Arterial Oxygen Saturation Levels Research Articles

Survival status and its predictors among adult victims of road traffic accident admitted to public hospitals of Bahir Bar City, Amhara regional state, Northwest, Ethiopia, 2023: multi center retrospective follow-up study

IntroductionRoad traffic accident is the most common cause of death in adults worldwide. Road traffic accident-related deaths increased from time to time in low- and middle-income countries including Ethiopia; however, there is limited evidence about Survival status and its predictors among adult victims of road traffic accidents admitted to Hospitals in Ethiopia specifically in the study area. Thus, this study aimed to assess Survival status and its predictors among adult victims of road traffic accident admitted to Hospitals.MethodsAn institutional-based retrospective follow-up study was conducted from July 01/2019 to June 30/2022. A total of 402 samples were chosen using simple random sampling. Data was collected by a prepared checklist from the victims’ chart and entered into Epi-Data version 4.6 software and then exported to STATA version 14.1 for analysis. Kaplan-Meier failure function and log-rank test were computed. The assumption was checked by Schoenfeld residual test. All variables in bivariable analysis, p-value < 0.25 were entered into multivariable cox-regression model. Adjusted Hazard Ratio with 95% Confidence Interval was reported to declare the strength of association and statistical significance p-value of < 0.05. Model fitness was checked by using Cox-Snell residual. Data was presented by text, table, and graph.ResultThe median survival time was 504 h. From all, 63(15.6%) deaths, 57% of deaths occurred between 24 and 168 h of follow-up with an overall incidence of 15.34deaths per10, 000 victims-hours observation. According to the Kaplan-Meier failure curve together with the log-rank test, the incidence density rate of death among victims who had a complication during admission was71.86per10,000victims-hour observation (95%, CI:53.66–96.25), which is different from those who did not have complication 5.17per10,000person-hour observation (95%, CI:3.26–8.21). The incidence density rate of death among victims who had low level of arterial oxygen saturation (SPO2 < 95%) during admission was 82.87per10, 000 victims-hour observation (95%, CI: 63.15-108.75), which is different from those who had arterial oxygen saturation ≥ 95% 3.16per10, 000victims -hour observation (95%, CI: 1.75–5.71) Develop complication (AHR = 3.1,95% CI:1.44–6.70), systolic blood pressure measurement value ≤ 89 mmHg (AHR = 2.4,95% CI:1.10–5.19), not admitted intensive care unit (AHR = 0.46,95% CI:0.022–0.97), Glasgow Coma Scale score ≤ 8 (AHR = 2.9,95% CI:1.07–7.75), Glasgow Coma Scale score 9–12(AHR = 3.8,95% CI:1.61–8.97) and, level of arterial oxygen saturation ≤ 95% (AHR = 6.5,95% CI:2.38–17.64) were predictors of outcome variable.Conclusion and recommendationsThe median survival time was short. Complication, low systolic blood pressure measurement value, low Glasgow Coma Scale score, not admit to intensive care unit and low level of arterial oxygen saturation were significant predictors of the outcome variable. So that healthcare providers better give special attention and care to those victims admitted to Hospitals. A further prospective study is recommended.

Стентування відкритої протоки як перший етап хірургічного лікування тетради Фалло з незливними гілками легеневої артерії

The aim – to show the results of patent ductus arteriosus (PDA) stenting as the first stage of palliative treatment in patients with tetralogy of Fallot with non-confluent branches of the pulmonary artery.Materials and methods. This retrospective, single-center study included 10 consecutive patients who underwent PDA stenting since 2013 to 2023. The average age at the time of surgery was 96.00 ± 82.92 days (range 4 to 411 days), the average weight was 5.10 ± 1.78 kg (range 2.8 to 11 kg). The arterial oxygen saturation level (SaO2) before the intervention was 72.0 ± 6.7 % (range 60 to 87 %).Results. There were no intraoperative complications in all patients of this group. The length of the stay in the intensive care unit after surgery was 5.00 ± 1.36 days. SaO2 level increased to 89.00 ± 4.08 %. The duration of artificial lung ventilation after surgery was 36.5 ± 18.00 hours, and the duration of inotropic support was 81.1 ± 33.8 hours. In the long term, all patients showed significant growth of the native pulmonary artery branches. All patients of this group achieved total repair of this pathology after 192.00 ± 60.28 days, on average. At the moment of total repair, the size of the left branch of the pulmonary artery increased from 3.9 ± 0.8 mm to 7.8 ± 1.6 mm, and the right branch increased from 5.8 ± 1.2 mm to 7.70 ± 1.04 mm; the Nakata index increased from 133.0 ± 29.1 mm2/m2 to 241.2 ± 97.8 mm2/m2; end-diastolic index of the left ventricle increased from 31.4 ± 10.8 ml/m2 to 43.1 ± 11.4 ml/m2.Conclusion. PDA stenting in patients with tetralogy of Fallot combined with non-confluent branches of the pulmonary artery is an effective palliative procedure. This method allows to postpone the total repair to an older age, ensures sufficient and symmetric growth of the branches of pulmonary artery, and helps to avoid risks associated with repeat open heart surgeries.

