pressure-discharge properties of peripheral aortic BRs. Results Periaxonal application of 1 μM CAP decreased the amplitude of the C-wave in the compound action potential conducting at 0.50 but completely inhibited discharge of an irregularly discharging BR (C-type. CAP at high concentrations (10–100 μM depressed BR sensitivity in regularly discharging BRs, an effect attributed to non-specific actions. RTX (≤ 10 μM did not affect the discharge properties of regularly discharging BRs (n = 7, p > 0.18. A CAP-sensitive BR had significantly lower discharge regularity expressed as the coefficient of variation than the CAP-resistant fibers (p Conclusion We conclude that functional TRPV1 channels are present in C-type but not A-type (A-δ myelinated aortic arch BRs. CAP has nonspecific inhibitory actions that are unlikely to be related to TRV1 binding since such effects were absent with the highly specific TRPV1 agonist RTX. Thus, CAP must be used with caution at very high concentrations.

  8. Multi-modal assessment of neurovascular coupling during cerebral ischaemia and reperfusion using remote middle cerebral artery occlusion

    DEFF Research Database (Denmark)

    Sutherland, Brad A; Fordsmann, Jonas C; Martin, Chris;


    how neurovascular coupling is affected hyperacutely during cerebral ischaemia and reperfusion. We have developed a remote middle cerebral artery occlusion model in the rat, which enables multi-modal assessment of neurovascular coupling immediately prior to, during and immediately following reperfusion....... Male Wistar rats were subjected to remote middle cerebral artery occlusion, where a long filament was advanced intraluminally through a guide cannula in the common carotid artery. Transcallosal stimulation evoked increases in blood flow, tissue oxygenation and neuronal activity, which were diminished...... by middle cerebral artery occlusion and partially restored during reperfusion. These evoked responses were not affected by administration of the thrombolytic alteplase at clinically used doses. Evoked cerebral blood flow responses were fully restored at 24 h post-middle cerebral artery occlusion indicating...

  9. Determination of oxygen tension in the subcutaneous tissue of cosmonauts during the Salyut-6 mission (United States)

    Baranski, S.; Bloszczynski, R.; Hermaszewski, M.; Kubiczkowa, J.; Piorko, A.; Saganiak, R.; Sarol, Z.; Skibniewsky, F.; Stendera, J.; Walichnowski, W.


    A polarographic technique was used to measure the oxygen tension in subcutaneous tissue of the forearm of a cosmonaut prior to, after, and on the fourth day of a space mission performed by Salut-6. A drop in the oxygen exchange rate in the peripheral tissues during weightlessness was observed. The mechanisms of this change are studied, taking into consideration the blood distribution in the organism and microcirculation disorders reflected by a decreased blood flow rate in arterial-venous junctions.

  10. Changes in oxygenation and pulmonary haemodynamics in preterm infants treated with inhaled nitric oxide


    Subhedar, N; Shaw, N


    AIM—To investigate changes in various cardiorespiratory variables with inhaled nitric oxide (NO), as part of a randomised controlled trial.
METHODS—Infants were treated with inhaled NO for 72 hours. Changes in oxygenation were assessed using the oxygenation index (OI). Serial changes in pulmonary artery pressure (PAP) were assessed using the Doppler derived acceleration time to right ventricular ejection time ratio (AT:RVET). Doppler measurements of right ventricular output, pulmonary blood f...

  11. Retinal artery occlusions in children. (United States)

    Dharmasena, Aruna; Wallis, Simon


    The purpose of this study is to present a case of RAO in a 13 year old girl with a preceding history of hyperextension of the neck at her hairdressers for a long duration and use of her mobile phone handset resting it against the side of her neck presumably exerting some pressure on carotids during the same time. Materials and methods of this study was reported as case report and review of literature. A 13 year-old girl presented with the left supero-nasal scotoma due to an inferior temporal branch retinal artery occlusion (BRAO). She underwent extensive investigations and no underlying cause was discovered. She gave a history of cervical extension over a long period of time while having the hair coloured twice in the preceding week. She also mentioned that she was using her mobile phone more or less continuously during both these occasions keeping it against her neck. Given the above history it is possible that the pressure on the ipsilateral carotid arteries or the prolong neck extension may have been responsible for the formation of a platelet embolus resulting in the BRAO. In conclusion, although cerebro-vascular accidents due to 'beauty parlor stroke syndrome' (JAMA 269:2085-2086, 1993) have been reported previously it has not been reported in children to our knowledge. On the other hand, 'beauty parlor stroke syndrome' occurs due to a dissection of the vertebral arteries or due to mechanical compression of the vertebral arteries during the prolonged hyperextension of the neck. The central retinal artery originates from the internal carotid circulation and it is highly unlikely for an embolus to enter the retinal circulation from the vertebral arteries. Therefore, the authors favour the possibility that the compulsive use of a mobile phone exerting pressure on the carotid arteries for a long time may have led to the formation of an embolus and subsequent RAO in this case.

  12. S35: a new parameter in blood gas analysis for monitoring the systemic oxygenation. (United States)

    Trouwborst, A; Tenbrinck, R; Van Woerkens, E C


    In the estimation of oxygen transport the term oxygen availability is used as the product of cardiac output and the arterial oxygen content (CaO2). Attempts can be made to modify the concept of oxygen availability by subtracting from the CaO2 the venous content at a critical PO2 as measured in mixed venous blood (Pv-O2), where oxygen diffusion into tissue becomes compromised and oxygen uptake (VO2) may decrease. The real arterial available oxygen content (CavlO2) can be calculated by estimating the saturation at the critical Pv-O2. For our concept S35 was chosen as such a dynamic baseline. Similar modification of oxygen extraction ratio (ERav) defined as VO2 divided by the real oxygen availability (O2av) should give, more than the classic ER, a realistic indices of oxygen availability in relation to oxygen consumption. It can be hypothesized that VO2 starts to decline when ERav is around 1.0. During isovolemic hemodilution VO2 started to drop when ERav reached 1.08 +/- 0.09. The S35 changed from 55.0 +/- 2.1% to 41.5 +/- 4.1%, correlated with changes in Pv-O2. A direct correlation was also found between the increase of the classic ER and the change in S35. We conclude that the S35, the CavlO2 and the ERav can be of value in monitoring the systemic oxygenation and that the concept also includes the effect of changes in oxyhemoglobin characteristics on oxygen delivery.

  13. Dose-Dependent Hemodynamic, Biochemical, and Tissue Oxygen Effects of OC99 following Severe Oxygen Debt Produced by Hemorrhagic Shock in Dogs

    Directory of Open Access Journals (Sweden)

    William W. Muir


    Full Text Available We determined the dose-dependent effects of OC99, a novel, stabilized hemoglobin-based oxygen-carrier, on hemodynamics, systemic and pulmonary artery pressures, surrogates of tissue oxygen debt (arterial lactate 7.2±0.1 mM/L and arterial base excess −17.9 ± 0.5 mM/L, and tissue oxygen tension (tPO2 in a dog model of controlled severe oxygen-debt from hemorrhagic shock. The dose/rate for OC99 was established from a pilot study conducted in six bled dogs. Subsequently twenty-four dogs were randomly assigned to one of four groups (n=6 per group and administered: 0.0, 0.065, 0.325, or 0.65 g/kg of OC99 combined with 10 mL/kg lactated Ringers solution administered in conjunction with 20 mL/kg Hextend IV over 60 minutes. The administration of 0.325 g/kg and 0.65 g/kg OC99 produced plasma hemoglobin concentrations of 0.63±0.01 and 1.11±0.02 g/dL, respectively, improved systemic hemodynamics, enhanced tPO2, and restored lactate and base excess values compared to 0.0 and 0.065 g/kg OC99. The administration of 0.65 g/kg OC99 significantly elevated pulmonary artery pressure. Plasma hemoglobin concentrations of OC99 ranging from 0.3 to 1.1 g/dL, in conjunction with colloid based fluid resuscitation, normalized clinical surrogates of tissue oxygen debt, improved tPO2, and avoided clinically relevant increases in pulmonary artery pressure.

  14. Dose-Dependent Hemodynamic, Biochemical, and Tissue Oxygen Effects of OC99 following Severe Oxygen Debt Produced by Hemorrhagic Shock in Dogs. (United States)

    Muir, William W; Del Rio, Carlos L; Ueyama, Yukie; Youngblood, Bradley L; George, Robert S; Rausch, Carl W; Lau, Billy S H; Hamlin, Robert L


    We determined the dose-dependent effects of OC99, a novel, stabilized hemoglobin-based oxygen-carrier, on hemodynamics, systemic and pulmonary artery pressures, surrogates of tissue oxygen debt (arterial lactate 7.2 ± 0.1 mM/L and arterial base excess -17.9 ± 0.5 mM/L), and tissue oxygen tension (tPO2) in a dog model of controlled severe oxygen-debt from hemorrhagic shock. The dose/rate for OC99 was established from a pilot study conducted in six bled dogs. Subsequently twenty-four dogs were randomly assigned to one of four groups (n = 6 per group) and administered: 0.0, 0.065, 0.325, or 0.65 g/kg of OC99 combined with 10 mL/kg lactated Ringers solution administered in conjunction with 20 mL/kg Hextend IV over 60 minutes. The administration of 0.325 g/kg and 0.65 g/kg OC99 produced plasma hemoglobin concentrations of 0.63 ± 0.01 and 1.11 ± 0.02 g/dL, respectively, improved systemic hemodynamics, enhanced tPO2, and restored lactate and base excess values compared to 0.0 and 0.065 g/kg OC99. The administration of 0.65 g/kg OC99 significantly elevated pulmonary artery pressure. Plasma hemoglobin concentrations of OC99 ranging from 0.3 to 1.1 g/dL, in conjunction with colloid based fluid resuscitation, normalized clinical surrogates of tissue oxygen debt, improved tPO2, and avoided clinically relevant increases in pulmonary artery pressure.

  15. A case report: accessory right renal artery

    Directory of Open Access Journals (Sweden)

    Patasi B


    Full Text Available Anatomical variations in the origin of the arteries in the abdominal area are very common. The arteries that show frequent variations include the celiac trunk, renal and gonadal arteries. During a routine dissection of a male cadaver, one main and one inferior accessory renal artery were found in the abdominal region. We discovered that the inferior accessory renal artery that originated from the right anterolateral aspect of abdominal aorta was running into the lower pole of the right kidney. The origin of the main right renal artery and the inferior accessory right renal artery were 19.8 mm and 53 mm below the superior mesenteric artery, respectively. The inferior accessory right renal artery ran directly into the inferior pole of the right kidney, in the area where the accessory right renal vein was leaving the right kidney. These anatomical variations and anomalies are important to know before any therapeutic or diagnostic procedures are performed in the abdominal area.

  16. Livergraftvascularvariantwith 3 extra-hepatic arteries

    Institute of Scientific and Technical Information of China (English)

    Paulo N Martins


     Vascular anatomy of the liver is varied, and the"standard"anatomy is seen in 55%-80%of cases. It is very important that extrahepatic arteries are identiifed precisely at the time of graft procurement to avoid injuries that might compromise the liver function. In the present case the liver donor had the vascular anatomy of Michels type Ⅶ, e.g. a hepatic artery originating from the celiac trunk and going to the left lobe, an accessory left hepatic artery coming from the left gastric artery, and a replaced right hepatic artery coming from the superior mesenteric artery. This pattern of vascular supply is uncommon, representing less than 5%of cases. The replaced hepatic artery was reconstructed in the back-table with polypropylene suture 7.0 by connecting it to the stump of the splenic artery, and the celiac trunk of the graft was anastomosed to the recipient common hepatic artery.

