Blood Gas Levels Research Articles

Assessment of the Correlation Between Arterial Blood Gas Indices and Duration of Stay in the Emergency Department Observation Unit for Pediatric Patients Aged 0-18 with Rotavirus Gastroenteritis

Purpose: Rotavirus (RV) is the predominant pathogen responsible for the onset of infectious acute gastroenteritis among children younger than five years of age, which is one of the important public health concerns and one of the childhood gastroenteritis that can cause morbidity and mortality. Although definitive diagnostic methods are important in such cases, these methods are not always easily accessible. That study aims to investigate the association between blood gas parameters in respondents who have tested positive for RV antigen and their subsequent observation time in the emergency department as well as the length of their hospitalization. Materials and methods: In this retrospective analysis encompassed 237 individuals ranging from 0 to 18 years old who sought medical attention at the outpatient clinic or emergency department of Adiyaman University Faculty of Medicine Training and Research Hospital and were found to have a positive RV antigen test. Respondents were segregated into cohorts in accordance with age, gender, blood gas parameters, hemogram, biochemical parameters, duration of stay in the emergency observation room, and duration of stay in the pediatric ward. The respondents were categorized based on various criteria including age, sex, blood gas readings, complete blood count, biochemical markers, duration of stay in the emergency observation area, and hospitalization period in the pediatric unit. Comprehensive demographic, blood gas, hematologic, and biochemical data were compiled and analyzed employing SPSS version 22.0. Results: The study identified significant differences in the pH, pO2, and HCO3 levels, along with the mean platelet volume (MPV) among the participants. Notably, a significant correlation was established between the pH levels of blood gases in the emergency room observation space and the observation span for respondents testing positive for RV, whereas no significant link was observed between blood gas values and the duration of hospital stay. Conclusion: The findings suggest that while blood gas analysis outcomes may not predict hospitalization length in cases of Rotavirus gastroenteritis, respondents presenting with lower blood pH levels tend to spend less time in the emergency observation unit. Therefore, it is recommended that blood gas analysis be conducted routinely for respondents presenting with symptoms of Rotavirus gastroenteritis upon their arrival at the emergency medical services.

Rotavirus Gastroenteriti Olan Hastalarda Elektrolit Dengesizliği ve Kan Gazı Parametrelerinin Değerlendirilmesi

Aim: In the present study, the cases admitted to the hospital because of acute gastroenteritis and diagnosed with common RVGE were evaluated in terms of demographic, epidemiological, clinical, and laboratory data. Methods: The clinical and laboratory data of the cases who applied to Selçuk University Faculty of Medicine, Pediatric Emergency Clinic because of acute gastroenteritis aged 0-18 were evaluated retrospectively in the study. Clinical findings, time of admission, place of observation, blood gas and electrolyte levels, electrolyte imbalance, and length of hospital stays of the patients were recorded. Results: Among the AGE patients who were included in the study, 148 (61.2%) were male and 94 (38.8%) were female. The incidence of hypokalemia in patients who had RV(+) GE was statistically significant. Statistically significant differences were detected between the groups in terms of creatinine, potassium, AST, ALT and albumin values of biochemical parameters. When the blood gas analysis of patients who had AGE was evaluated, although acidosis was detected in 24 (9.9%) patients who had pH value, alkalosis was detected in 27 (11.2%) patients. Conclusion: Cases with metabolic acidosis in rotavirus gastroenteritis are hospitalized more frequently, and for this reason, blood gas studies in cases of RV gastroenteritis will guide clinicians.