Effects of intraoperative fluid management on hemodynamics and tissue oxygenation according to the Pleth Variability Index in thoracic surgery.

The aim of this study was to compare the total fluid volume performed by noninvasive Pleth Variability Index in thoracic surgery patients in comparison to conventional fluid management. In this prospective randomized controlled study conducted between May 2019 and May 2020, 80 patients (68 males, 12 females; mean age: 58.5±6.7 years; range, 18 to 65 years) were divided into two groups: control (Group C) and the Pleth Variability Index (Group P). After performing routine anesthesia and Pleth Variability Index monitoring for all patients, fluids were given at a rate of 2 mL/kg/h with the standard anesthesia technique. Additional fluid supplementation was provided based on hemodynamic data in Group C. In Group P, 250 mL bolus crystalloid fluid was provided when Pleth Variability Index was >14%. Mean arterial pressure, heart rate, oxygen saturation, arterial blood gas, and blood biochemistry were recorded. Total fluid volumes and urinary output were also recorded. There was no significant difference between the groups in terms of total fluid volumes or urinary output. In the postoperative period, the oxygen saturation and mean arterial pressure of Group P were found to be higher than those of Group C. The postoperative creatinine and lactate values of Group P were lower than those of Group C. Although there was no significant difference in the total fluid given to the patients, fluid management by Pleth Variability Index monitoring had a positive effect on mean arterial pressure, oxygen saturation, lactate, and creatinine levels.

The Impact of Rubber Dam Association With Physiological Stress Parameters on Children of 7-10 Years Undergoing Pit and Fissure Sealant Treatment: An In-Vivo Study.

Introduction Anxiety is an emotion representing apprehension towards an unknown stimulus or situation. Rubber dam application during dental procedures in children makes the treatment more comfortable and acceptable as it gives them a psychological feeling that treatment is being carried out outside the oral cavity.The prime objective of this study was to evaluate and compare physiological parameters, which include pulse rate, arterial oxygen saturation level, blood pressure, and respiratory rate before and after rubber dam isolation. Material and methods The study consisted of 30 children patients of 7-10 years, comprised of 14 females and 16 males with a mean age of 8.15 ± 0.93 years. The study was a 'split mouth' clinical design study, where 60 sites in 30 patients (two sites in each patient) were used. The selected sites were divided into two groups by a convenience sampling method and were categorized as Group-I (control group - 30 sites were treated with pit and fissure sealants under cotton roll and saliva ejectors on mandibular right permanent first molar) and Group-II (study group - 30 sites were treated with pit and fissure sealants underrubber dam isolationon mandibular left permanent first molar). Results Rubber dam application reduced different physiological parameters of stress such as pulse rate, systolic and diastolic blood pressure, and respiratory rate at different intervals from the baseline values. Rubber dam and cotton roll applications have no significant effects on oxygen saturation levels at different intervals in healthy individuals. From statistical analysis, it was evident that a statistically significant difference was evident between the control and experimental groups (P value < 0.005). Conclusion It is confirmed in this study that rubber dam reduces different physiologic parameters of stress. After the application of the rubber dam, children's pulse rate, systolic and diastolic blood pressure, and respiratory rate were reduced. Clinical significance The study highlights the imperative role of rubber dam isolation in improving dental and medical effectiveness. In addendum to this, our research promotes the clinical use of rubber dams in pediatric dentistry.