  17. Desaturation of excess intramyocellular triacylglycerol in obesity

    DEFF Research Database (Denmark)

    Haugaard, S B; Madsbad, S; Mu, Huiling;


    diabetes (T2DM), body mass index (BMI)=35.5+/-0.8 kg m(-2)) and 25 men, age 49+/-2 years (20 obese including 6 T2DM, BMI=35.8+/-0.8 kg m(-2))), IMTG FA composition was determined by gas-liquid chromatography after separation from phospholipids by thin-layer chromatography. RESULTS: Independently of gender......OBJECTIVE: Excess intramyocellular triacylglycerol (IMTG), found especially in obese women, is slowly metabolized and, therefore, prone to longer exposure to intracellular desaturases. Accordingly, it was hypothesized that IMTG content correlates inversely with IMTG fatty acid (FA) saturation...... in sedentary subjects. In addition, it was validated if IMTG palmitic acid is associated with insulin resistance as suggested earlier. DESIGN: Cross-sectional human study. SUBJECTS: In skeletal muscle biopsies, which were obtained from sedentary subjects (34 women, age 48+/-2 years (27 obese including 7 type 2...

  18. Cup or bottle for preterm infants: effects on oxygen saturation, weight gain, and breastfeeding. (United States)

    Rocha, Neide M N; Martinez, Francisco E; Jorge, Salim M


    The impact of cup-feeding or bottle-feeding on weight gain, oxygen saturation, and breastfeeding rates of preterm infants was studied in 34 bottle-fed and 44 cup-fed preterm infants. At initiation of oral feeding, postconceptional age and weight were 37.2 +/- 2.2 weeks and 1676 +/- 83 g for the bottle-fed group (BF) and 37.0 +/- 1.6 weeks and 1637 +/- 40 g for the cup-fed (CF) group, respectively. No significant differences between groups were found with regard to time spent feeding, feeding problems, weight gain, or breastfeeding prevalence at discharge or at 3-month follow-up. Possible beneficial effects of cup-feeding were lower incidence of desaturation episodes (13.6% vs 35.3%, CF vs BF, P = .024) and a higher prevalence of breastfeeding at 3 months among those still breastfeeding at the first follow-up visit (68.4% vs 33.3%, CF vs BF, P = .04).

  19. Bronchial artery embolization in hemoptysis

    Institute of Scientific and Technical Information of China (English)

    DAI Hong-xiu; YANG Ding-cai; LIU Wei-hong; TANG He-qing; LIU Ke-yong; ZHAO Xiao-hua; TAN Yi-qing; WANG Jun


    Massive hemoptysis is one of the most dreaded of all respiratory emergencies and can have a variety of underlying causes. It is mostly caused by bleeding from bronchial circulation. Bronchial artery embolization is now considered to be the treatment of choice for acute massive hemoptysis. Bronchial artery embolization (BAE) is a safe and effective nonsurgical treatment for patients with massive hemoptysis. However, nonbronchial systemic arteries can be a significant source of massive hemoptysis and a cause of recurrence after successful BAE. So knowledge of the bronchial artery anatomy, together with an understanding of the pathophysiologic features of massive hemoptysis, are essential for planning and performing BAE in affected patients. In addition, interventional radiologists should be familiar with the techniques, results, efficacy, safety and possible complications of BAE and with the characteristics of the various embolic agents. Bronchial arterial catheterisation in human via a percutaneous approach has been practiced for 32 years (1973) in the world and 20 years (1986) in China, initially for direct chemotherapy treatment for bronchial malignancies and then for the embolization of patients with massive haemoptysis. A review of clinical experience to evaluate technique,embolic materials,outcome and complications of BAE is presented.

  20. Arterial calcification: A new perspective? (United States)

    Nicoll, R; Henein, M


    Arterial calcification is commonly seen in atherosclerosis, chronic kidney disease (CKD) and diabetes and has long been considered a natural progression of atherosclerosis. Yet it is a systemic condition, occurring in a wide and diverse range of disease states and no medical treatment for cardiovascular disease has yet found a way to regress it; on the contrary, lipid-lowering therapy may worsen its progression. Although numerous studies have found associations between calcification and biomarkers, none has yet found a unifying mechanism that explains the calcification found in atherosclerosis, CKD or diabetes and many of the biomarkers are equally associated with atheroma development and cardiovascular events. Furthermore, both presence and absence of coronary artery calcification appear predictive of plaque rupture and cardiovascular events, indicating that the association is not causal. This suggests that we are no further forward in understanding the true nature of arterial calcification or its pathogenesis, other than noting that it is 'multifactorial'. This is because most researchers view arterial calcification as a progressive pathological condition which must be treated. Instead, we hypothesise that calcification develops as an immune response to endothelial injury, such as shear stress or oxidative stress in diabetics, and is consequently part of the body's natural defences. This would explain why it has been found to be protective of plaque rupture and why it is unresponsive to lipid-lowering agents. We propose that instead of attempting to treat arterial calcification, we should instead be attempting to prevent or treat all causes of endothelial injury.

  1. A comparison of central venous-arterial and mixed venous-arterial carbon dioxide tension gradient in circulatory failure. (United States)

    Ho, K M; Harding, R; Chamberlain, J


    The arterial and mixed venous carbon dioxide tension gradient has been shown to increase when there is a decrease in cardiac output. Monitoring central venous gases is an attractive alternative to monitoring mixed venous gases in circulatory failure because central venous catheterisation is a less invasive procedure than pulmonary artery catheterisation. This study aims to evaluate the agreement between central venous-arterial carbon dioxide (CVA-CO2) and mixed venous-arterial carbon dioxide (SVA-CO2) tension gradients and assess whether CVA-CO2 tension gradient can be used to predict cardiac output in circulatory failure. Samples of arterial, central venous and mixed venous blood were obtained from 16 patients with circulatory failure at different inspired oxygen concentrations and cardiac indexes within 24 hours of study enrolment. CVA-CO2 and SVA-CO2 tension gradient were not interchangeable numerically (bias = 0.14 mmHg, 95% limits of agreement: -3.0 to 3.2 mmHg). CVA-CO2 (Spearman correlation coefficient r = -0.385) and SVA-CO, (r = -0.578) tension gradient were significantly correlated with the cardiac index but the cardiac index only accounted for 21% and 32% of the variability of CVA-CO, and SVA-CO2 tension gradient, respectively. The ability of CVA-CO2 tension gradient (area under the ROC curve = 0.77, 95% confidence interval [CI]: 0.49-0.99; P = 0.08) to predict a low cardiac output state (cardiac index tension gradient appeared to be limited to their negative predictive value to exclude a low cardiac output state when CVA-CO, or SVA-CO, tension gradient was normal (< or =5 mmHg).

  2. Optical studies of oxidative stress in pulmonary artery endothelial cells (United States)

    Ghanian, Zahra; Sepehr, Reyhaneh; Eis, Annie; Kondouri, Ganesh; Ranji, Mahsa


    Reactive oxygen species (ROS) play an essential role in facilitating signal transduction processes within the cell and modulating the injuries. However, the generation of ROS is tightly controlled both spatially and temporally within the cell, making the study of ROS dynamics particularly difficult. This study present a novel protocol to quantify the dynamic of the mitochondrial superoxide as a precursor of reactive oxygen species. To regulate the mitochondrial superoxide level, metabolic perturbation was induced by administration of potassium cyanide (KCN). The presented method was able to monitor and measure the superoxide production rate over time. Our results demonstrated that the metabolic inhibitor, potassium cyanide (KCN) induced a significant increase in the rate of superoxide production in mitochondria of fetal pulmonary artery endothelial cells (FPAEC). Presented method sets the stage to study different ROS mediated injuries in vitro.

  3. Inspired fraction of carbon dioxide in oxygen supply to chronic pulmonary disease. (United States)

    Fremault, Antoine; Silva, Mitchell; Beaucage, François; Berckmans, Daniel; Decramer, Marc


    Hypoxemic patients with chronic obstructive pulmonary disease (COPD) are at risk of carbon dioxide (CO(2)) retention during oxygen therapy and hypercapnia in COPD is associated with an ominous prognosis. Rebreathing with oxygen mask is possible in practice and possibly affects CO(2) retention due to an increased inspired fraction of CO(2). Its effects on arterial partial pressure of CO(2) during oxygen supply have, to the best of our knowledge, never been studied. We measured the inspired fraction of CO(2) in eighteen non-hypoxemic stable COPD patients with a capnograph during a 5 min trial with two different modes of oxygen supply (oxygen mask without reservoir bag and nasal prongs, respectively at a flow of 10 l/min and 2l/min). We found no significant increase in inspiratory CO(2) concentration. These findings suggest that inspired fraction of CO(2) does not increase markedly during controlled oxygen therapy.

  4. Application of a modified regularization procedure for estimating oxygen tension in large retinal blood vessels (United States)

    Yildirim, Isa; Ansari, Rashid; Samil Yetik, I.; Shahidi, Mahnaz


    Phosphorescence lifetime measurement based on a frequency domain approach is used to estimate oxygen tension in large retinal blood vessels. The classical least squares (LS) estimation was initially used to determine oxygen tension indirectly from intermediate variables. A spatial regularized least squares (RLS) method was later proposed to reduce the high variance of oxygen tension estimated by LS method. In this paper, we provide a solution using a modified RLS (MRLS) approach that utilizes prior knowledge about retinal vessels oxygenation based on expected oxygen tension values in retinal arteries and veins. The performance of MRLS method was evaluated in simulated and experimental data by determining the bias, variance, and mean absolute error (MAE) of oxygen tension measurements and comparing these parameters with those derived with the use of LS and RLS methods.

  5. First jejunal artery, an alternative graft for right hepatic artery reconstruction. (United States)

    Aryal, Bibek; Komokata, Teruo; Kadono, Jun; Motodaka, Hiroyuki; Ueno, Tetsuya; Furoi, Akira; Imoto, Yutaka


    Common bile duct cancer invading right hepatic artery is sometimes diagnosed intraoperatively. Excision and safe reconstruction of the artery with suitable graft is essential. Arterial reconstruction with autologous saphenous vein graft is the preferred method practiced routinely. However the right hepatic artery reconstruction has also been carried out with several other vessels like gastroduodenal artery, right gastroepiploic artery or the splenic artery. We report a case of 63-year-old man presenting with history of progressive jaundice, pruritus and impaired appetite. Following various imaging modalities including computed tomography, endoscopic retrograde cholangiopancreatography, magnetic resonance cholangiopancreatography, intraductal ultrasound extrahepatic bile duct cancer was diagnosed; however, none of those detected vessel invasion. Intraoperatively, right hepatic artery invasion was revealed. Right hepatic artery was resected and reconstructed with a graft harvested from the first jejunal artery (JA). Postoperative outcome was satisfactory with a long-term graft patency. First JA can be a reliable graft option for right hepatic artery reconstruction.