Probe-based confocal laser endomicroscopy for evaluating high-altitude pulmonary edema in canines

BackgroundReal-time assessment of high-altitude pulmonary edema (HAPE) remains a challenge. Probe-based confocal laser microscopy (pCLE) allows a real-time in vivo visualization of the alveoli. This study aimed to develop a new non-invasive method for analyzing microscopic images in a canine model of HAPE using pCLE. Materials and methodsThis was a prospective, controlled animal study in adult male beagle dogs randomized to control and HAPE groups. The HAPE group was exposed to a high altitude of 6000 m for 48 h. The blood gas levels, lung morphological changes, infectious factors, and lung wet-to-dry ratio were analyzed in different groups. The pCLE images were described based on the volume air index (VAI), which applies an integral over specific signal intensities. ResultsThe lung wet-to-dry weight ratio and injury scores in the HAPE group were significantly increased compared with those of the control group. The levels of infectious factors interleukin-1 beta, tumor necrosis factor-alpha, and interleukin-6 were significantly increased in the HAPE group compared with those in the control group. VAI was significantly decreased in the HAPE group. ConclusionpCLE is a potential adjudicative bronchoscopic imaging technique for assessing HAPE. VAI may be acquired from quantitative parameters in the analysis of images.

Importance of lactate/albumin ratio in pediatric nosocomial infection and mortality at different times.

Aim: To evaluate the lactate/albumin ratio and its relation to mortality in children with nosocomial infections. Materials & methods: One hundred six children were included in this study. Blood gas and albumin levels were analyzed at the first, 24th and 48th h. Results: The types of detected microbial agents, signs of sepsis, development of septic shock and mortality rates were different. The first-, 24th- and 48th h lactate levels of the children who died were higher than those of the living children, but the albumin levels were lower. The highest area under the curve value for the lactate/albumin ratio was detected at the 24th h. Conclusion: Lactate/albumin ratio can be used to predict mortality in children with nosocomial infections.

Theoretical background of hypoxytherapy

The review discusses the structure and physiology of the oxygen supply functional system and its self-regulatory potential and role in maintaining the bodys optimal metabolic homeostasis level of blood gases. Up-to-date data on the functioning of peripheral (arterial) and central (medullary) chemoreceptors, molecular mechanisms of the oxygen and carbon dioxide content and pH perception, and their association with afferent nerve endings are presented. The paths and centers of the chemosensory reflex in various brain regions, effector elements, and reverse afferentation mechanisms are shown. Response patterns to exogenous and endogenous hypoxic stimuli from the various elements of the oxygen supply system are described. The role of intracellular HIF-dependent and HIF-independent pathways in adaptive reactions for maintaining an optimal intracellular metabolism is demonstrated. Cell mechanisms with adaptive roles in hypoxia/reoxygenation under the conditions of interval normobaric hypoxic therapy are discussed.
 The review of current concepts and analysis of research results on the physiology of the oxygen supply functional system, its structural and functional status, and its molecular regulation under exogenous hypoxic conditions will draw attention to the expediency of further randomized clinical trials on interval normobaric hypoxytherapy as a rehabilitation method for patients with chronic cardiovascular diseases

Therapeutic effect of cisatracurium in patients with acute respiratory distress syndrome

Purpose: To investigate the therapeutic effect of cisatracurium, (a neuromuscular blocking agent) in the treatment of acute respiratory distress syndrome (ARDS).
 Methods: A total of 94 ARDS patients admitted to The Third People's Hospital of Honghe Hani and Yi Autonomous Prefecture ICU from March 2020 to December 2021 were randomly assigned to study and control groups (47 patients each). Both groups received mechanical ventilation, but the study group also received continuous intravenous cisatracurium for 48 h. Health parameters, such as blood gas levels, respiratory mechanics, duration of stay in intensive care unit ICU), mortality rate, and the occurrence of complications, were monitored at 3, 6, and 12 months after treatment.
 Results: The study group showed significant improvements compared to control group. Study group also had reduced duration of mechanical ventilation, duration of ICU stay, ICU mortality rate, and incidence of complications (p < 0.05). There were no significant differences in pre-treatment health parameters, but post-treatment, study group had significantly higher levels of blood gas levels and improved lung function (p < 0.05). Study group also had lower scores of illness severity and reduced total mortality rate at 3, 6, and 12 months (p < 0.05).
 Conclusion: Administering cisatracurium reduces mechanical ventilation, duration of ICU stay and mortality rate, as well as improves lung function in ARDS patients. Future research involving larger sample size, and takes into consideration regional/environmental differences, is required to validate these findings for reliability.

