Automatic Blood Gas Research Articles

Long-Term Ex Situ Normothermic Kidney Perfusion

Abstract Background Marginal grafts are increasingly considered for transplantation due to the widening gap of available donor grafts and waiting recipients. Graft assessment and repair prior to implantation are therefore essential to minimize the risk of failure. Normothermic perfusion has not been widely evaluated for kidney grafts, with existing perfusions limited to 2 days. Aims The aim of this study was to develop a long-term (>3 days) normothermic ex situ swine perfusion model in kidney grafts, while maintaining organ viability. We also wanted to investigate possible regenerative processes of the kidney during this period outside the donor animal. Methods Swine kidneys were retrieved with minimal injury. After cannulation, organs were perfused at 37°C for up to several days in a newly designed normothermic ex situ device with automated blood gas and glucose regulation, addition of nutrition, antibiotics, and vasodilators. Kidney biopsies, urine and perfusate samples were taken daily for analysis as well as markers of viability. Results In total 17 kidneys were perfused. Four kidneys were perfused for 3 or more days. Viability was maintained up to 4 days without histological evidence of glomerular and minimal to moderate tubular necrosis. We observed upregulation of ki67 and pH3 in tubular cells with mean values of up to 14.2% and 2.2% respectively. This expression of ki67, a proliferation associated protein, correlated with the duration of ex situ perfusion. Conclusion This is the first report of normothermic kidney perfusion for up to 4 days with unprecedented observation of upregulated ki67 and pH3 after multiple days of perfusion. These preclinical results open the door for development of long-term perfusion protocols for discarded human grafts while also hinting at limitations and challenges.

Assessment of Blood Gas Pattern amongst Artisanal Refinery Operators in Rivers State, Nigeria

Some identified setbacks of the legitimate and illegitimate explorations/exploitations of crude oil and its derivatives in the Niger Delta are degraded environment, weak economy, and deteriorating health of the populace. Therefore, the current study evaluated the effect of artisanal refinery operation on respiratory blood gases and renal functions of its workers in Rivers State. As a cross-sectional investigation with sparse population, the multistage sampling technique (including purposive and snowball tools) was adopted to recruit 203 (including 120 operators of artisanal refinery―OAR-actively exposed and 83 non-OAR- actively exposed) willing and apparently healthy male and female adult subjects. Following receipt of ethical approval and consent, five milliliter of blood was taken from each subject from their antecubital vein after sterilizing the portion of the cubital fossa. The sample was then put into plain sample bottle and centrifuged to recover serum. Thereafter, the automated blood gas analyzer was used to measure the arterial blood gases of the subjects. The result showed marked (P<0.05) reductions in the partial pressure of oxygen (PO2) and oxygen saturation (SO2) levels in artisanal refinery operators (actively exposed) when compared to that of the passively-exposed subjects. Again, there were marked (P<0.05) elevations in the plasma pH and bicarbonate ions (HCO-3) levels in the actively exposed subjects compared to their passively-exposed counterparts. In conclusion, there could be adverse impact on respiratory blood gases and incidences of metabolic alkalosis over chronic exposures to the OAR activities.

Alteration of Biochemical Parameters in Patients with Respiratory Acidosis and Alkalosis: A Hospital Based CrossSectional Study

Biochemical parameters like pH, pO2, pCO2, HCO3-, TCO2 and SO2 are frequently measured in critically ill patients with respiratory acidosis and alkalosis. These parameters have utmost importance in the assessment of ventilation, oxygenation and acid base status of these patients. The present study was undertaken to determine alteration of different biochemical parameters in patients with respiratory acidosis and alkalosis. This is a hospital based cross-sectional study conducted from May to December 2023, in the Department of Biochemistry, CMCTH. Arterial blood was collected and biochemical parameters like pH, pO2, pCO2, HCO3-, TCO2 and SO2 were measured using automated blood gas analyzer. Statistical analysis was done with SPSS version 21. This study showed that majority of the patients with respiratory acid-base disorder were females (58.1%) and elderly (41.8%). Respiratory acidosis and alkalosis were more common in elderly patients under age group 61- 70 years followed by >70 years category. Respiratory acidosis was accompanied by alteration of various ABG parameters like low pH, low pO2, high pCO2, high HCO3-, normal TCO2 and normal SO2 levels while respiratory alkalosis was accompanied by high pH, low pCO2, low HCO3-, low TCO2, normal sO2 and normal pO2 levels. Respiratory acid-base disorders are common in hospital settings with ailing respiratory diseases like COPD, Pneumonia, TB and Sepsis with higher incidences among elderly patients. Respiratory acidosis and alkalosis should be treated promptly giving highest consideration to various biochemical parameters in order to reduce comorbidities and mortalities associated with these conditions.