Effect of Unexpected Prolonged Fasting on Patients Undergoing Elective Surgery under Spinal Anaesthesia: An Observational Study

Introduction: Preoperative fasting is a standard practice aimed at minimising the risk of pulmonary aspiration during surgery. However, patients often experience prolonged fasting periods beyond the recommended duration due to unanticipated delays in the operating theatre, communication failures between teams, inadequate preoperative planning and other factors. Aim: To investigate the effects of unexpectedly prolonged fasting on intraoperative and postoperative parameters in patients undergoing elective surgery under spinal anaesthesia. Materials and Methods: This prospective observational study was conducted from October 2023 to June 2024 at the Department of Anaesthesiology, Dr. D.Y. Patil Medical College, Hospital and Research Centre, Pimpri, Pune, Maharashtra, India. The study included 70 patients undergoing elective surgery under spinal anaesthesia. Patients were divided into two groups: Group A (AM group, n=35), scheduled for surgery between 8:00 AM and 12:00 PM and Group B (PM group, n=35), scheduled for surgery after 12:00 PM or with delayed surgeries. Intraoperative parameters, including Mean Arterial Pressure (MAP), Heart Rate (HR), oxygen saturation (SpO2 ) and random blood glucose levels, were recorded at specific time points. Postoperative outcomes, such as nausea, vomiting and random blood glucose levels, were also assessed. Continuous and discrete variables were summarised as mean±SD and median, while categorical variables were presented as frequencies and percentages. Associations between categorical variables were tested using Pearson’s Chi-square or Fisher’s-exact test, with p-values&lt;0.05 considered statistically significant. Results: The PM group exhibited higher preoperative random blood glucose levels (102.3±18.7 mg/dL) compared to the AM group (89.2±12.5 mg/dL). Postoperative nausea and vomiting were observed in 5 (14.3%) patients in the AM group and 11 (31.4%) patients in the PM group. Both groups showed a gradual decrease in MAP and HR from the preoperative period to 30 minutes after spinal anaesthesia administration, with slightly higher values noted in the PM group. No significant differences in SpO2 were observed between the groups. Conclusion: Unexpected prolonged fasting before elective surgery under spinal anaesthesia may contribute to higher preoperative blood glucose levels and an increased risk of postoperative nausea and vomiting. These findings underscore the importance of adhering to preoperative fasting guidelines and exploring potential strategies to minimise prolonged fasting periods, such as carbohydrate loading or allowing clear fluids closer to surgery

Comparing the Efficiency of Laryngeal Mask Airway and Endotracheal Tube Insertion in Airway Management in Patients Planning for Elective Orthopedic Surgery under General Anesthesia: A Randomized Clinical Trial.

The present study compared respiratory parameters between the two methods of airway establishment, ETT and LMA, for patients scheduled for orthopedic surgery with general anesthesia. This randomized double-blinded clinical trial was conducted on patients scheduled for elective orthopedic surgery under general anesthesia, in Bandar Abbas, Iran, from January 2021 to December 2021. Using a random allocation table, the study participants were randomly divided into two groups, to employ either ETT (n=48) or LMA insertion (n=48). The study's ultimate goal was to assess the respiratory parameters in 1, 3, 5, 10, and 15 minutes following intubation. At all-time points, the average of peak airway pressure (P peak) and P plateau parameters in the ETT group was much higher than the EMA group (p<0.001 in all comparisons). The value of dynamic lung compliance in the LMA group was significantly higher than the ETT group in all considered time periods (p<0.001 in all comparisons). The upward trend in the value of this index was significant only in the LMA group (p=0.030). There were no significant differences in arterial oxygen saturation and end-tidal carbon dioxide levels between the two groups (p>0.05). In terms of arterial oxygen saturation stability and at the same time providing respiratory dynamic compliance, the LMA device outperformed the ETT.

Epidemiological Aspects of Opioid Poisoning in Northern Iran: A Registry-Based Clinical Study.