  6. Hypothenar hammer syndrome: Distal ulnar artery reconstruction with autologous inferior epigastric artery. (United States)

    Smith, Hadley E; Dirks, Marco; Patterson, Robert B


    Digital artery embolization and ulnar artery thrombosis are consequences of repetitive trauma and can lead to digit loss and debility from ischemia and cold intolerance. We postulate that an arterial autograft is a theoretically superior conduit to traditional saphenous vein, and report reconstruction with inferior epigastric artery. Three adult male smokers, ages 39 to 49 years, had severe digital ischemia and cold-induced vasospasm. Arteriograms confirmed occlusion of the distal ulnar artery without direct perfusion of the superficial palmar arch, distal digital artery embolization, and normal proximal vasculature. All reconstructions were performed from the distal most patent ulnar artery at the wrist to the superficial palmar arch (1 patient) or sequentially to the involved common digital arteries (2 patients), with inferior epigastric artery. Handling characteristics and size match between the arterial autografts and bypassed arteries was excellent. Patency has been confirmed with duplex scanning at follow-up of 8 to 24 months, with resolution of cold intolerance and successful digital preservation.

  7. Subxyphoid pleural drain confers lesser impairment in respiratory muscle strength, oxygenation and lower chest pain after off-pump coronary artery bypass grafting: a randomized controlled trial Dreno pleural subxifoide confere menor comprometimento da força muscular respiratória, oxigenação e menor dor torácica após cirurgia de revascularização do miocárdio sem circulação extracorpórea: estudo controlado randomizado

    Directory of Open Access Journals (Sweden)

    Andreia S. A. Cancio


    Full Text Available OBJECTIVE: To evaluate respiratory muscle strength, oxygenation and chest pain in patients undergoing off-pump coronary artery bypass (OPCAB using internal thoracic artery grafts comparing pleural drain insertion site at the subxyphoid region versus the lateral region. METHODS: Forty patients were randomized into two groups in accordance with the pleural drain site. Group II (n = 19 -pleural drain exteriorized in the intercostal space; group (SI (n = 21 chest tube exteriorized at the subxyphoid region. All patients underwent assessment of respiratory muscle strength (inspiratory and expiratory on the pre, 1, 3 and 5 postoperative days (POD. Arterial blood gas analysis was collected on the pre and POD1. The chest pain sensation was measured 1, 3 and 5 POD. RESULTS: A significant decrease in respiratory muscle strength (inspiratory and expiratory was seen in both groups until POD5 (P OBJETIVO: Avaliar a força muscular respiratória, oxigenação e dor torácica em pacientes submetidos à cirurgia de revascularização miocárdica (RM sem circulação extracorpórea (CEC comparando o local de inserção do dreno pleural na região subxifoidea versus lateral. MÉTODOS: Quarenta pacientes foram randomizados em dois grupos Grupo (II - n = 19 - dreno pleural exteriorizado na região intercostal; Grupo (SI - n = 21 dreno pleural exteriorizado na região subxifoidea. Os pacientes foram submetidos à avaliação da força muscular respiratória no pré, 1º, 3ºe 5º dias de pós-operatório (PO. Gasometria arterial foi coletada no pré e 1º dia do PO. A dor torácica foi avaliada no 1º, 3º e 5º dias de PO. RESULTADOS: Ambos os grupos apresentaram diminuição significante da força muscular respiratória até o quinto dia do PO (P <0,05. A diferença entre os grupos manteve-se significante com maior decréscimo no grupo II (P <0,05. Houve queda na pressão arterial de oxigênio em ambos os grupos (P <0,05, mas quando comparado à queda foi maior no

  8. Oxygenation and ventilation characteristics in obese sedated dogs before and after weight loss: a clinical trial. (United States)

    Mosing, M; German, A J; Holden, S L; MacFarlane, P; Biourge, V; Morris, P J; Iff, I


    This prospective clinical study examined the effect of obesity and subsequent weight loss on oxygenation and ventilation during deep sedation in pet dogs. Data from nine dogs completing a formalised weight loss programme were evaluated. Dual-energy X-ray absorptiometry (DEXA) was used to quantify body fat mass prior to and after weight loss. Dogs were deeply sedated and positioned in dorsal recumbency. Sedation was scored using a semi-objective scheme. As part of the monitoring of sedation, arterial oxygen partial pressure (PaO2) and arterial carbon dioxide partial pressure (PaCO2) were measured after 10 min in dorsal recumbency. Oxygen saturation of haemoglobin (SpO2) was monitored continuously using pulse oximetry, starting oxygen supplementation where indicated (SpO2PaO2/FiO2 (inspired oxygen fraction) and Pa/AO2 (ratio of PaO2 to alveolar PO2) also improved significantly, but there was no change in f-shunt and PaCO2 after weight loss. On multiple linear regression analysis, all oxygen indices were negatively associated with thoracic fat percentage. In conclusion, obesity decreases oxygenation in dogs during deep sedation. Oxygenation status improves with successful weight loss, but ventilation is not influenced by obesity.

  9. Spontaneous internal carotid artery dissection. (United States)

    Khimenko, L P; Esham, H R; Ahmed, W


    Once considered uncommon, spontaneous dissection of the carotid artery is an increasingly recognized cause of stroke, headache, cranial nerve palsy, or ophthalmologic events, especially in young adults. Even in the presence of existing signs and symptoms, the diagnosis can be missed by experienced physicians of all specialties. We report a case of spontaneous internal carotid artery dissection in a 38-year-old woman with a cortical stroke and visual disturbances as initial symptoms. The diagnosis was confirmed by magnetic resonance imaging/angiography and by angiography. Prompt anticoagulation was instituted, and the patient had complete resolution of symptoms. Cervicocephalic arterial dissection should be included in the differential diagnosis of the causes of cerebrovascular events.

  10. Measuring gas exchange with step changes in inspired oxygen: an analysis of the assumption of oxygen steady state in patients suffering from COPD. (United States)

    Thomsen, Lars P; Weinreich, Ulla M; Karbing, Dan S; Wagner, Peter D; Rees, Stephen E


    Bedside estimation of pulmonary gas exchange efficiency may be possible from step changes in FIO2 and subsequent measurement of arterial oxygenation at steady state conditions. However, a steady state may not be achieved quickly after a change in FIO2, especially in patients with lung disease such as COPD, rendering this approach cumbersome. This paper investigates whether breath by breath measurement of respiratory gas and arterial oxygen levels as FIO2 is changed can be used as a much more rapid alternative to collecting data from steady state conditions for measuring pulmonary gas exchange efficiency. Fourteen patients with COPD were studied using 4-5 step changes in FIO2 in the range of 0.15-0.35. Values of expired respiratory gas and arterial oxygenation were used to calculate and compare the parameters of a mathematical model of pulmonary gas exchange in two cases: from data at steady state; and from breath by breath data prior to achievement of a steady state. For each patient, the breath by breath data were corrected for the delay in arterial oxygen saturation changes following each change in FIO2. Calculated model parameters were shown to be similar for the two data sets, with Bland-Altman bias and limits of agreement of -0.4 and -3.0 to 2.2 % for calculation of pulmonary shunt and 0.17 and -0.47 to 0.81 kPa for alveolar to end-capillary PO2, a measure of oxygen abnormality due to shunting plus regions of low [Formula: see text] A/[Formula: see text] ratio. This study shows that steady state oxygen levels may not be necessary when estimating pulmonary gas exchange using changes in FIO2. As such this technique may be applicable in patients with lung disease such as COPD.


    Directory of Open Access Journals (Sweden)



    Full Text Available Introduction: Persistent median artery originates from the anterior interosseous artery in proximal one-third of the forearm and accompanies median nerve. Median artery may regress in the forearm or enter palm through the carpal tunnel deep to flexor retinaculum of wrist and supply palm by anastomosing with the superficial palmar arch. Objective: In present study the objective was to study presence of persistent median artery accompanying median nerve and its termination Materials and Methods: The study included 50 human cadaver upper limb specimens at the Department of Anatomy, Mysore Medical College & Research Institute, Mysore during 2011-13. These specimens fixed in 10% formalin were finely dissected and persistent median artery was traced from origin to termination. Results: Out of 50 human cadaver specimens, persistent median artery was present in 4 specimens (8%. All the 4 median arteries originated from anterior interosseous artery and were of palmar type which reached palm. Out of 4 median arteries, 3 median arteries (6% took part in completion of superficial palmar arch, supplying the distal aspect of palm and 1 median artery (2% directly supplied radial two and half fingers without forming arch. Conclusion: Knowledge of unusual variations helps in proper treatment of disorders of the median nerve. Presence of persistent median artery usually will be asymptomatic but may cause symptoms of carpal tunnel syndrome or pronator teres syndrome when subjected to compression. Rarely this artery can be taken for reconstruction

  12. Spontaneous isolated celiac artery dissection

    Directory of Open Access Journals (Sweden)

    Tuba Cimilli Ozturk


    Full Text Available Dyspepsia with mild, stabbing epigastric discomfort without history of trauma is a very common symptom that emergency physicians see in their daily practice. Vascular emergencies, mostly the aortic dissection and aneurysm, are always described in the differential diagnosis with persistent symptoms. Isolated celiac artery dissection occurring spontaneously is a very rare diagnosis. The involvement of branch vessels is generally observed and patients show various clinical signs and symptoms according to the involved branch vessel. Here we are presenting a case with spontaneous isolated celiac artery dissection, without any branch vessel involvement or visceral damage, detected by computed tomography scans taken on admission.

  13. Motor performance in five-year-old extracorporeal membrane oxygenation survivors: a population-based study.

    NARCIS (Netherlands)

    Nijhuis-Van der Sanden, M.W.G.; Cammen-van Zijp, M.H. van der; Janssen, A.J.M.; Reuser, J.J.C.M.; Mazer, P.; Heyst, A.F.J. van; Gischler, S.J.; Tibboel, D.; Kollee, L.A.A.


    INTRODUCTION: Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) is a cardio-pulmonary bypass technique to provide life support in acute reversible cardio-respiratory failure when conventional management is not successful. Most neonates receiving ECMO suffer from meconium aspiration syndrom

  14. Motor performance in five-year-old extracorporeal membrane oxygenation survivors: A population-based study

    NARCIS (Netherlands)

    M.W.G. Nijhuis-van der Sanden (Maria); M.H.M. van der Cammen-van Zijp (Monique); A.J.W.M. Janssen (Anjo); J.J.C.M. Reuser (Jolanda); P. Mazer (Petra); A.F.J. van Heijst (Arno); S.J. Gischler (Saskia); D. Tibboel (Dick); L.A. Kollee


    textabstractIntroduction: Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) is a cardio-pulmonary bypass technique to provide life support in acute reversible cardio-respiratory failure when conventional management is not successful. Most neonates receiving ECMO suffer from meconium aspira

  15. Near-infrared spectroscopy assessed cerebral oxygenation during open abdominal aortic aneurysm repair

    DEFF Research Database (Denmark)

    Sørensen, H.; Nielsen, H. B.; Secher, N H


    intend to adjust ventilation according end-tidal CO2 tension (EtCO2) and here evaluated to what extent that strategy maintains frontal lobe oxygenation (ScO2) as determined by near infrared spectroscopy. For 44 patients [5 women, aged 70 (48-83) years] ScO2, mean arterial pressure (MAP), EtCO2...