Knock-down of IGFBP2 ameliorates lung fibrosis and inflammation in rats with severe pneumonia through STAT3 pathway

Objective To observe the mechanism of IGFBP2 knock-down in improving lung fibrosis and inflammation through STAT3 pathway in rats with severe pneumonia. Materials and Methods First, SP rat model was established. Then rats were divided into the Control group, the SP group, the SP + Lv-vector shRNA group, the SP + Lv-IGFBP2 shRNA group, the SP + Lv-vector group, and the SP + Lv-IGFBP2 group. The mRNA and protein levels of IGFBP2, NOS, CD206 and Arg 1 were detected by RT-qPCR and Western blot. IHC was used to check the positive expression of IGFBP2 and MCP1. A fully automated blood gas analyzer was used to detected PaCO2, CO2 content, PaO2 and SaO2. HE and Masson staining were performed to observe the lung tissue injury and collagen deposition of rats in each group. ELISA assays were used to calculate the levels of inflammatory factors IL-1β, IL-6, TNF-α, IL-4, and IL-10. Flow cytometry was conducted to acquire the ratio of M1-type AMs and M2-type AMs. Results Compared with the Control group, IGFBP2, iNOS, CD206, and Arg1 mRNA and protein expression levels, IGFBP2 and MCP1 positive expressions, PaCO2, p-STAT3/STAT3, p-JAK2/JAK2, IL-1β, IL-6, and TNF-α levels, the number of AMs and neutrophils, the proportion of M1 type AMs and the expressions of α-SMA, Collagen-I, Collagen III, and Fibronectin were significantly increased in SP rats (p < 0.05), while PaCO2, CO2, and SaO2, IL-4 and IL-10 levels, and the proportion of M2 type AMs decreased (p < 0.05). However, the knockdown of IGFBP2 reversed the above index trends. Conclusion Knock-down of IGFBP2 ameliorated lung injury in SP rats, inhibited inflammation and pulmonary fibrosis, and promoted M2-type transformation of AMs by activating the STAT3 pathway.

The signal axis GATA2-EDN1-AGT induced hypertension from obstructive sleep apnea-hypopnea syndrome with the clinical and animal study

Hypertension occurred in 50% obstructive sleep apnea-hypopnea syndrome (OSAHS) patients meanwhile OSAHS occurred in 30% hypertension patients. The present study aimed to explore the molecular mechanism of GATA2-EDN1-AGT induced hypertension in the development of obstructive sleep apnea-hypopnea syndrome. OSAHS patients (56 cases: 36 cases of male, 20 cases of female, 42~60 years old) were divided into two groups (case group: patients with hypertension monitored by 24 h ambulatory blood pressure and polysomnography; control group: patients without hypertension). Wistar rats were used to establish the OSAHS model (narrow pharyngeal cavity). PaO2 and PaCO2 of patients and rats were measured by an automatic blood gas analyzer. The profile of total protein in the OSAHS group and normal group was evaluated. Protein-protein-interaction (PPI) was carried out to show all matter proteins related. The levels of EDN-1, AGTII and atrial natriuretic peptide (ANP) in blood samples of patients and rats were analyzed by enzyme-linked immunosorbent assay (ELISA). The expression of GATA2, EDN1, endothelin-converting enzyme 1 (ECE-1) and AGTⅡ was measured. The results showed that SaO2 and AHI were positively associated with systolic pressure (P&lt;0.05) in OSAHS patients. There was no correlation among other indexes (P&gt;0.05). It was also observed that GATA2 had a strong relationship with AGTⅡ and EDN1. The results of ELISA presented that the levels of EDN1, AGTⅡ and ANP in the OSAHS group of human and animal models were significantly increased (P&lt;0.05). The results of immunochemistry showed that the expression of GATA2 and AGTⅡ in the vascular of OSAHS group was upregulated manifestly (P&lt;0.05). It was concluded that OSAHS can induce AHI, which increases hypertension via the GATA2-EDN1-AGT Ⅱ axis.