Opioids are a class of drugs that are commonly used to manage pain due to their analgesic and sedative effects. However, the high consumption of opioids in the community has led to an increase in the incidence of overdoses and poisonings caused by various types of these drugs, whether intentional or unintentional. Therefore, comprehending the epidemiological features of patients experiencing opioid poisoning is crucial. We decided to investigate various epidemiological aspects of patients with opioid poisoning in the Mazandaran province, located in northern Iran, during the period of 2020 to 2021. The present investigation was conducted as a descriptive cross-sectional study, wherein we collected data on patients registered in the Mazandaran Registry Center of Opioid Poisoning (MRCOP) who had a history of using any kind of opioid. We collected information on various parameters, including patient demographics, the type of opioid consumed, the mode of consumption, and clinical outcomes. A total of 240 patients were initially registered at the registry center. However, 17 cases were excluded with personal consent, and eventually, a total of 223 patients were included in the investigation. The majority of the patients 70.9% (n = 158) were male, and the average age was 34.4 ± 16.55 years. The most common cause of poisoning reported in our study was intentional, which was mainly due to a suicide attempt. Furthermore, the most prevalent type of opioid consumed was methadone. The most frequently observed symptoms of poisoning among the patients were drowsiness, a decreased level of consciousness, and reduced arterial oxygen saturation levels. Based on the results of our study, several factors were found to be significant in methadone poisoning, including addiction, age, gender, suicide attempt, and a history of psychiatric disorder. These findings highlight the need for public education and awareness campaigns on the risks associated with opioid use, particularly methadone.

Machine learning model for predicting immediate postoperative desaturation using spirometry signal data

Postoperative desaturation is a common post-surgery pulmonary complication. The real-time prediction of postoperative desaturation can become a preventive measure, and real-time changes in spirometry data can provide valuable information on respiratory mechanics. However, there is a lack of related research, specifically on using spirometry signals as inputs to machine learning (ML) models. We developed an ML model and postoperative desaturation prediction index (DPI) by analyzing intraoperative spirometry signals in patients undergoing laparoscopic surgery. We analyzed spirometry data from patients who underwent laparoscopic, robot-assisted gynecologic, or urologic surgery, identifying postoperative desaturation as a peripheral arterial oxygen saturation level below 95%, despite facial oxygen mask usage. We fitted the ML model on two separate datasets collected during different periods. (Datasets A and B). Dataset A (Normal 133, Desaturation 74) was used for the entire experimental process, including ML model fitting, statistical analysis, and DPI determination. Dataset B (Normal 20, Desaturation 4) was only used for verify the ML model and DPI. Four feature categories—signal property, inter-/intra-position correlation, peak value/interval variability, and demographics—were incorporated into the ML models via filter and wrapper feature selection methods. In experiments, the ML model achieved an adequate predictive capacity for postoperative desaturation, and the performance of the DPI was unbiased.

Relationship between Oxygen Saturation and Blood Cholesterol Levels in the Elderly

According to the World Health Organization (WHO), elderly people are a population group aged 60 years or more (WHO, 2015). In 2010 the number of elderly people was 18.1 million people or 17.6 percent. In 2014 the number increased to 18.8 million people. In Indonesia, elderly people in 2020 are estimated to reach 28.8 million people or 11.34 percent of the total population in the country. Based on 2018 data, Indonesia Health Research Organization (RISKESDA) stated the majority of elderly people in Indonesia have degenerative diseases and/or chronic health problems, such as diabetes and heart disease (Ministry of Health of the Republic of Indonesia, 2018). In the 21st century, a special challenge in the health sector from the continuing increase in the number of elderly people is the emergence of degenerative problems and non-communicable diseases (NCDs) such as hypercholesterolemia, diabetes mellitus, hypertension, and mental health disorders, namely depression, dementia, anxiety disorders, and sleeping disorders. These diseases will cause problems if they are not treated or prevented. Oxygen saturation is the hemoglobin fraction of oxygen saturation relative to the total hemoglobin in the blood or the oxygen level in the blood. Oxygen is bound to Hemoglobin in the Red blood cells or Erythrocytes. The human body needs and regulates a very precise and specific balance of oxygen in the blood, because the human body needs oxygen from the environment outside the body for metabolic processes and body activities. The normal arterial blood oxygen saturation level in humans is 95-100 percent. Based on data from the Global Health Observatory (GHO) from the World Health Organization (WHO), it shows that one third of ischemic heart disease is caused by high cholesterol levels. Overall, elevated cholesterol is estimated to cause 2.6 million deaths (4.5% of total deaths in the world) and 29.7 million disability-adjusted life years (DALYS), or 2% of total DALYS. (Increased ......

Remote photoplethysmography-based human vital sign prediction using cyclical algorithm.