  16. An experimental study on pumpless extracorporeal membrane oxygenation (ECMO support in a canine model.

    Directory of Open Access Journals (Sweden)



    Full Text Available

    This study was carried out to determine whether an extracorporeal membrane oxygenation (ECMO support could be sufficiently conducted by the right ventricle alone from the viewpoint of the hemodynamics and blood gas state. Six infant dogs underwent a bypass between the left pulmonary artery and left atrium with an in-line oxygenator after a left pneumonectomy. Partial ECMO support was conducted simply by opening the circuit, and total ECMO support was conducted by ligating the right pulmonary artery. After the establishment of partial ECMO, approximately one-third of the right ventricular output was passively shunted through the bypass circuit, and the cardiac index and central venous pressure did not change. The mean pulmonary arterial pressures increased significantly. After a complete ligation of the right pulmonary artery, all 6 dogs survived for 12 h, but the cardiac output and blood pressure decreased significantly. The blood gas state was sufficiently maintained throughout the experiment. The results suggest the possibility of using the pumpless ECMO support. However, the flow resistance of the membrane oxygenator proved to still be too high for use in a total pumpless ECMO. Further studies on long-term ECMO and the development of a membrane oxygenator with a considerably low flow-resistance are needed.

  17. Measurement of the ductal L-R shunt during extracorporeal membrane oxygenation in the lamb.

    NARCIS (Netherlands)

    Tanke, R.B.; Heijst, A.F.J. van; Klaessens, J.H.G.M.; Daniels, O.; Festen, C.


    OBJECTIVE: In neonates, initially a ductal shunt is often observed during veno-arterial extracorporeal membrane oxygenation (ECMO). Depending on the degree of pulmonary hypertension in these patients, the ductal shunt will be right to left (R-L), left to right (L-R), or bidirectional. A ductal L-R s

  18. Non-intubated recovery from refractory cardiogenic shock on percutaneous VA-extracorporeal membrane oxygenation

    NARCIS (Netherlands)

    van Houte, J; Donker, D W; Wagenaar, L J; Slootweg, A P; Kirkels, J H; van Dijk, D


    We report on the use of percutaneous femoral veno-arterial extracorporeal membrane oxygenation (VA-ECMO) in a fully awake, non-intubated and spontaneously breathing patient suffering from acute, severe and refractory cardiogenic shock due to a (sub)acute anterior myocardial infarction. Intensified h

  19. Oxygen ion conductors

    Directory of Open Access Journals (Sweden)

    Stephen J Skinner


    A very interesting subgroup of this class of materials are the oxides that display oxygen ion conductivity. As well as the intrinsic interest in these materials, there has been a continued drive for their development because of the promise of important technological devices such as the solid oxide fuel cell (SOFC, oxygen separation membranes, and membranes for the conversion of methane to syngas1. All of these devices offer the potential of enormous commercial and ecological benefits provided suitable high performance materials can be developed. In this article we will review the materials currently under development for application in such devices with particular reference to some of the newly discovered oxide ion conductors.

  20. Neurological oxygen toxicity. (United States)

    Farmery, Scott; Sykes, Oliver


    SCUBA diving has several risks associated with it from breathing air under pressure--nitrogen narcosis, barotrauma and decompression sickness (the bends). Trimix SCUBA diving involves regulating mixtures of nitrogen, oxygen and helium in an attempt to overcome the risks of narcosis and decompression sickness during deep dives, but introduces other potential hazards such as hypoxia and oxygen toxicity convulsions. This study reports on a seizure during the ascent phase, its potential causes and management and discusses the hazards posed to the diver and his rescuer by an emergency ascent to the surface.

  1. Correlation between arterial and venous blood gas analysis parameters in patients with acute exacerbation of chronic obstructive pulmonary disease

    Directory of Open Access Journals (Sweden)

    Novović Miloš


    Full Text Available Introduction. Arterial blood gas (ABG analyses have an important role in the assessment and monitoring of the metabolic and oxygen status of patients with acute exacerbation of chronic obstructive pulmonary disease (COPD. Arterial puncture could have a lot of adverse effects, while sampling of venous blood is simpler and is not so invasive. Objective. The aim of this study was to evaluate whether venous blood gas (VBG values of pH, partial pressure of carbon dioxide (PCO2, partial oxygen pressure (PO2, bicarbonate (HCO3, and venous and arterial blood oxygen saturation (SO2 can reliably predict ABG levels in patients with acute exacerbation of COPD. Methods. Forty-seven patients with a prior diagnosis of COPD were included in this prospective study. The patients with acute exacerbation of this disease were examined at the General Hospital EMS Department in Prijepolje. ABG samples were taken immediately after venous sampling, and both were analyzed. Results. The Pearson correlation coefficients between arterial and venous parameters were 0.828, 0.877, 0.599, 0.896 and 0.312 for pH, PCO2, PO2, HCO3 and SO2, respectively. The statistically significant correlation between arterial and venous pH, PCO2 and HCO3, values was found in patients with acute exacerbation of COPD (p<0.001. Conclusion. When we cannot provide arterial blood for analysis, venous values of the pH, Pv,CO2 and HCO3 parameters can be an alternative to their arterial equivalents in the interpretation of the metabolic status in patients with acute exacerbation of COPD, while the values of venous Pv,O2 and Sv,O2 cannot be used as predictors in the assessment of oxygen status of such patients.

  2. Hypoxia stimulates prostacyclin synthesis in newborn pulmonary artery endothelium by increasing cyclooxygenase-1 protein. (United States)

    North, A J; Brannon, T S; Wells, L B; Campbell, W B; Shaul, P W


    In newborn lambs, pulmonary prostacyclin (PGI2) production increases acutely in response to low oxygen. We tested the hypothesis that decreased oxygenation directly stimulates PGI2 synthesis in arterial segments and cultured endothelial cells from newborn lamb intrapulmonary arteries. In segments studied at PO2 of 680 mm Hg, the synthesis of PGI2 exceeded prostaglandin E2 (PGE2) by 73%. Endothelium removal lowered PGI2 by 77% and PGE2 by 66%. At low oxygen tension (PO2, 40 mm Hg), PGI2 and PGE2 synthesis rose by 96% and 102%, respectively. Similarly, in endothelial cells studied at PO2 of 680 mm Hg, the synthesis of PGI2 exceeded PGE2 by 50%, and at low oxygen tension both PGI2 and PGE2 increased (89% and 64%, respectively). Endothelial cell PGI2 synthesis maximally stimulated by bradykinin, A23187, or arachidonic acid was also increased at low PO2 by 50%, 66%, and 48%, respectively. PGE2 synthesis was similarly altered, increasing by 33%, 37%, and 41%, respectively. In contrast, lowering oxygen had minimal effect on PGI2 and PGE2 synthesis with exogenous PGH2, which is the product of cyclooxygenase. Immunoblot analyses revealed that there was a 2.6-fold greater abundance of cyclooxygenase-1 protein at PO2 of 40 versus 680 mm Hg, and the increase at lower oxygen tension was inhibited by cycloheximide. The cyclooxygenase-2 isoform was not detected. Thus, attenuated oxygenation directly stimulates PGI2 and PGE2 synthesis in intrapulmonary arterial segments and endothelial cells from newborn lambs. This process is due to enhanced cyclooxygenase activity related to increased abundance of the cyclooxygenase-1 protein, and this effect may be due to increased synthesis of the enzyme protein.

  3. Acute effect of hydralazine administration on pulmonary artery hemodynamics in dogs with chronic heartworm disease. (United States)

    Atkins, C E; Keene, B W; McGuirk, S M; Sato, T


    In an effort to better understand the role of vasodilators in the management of pulmonary hypertension associated with chronic heartworm disease (HWD), pulmonary hemodynamic measurements were obtained from 7 experimentally infected, anesthetized dogs before and after hydralazine administration (mean dose, 1.96 mg/kg of body weight). Five dogs were maintained on room air, while 2 were maintained on 100% oxygen during the hydralazine study. The hemodynamic effect of hydralazine in dogs with HWD was evaluated, using heart rate, cardiac index, mean pulmonary artery pressure, mean arterial pressure, total pulmonary resistance, total systemic resistance, total systemic resistance/total pulmonary resistance, left ventricular dP/dtmax, left ventricular end diastolic pressure, and left and right ventricular double products ([mean arterial pressure x heart rate] and [mean pulmonary artery pressure x heart rate], respectively). Responders were defined as those in which total pulmonary resistance decreased > or = 20% without an increase in mean pulmonary arterial pressure and in which heart rate increase was < or = 10%. Comparison was also made between maximal hemodynamic effect of hydralazine with that after 100% oxygen administration for 15 minutes to previously normoxemic dogs (n = 5). Significance was determined if P < 0.05, using the paired t-test. Hydralazine induced significant reductions in mean pulmonary and systemic arterial pressures and total pulmonary resistance, with no significant change in heart rate, cardiac index, total systemic resistance, left ventricular dP/dtmax, left ventricular end diastolic pressure, or right and left ventricular double products. Four (57%) of the 7 dogs studied were considered responders. Pretreatment cardiac index, mean pulmonary artery pressure, and total pulmonary resistance did not allow differentiation of responders from nonresponders.(ABSTRACT TRUNCATED AT 250 WORDS)

  4. Three new families with arterial tortuosity syndrome.

    NARCIS (Netherlands)

    Wessels, M.W.; Catsman-Berrevoets, C.E.; Mancini, G.M.; Breuning, M.H.; Hoogeboom, J.J.; Stroink, H.; Frohn-Mulder, I.M.; Coucke, P.J.; Paepe, A.D.; Niermeijer, M.F.; Willems, P.J.


    Arterial tortuosity syndrome (ATS) is a rare condition with autosomal recessive inheritance characterized by connective tissue abnormalities. The most specific clinical findings are cardiovascular anomalies including tortuosity, lengthening, aneurysm, and stenosis formation of major arteries. Also v

  5. Could Peripheral Arterial Disease Be Your Problem? (United States)

    ... exercise and yoga classes and has returned to teaching. Fast Facts Peripheral arterial disease (P.A.D.) occurs when a fatty material called plaque (pronounced plak) builds up on the inside walls of the arteries that carry blood from ...

  6. Transposition of the Greater Arteries (TGA) (United States)

    ... Atrioventricular Canal Defect Transposition of the Great Arteries Coarctation of the Aorta Truncus Arteriosus Single Ventricle Defects ... Atrioventricular Canal Defect Transposition of the Great Arteries Coarctation of the Aorta Truncus Arteriosus Single Ventricle Defects ...

  7. The effect of sumatriptan on cephalic arteries

    DEFF Research Database (Denmark)

    Amin, Faisal Mohammad; Asghar, Mohammad Sohail; Ravneberg, Julie W;


    AIM: To explore a possible differential effect of sumatriptan on extracerebral versus cerebral arteries, we examined the superficial temporal (STA), middle meningeal (MMA), extracranial internal carotid (ICAextra), intracranial internal carotid (ICAintra), middle cerebral (MCA) and basilar arteries...

  8. Middle cerebral artery blood velocity during rowing

    DEFF Research Database (Denmark)

    Secher, Niels Henry; Pott, F; Knudsen, L.;


    original,arterial blood pressure,central venous pressure,cerebral blood flow, exercise, transcranial Doppler......original,arterial blood pressure,central venous pressure,cerebral blood flow, exercise, transcranial Doppler...

  9. Pulse Oximetry for the Detection of Obstructive Sleep Apnea Syndrome: Can the Memory Capacity of Oxygen Saturation Influence Their Diagnostic Accuracy?