Continuous measurement of arterial oxygenation in mechanically ventilated horses.

The possibility of accurately and continuously measuring arterial oxygen partial pressure (PaO2 ) in horses may facilitate the management of hypoxaemia during general anaesthesia. The aim of this study was to evaluate the ability of a novel fibreoptic sensor to measure PaO2 (PaO2Sensor ) continuously and in real time in horses undergoing ventilatory manoeuvres during general anaesthesia. In vivo experimental study. Six adult healthy horses were anaesthetised and mechanically ventilated in dorsal recumbency. A fibreoptic sensor was placed in one of the facial arteries through a catheter to continuously measure and record PaO2Sensor . After an alveolar recruitment manoeuvre, a decremental positive end-expiratory pressure (PEEP) titration using 20-minute steps of 5cmH2 O from 20 to 0cmH2 O was performed. An arterial blood sample was collected at 15minutes of ventilation at each PEEP level for PaO2 measurement using an automated blood gas machine (PaO2Ref ). The agreement between PaO2Sensor and PaO2Ref was assessed by Pearson's correlation, Bland-Altman plot and four-quadrant plot analysis. In the last minute of ventilation at each PEEP level, a slow tidal inflation/deflation manoeuvre was performed. The mean relative bias between PaO2Sensor and PaO2Ref was 4% with limits of agreement between -17% and 29%. The correlation coefficient between PaO2Sensor and PaO2Ref was 0.98 (P<.001). The PaO2Sensor and PaO2Ref concordance rate for changes was 95%. Measurements of PaO2Sensor during the slow inflation/deflation manoeuvre at PEEP 15 and 10cmH2 O were not possible because of significant noise on the PaO2 signal generated by a small blood clot. Small sample size. The tested fibreoptic probe was able to accurately and continuously measure PaO2Sensor in anaesthetised horses undergoing ventilatory manoeuvres. A heparinised system in the catheter used by the fibreoptic sensor should be used to avoid blood clots and artefacts in the PaO2 measurements.

Venous blood gas parameters, electrolytes, glucose and lactate concentration in sick neonatal foals: Direct venipuncture versus push-pull technique.

Blood collection by indwelling intravenous catheter (IVC) avoids repeated venipuncture, which could cause thrombophlebitis risk, anxiety and pain in patients. To compare blood gas parameters, electrolytes, glucose, lactate and haematocrit concentration obtained from venous blood samples collected via a jugular IVC by push-pull (PP) technique to those obtained by venipuncture in hospitalised foals, at the time of catheter placement (T0) and 24hours after the beginning of intravenous therapy (T24). Prospective observational study. Paired blood samples were drawn from hospitalised foals at T0 and T24. In each foal, one venous blood sample was collected via IVC by the following PP technique: 2.4mL of blood was aspirated and immediately reinfused through the catheter three times consecutively, then 1mL of blood was collected using a 1mL heparinised syringe. Thereafter, another sample was collected by direct venipuncture of the contralateral jugular vein, with an identical 1mL heparinised syringe, with a 1-inch, 20-G needle. All samples were analysed with an automated blood gas analyser within 10minutes of collection. The agreement between the two techniques was assessed by Bland-Altman analysis and intraclass correlation coefficient (ICC). The level of agreement of blood gas values obtained by the two different techniques was high with very small bias and clinically acceptable ICC (>0.907 at T0; >0.794 at T24) for all variables, except for haematocrit (bias -3.52 at T0; -2.44 at T24) and PvO2 at T0 and T24 (ICC 0.669 and 0.733, respectively). Potential sub-clinical catheter-related complications were not investigated by ultrasound or bacterial culture of the catheter; short duration of the study. PP technique appears to be acceptable for collection of blood samples for venous blood gas parameters, as well as electrolytes, glucose and lactate in sick neonatal foals.