This article aims to predict vital signs like heart rate (HR), respiration rate, and arterial oxygen saturation using ambient light video, eliminating chronic distortions through improved frame quality with BER estimation. The study employs the cascade residual CNN-FPNR technique for preprocessing and SNR enhancement using energy variance maximization. The image cascade network (ICNet) facilitates segmentation, achieving strong segmentation in low-light ambient videos. Remote photoplethysmography (iPPG) enables noncontact vital sign monitoring, predicting HR and respiratory rate (RR). An innovative noninvasive temperature and cyclical algorithm, incorporating principal component analysis and fast Fourier transform, evaluate patient HR and RR. To address challenges related to involuntary movements, a dynamic time-warping-based optimization method is used for precise region selection. The study introduces an intensity variance-based threshold analysis for arterial oxygen saturation level determination. Ultimately, the support vector machine (SVM) classification technique evaluates the ground truth, showcasing the system's promising potential for remote and accurate vital sign assessment.

Combined remifentanil/sevoflurane in paediatric tonsil surgery anesthesia: Effect on recovery time of respiration and consciousness in paediatric patients

Purpose: To evaluate the effectiveness of combined remifentanil/sevoflurane anesthesia on hemodynamic stability and postoperative recovery in paediatric tonsil surgery.&#x0D; Methods: In this prospective study, a total of 102 paediatric patients who underwent tonsil surgery in Taihe County People's Hospital between February 2021 and April 2022 were recruited and randomized at a ratio of 1:1 to receive either propofol alone (control group) or remifentanil plus sevoflurane (study group) during paediatric tonsil surgery, with 51 patients in each group. The anaesthetic effect of the two regimens was the primary endpoint and was evaluated by monitoring the mean arterial pressure (MAP), heart rate (HR) and oxygen saturation (SpO2) levels of the patients before anaesthesia (T0), immediately after intubation (T1), at the beginning of surgery (T2) and at extubation (T3).&#x0D; Results: Remifentanil plus sevoflurane resulted in more stable MAP and HR of patients at T1, T2 and T3 than propofol alone (p &lt; 0.05). Furthermore, patients in the two groups exhibited similar SpO2 levels at T0, T1, T2 and T3 (p &gt; 0.05).&#x0D; Conclusion: The combined use of remifentanil and sevoflurane anaesthetics is effective in paediatric patients undergoing tonsil surgery and thus may offer a viable alternative for such clinical practice. The drug combination maintains intraoperative haemodynamic stability in patients, boosts postoperative recovery, and lowers the risk of postoperative adverse events.

Anesthetic effect of sufentanil in patients undergoing cardiovascular surgery

Purpose: To investigate the effect of sufentanil on anesthesia in patients undergoing cardiovascular surgery. &#x0D; Methods: The subjects comprised a total of 100 patients who were scheduled to undergo cardiovascular surgery in Taikang Tongji (Wuhan) Hospital from January 2021 to December 2021 and met the inclusion criteria. The eligible patients were assigned in a ratio of 1:1 to receive either remifentanil (control group) or sufentanil (study group) during cardiovascular surgery, with 50 patients in each group. The anesthetic effect of remifentanil and sufentanil was compared. &#x0D; Results: Patients treated with sufentanil experienced a faster onset of anesthesia and a shorter time-lapse before extubation, postoperative spontaneous breathing recovery, and postoperative anesthesia recovery when compared with those administered with remifentanil (p &lt; 0.05). Sufentanil provided more potent pain mitigation for patients undergoing cardiovascular surgery than remifentanil, as shown by the lower visual analogue scale (VAS) scores of patients in the study group (p &lt; 0.05). Patients administered with sufentanil showed better levels of mean arterial pressure (MAP) and oxygen saturation (SpO2) than remifentanil, suggesting better hemodynamic benefits provided by sufentanil (p &lt; 0.01). During cardiovascular surgery performed in this study, sufentanil resulted in a higher safety profile by reducing significantly the incidence of adverse reactions (6 %) than remifentanil (30 %) (p &lt; 0.01). &#x0D; Conclusions: Sufentanil exhibits a better anesthetic effect in patients undergoing cardiovascular surgery than remifentanil. It provides potent pain mitigation, effectively ameliorates patients’ hemodynamic status, and reduces the risk of adverse reactions. Future studies with larger sample sizes are required to validate these findings.