    Directory of Open Access Journals (Sweden)

    Carlos A. Nigro


    Full Text Available Objective. To assess the diagnostic ability of WristOx 3100 using its three different recording settings in patients with suspected obstructive sleep apnea syndrome (OSAS. Methods. All participants (135 performed the oximetry (three oximeters WristOx 3100 and polysomnography (PSG simultaneously in the sleep laboratory. Both recordings were interpreted blindly. Each oximeter was set to one of three different recording settings (memory capabilities 0.25, 0.5, and 1 Hz. The software (nVision 5.1 calculated the adjusted O2 desaturation index-mean number of O2 desaturation per hour of analyzed recording ≥2, 3, and 4% (ADI2, 3, and 4. The ADI2, 3, and 4 cutoff points that better discriminated between subjects with or without OSAS arose from the receiver-operator characteristics (ROCs curve analysis. OSAS was defined as a respiratory disturbance index (RDI ≥ 5. Results. 101 patients were included (77 men, mean age 52, median RDI 22.6, median BMI 27.4 kg/m2. The area under the ROCs curves (AUC-ROCs of ADI2, 3, and 4 with different data storage rates were similar (AUC-ROCs with data storage rates of 0.25/0.5/1 Hz: ADI2: 0.958/0.948/0.965, ADI3: 0.961/0.95/0.966, and ADI4: 0.957/0.949/0.963, P NS. Conclusions. The ability of WristOx 3100 to detect patients with OSAS was not affected by the data storage rate of the oxygen saturation signal. Both memory capacity of 0.25, 0.5, or 1 Hz showed a similar performance for the diagnosis of OSAS.

  10. Bilateral Internal Thoracic Artery Configuration for Coronary Artery Bypass Surgery (United States)

    Boodhwani, Munir; Hanet, Claude; de Kerchove, Laurent; Navarra, Emiliano; Astarci, Parla; Noirhomme, Philippe; El Khoury, Gebrine


    Background— Bilateral internal thoracic arteries (BITA) have demonstrated superior patency and improved survival in patients undergoing coronary artery bypass grafting. However, the optimal configuration for BITA utilization and its effect on long-term outcome remains uncertain. Methods and Results— We randomly assigned 304 patients undergoing coronary artery bypass grafting using BITA to either in situ or Y grafting configurations. The primary end point was 3-year angiographic patency. Secondary end points included major adverse cardiac and cerebrovascular events (ie, death from any cause, stroke, myocardial infarction, or repeat revascularization) at 7 years. More coronary targets were able to be revascularized using internal thoracic arteries in patients randomized to Y grafting versus in situ group (3.2±0.8 versus 2.4±0.5 arteries/patient; P<0.01). The primary end point did not show significant differences in graft patency between groups. Secondary end points occurred more frequently in the in situ group (P=0.03), with 7-year rates of 34±10% in the in situ and 25±12% in the Y grafting groups, driven largely by a higher incidence of repeat revascularization in the in situ group (14±4.5% versus 7.4±3.2% at 7 years; P=0.009). There were no significant differences in hospital mortality or morbidity or in late survival, myocardial infarction, or stroke between groups. Conclusions— Three-year systematic angiographic follow-up revealed no significant difference in graft patency between the 2 BITA configurations. However, compared with in situ configuration, the use of BITA in a Y grafting configuration results in lower rates of major adverse cardiovascular and cerebrovascular events at 7 years. Clinical Trial Registration— URL: Unique identifier: NCT01666366. PMID:27406988

  11. An unreported type of coronary artery naomaly in congenitally corrected transposition of great arteries

    Energy Technology Data Exchange (ETDEWEB)

    Kwak, Min Kyu; Jeong, Yeon Joo; Lee, Gee Won; Lee, Nam Kyung; Choi, Jung Hyun; Lee, Ji Won [Medical Research Institute, Pusan National University Hospital, Busan (Korea, Republic of)


    Coronary artery variations are associated anomalies in 45% of congenitally corrected transposition of the great arteries (ccTGA) cases, and it is important to detect any coronary artery anomalies before cardiac surgery. We report a case of a 51-year-old woman with ccTGA and an unreported type of coronary artery anomaly.

  12. Cardioembolic occlusion of the internal carotid artery presented with infarction in the posterior cerebral artery territory

    Institute of Scientific and Technical Information of China (English)

    XUE Su-fang; JIA Jian-ping


    @@ Posterior circulation stroke may rarely be associated with occlusive disease in the anterior circulation, such as in the context of a direct (fetal) origin of the posterior cerebral artery (PCA) from the internal carotid artery (ICA), or in the presence of a persistent trigeminal artery (PTA) or persistent hypoglossal artery (PHA).1,2

  13. Correlation of invasive central arterial pressure with peripheral arterial pressure and coronary sclerosis

    Institute of Scientific and Technical Information of China (English)



    Objective To study the consistency among non-invasive and invasive brachial artery pressure,radial artery pressure and invasive central arterial pressure,and to explore the correlation between the severe degree of coronary artery disease and invasive central aortic pressure.

  14. Hypogastric artery autograft treating hemorrhage with infection of external iliac artery secondary to renal transplantation

    Institute of Scientific and Technical Information of China (English)

    WANG Ze-hou; YI Shan-hong; YAO Zhi-yong; SUN Bin; HONG Quan; ZHANG Zhi-chao


    @@ Massive hemorrhage from infected anastomosed site between the graft artery and the external iliac artery is one of the most serious complications of renal transplantation. Clinically, it is a rare but fatal occasion. We reported here one case of hemorrhage with infection in the iliac artery anastomosed site treated successfully with hypogastric artery autograft interposition in March 2003.

  15. Moyamoya disease associated with an anterior inferior cerebellar artery arising from a persistent trigeminal artery

    Energy Technology Data Exchange (ETDEWEB)

    Uchino, A.; Sawada, A.; Takase, Y.; Kudo, S. [Department of Radiology, Saga Medical School, 5-1-1, Nabeshima, Saga, 849-8501 (Japan); Koizumi, T. [Department of Neurosurgery, Saga Medical School, 5-1-1, Nabeshima, Saga, 849-8501 (Japan)


    The authors present a case of moyamoya disease associated with a persistent trigeminal artery from which the anterior inferior cerebellar artery arose. We reviewed previously reported cases of moyamoya disease associated with persistent carotid-basilar arterial anastomosis and investigated the embryology of this rare arterial variation. (orig.)

  16. Arterial and Venous Thrombosis in Cancer Patients

    Directory of Open Access Journals (Sweden)

    Andrew D. Blann


    Full Text Available The most frequent ultimate cause of death is myocardial arrest. In many cases this is due to myocardial hypoxia, generally arising from failure of the coronary macro- and microcirculation to deliver enough oxygenated red cells to the cardiomyocytes. The principle reason for this is occlusive thrombosis, either by isolated circulating thrombi, or by rupture of upstream plaque. However, an additionally serious pathology causing potentially fatal stress to the heart is extra-cardiac disease, such as pulmonary hypertension. A primary cause of the latter is pulmonary embolus, considered to be a venous thromboembolism. Whilst the thrombotic scenario has for decades been the dominating paradigm in cardiovascular disease, these issues have, until recently, been infrequently considered in cancer. However, there is now a developing view that cancer is also a thrombotic disease, and notably a disease predominantly of the venous circulation, manifesting as deep vein thrombosis and pulmonary embolism. Indeed, for many, a venous thromboembolism is one of the first symptoms of a developing cancer. Furthermore, many of the standard chemotherapies in cancer are prothrombotic. Accordingly, thromboprophylaxis in cancer with heparins or oral anticoagulation (such as Warfarin, especially in high risk groups (such as those who are immobile and on high dose chemotherapy, may be an important therapy. The objective of this communication is to summarise current views on the epidemiology and pathophysiology of arterial and venous thrombosis in cancer.

  17. Optic nerve oxygen tension

    DEFF Research Database (Denmark)

    Kiilgaard, Jens Folke; Pedersen, D B; Eysteinsson, T


    The authors have previously reported that carbonic anhydrase inhibitors such as acetazolamide and dorzolamide raise optic nerve oxygen tension (ONPO(2)) in pigs. The purpose of the present study was to investigate whether timolol, which belongs to another group of glaucoma drugs called beta block...

  18. Aircraft Oxygen Generation (United States)


    aircraft use some form of on-board oxygen generation provided by one of two corporations that dominate this market . A review of safety incident data...manufacture of synthetic resins (e.g., Bakelite), and for 161 making dyestuffs, flavorings, perfumes , and other chemicals. Some are used as

  19. Oxygenated Derivatives of Hydrocarbons (United States)

    For the book entitled “Insect Hydrocarbons: Biology, Biochemistry and Chemical Ecology”, this chapter presents a comprehensive review of the occurrence, structure and function of oxygenated derivatives of hydrocarbons. The book chapter focuses on the occurrence, structural identification and functi...

  20. Hybrid Oxygen System (United States)


    otherwise in any manner construed, as licensing the holder or any other person or corporation ; or as conveying any rights or permission to manufacture, use...12 Modest Activity 2 12 24 Comnat ane G’s Average 5 32 64 Peak Activity (NATO) 10 50 Instantaneous Peak Flow N/A 150-20W_ Published oxygen flow rates

  1. Oxygen Extraction from Minerals (United States)

    Muscatello, Tony


    Oxygen, whether used as part of rocket bipropellant or for astronaut life support, is a key consumable for space exploration and commercialization. In Situ Resource Utilization (ISRU) has been proposed many times as a method for making space exploration more cost effective and sustainable. On planetary and asteroid surfaces the presence of minerals in the regolith that contain oxygen is very common, making them a potential oxygen resource. The majority of research and development for oxygen extraction from minerals has been for lunar regolith although this work would generally be applicable to regolith at other locations in space. This presentation will briefly survey the major methods investigated for oxygen extraction from regolith with a focus on the current status of those methods and possible future development pathways. The major oxygen production methods are (1) extraction from lunar ilmenite (FeTiO3) with either hydrogen or carbon monoxide, (2) carbothermal reduction of iron oxides and silicates with methane, and (3) molten regolith electrolysis (MRE) of silicates. Methods (1) and (2) have also been investigated in a two-step process using CO reduction and carbon deposition followed by carbothermal reduction. All three processes have byproducts that could also be used as resources. Hydrogen or carbon monoxide reduction produce iron metal in small amounts that could potentially be used as construction material. Carbothermal reduction also makes iron metal along with silicon metal and a glass with possible applications. MRE produces iron, silicon, aluminum, titanium, and glass, with higher silicon yields than carbothermal reduction. On Mars and possibly on some moons and asteroids, water is present in the form of mineral hydrates, hydroxyl (-OH) groups on minerals, andor water adsorbed on mineral surfaces. Heating of the minerals can liberate the water which can be electrolyzed to provide a source of oxygen as well. The chemistry of these processes, some key

  2. Characterization of hemodynamics and oxygenation in the renal cortex of rats (United States)

    Grosenick, Dirk; Wabnitz, Heidrun; Macdonald, Rainer; Niendorf, Thoralf; Cantow, Kathleen; Flemming, Bert; Arakelyan, Karen; Seeliger, Erdmann


    We have performed a pre-clinical study on 13 rats to investigate the potential of near-infrared spectroscopy for quantification of hemoglobin concentration and oxygen saturation of hemoglobin in the renal cortex of small animals. These measurements were combined with laser-Doppler fluxmetry and a fluorescence quenching technique for quantification of tissue oxygen tension. Hemoglobin concentration and oxygen saturation were determined from experimental data by a Monte Carlo model. The methods were applied to investigate and compare temporal changes during several types of interventions such as arterial and venous occlusions, as well as hyperoxia, hypoxia and hypercapnia induced by different mixtures of the inspired gas.