Ursodeoxycholic Acid (UDCA) Promotes Lactate Metabolism in Mouse Hepatocytes through Cholic Acid (CA) - Farnesoid X Receptor (FXR) Pathway.

Persistent hyperlactatemia is associated with greater mortality in shock. Liver is the main site of lactate metabolism. In the first part, freshly isolated hepatocytes were incubated in 10% fetal bovine serum William's E medium supplemented with 10 mM lactate. Cells were then exposed to 100 μM ursodeoxycholic acid (UDCA), with no addition (control) for 2, 4, 6, 8 h. In the second part, hepatocytes were treated with Silencer select siRNA targeting FXR or scramble siRNA. The siRNA treatment was repeated twenty four hours later, and the cells were used in the experiments twenty-four hours after the second treatment. Then hepatocytes were incubated in 10% fetal bovine serum William's E medium supplemented with 10 mM lactate. Cells were then exposed to 100 μM UDCA for 2, 4, 6, 8 h. Lactate concentration was determined by ABL80 automatic blood gas analyzer. UDCA increased ability of hepatocytes to remove lactate. After the knockdown of FXR, effects caused by UDCA were weakened. These results demonstrate that UDCA promotes lactate metabolism in mouse hepatocytes through CA-FXR pathway.

Concentration of sodium, potassium, chloride and calcium across trimester of pregnancy

Pregnancy is a period of altered body systems. This study is aimed at assessing electrolytes level in the three trimesters of pregnancy. Blood samples of one hundred pregnant women in their various trimesters were collected by aseptic techniques into a lithium heparin bottle for electrolytes analysis. Using standard laboratory methods, the serum electrolytes level were analyzed using an automated blood gas and electrolytes analyzer (OPTI CCA – TS2). Based on Reference values of electrolytes during pregnancy, 94% had normal serum sodium concentration, potassium serum concentration 48% and Chloride serum while calcium serum concentration was low 12% across the trimesters. Descriptive statistics were used (frequency and percentage distribution) for socio-demographic characteristics; chi-square was used to test the hypothesis at 0.05 level of significance. Statistical Package for Social Sciences Version 20.0 was used to support the data analysis. The study revealed no significant relationship between electrolytes level and trimesters of pregnant women receiving antenatal care in the selected obstetric and gynaecological hospitals in a low income country. This may suggest poor kidney adaptation in maintaining electrolyte balance in pregnancy among the women, Therefore there may be need to assess electrolytes levels during antenatal care as part of routine investigations.

Threshold value of lactic acid and buffer excess in umbilical cord arterial blood gas during neonatal asphyxia

Objective To study the threshold values of lactic acid (Lac)and buffuer excess (BE) when neonatal umbilical arterial blood gas is at pH <7.20. Methods A total of 2 518 pregnant women admitted in Beijing New Century Women and Children′s Hospital from January 2017 to February 2019 were enrolled.The general conditions in perinatal period and labor methods were counted.Umbilical cord arterial blood was immediately collected before the first cry of newborn and was detected on the Abbott I-STAT automatic blood gas analyzer from the United States, and then the umbilical arterial blood gas was measured.We analyzed the perinatal factors affecting umbilical arterial blood gas.We studied the threshold values of Lac and BE for neonal asphyxia by receiver operating characteristic curve. Results (1)Maternal anemia, Streptococcus agalactiae infection, precipitate labour, placenta abnormalities had no significant impact on neonatal umbilical artery blood gas.The Lac value in blood gas was higher in the group of premature rupture of fetal membranes and fetal intrauterine distress.The value of BE was lower in the group with premature rupture of fetal membranes and fetal distress (P 3.97 mmol/L, the sensitivity and specificity of the diagnosis of asphyxia were 0.864 and 0.791, respectively.When BE was ≤-6 mmol/L, the diagnostic sensitivity and specificity of asphyxia were 0.613 and 0.756, respectively. Conclusion Neonatal umbilical arterial blood gas is affected by many factors.The effect of accouche on umbilical arterial blood gas is large.When there is asphyxia with pH 3.97 mmol/L and ≤-6 mmol/L, respectively. Key words: Umbilical artery; Blood gas analysis; Lactic acid; Buffuer excess; Newborn