A Comparative Study of Nasal Fiberoptic Intubation with Laryngeal Mask Airway Fiberoptic Intubation in Children with a Difficult Airway

Background: Considering that the gold standard for intubation in children with a difficult airway is the use of fiberoptic bronchoscopy, and few studies have evaluated its application in children, the present study aimed at comparing two bronchoscopic techniques of nasal fiberoptic tracheal intubation (FOI-Nasal) and fiberoptic intubation via laryngeal mask airway (FOI-LMA) in children with a difficult airway.&#x0D; Methods: A single-blind randomized clinical trial was performed on 40 six-month-old to six-year-old children that were divided into two groups each consisting of 20 patients. The participants were all candidates for elective surgery with clinical criteria for the anticipated difficult intubation. FOI-Nasal and FOI-LMA were performed in the first and second groups, respectively. Mean arterial pressure (MAP), heart rate (HR), and blood oxygen saturation levels (SpO2) were assessed and recorded before anesthesia (T1), immediately before bronchoscopy (T2), and immediately after intubation with endotracheal tube (T3). Moreover, ETCO2, the first successful insertion attempt, and the intubation time were recorded, as well.&#x0D; Results: The results of the present study revealed that parameters including MAP, HR, and SpO2 at times T1, T2, and T3 were not significantly different between the two groups after adjusting for potential confounding factors (P&gt; 0.05). However, ETCO2 in FOI-Nasal group with a mean of 38.40 ± 3.57 was significantly higher than that of the FOI-LMA group with a mean of 34.35 ± 3.15 (P = 0.001). In addition, the intubation time in the FOI-LMA group with a mean of 32.40 ± 7.45 was significantly shorter than that of the FOI-Nasal group with a mean of 51.75 ± 9.97 (P &lt;0.001). The success rate in the first attempt in the FOI-Nasal group with the value of 70% was lower than that of the FOI-LMA group with the value of 90%; however, this difference was not statistically significant (P&gt; 0.05).&#x0D; Conclusion: According to the results of the present study, the intubation time in the FOI-LMA group was significantly shorter than that of the FOI-Nasal group. Moreover, the success rate of the first attempt in the FOI-LMA group was higher than that of the FOI-Nasal group. Therefore, it can be stated that FOI-LMA as compared to FOI-Nasal can be regarded as an easier technique, with a shorter intubation time, a higher success rate, and a greater stability of children’s hemodynamic parameters.

Development of a Flexible Smart Wearable Oximeter Insole for Monitoring SpO2 Levels of Diabetics’ Foot Ulcer

This work presents the development of a fully functional prototype of a wearable smart shoe insole that can monitor arterial oxygen saturation (SpO <sub xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">2</sub> ) levels at the foot of a diabetic patient using photoplethysmography (PPG) signals. Continuous monitoring of SpO <sub xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">2</sub> levels at foot in patients with diabetic foot ulcer (DFU) can provide critical information on the severity of the ulcer, the wound healing process, and alerting clinicians for critical limb ischemia. The developed oximetry system seamlessly integrates the Internet of things (IoT) via a custom-developed Android mobile application, thus enabling “at-home” monitoring. Twenty healthy subjects were tested, and the insole oximeter was able to successfully estimate SpO <sub xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">2</sub> levels at the toe. An average error of ≈ 2.6% was calculated for the measured/estimated SpO <sub xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">2</sub> levels at the subjects’ toe when compared to a reference oximeter attached to the finger. Perfusion Index (PI) - which represents the blood flow/supply in tissues - was used as a method for validating the oximeter readings. It was observed that fingers (index fingers) generally have larger PI values when compared to the toe, while PI results of both monitoring sites were in the acceptable range. In addition, a dataset was formed for the twenty test subjects, and machine learning (ML) techniques were applied to predict the SpO <sub xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">2</sub> level and the site of measurement (Finger or Toe), using multiple linear regression and classification methods. The ML results show that AC components of the PPG signals have a more significant contribution to the SpO <sub xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">2</sub> estimations when compared to the DC components. In addition, KNN (K=1) classifier, was able to successfully predict the monitoring sites, with a test accuracy of 96.86%.

Risk factors for persistent tomographic abnormalities at 6 months of follow-up in a cohort of hospitalized patients with moderate and severe COVID-19 living at high altitude.