Modeling and Evaluation of a Rate-Based Transcutaneous Blood Gas Monitor.

Current methods for transcutaneous blood gas monitoring (TBM) - a common health monitoring method in neonatal care - comes with a suite of challenges like limited attachment opportunities, and risks of infections from burning and tearing of the skin, which limits its use. This study presents a novel system and method for rate-based transcutaneous CO2 measurements with a soft, unheated skin-interface that can address many of these problems. Additionally, a theoretical model for the gas transport from the blood to the system's sensor is derived. By simulating CO2 advection and diffusion through the cutaneous microvasculature and epidermis to the system's skin interface, the effect of a wide range of physiological properties on the measurement has been modeled. Following these simulations, a theoretical model for the relationship between the measured CO2 concentration and that in the blood was derived and compared to empirical data. Applying the model on measured blood gas levels, even when the theory was based solely on the simulations, produced blood CO2 concentrations within ∼35% of empirical measurements from a state-of-the-art device. Further calibration of the framework, also using the empirical data, yielded an output with a Pearson correlation of 0.84 between the two methods. Compared to the state-of-the-art device the proposed system measured the partial CO2 pressure in the blood with an average deviation of 0.04 kPa and 1.97σ of ±1.1 kPa. However, the model indicated that this performance could be hampered by different skin properties. Given its soft and gentle skin interface and lack of heating, the proposed system could significantly decrease health risks like, burns, tears, and pain, currently associated with TBM on premature neonates.

Association of carbon monoxide poisonings and carboxyhemoglobin levels with COVID-19 and clinical severity.

Coronavirus disease 2019 (COVID-19), which recently spread throughout the entire world, is still a significant health issue. Additionally, the most common cause of risky poisoning in emergency services is carbon monoxide (CO) poisoning. Both disorders seem to merit more research as they have an impact on all bodily systems via the lungs. To determine how arterial blood gas and carboxyhemoglobin (COHb) levels affect the clinical and prognostic results of individuals requiring emergency treatment who have both COVID-19 and CO poisoning. Between January 2018 and December 2021, 479 CO-poisoning patients participated in this single-center, retrospective study. Patients were primarily divided into two groups for analysis: Pre-pandemic and pandemic periods. Additionally, the pandemic era was divided into categories based on the presence of COVID-19 and, if present, the clinical severity of the infection. The hospital information system was used to extract patient demographic, clinical, arterial blood gas, COVID-19 polymerase chain reaction, and other laboratory data. The mean age of the 479 patients was 54.93 ± 11.51 years, and 187 (39%) were female. 226 (47%) patients were in the pandemic group and 143 (30%) of them had a history of COVID-19. While the mean potential of hydrogen (pH) in arterial blood gas of all patients was 7.28 ± 0.15, it was 7.35 ± 0.10 in the pre-pandemic group and 7.05 ± 0.16 in the severe group during the pandemic period (P < 0.001). COHb was 23.98 ± 4.19% in the outpatients and 45.26% ± 3.19% in the mortality group (P < 0.001). Partial arterial oxygen pressure (PaO2) was 89.63 ± 7.62 mmHg in the pre-pandemic group, and 79.50 ± 7.18 mmHg in the severe group during the pandemic period (P < 0.001). Despite the fact that mortality occurred in 35 (7%) of all cases, pandemic cases accounted for 30 of these deaths (85.7%) (P <0.001). The association between COHb, troponin, lactate, partial arterial pressure of carbon dioxide, HCO3, calcium, glucose, age, pH, PaO2, potassium, sodium, and base excess levels in the pre-pandemic and pandemic groups was statistically significant in univariate linear analysis. Air exchange barrier disruption caused by COVID-19 may have pulmonary consequences. In patients with a history of pandemic COVID-19, clinical results and survival are considerably unfavorable in cases of CO poisoning.

Can lactate be valuable in early diagnosis and prognosis of neonatal sepsis?