Curcumin protects the pancreas from acute pancreatitis via the mitogen‑activated protein kinase signaling pathway.

Curcumin has been demonstrated to reduce markers of inflammation during acute pancreatitis (AP). However, the underlying mechanisms of the protective effects of curcumin are unknown. In the present study the effects of curcumin in an AP animal model and cell models was examined and the underlying mechanisms were investigated. An AP animal model was established by injection of 5% sodium taurocholate into the biliopancreatic duct of rats, and the cell model was established by treatment with 0.5 nM cerulein with an optimal concentration of lipopolysaccharide in AR42J rat pancreatic cancer cells. Amylase activity and arterial blood gas composition were assessed by automatic biochemical and blood gas analyzers. Pathological alteration of the pancreas was determined by hematoxylin and eosin staining. Interleukin (IL-6), tumor necrosis factor (TNF)-α and C-reactive protein (CRP) levels were measured by ELISA. Cell viability was determined by Cell Counting Kit-8 and protein expression levels were assessed by western blotting. Curcumin reduced the ascites volume after 12 and 24 h, the weight of pancreas after 12, 24 and 36 h of surgery, but also attenuated injury to the pancreas. Serum expression levels of TNF-α and CRP were reduced by curcumin. In addition, curcumin decreased the cell viability, amylase activity and the phosphorylation of p38 in AR42J cells, but did not affect the intracellular levels of IL-6 and TNF-α. Curcumin may lower the severity and inflammatory response via the mitogen-activated protein kinase-signaling pathway, to some extent. However, future studies are required to fully understand the protective effects of curcumin on AP.

Evaluation of Two Handheld Point-of-Care Blood Gas Analyzers in Healthy Donkeys

There has been increasing interest in blood gas analysis in donkeys. “Point-of-care (POC) testing” is a diagnostic testing performed on or immediately next to the patient. This study assesses the agreement between two POC blood gas analyzers in donkeys. Arterial and venous blood samples were collected from 17 donkeys and analyzed using a fully automated blood gas analyzer (ABL 700 Series Radiometer, Denmark) (RAD) and two POC blood gas analyzers (i-STAT System; VetStat, Idexx). The parameters revealed by all three devices were submitted to a canonical discriminant analysis, to evaluate which parameters differentiated the POC analyzers from the RAD. On the basis of the discriminant analysis, we evaluated the best POC for each parameter registered, in comparison with RAD. The results also changed depending on the type of blood (venous or arterial blood). The agreement between i-STAT and RAD was good for venous samples, but was poor for arterial samples. A poor agreement was found between VetStat and RAD for both venous and arterial samples. The increment of the number of subjects might lead to a better understanding of the potential role of the POCs in clinical setting. Finally, increasing the study population is recommended to set reference values.

Evaluation of Intestinal Damage Biomarkers in Calves with Atresia Coli.