  3. Activation-induced resetting of cerebral oxygen and glucose uptake in the rat

    DEFF Research Database (Denmark)

    Madsen, P L; Linde, R; Hasselbalch, S G;


    In the clinical setting it has been shown that activation will increase cerebral glucose uptake in excess of cerebral oxygen uptake. To study this phenomenon further, this study presents an experimental setup that enables precise determination of the ratio between cerebral uptake of glucose...... and oxygen in the awake rat. Global CBF was measured by the Kety-Schmidt technique, and the ratio between cerebral uptake rates for oxygen, glucose, and lactate was calculated from cerebral arterial-venous differences. During baseline conditions, rats were kept in a closed box designed to minimize...

  4. Pulsed Dose Delivery of Oxygen in Mechanically Ventilated Pigs with Acute Lung Injury (United States)


    ALI is diagnosed, in part, by comparing the ratio of arterial oxygen concentration ( PaO2 ) to the percentage of oxygen in the air used for...breathing (fraction of inspired oxygen, FiO2). ALI is defined as a PaO2 : FiO2 (P:F) ratio of , while a ratio of  is characteristic of acute...P:F ratios were calculated by dividing the PaO2 by the FiO2. All data are expressed as mean ± SD. Student’s t-test was used to compare the data

  5. Rare anatomic variation of left gastric artery and right hepatic artery in a female cadaver. (United States)

    Troupis, Theodore; Chatzikokolis, Stamatis; Zachariadis, Michael; Troupis, George; Anagnostopoulou, Sofia; Skandalakis, Panayiotis


    The present report describes a rare case in which the left gastric artery arises directly from the abdominal aorta and the right hepatic artery from the superior mesenteric artery, as observed during the dissection of a female cadaver. The left gastric artery usually rises as one of the three branches of the celiac trunk, which was originally described by Haller in 1756, whereas the right hepatic artery usually originates from the proper hepatic artery. The knowledge of the typical anatomy of the abdominal arteries, and their variations, is especially important due to the numerous interventions performed in the abdominal area.

  6. Pregnancy after uterine arterial embolization

    Directory of Open Access Journals (Sweden)

    Cláudio E. Bonduki


    Full Text Available OBJECTIVE: To evaluate pregnancy outcomes, complications and neonatal outcomes in women who had previously undergone uterine arterial embolization. METHODS: A retrospective study of 187 patients treated with uterine arterial embolization for symptomatic uterine fibroids between 2005-2008 was performed. Uterine arterial embolization was performed using polyvinyl alcohol particles (500-900 mm in diameter. Pregnancies were identified using screening questionnaires and the study database. RESULTS: There were 15 spontaneous pregnancies. Of these, 12.5% were miscarriages (n = 2, and 87.5% were successful live births (n = 14. The gestation time for the pregnancies with successful live births ranged from 36 to 39.2 weeks. The mean time between embolization and conception was 23.8 months (range, 5-54. One of the pregnancies resulted in twins. The newborn weights (n = 14 ranged from 2.260 to 3.605 kg (mean, 3.072 kg. One (7.1% was considered to have a low birth weight (2.260 kg. There were two cases of placenta accreta (12.5%, treated with hysterectomy in one case [6.3%], one case of premature rupture of the membranes (PRM (6.3%, and one case of preeclampsia (6.3%. All of the patients were delivered via Cesarean section. CONCLUSION: In this study, there was an increased risk of Cesarean delivery. There were no other major obstetric risks, suggesting that pregnancy after uterine arterial embolization is possible without significant morbidity or mortality.

  7. Capsaicin and arterial hypertensive crisis. (United States)

    Patanè, Salvatore; Marte, Filippo; La Rosa, Felice Carmelo; La Rocca, Roberto


    Chili peppers are rich in capsaicin. The potent vasodilator calcitonin gene-related peptide (CGRP) is stored in a population of C-fiber afferents that are sensitive to capsaicin. CGRP and peptides released from cardiac C fibers have a beneficial effect in myocardial ischemia and reperfusion. It has been reported that capsaicin pretreatment can deplete cardiac C-fiber peptide stores. Furthermore, it has also been reported that capsaicin-treated pigs have significantly increased mean arterial blood pressure compared with controls, and that the decrease in CGRP synthesis and release contributes to the elevated blood pressure. A case has also been reported of an arterial hypertensive crisis in a patient with a large ingestion of peppers and chili peppers the day before. We present a case of an arterial hypertensive crisis in a 19-year-old Italian man with an abundant ingestion of peppers and of chili peppers the preceding day. This case describes an unusual pattern of arterial hypertensive crisis due to capsaicin.

  8. Management of pulmonary arterial hypertension.

    LENUS (Irish Health Repository)

    Judge, Eoin P


    Pulmonary arterial hypertension (PAH) is a complex disease with a high mortality. Management of this disease is underpinned by supportive and general therapies delivered by multidisciplinary teams in specialist centres. In recent years, a number of PAH-specific therapies have improved patient outcomes. This article will discuss the management of PAH in the context of relevant recently published studies in this area.

  9. Diagnosis and treatment of renal artery stenosis.

    NARCIS (Netherlands)

    Plouin, P.F.; Bax, L.


    A reduction in the diameter of the renal arteries can lead to hypertension, renal dysfunction and/or pulmonary edema. About 90% of patients with renal artery stenosis have atherosclerosis, and 10% have fibromuscular dysplasia. Atherosclerotic renal artery stenosis is a common condition that typicall

  10. Peripheral Arterial Disease (P.A.D.) (United States)

    ... page please turn Javascript on. Peripheral Artery Disease (P.A.D.) What is P.A.D.? Arteries Clogged With Plaque Peripheral arterial ... Escape (Esc) button on your keyboard.) Why Is P.A.D. Dangerous? Click for more information Blocked ...

  11. Fenestration of the anterior cerebral artery

    Energy Technology Data Exchange (ETDEWEB)

    Ito, J.; Washiyama, K.; Hong, K.C.; Ibuchi, Y.


    Three cases of angiographically demonstrated fenestration of the anterior cerebral artery are reported. Fenestration occurred at the medial half of the horizontal segment of the anterior cerebral artery in all cases. Its embryology and clinical significance are briefly discussed, and the anatomical and radiological literature on fenestration of the anterior cerebral artery is reviewed.

  12. Spectral characteristics of normal and atherosclerotic human coronary artery intima and media (United States)

    Morcos, N. C.; Levy, Guy C.; Rizoiu, Ioana-Mihaela; Tomita, M.


    Efficient use and specific targeting of laser energy to atherosclerotic lesions necessitate understanding of spectral characteristics of intima and media from normal and diseased segments. We report absorption, transmission, and reflectance spectra from 19 normal and 21 diseased coronary artery segments which were obtained at autopsy within 5 to 10 h post mortem and submerged in oxygenated Ringer's solution. Spectra were obtained from the luminal surface of 1 X 1 cm full thickness arteries or bluntly dissected intima and media segments in the range 250 to 2500 nm. Water peaks were subtracted. Absorption and transmission for full thickness artery, intima, and media from normal and atherosclerotic arteries shared main bands at 1150 and 1700 nm with variation in intensity. Significant differences in reflectance showed bands at 1080, 1340, 1600, 1739 nm in normal intima and media and atherosclerotic intima but absent in media from atherosclerotic arteries. Peaks at 1340, 1600, and 1739 nm in normal intima and media are equalized in atherosclerotic intima and absent in atherosclerotic media. In conclusion, absence of reflectance at 1080, 1340, 1600, and 1739 nm in atherosclerotic media may be selectively utilized to target laser energy and ablation at intimal plaque and spare media of atherosclerotic arteries.

  13. Anomalous external carotid artery-internal carotid artery anastomosis in two patients with proximal internal carotid arterial remnants

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Chang Hun [Dept. of Neurology, Stroke Center, Myongji Hospital, Goyang (Korea, Republic of); Cho, Young Dae; Kang, Hyun Seung; Kim, Jeong Eun; Han, Moon Hee [Seoul National University Hospital, Seoul National University College of Medicine, Seoul (Korea, Republic of); Jung, Seung Chai [Dept. of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea, Republic of); Ahn, Jun Hyong [Dept. of Neurosurgery, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang (Korea, Republic of)


    Two angiographic instances of anomalous external carotid artery (ECA) and internal carotid artery (ICA) anastomosis are described, each occurring at the C2-3 level and bearing remnants of proximal ICA. The ICA remnant of one patient (identifiable immediately upon bifurcation of the common carotid artery) was hypoplastic, and that of the other patient was an occluded arterial stump. These features are not typical of non-bifurcating ICA. The occipital artery originated from an anomalous connection in one instance and from the main trunk of the ECA (just past the ECA-ICA connection) in the other.

  14. Revascularization using satellite vein after radial artery harvested for coronary artery bypass grafting. (United States)

    Gon, Shigeyoshi; Yoshida, Shigehiko; Sanae, Tsutomu; Takahashi, Tamami; Inada, Eiichi


    The radial artery has been increasingly used for coronary artery bypass grafting and has excellent long-term patency rates. Hand claudication is one of the adverse effects after radial artery harvest. We reconstructed a radial artery using the satellite vein to prevent hand claudication. Pulsating blood flow at 35 cm/sec was evaluated using color Doppler echocardiography three months after surgery. This method makes it possible to use a radial artery in patients with a positive Allen test.

  15. Endovascular rescue from arterial rupture and thrombosis during middle cerebral artery stenting

    Energy Technology Data Exchange (ETDEWEB)

    Ahn, J.Y.; Chung, Y.S. [Department of Neurosurgery, College of Medicine, Pundang CHA Hospital, 351 Yatap-ding, Pundang-gu, 463-712, Sungnam (Korea); Lee, B.H. [Department of Interventional Neuroradiology, College of Medicine, Pundang CHA Hospital, 351 Yatap-dong, Pundang-gu, 463-712, Sungnam (Korea); Kim, O.J. [Department of Emergency Medicine, College of Medicine, Pundang CHA Hospital, 351 Yatap-dong, Pundang-gu, 463-712, Sungnam (Korea)


    Intravascular stents are being used with increasing frequency in interventional neuroradiology. Iatrogenic arterial rupture is an uncommon but serious complication. We present a case of arterial rupture and subarachnoid haemorrhage during middle cerebral artery stenting, treated by emergency additional, overlapping stenting and balloon tamponade of the dissected vessel. Thrombotic occlusion of the artery was managed by intra-arterial abciximab. Normal vessel patency was re-established within 20 min and the patient recovered with no neurological deficit. (orig.)

  16. Iatrogenic subclavian artery pseudoaneurysm close to the origin of the vertebral artery: an endovascular strategy

    Institute of Scientific and Technical Information of China (English)

    XU Gao-feng; Dae Chul Suh


    Subclavian artery pseudoaneurysm that induced from central venous catheterization through the internal jugular vein is relatively uncommon. However, the management of subclavian artery pseudoaneurysm remains a challenge because of their non-compressibility of deep locality and relationship to important surrounding anatomy, such as the origin of vertebral artery. In this paper, the authors report a patient with larger iatrogenic subclavian arterial pseudoaneurysm near the origin of vertebral artery, that was treated successfully by endovascular covered stent and coils.