After COVID-19, functional and tomographic lung alterations may occur, but there are no studies at high altitude where, due to lower barometric pressure, there are lower levels of arterial oxygen pressure and saturation in both normal subjects and patients with respiratory disease. In this study, we evaluated the computed tomographic (CT), clinical, and functional involvement at 3 and 6 months post-hospitalization in survivors with moderate-severe COVID-19, as well the risk factors associated with abnormal lung computed tomography (ALCT) at 6 months of follow-up. Prospective cohort, after hospitalization for COVID-19, of patients older than 18 years residing at high altitude. Follow-up at 3 and 6 months with lung CT, spirometry, diffusing capacity of the lung for carbon monoxide (DLCO), six-minute walk test (6MWT), and oxygen saturation (SpO2). Comparisons between ALCT and normal lung computed tomography (NLCT) groups with X2 and Mann-Whitney U test, and paired test for changes between 3 and 6 months. A multivariate analysis was performed to evaluate the variables associated with ALCT at 6-month follow-up. We included 158 patients, 22.2% hospitalized in intensive care unit (ICU), 92.4% with typical COVID CT scan (peripheral, bilateral, or multifocal ground glass, with or without consolidation or findings of organizing pneumonia), and median hospitalization of 7 days. At 6 months, 53 patients (33.5%) had ALCT. There were no differences between ALCT and NLCT groups in symptoms or comorbidities on admission. ALCT patients were older and more frequently men, smokers and hospitalized in ICU. At 3 months, ALCT patients had more frequently a reduced forced vital capacity (< 80%), and lower meters walked (6MWT) and SpO2. At 6 months, all patients improved lung function with no differences between groups, but there were more dyspnea and lower exercise SpO2 in ALCT group. The variables associated with ALCT at 6 months were age, sex, ICU stay, and typical CT scan. At 6-month follow-up, 33.5% of patients with moderate and severe COVID had ALCT. These patients had more dyspnea and lower SpO2 in exercise. Regardless of the persistence of tomographic abnormalities, lung function and 6MWT improved. We identified the variables associated with ALCT.

Correlation between Oxygen Saturation and Fasting Blood Sugar Levels in the Elderly

According to the World Health Organization (WHO), the elderly are a group of people aged 60 years or more [1]. In 2010 the number of elderly people was recorded at 18.1 million people or 17.6 percent. In 2014 the number increased to 18.8 million people [2]. In Indonesia, the elderly in 2020 are estimated to reach 28.8 million people or 11.34 percent of the total population in the country. The 2018 Riskesdas data noted that the majority of elderly people in Indonesia have degenerative diseases and or chronic health problems, such as diabetes and heart disease. These diseases will cause problems if they are not treated or prevented [3]. Oxygen saturation is the fraction of hemoglobin in oxygen saturation relative to the total hemoglobin in the blood or the oxygen level in the blood. Oxygen is bound by Hemoglobin in red blood cells or Erythrocytes. The human body needs and regulates a very precise and specific oxygen balance in the blood, because the human body needs oxygen from the environment outside the body for metabolic processes and body activities [4]. Normal arterial blood oxygen saturation level in humans is 95-100 percent. Diabetes Mellitus (DM) is a major health problem. Data from a global study shows that the number of people with Diabetes Mellitus in 2011 has reached 366 million people in the world [5]. Objective: The objective is to determine the relationship between oxygen saturation and fasting blood sugar levels in the elderly. Method: This research is an analytic observational study with a cross-sectional design. The research subjects were elderly aged ≥ 60 years who live in the Malalayang Dua Village, Manado City, Indonesia. In this study, the normal reference value for oxygen saturation was 95-100% and the normal fasting blood sugar/glucose (FBG) reference value according to WHO was &lt;100 mg/dL. Based on the analysis of the relationship using the Pearson correlation test, there was a significant relationship between oxygen saturation and fasting ....