IntroductionIntestinal obstruction such as atresia coli causes pathophysiological changes in gastrointestinal tissue due to the rise of intra-abdominal pressure. The aim of this study is to determine the intestinal damage with intestinal biomarkers in calves with atresia coli.Material and MethodsThe study was conducted on 40 Holstein calves diagnosed with atresia coli with mild to moderate abdominal distention and 10 healthy Holstein calves which served as the control. Blood samples were collected from all calves, and then serum concentrations of intestinal biomarkers were estimated, namely intestinal fatty acid binding protein (IFABP), liver fatty acid binding protein (LFABP), trefoil factor 3 (TFF3), and intestinal alkaline phosphatase (IAP), using commercially available specific bovine ELISA kits. An automatic blood gas analyser was employed for determining the lactate concentration.ResultsThe concentrations of serum LFABP (P < 0.01), IFABP, TFF3, IAP, and blood lactate (P < 0.001) were significantly higher in calves with atresia coli than in healthy calves.ConclusionThe calves affected with atresia coli exhibited severe intestinal damage, and IFABP, LFABP, and TFF3 have significant diagnostic importance and play a useful role in determining the intestinal damage due to intestinal obstruction. High levels of IAP and lactate may serve as a signal for the development of intestinal injury.

Physiological and metabolic responses in newborn piglets associated with the birth order

The objective of this study was to evaluate the effect of birth order on the physiological and metabolic responses of the newborn piglet the first hours after birth. A total of 281 randomly selected newborn piglets were included, classified according to birth order in 12 groups (L1-L12). The expulsion interval, neonatal vitality, latency in connecting to the maternal teat and physiological profile were recorded for each piglet. The number of piglets born alive and dead was also recorded. The blood gases, electrolytes and glucose levels of the neonates were obtained by means of an automatic blood gas and electrolyte analyzer. Groups L1, L2, L11, and L12 had the least score on the vitality scale, the longest expulsion intervals, and longest latency to connect with the maternal teat, as well as greater physiological alterations (hyperglycemia, hyperlactatemia and hypercapnia) compared to groups L4 to L9. Likewise, type-II stillbirths only occurred in the first and last quarter of the birth order of the litter. In conclusion, piglets born in the first and last quarter of the birth order of the litter had a greater risk of having physiological and behavioral alterations during farrowing.

Analysis on effects of modified dosage of calcium gluconate on patients with hydrofluoric acid burns not in hands or feet

Objective: To retrospectively explore the effects of modified dosage of calcium gluconate (CG) on the patients with hydrofluoric acid burns not in hands or feet. Methods: One hundred and sixty patients with hydrofluoric acid burns not in hands or feet were hospitalized in our burn ward from January 2004 to December 2017. Based on the dosage of CG at different admission time, 76 patients hospitalized from January 2004 to December 2012 were included in traditional group, and 84 patients hospitalized from January 2013 to December 2017 were included in modified group. For patients in the two groups, subcutaneous injection of CG solution at one time was immediately conducted on admission in topical treatment. In traditional group, the injection was CG solution with mass concentration of 100 g/L. For wounds of superficial partial-thickness and above degree, CG solution was prescribed at the dosage of 50 mg/cm(2). Wounds of superficial-thickness or mass fraction of hydrofluoric acid less than 20.0% did not receive injection. In modified group, the mass concentration of CG solution for injection was diluted with normal saline to 25 g/L. For wounds of deep partial-thickness and above degree, CG solution was prescribed at the dosage of (50×mass fraction of hydrofluoric acid) mg/cm(2). For wounds of superficial partial-thickness, CG solution was prescribed at the dosage of (25×mass fraction of hydrofluoric acid) mg/cm(2). For wounds of superficial-thickness, CG solution was prescribed at the dosage of 2.5 mg/cm(2). For systemic treatment, the injection velocity of CG solution via venous access was adjusted according to the level of serum calcium namely total serum calcium of patients in traditional group. In modified group, serum ionized calcium was additionally detected through automatic blood gas analyzer by the bed to regulate the injection velocity of CG via venous access. The incidence rate of hypercalcemia and mortality of patients after treatment in the two groups, and the situation about treatment of survivors in the two groups were analyzed. Data were processed with chi-square test, Fisher's exact probability test, t test, and Mann-Whitney U test. Results: (1) After treatment, 9 patients (11.8%) had hypercalcemia, while the other 67 patients (88.2%) did not have hypercalcemia in traditional group. Two patients (2.4%) had hypercalcemia, while the other 82 patients (97.6%) did not have hypercalcemia in modified group. The incidence rate of hypercalcemia of patients in traditional group was significantly higher than that in modified group (χ(2)=5.579, P=0.02). (2) There were two deaths (2.6%) and 74 survivors (97.4%) in traditional group, while there were two deaths (2.4%) and 82 survivors (97.6%) in modified group. The mortalities of patients in the two groups were close (P>0.05). (3) The ratios of eschar excision and skin grafting and hyperplastic scar formation, wound healing time, and ratio of esophageal scar stenosis of survivors in the two groups were close (χ(2)=0.002, 0.054, Z=0.66, P>0.05). Conclusions: Hydrofluoric acid is highly dangerous. The early management of patients with hydrofluoric acid burns emphasizing specialized dosage of CG for treatment can be helpful to reduce incidence of complications and improve the safety of treatment.