  17. Cerebral oxygenation and haemodynamic effects induced by nimodipine in healthy subjects. (United States)

    Canova, Daniela; Roatta, Silvestro; Micieli, Giuseppe; Bosone, Daniele


    The cerebrovascular effects of nimodipine are still poorly understood even in the healthy condition; in particular, its effects on tissue oxygenation have never been investigated. The aim of the present study was to investigate changes in cerebral oxygenation and blood volume upon oral administration of nimodipine (90 mg) in the healthy condition. In eight subjects, changes in cerebral tissue oxygenation and blood volume were determined simultaneously with changes in blood velocity of the middle cerebral artery (VMCA) by using, respectively, near infrared spectroscopy (NIRS) and transcranial Doppler ultrasonography (TCD). The subjects also underwent noninvasive assessment of arterial blood pressure (ABP) and end-tidal CO2. TCD and NIRS CO2 reactivity indices were al-so extracted. Nimodipine significantly reduced ABP (11±13%) and increased heart rate, as well as NIRS oxygenation(6.0±4.8%) and blood volume indices (9.4±10.1%), while V(MCA) was not significantly decreased (2.0±3.5%). Nimodipine slightly but significantly reduced the V(MCA) response to changes in pCO2 whereas the CO2 reactivity of NIRS parameters was improved. The observed changes in cerebral tissue oxygenation and blood volume indicate nimodipine-induced cerebrovascular dilation and increased perfusion, while the effect on V(MCA)possibly results from dilation of the insonated artery. The present results cast doubt on the putative nimodipine-induced impairment of CO2 reactivity.

  18. Oxygen treatment of cluster headache

    DEFF Research Database (Denmark)

    Petersen, Anja S; Barloese, Mads C J; Jensen, Rigmor H


    of oxygen treatment. One study is observational and the remaining five are RCTs. Another five studies were on hyperbaric oxygen treatment hereof two case studies. CONCLUSION: Oxygen therapy can be administered at different flow rates. Three studies investigate the effect of low-flow oxygen, 6-7 l....../min, and found a positive response in 56%, 75% and 82%, respectively, of the patients. One study investigates high-flow oxygen, 12 l/min, and found efficacy in 78% of attacks. The effect of hyperbaric oxygen therapy has been investigated in a few small studies and there is evidence only for an acute...

  19. Determination of arterial wall shear stress

    Institute of Scientific and Technical Information of China (English)


    The arteries can remodel their structure and function to adapt themselves to the mechanical environment. In various factors that lead to vascular remodeling, the shear stress on the arterial wall induced by the blood flow is of great importance. However, there are many technique difficulties in measuring the wall shear stress directly at present. In this paper, through analyzing the pulsatile blood flow in arteries, a method has been proposed that can determine the wall shear stress quantitatively by measuring the velocity on the arterial axis, and that provides a necessary means to discuss the influence of arterial wall shear stress on vascular remodeling.

  20. [Periodic breathing with periodic oxygen variation in infancy]. (United States)

    von Czettritz, G; Bax, R T; Eckardt, T; Springer, S; Emmrich, P


    Oxycardiorespirographies, recording arterial oxygen saturation (SaO2), breathing movements, heart rate and ECG with a mean recording time of 22.3 hours, were performed on 85 preterm (mean postconceptional age: 38 weeks) and 81 term infants (mean postconceptional age 42.4 weeks). 83% of the preterm infants showed periodic breathing (PB), in 97% of them this was accompanied by periodic variations of arterial oxygen saturation (PVO). Periodic breathing occurred in 61% of the term infants, 84% of them showed PVO during periodic breathing. The mean variation of oxygen saturation was between 92.8 and 96.8% (+/- 1.7) for preterm and between 92.9 and 96.0% (+/- 2.2) for term infants. In some infants the peak to peak amplitude of the SaO2 cycles was up to 22%, sometimes a further fall of SaO2 occurred. There was a strong correlation of the PVO both at the beginning and end of the episode as well as with the PB-cycle periodicity itself. The fall of the oxygen saturation occurred 3.1 to 7.8 s after the beginning of the first apnea of an episode of periodic breathing, the minimum SaO2 was reached approximately 4.2 to 8.6 s later. This periodic rapid fall of SaO2 from a high oxygenation level cannot be explained by the apneas of a rather short duration during periodic breathing. It is discussed that PVO during periodic breathing may be caused by an ideopathic right to left shunting across fetal circulation pathways which occurs intermittently and periodically. This mechanism could-via patterns of reaction exhibited during the fetal and neonatal time period-lead to acute hypoxemia, as found in apparently life threatening events (ALTE) and as postulated in sudden infant death (SID).

  1. Extracorporeal membrane oxygenation as a support for TGA/IVS with low cardiac output syndrome and pulmonary hemorrhage

    Directory of Open Access Journals (Sweden)

    Xiaoyang Hong


    Full Text Available A 15-day-old neonate with complete transposition of the great arteries/intact ventricular septum was admitted with life-threatening hypoxemia and heart arrest. After successful resuscitation, heart beat recovered but blood lactate began to arise and maintained above 15 mmol/L 6 hours later. Emergency arterial switch operation was done at 20 hours after resuscitation. Planned extracorporeal membrane oxygenation support was employed postoperatively. The baby experienced severe pulmonary hemorrhage and severe hypoxemia after weaning from cardiopulmonary bypass, which were treated with extracorporeal membrane oxygenation support.

  2. Extracorporeal membrane oxygenation as a support for TGA/IVS with low cardiac output syndrome and pulmonary hemorrhage. (United States)

    Hong, Xiaoyang; Feng, Zhichun; Zhou, Gengxu; Xu, Xuan


    A 15-day-old neonate with complete transposition of the great arteries/intact ventricular septum was admitted with life-threatening hypoxemia and heart arrest. After successful resuscitation, heart beat recovered but blood lactate began to arise and maintained above 15 mmol/L 6 hours later. Emergency arterial switch operation was done at 20 hours after resuscitation. Planned extracorporeal membrane oxygenation support was employed postoperatively. The baby experienced severe pulmonary hemorrhage and severe hypoxemia after weaning from cardiopulmonary bypass, which were treated with extracorporeal membrane oxygenation support.

  3. Exercise training restores coronary arteriolar dilation to NOS activation distal to coronary artery occlusion - Role of hydrogen peroxide

    NARCIS (Netherlands)

    Thengchaisri, Naris; Shipley, Robert; Ren, Yi; Parker, Janet; Kuo, Lih


    Objective - Exercise training has been shown to restore vasodilation to nitric oxide synthase (NOS) activation in arterioles distal to coronary artery occlusion. Because reactive oxygen species are generated during NOS uncoupling and the production of vasodilator H2O2 is increased during exercise in

  4. Pulmonary Artery Intimal Sarcoma: A Case Report

    Directory of Open Access Journals (Sweden)

    Joseph P. Kriz


    Full Text Available Pulmonary artery intimal sarcomas are rare and lethal malignant tumors that typically affect larger vessels: the aorta, inferior vena cava, and pulmonary arteries. Since symptoms and imaging of pulmonary arterial intimal sarcomas mimic pulmonary thromboembolism, the differential diagnosis of a patient presenting with chest pain, dyspnea, and filling defect within the pulmonary arteries should include intimal sarcoma. Often right ventricular failure is observed due to pulmonary hypertension caused by the obstructive effect of the tumor and concomitant chronic thromboembolism. We report the case of a 72-year-old African-American male with arterial intimal sarcoma of the left and right pulmonary artery with extension through the right artery into the bronchus and right lung.

  5. Location of foot arteries using infrared images (United States)

    Villasenor-Mora, Carlos; González-Vega, Arturo; Martín Osmany Falcón, Antonio; Benítez Ferro, Jesús Francisco Guillemo; Córdova Fraga, Teodoro


    In this work are presented the results of localization of foot arteries, in a young group of participants by using infrared thermal images, these are the dorsal, posterior tibial and anterior tibial arteries. No inclusion criteria were considered, that causes that no strong statistical data about the influence of the age in the arterial localization. It was achieved to solve the confusion when veins present a heat distribution similar to the artery and in the position of this. it contributes to enhance the rate of location of arteries. In general it is possible to say that the use of infrared thermal images is a good technique to find the foot arteries and can be applied in its characterization in a future. The procedure proposed is a non-invasive technique, and in certain fashion does not requires specialized personnel to achieve locate the arteries. It is portable, safe, and relatively economical.

  6. Arterial endothelial function measurement method and apparatus

    Energy Technology Data Exchange (ETDEWEB)

    Maltz, Jonathan S; Budinger, Thomas F


    A "relaxoscope" (100) detects the degree of arterial endothelial function. Impairment of arterial endothelial function is an early event in atherosclerosis and correlates with the major risk factors for cardiovascular disease. An artery (115), such as the brachial artery (BA) is measured for diameter before and after several minutes of either vasoconstriction or vasorelaxation. The change in arterial diameter is a measure of flow-mediated vasomodification (FMVM). The relaxoscope induces an artificial pulse (128) at a superficial radial artery (115) via a linear actuator (120). An ultrasonic Doppler stethoscope (130) detects this pulse 10-20 cm proximal to the point of pulse induction (125). The delay between pulse application and detection provides the pulse transit time (PTT). By measuring PTT before (160) and after arterial diameter change (170), FMVM may be measured based on the changes in PTT caused by changes in vessel caliber, smooth muscle tone and wall thickness.

  7. Physiologic assessment of coronary artery fistula

    Energy Technology Data Exchange (ETDEWEB)

    Gupta, N.C.; Beauvais, J. (Creighton Univ., Omaha, NE (USA))


    Coronary artery fistula is an uncommon clinical entity. The most common coronary artery fistula is from the right coronary artery to the right side of the heart, and it is less frequent to the pulmonary artery. The effect of a coronary artery fistula may be physiologically significant because of the steal phenomenon resulting in coronary ischemia. Based on published reports, it is recommended that patients with congenital coronary artery fistulas be considered candidates for elective surgical correction to prevent complications including development of congestive heart failure, angina, subacute bacterial endocarditis, myocardial infarction, and coronary aneurysm formation with rupture or embolization. A patient is presented in whom treadmill-exercise thallium imaging was effective in determining the degree of coronary steal from a coronary artery fistula, leading to successful corrective surgery.

  8. New Technologies in Coronary Artery Surgery

    Directory of Open Access Journals (Sweden)

    David Taggart


    Full Text Available Coronary artery disease remains the leading cause of death in developed countries. Major recent studies such as SYNTAX and FREEDOM have confirmed that coronary artery bypass grafting (CABG remains the gold standard treatment in terms of survival and freedom from myocardial infarction and the need for repeat revascularization. The current review explores the use of new technologies and future directions in coronary artery surgery, through 1 stressing the importance of multiple arterial conduits and especially the use of bilateral mammary artery; 2 discussing the advantages and disadvantages of off-pump coronary artery bypass; 3 presenting additional techniques, e.g. minimally invasive direct coronary artery bypass grafting, hybrid, and robotic-assisted CABG; and, finally, 4 debating a novel external stenting technique for saphenous vein grafts.