Comparison of the Effects of Midazolam, Propofol, and Dexmede-tomidine on Hemodynamics Variation in Patients Undergoing Cataract Surgery under Local Anesthesia at 5th Azar Hospital in Gorgan in 2021-2022

Introduction: Cataract surgery is a common surgery, especially among the elderly, and the choice of anesthesia medications is critical in such patients. In this study, the effects of midazolam, propofol, and dexmedetomidine were investigated for sedation in patients undergoing cataract surgery under local anesthesia. Method: Ninety patients were included in this study and underwent cataract surgery using class II and III anesthesia (according to the ASA criteria). They were also randomly assigned to three groups. The first group received midazolam, the second group received propofol, and the third group received dexmedetomidine. During the surgery and recovery phase, blood pressure, arterial blood oxygen saturation, heart rate, and the occurrence of complications were recorded. Data were analyzed using the SPSS software (version 23) at a significance level of 0.05. Results: Alterations in arterial blood oxygen saturation (SpO2) levels were not significantly different among the three groups (P&gt;0.05); however, there were fewer changes in SpO2 levels at recovery in the propofol group (P&lt;0.05). Moreover, alterations in blood pressure did not differ significantly across the three groups during the surgery (P&gt;0.05), whereas during the recovery, they were lower in the group receiving dexmedetomidine (P&gt;0.05). Finally, Heart rates were not significantly different among the three groups during surgery and recovery (P&gt;0.05). Conclusion: The results demonstrated that in patients with hypertension and tachycardia, dexmedetomidine may be a better choice for sedation.

Impaired brain networks functional connectivity after acute mild hypoxia.

This study aimed to analyze the changes in brain networks functional connectivity of pilots exposed to simulated hypoxia using resting-state functional magnetic resonance imaging (fMRI). A total of 35 healthy male pilots exposed to 14.5% oxygen concentration (corresponding to an altitude of 3000 m) underwent resting-state fMRI scans. The independent component analysis (ICA) approach was used to analyze changes in the resting-state brain networks functional connectivity of pilots after hypoxic exposure, and 9 common components in brain functional networks were identified. In the functional connections that showed significant group differences, linear regression was used to examine the association between functional connectivity and clinical characteristics. The brain networks functional connectivity after hypoxia exposure decreased significantly, including the left frontoparietal network and visual network 1-area, left frontoparietal network and visual network 2-area, right frontoparietal network and visual network 2-area, dorsal attention network and ventral attention network, dorsal attention network and auditory network, and ventral attention network and visual network 1-area. We found no correlation between the altered functional connectivity and arterial oxygen saturation level. Our findings provide insights into the mechanisms underlying hypoxia-induced cognitive impairment in pilots.

A case report of Budd-Chiari syndrome with cardiac complications and low SpO2 successfully managed by an Integrated-approach

Budd-Chiari syndrome [BCS] is a rare, potentially life-threatening condition characterized by the triad of abdominal pain, ascites, and hepatomegaly (with or without jaundice). There will be an underlying disorder in most cases. The diagnosis, as well as management of the case, requires a multidisciplinary approach. The treatment should aim at reducing the presenting symptoms as well as removing the underlying pathology. Here we explain a case report of a 21-year-old male patient in the subacute stage of BCS with its complications and considered as a candidate for liver transplantation. His liver enzymes, PT/INR, D- dimer, and homocysteine values were above normal levels. The arterial oxygen saturation level was subnormal, and he was on supportive oxygen supplement. Inferior venacava [IVC] Doppler revealed a non-obstructive intrahepatic thrombus. The patient was treated with Homoeopathic medicine Arsenicum album and Arnica montana, given as an adjuvant to conventional treatment.

The use of protective masks and the level of arterial oxygen saturation at rest and after exercise.

Studies of influenza, and human coronaviruses provide evidence that the use of a medical mask can prevent the spread of infectious droplets from an infected person to someone else. After global public health emergency of coronavirus SARS-CoV-2 causing illness of COVID-19 was changing frequency of wearing a mask. Therefore, study was undertaken to assess whether the use of protective masks affects the level of oxygen saturation during rest and during exercise. The test consisted of a non-invasive measurement of oxygen saturation by percutaneous determination of arterial oxygen saturation with the use of the pulse oximeter. Oxygen saturation was measured during rest and after physical exertion performed without a protective mask (2 types of masks were used: surgical and FFP2), as well as during rest and after physical exertion performed with the use of a protective mask. The analysis of the oxygen saturation, heart rate, blood pressure and respiratory rate included data on 48 subjects. Comparing the post-exercise and pre-exercise values showed a significant difference between all of them. There were no differences found in any variables according to the mask/no-mask status. A short-term physical exercise performed in a group of healthy young people using protective masks did not affect oxygen saturation, heart rate, blood pressure and respiratory rate. Med Pr. 2022;73(5):363-68.