Measurement of total CO2 in microliter samples of urine and other biological fluids using infrared detection of CO2.

The purpose of this study is to describe a low-cost and simply made instrument capable of measuring the total CO2 content of microliter volumes of biological fluids utilizing a commercially available CO2 sensor based on a NDIR detector. The described instrument is based on transformation of dissolved HCO3- to CO2 by acidification and subsequent measurement of the produced CO2. The instrument has a linear response in the range 0.025-10μmol HCO3-, which enables measurements in fresh urine and plasma samples down to 5μl. The values from plasma were compared to measurements made on 65μl whole blood in an automatic blood gas analyzer and found not to differ significantly. Compared to currently commercially available instruments applying the same principles to measure total CO2, this study provides a simple and robust alternative which even can be used on smaller sample volumes.

English

OBJECTIVE: To study pH disorders in severe acute malnutrition. DESIGN: A prospective, cohort, observational study. SETTING: Severe malnutrition treatment unit in a tertiary level care hospital in central India. PARTICIPANTS: 202 children between 6 to 60 months of age. METHODOLOGY: Radial artery sample was taken at admission which was analyzed by automated blood gas analyzer; results were studied and correlated with nutritional status at discharge/outcome. STATISTICAL ANALYSIS: The data were analyzed using SPSS 20. Univariate and bivariate analysis of data was done using the Student t test and two-tailed Fisher exact or chi-square test. RESULTS: Out of 202 children studied 51.5% were males and 48.5% were females, 16.8% children had pH 7.45. The mean values of pH, HCO3-, PCO2, PO2 and Cl- were 7.42, 17.1mmol/l, 25.22 mmHg, 93.71mmHg and 109.05mmol/l respectively. Most children (n = 173/202; 85.6%) were discharged, 11(5.4 %) expired and 18 patients left the treatment. In pH 7.46 group. CONCLUSION: In this study, metabolic acidosis with hyperchloremia was associated with poor outcome. There is no significant change in the duration of hospital stay and rate of weight gain in any pH group.

A critical evaluation of automated blood gas measurements in comparative respiratory physiology

Precise measurements of blood gases and pH are of pivotal importance to respiratory physiology. However, the traditional electrodes that could be calibrated and maintained at the same temperature as the experimental animal are increasingly being replaced by new automated blood gas analyzers. These are typically designed for clinical use and automatically heat the blood sample to 37°C for measurements. While most blood gas analyzers allow for temperature corrections of the measurements, the underlying algorithms are based on temperature-effects for human blood, and any discrepancies in the temperature dependency between the blood sample from a given species and human samples will bias measurements. In this study we review the effects of temperature on blood gases and pH and evaluate the performance of an automated blood gas analyzer (GEM Premier 3500). Whole blood obtained from pythons and freshwater turtles was equilibrated in rotating Eschweiler tonometers to a variety of known PO2's and PCO2's in gas mixtures prepared by Wösthoff gas mixing pumps and blood samples were measured immediately on the GEM Premier 3500. The pH measurements were compared to measurements using a Radiometer BMS glass capillary pH electrode kept and calibrated at the experimental temperature. We show that while the blood gas analyzer provides reliable temperature-corrections for PCO2 and pH, PO2 measurements were substantially biased. This was in agreement with the theoretical considerations and emphasizes the need for critical calibrations/corrections when using automated blood gas analyzers.