  9. Oxygen Transport Ceramic Membranes

    Energy Technology Data Exchange (ETDEWEB)

    S. Bandopadhyay; T. Nithyanantham; X.-D Zhou; Y-W. Sin; H.U. Anderson; Alan Jacobson; C.A. Mims


    The present quarterly report describes some of the investigations on the structural properties of dense OTM bars provided by Praxair and studies on newer composition of Ti doped LSF. The in situ electrical conductivity and Seebeck coefficient measurements were made on LSFT at 1000 and 1200 C over the oxygen activity range from air to 10{sup -15} atm. The electrical conductivity measurements exhibited a p to n type transition at an oxygen activity of 1 x 10{sup -10} at 1000 C and 1 x 10{sup -6} at 1200 C. Thermogravimetric studies were also carried out over the same oxygen activities and temperatures. Based on the results of these measurements, the chemical and mechanical stability range of LSFT were determined and defect structure was established. The studies on the fracture toughness of the LSFT and dual phase membranes exposed to air and N{sub 2} at 1000 C was done and the XRD and SEM analysis of the specimens were carried out to understand the structural and microstructural changes. The membranes that are exposed to high temperatures at an inert and a reactive atmosphere undergo many structural and chemical changes which affect the mechanical properties. A complete transformation of fracture behavior was observed in the N{sub 2} treated LSFT samples. Further results to investigate the origin of the slow kinetics on reduction of ferrites have been obtained. The slow kinetics appear to be related to a non-equilibrium reduction pathway that initially results in the formation of iron particles. At long times, equilibrium can be reestablished with recovery of the perovskite phase. Recent results on transient kinetic data are presented. The 2-D modeling of oxygen movement has been undertaken in order to fit isotope data. The model is used to study ''frozen'' profiles in patterned or composite membranes.

  10. Oxygen Transport Ceramic Membranes

    Energy Technology Data Exchange (ETDEWEB)

    S. Bandopadhyay; T. Nithyanantham; X.-D Zhou; Y-W. Sin; H.U. Anderson; Alan Jacobson; C.A. Mims


    The present quarterly report describes some of the investigations on the structural properties of dense OTM bars provided by Praxair and studies on newer composition of Ti doped LSF. In the previous research, the reference point of oxygen occupancy was determined and verified. In the current research, the oxygen occupancy was investigated at 1200 C as a function of oxygen activity and compared with that at 1000 C. The cause of bumps at about 200 C was also investigated by using different heating and cooling rates during TGA. The fracture toughness of LSFT and dual phase membranes at room temperature is an important mechanical property. Vicker's indentation method was used to evaluate this toughness. Through this technique, a K{sub Ic} (Mode-I Fracture Toughness) value is attained by means of semi-empirical correlations between the indentation load and the length of the cracks emanating from the corresponding Vickers indentation impression. In the present investigation, crack propagation behavior was extensively analyzed in order to understand the strengthening mechanisms involved in the non-transforming La based ceramic composites. Cracks were generated using Vicker's indenter and used to identify and evaluate the toughening mechanisms involved. Preliminary results of an electron microscopy study of the origin of the slow kinetics on reduction of ferrites have been obtained. The slow kinetics appear to be related to a non-equilibrium reduction pathway that initially results in the formation of iron particles. At long times, equilibrium can be reestablished with recovery of the perovskite phase. Modeling of the isotopic transients on operating membranes (LSCrF-2828 at 900 C) and a ''frozen'' isotope profile have been analyzed in conjunction with a 1-D model to reveal the gradient in oxygen diffusivity through the membrane under conditions of high chemical gradients.

  11. Evolution of Oxygenic Photosynthesis (United States)

    Fischer, Woodward W.; Hemp, James; Johnson, Jena E.


    The origin of oxygenic photosynthesis was the most important metabolic innovation in Earth history. It allowed life to generate energy and reducing power directly from sunlight and water, freeing it from the limited resources of geochemically derived reductants. This greatly increased global primary productivity and restructured ecosystems. The release of O2 as an end product of water oxidation led to the rise of oxygen, which dramatically altered the redox state of Earth's atmosphere and oceans and permanently changed all major biogeochemical cycles. Furthermore, the biological availability of O2 allowed for the evolution of aerobic respiration and novel biosynthetic pathways, facilitating much of the richness we associate with modern biology, including complex multicellularity. Here we critically review and synthesize information from the geological and biological records for the origin and evolution of oxygenic photosynthesis. Data from both of these archives illustrate that this metabolism first appeared in early Paleoproterozoic time and, despite its biogeochemical prominence, is a relatively late invention in the context of our planet's history.

  12. Extra-corporeal membrane oxygenation (United States)

    ... page: // Extracorporeal membrane oxygenation To use the sharing features on this page, please enable JavaScript. Extracorporeal membrane oxygenation (ECMO) is a treatment that uses a ...


    A small backpack , for use by Naval aviators, containing a long duration emergency oxygen system and a separate humidifier for the aircraft’s oxygen supply, has been devised and a feasibility model built. (Author)

  14. Oxygen-Methane Thruster Project (United States)

    National Aeronautics and Space Administration — Orion Propulsion, Inc. proposes to develop an Oxygen and Methane RCS Thruster to advance the technology of alternate fuels. A successful Oxygen/CH4 RCS Thruster will...

  15. Variant origin of right testicular artery – a rare case

    Directory of Open Access Journals (Sweden)

    Salve VM


    Full Text Available Testicular arterial anatomy is important for testicular and renal surgeries. It may vary at the origin and arise from renal artery, suprarenal artery or lumbar artery. During routine dissection of 52-year-old male cadaver; the right testicular artery arising from right aberrant renal artery was found. Anatomical variation of testicular arteries is reported to be 4.7%. Presence of aberrant renal artery is seen in 13–16% of cases only. The origin of right testicular artery from right aberrant renal artery is very rare. Thus knowledge of this type of variation is very important in avoiding complications during operative surgeries.

  16. Retinal hemodynamic oxygen reactivity assessed by perfusion velocity, blood oximetry and vessel diameter measurements

    DEFF Research Database (Denmark)

    Klefter, Oliver Niels; Lauritsen, Anne Øberg; Larsen, Michael


    PURPOSE: To test the oxygen reactivity of a fundus photographic method of measuring macular perfusion velocity and to integrate macular perfusion velocities with measurements of retinal vessel diameters and blood oxygen saturation. METHODS: Sixteen eyes in 16 healthy volunteers were studied at two...... examination sessions using motion-contrast velocimetry and retinal oximetry with vessel diameter corrections. To test oxygen reactivity, participants were examined during normoxia, after 15 min of hyperoxia and finally after 45 min of normoxia. Repeatability was assessed by intraclass correlation coefficients...... retinal arterial oxygen saturation from 95.1 ± 5.0% to 96.6 ± 6.4% (p = 0.038) and increased retinal venous oxygen saturation from 62.9 ± 6.7% to 70.3 ± 7.8% (p = 0.0010). Parameters returned to baseline levels after subsequent normoxia. Saturation and vessel diameter ICCs were 0.88-0.98 (range...

  17. A pitfall in the measurement of arterial blood pressure in the ischaemic limb during elevation

    DEFF Research Database (Denmark)

    Bülow, J; Jelnes, Rolf


    kept at 10 mmHg during elevation. In these patients, the increase in vascular resistance was significantly less compared with the situation in which venous pressure was 0 mmHg during elevation. The arterial pressure still did not decrease. It is concluded that perfusion pressure in the ischaemic lower......In order to evaluate if elevation of the ischaemic limb above heart level is an alternative to the conventionally applied method with external counterpressure for estimation of skin perfusion pressure, femoral and popliteal artery pressures were measured directly in eight patients with occlusion...... of the superficial femoral artery. The measurements were done in the horizontal position and during elevation of the calf above heart level. During elevation relative blood flow, measured by arterio-venous oxygen saturation differences, decreased compared with the horizontal position. In contrast the popliteal...

  18. The impact of peripheral arterial disease: A proposal for a new classification. (United States)

    Vaquero Morillo, Fernando


    Clasically, intermittent claudication, an intermediate stage in peripheral arterial disease, has been considered as a benign condition when considering only the muscular pain on walking. In this paper our aim is to attract attention about the effects linked to ischemic pain and the oxidative injury resulting from episodes of ischemia/reperfusion. Throughout this process alterations in calcium homeostasis as well as uncontrolled generation of reactive oxygen species, in association with the mitochondrial dysfunction and inflammatory phenomena, could lead to accelerate atherosclerosis, with an increased cardiovascular risk stated by means of a reduced ankle-brachial index. Taking this idea into account we propose a possible new classification for the management of the peripheral arterial disease, combining the Fontaine and Rutherford classifications and thinking about the described systemic effects in order to change the traditional management of peripheral arterial disease.

  19. Evaluation of renal artery stenosis using color Doppler sonography in young patients with multiple renal arteries

    Institute of Scientific and Technical Information of China (English)

    QIN Wei; ZHANG Xin; YANG Min; ZHONG Xu-hui; ZHAO Ming-hui


    Background Some individuals have multiple renal arteries. Severe stenosis in one of the arteries may cause refractory hypertension. The detection of stenosis within one of the multiple renal arteries usually required invasive procedures, such as computed tomographic angiography (CTA) and magnetic resonance angiography (MRA). This study reported the application of color Doppler sonography (CDS) in the detection of severe stenosis in one of the multiple arteries.Methods Patients with multiple renal arteries and one of the arteries with severe stenosis were retrospectively studied. Peak systolic velocities (PSV) of renal arteries and the intrarenal CDS patterns were collected and compared. The diagnosis was confirmed by digital subtraction angiography (DSA).Results Four children with multiple renal arteries and one of the arteries with stenosis were investigated. They were admitted due to refractory hypertension. CDS screening identified two renal arteries in one kidney of each patient with one of the two renal arteries having stenosis >70%. The PSV of the stenosed arteries were much higher, and the intrarenal CDS patterns supplied by the stenosed arteries changed into T-P patterns.Conclusion Non-invasive CDS technology may be a useful method to identify severe stenosis in one of multiple renal arteries in young patients.

  20. Arterial and end-tidal carbon dioxide difference in pediatric intensive care

    Directory of Open Access Journals (Sweden)

    Chulananda Dias Goonasekera


    Full Text Available Background and Aim: Arterial carbon dioxide tension (PaCO 2 is considered the gold standard for scrupulous monitoring in pediatric intensive care unit (PICU, but it is invasive, laborious, expensive, and intermittent. The study aims to explore when we can use end-tidal carbon dioxide tension (P ET CO 2 as a reliable, continuous, and noninvasive monitor of arterial CO 2 Materials and Methods: Concurrent P ET CO 2 , fraction of inspired oxygen, PaCO 2 , and arterial oxygen tension values of clinically stable children on mechanical ventilation were recorded. Children with extra-pulmonary ventriculoatrial shunts were excluded. The P ET CO 2 and PaCO 2 difference and its variability and reproducibility were studied. Results: A total of 624 concurrent readings were obtained from 105 children (mean age [SD] 5.53 [5.43] years requiring invasive bi-level positive airway pressure ventilation in the PICU. All had continuous P ET CO 2 monitoring and an arterial line for blood gas measurement. The mean (SD number of concurrent readings obtained from each child, 4-6 h apart was 6.0 (4.05. The P ET CO 2 values were higher than PaCO 2 in 142 observations (22.7%. The PaCO 2 -P ET CO 2 difference was individual admission specific (ANOVA, P < 0.001. The PaCO 2 -P ET CO 2 difference correlated positively with the alveolar-arterial oxygen tension [P(A-aO 2 ] difference (ρ = 0.381 P < 0.0001. There was a fixed bias between the P ET CO 2 and PaCO 2 measuring methods, difference +0.66 KPa (95% confidence interval: +0.57 to +0.76. Conclusions: The PaCO 2 -P ET CO 2 difference was individual specific. It was not affected by the primary disorder leading to the ventilation.