Sepsis monitoring tissue perfusion is crucial for detecting circulatory failure early, implementing the right treatments, and assessing response. Insufficient oxygenation leads to a rise in lactate level and has been shown to be useful in predicting mortality and morbidity in newborns. There have not been many studies on how lactate measurement affects neonatal sepsis diagnosis and prognosis. The aim of our study was to determine the impact of lactate on early diagnosis and prognosis in neonatal sepsis. Eighty-seven newborns diagnosed with neonatal sepsis at a neonatal intensive care unit between January 2010 and July 2021 were included in the study. Venous blood gas, lactate, and C-reactive protein (CRP) levels and complete blood count on the first, second, and third day of hospitalization were noted. Lactate values were correlated with other variables to determine the impact of hyperlactatemia on morbidity and to determine factors affecting the length of stay. IBM SPSS Statistics version 22.0 for Windows was used to analyze the data (SPSS Inc., Chicago, IL, United States). A strong negative correlation between lactate and oxygenation and perfusion indicators (HCO3, BE, PaO2) during the therapeutic process was observed. With treatment, the initial measured lactate value decreased, and a significant increase in CRP and oxygen saturation was observed, which was interpreted as the observation of an early lactate response to infection before a CRP response. The initial lactate level, as well as the change in lactate levels, was not, however, significantly correlated with the length of stay. Lactate can be used in the early diagnosis of neonatal sepsis and for determining prognosis.

The Relationship Between Decreased CD-8 T-Cells and Mortality in Patients with COVID-19 Pneumonia in the Intensive Care Unit, A Retrospective Study.

CD-8 T-cells are responsible for the clearance of virally infected cells. In patients with Coronavirus disease-2019 (COVID-19) pneumonia, there are quantitative reductions and functional impairments in T-cells. Low CD-8 T-cell levels cause worse clinical situations. In this study, the relationship between decreased CD-8 T-cells and mortality in patients with COVID-19 pneumonia in the intensive care unit (ICU) was investigated. In this multicenter retrospective study, 277 patients were analyzed. Demographic data, ICU admission scores, blood gas levels, laboratory samples, and outcomes were recorded. Statistical Package for the Social Sciences version 28 was used for statistical analysis. Two hundred forty of 277 patients were included in the study. The mortality rate was 43.3%. In non-survivors, median values of age, Charlson comorbidity index, Acute Physiology and Chronic Health Evaluation II (APACHE-II), procalcitonin, leukocyte count, neutrophil count, neutrophil-lymphocyte count ratio, and duration of invasive mechanical ventilation were significantly higher, whereas median values of PaO2-FiO2 ratio, lymphocyte count, CD-4, and CD-8 T-cells were significantly lower than those in survivors. In the multivariate Cox regression model, the risk of mortality increased 1.04-fold (1.02-1.06) and 1.05-fold (1.01-10.8) by every one unit increase in age and APACHE-II, respectively, whereas it decreased 0.71-fold (0.58-0.87) by every hundred increase in CD-8 T-cells P < 0.001, P=0.007 and P=0.001 respectively. According to our findings, age, APACHE-II, and CD-8 T-cell levels seem to be independent risk factors for mortality in patients with COVID-19 pneumonia in the ICU.

The impact of various periods of mercury exposure on the osmoregulatory and blood gas parameters of tilapia (Oreochromis niloticus)

Mercury (Hg) poses a significant risk to aquatic ecosystems and living organisms as a result of human activities. Hg found in fish can be detrimental to human health when consumed, causing harmful effects. The potential impact of Hg on fish physiology is a significant concern, given its presence in fish. The rapid accumulation of Hg in fish tissues has the potential to impact their blood gas and electrolyte compositions. The objective of this investigation was to analyze the effects of sublethal concentrations of Hg on the blood gas and electrolyte levels of tilapia (Oreochromis niloticus) over different periods of exposure. This research was conducted through laboratory experiments. The study involved subjecting fish to sublethal concentrations of Hg at levels of 0.06 and 0.6 mg/L for a duration of 4 and 15 days. Upon completion of the toxicity test, fish specimens were taken from each testing group for the purpose of analyzing the Hg and carbonic anhydrase (CA) concentrations present in the gills, as well as osmoregulatory, acid-base, and hematological parameters. The results indicate that solely the fish that were subjected to a concentration of 0.6 mg/L Hg for a duration of 15 days exhibited a higher concentration of Hg in their gills compared to the control group. The inhibition of respiration by Hg was observed to be a result of the generation of metabolic acidosis, reduction in gill CA, decrease in pO2, as well as a decrease in plasma osmolality, Cl−, Na+, and K+. The levels of red blood cells, hemoglobin, and hematocrit exhibited a decrease solely at the concentration of 0.6 mg/L over a period of 15 days. The previously mentioned impairments have the potential to restrict the capacity of fish to adequately supply oxygen to their cells, thereby reducing overall performance.