Outcomes of gestation length in relation to farrowing performance in sows and daily weight gain and metabolic profiles in piglets

The objective of this study was to evaluate uterine activity at farrowing in sows with different gestation lengths (GL), and its effect on the metabolic profile, blood gases and daily weight gain of neonate piglets. The experiment covered a period of 25 weeks and involved 200 Yorkshire-Landrace sows. The animals were assigned to four groups of 50 sows each and distributed according to GL, as follows: GL1: 107–109 days; GL2: 110–113 days; GL3: 114–116 days; GL4: 117–119 days. The productive indicators of the sows were recorded, as were the survival outcomes of the neonatal pigs. Fetal cardiac frequency and both intensity and frequency of myometrial contractions were monitored using a Corometrics Fetal monitor. The blood gases, electrolytes and glucose levels of the neonates were obtained by means of an automatic blood gas and electrolyte analyser. The GL groups GL1 and GL2 had more prolonged births (&gt;226.26 ± 4.95 min) regardless of litter size (P &lt; 0.05). Of the four groups, GL1 presented the longest duration (P &lt; 0.05) of the expulsion phase (P &lt; 0.05), the highest number of uterine contractions (P &lt; 0.05), and the highest and lowest number of intra-partum deaths (P &lt; 0.05) and live births, respectively. The live birth piglets in this group had both the lowest birthweights (P &lt; 0.05) and the highest incidences of hypercapnia, hyperlactatemia and hypercalcaemia (P &lt; 0.05), which later resulted in lower rates of daily weight gain (P &lt; 0.05). In conclusion, premature births increase the number of intra-partum deaths and result in lower birthweights, the presence of apnoea, and severe metabolic alterations in piglets.

Efficiency of oxygen therapy by head box for acute respiratory failure in infants

Oxygen therapy is the main treatment method for acute respiratory failure in children. The method consisting in the administration of oxygen therapy by head box to infants is frequently used in pediatric practice. Objectives. To evaluate the efficiency of oxygen therapy administered by head box to infants suffering from pneumonic acute respiratory failure by comparing two methods for measuring hemoglobin oxygen saturation: in arterialized capillary blood and by pulse oximetry. Material and method. 30 infants suffering from pneumonic acute respiratory failure were studied. We used a clinical appraisal score for acute respiratory failure, which appraises respiratory rate, nasal flaring, recession, cyanosis, sensorial, before and after oxygen therapy. In arterialized capillary blood we measured partial pressure of oxygen and hemoglobin oxygen saturation, and we used an Automatic Blood Gas System analyzer. We also measured hemoglobin oxygen saturation using a pulse oximeter. Determinations were made before the initiation of oxygen therapy, and 30 minutes and 60 minutes after the initiation of oxygen therapy. Results. As compared to the baseline values, determined before the initiation of oxygen therapy, we recorded a statistically significant improvement in the clinical score both after 30 minutes and 60 minutes from the initiation of oxygen therapy (p&lt;0.001). The improvement was greater after 60 minutes. The increase in the partial pressure of oxygen was statistically significant both at the 30 minute and 60 minute determination (p&lt;0.001). Both methods of SaO2 measurement recorded statistically significant increases (p&lt;0.001) in this variable after 30 and 60 minutes, respectively. Conclusions. Oxygen therapy administered by head box improves acute respiratory failure appraised by clinical score. The administration of oxygen therapy by head box to infants significantly increases the values of partial pressure of oxygen and hemoglobin oxygen saturation measured in capillary blood, as well as the values of hemoglobin oxygen saturation determined by pulse oximeter both after 30 minutes and after 60 minutes. The increases in the three parameters are larger after 60 minutes. There is statistically significant concordance between the values of hemoglobin oxygen saturation determined in capillary blood and by pulse oximetry at all determinations.