Pilot testing the impact of an aerobic exercise plus rehabilitation training on respiratory function in older adults with COPD

Chronic obstructive pulmonary disease (COPD) is a chronic intractable lung disease. To investigate the therapeutic effect, older adult patients were subjected to aerobic exercise and respiratory rehabilitation (diaphragmatic breathing) for six months. At the end of six-month intervention, forced expiratory volume in one second (FEV1), forced vital capacity (FVC), 6-minute walking distance (6 MWD), and patient activation measure scores increased; St. George's respiratory questionnaire scores and disease impact score decreased; and PaCO2 and PaO2 were significantly improved in both groups, particularly in the experimental group. In addition, FEV1, FEV1/FVC, 6 MWD, blood gas levels, quality of life, and self-care ability in the experimental group were significantly improved compared with those in the control group, and the improvements were significantly greater in male, younger, and less diseased patients. Our study demonstrated that aerobic exercise combined with diaphragmatic breathing significantly improves respiratory function and quality of life in older adult patients.

Pattern of self-reported adverse events related to COVID-19 vaccines in Saudi Arabia: A nationwide study.

Vaccination against coronavirus disease 2019 (COVID-19) is the most effective way to end the pandemic. Any development of adverse events (AEs) from various vaccines should be reported. We therefore aimed to explore major and minor AEs among vaccinated individuals in Saudi Arabia. This is a nationwide report based on the Saudi Arabian Ministry of Health (MOH) registry. It included those who received COVID-19 vaccines from 17th December 2020 to 31st December 2021. The study included spontaneous self-reported adverse effects to COVID-19 vaccines where the study participants used a governmental mobile app (Sehhaty) to report their AEs following vaccination using a checklist option that included a selection of side-effects. The primary outcome was to determine AEs reported within 14 days of vaccination which included injection site itching, pain, reaction, redness, swelling, anxiety, dizziness, fever, headache, hoarseness, itchiness, loss of consciousness, nausea, heartburn, sleep disruption, fatigue, seizures, anaphylaxis, shortness of breath, wheezing, swelling of lips, face, and throat, loss of consciousness, and admissions into the intensive care unit (ICU). The study included a total number of 28,031 individuals who reported 71,480 adverse events (AEs); which were further classified into minor and major adverse events including ICU admissions post vaccination. Of the reported AEs, 38,309 (53. 6%) side-effects were reported following Pfizer-BioNTech, 32,223 (45%) following Oxford-AstraZeneca, and 948 (1.3%) following Moderna. The following reported AEs were statistically significant between the different vaccine types: shortness of breath\difficulty of breathing, dizziness, fever above 39°C, headache, hoarseness, injection site reactions, itchiness, nausea, sleep disruption, fatigue, wheezing, swelling of lips/face and\or throat, and loss of consciousness (p-value < 0.05). Fever and seizure were the only statistically significant AEs amongst the number of vaccine doses received (p-value < 0.05). Ten ICU admissions were reported in the 14 days observation period post-COVID-19 vaccination with the following diagnoses: acute myocardial infarction, pneumonia, atherosclerosis, acute respiratory failure, intracranial hemorrhage, grand mal seizure, Guillain-Barré syndrome, abnormal blood gas levels, and septic shock. This study demonstrated that the most prevalent SARS-CoV-2 vaccine side-effects among adults in Saudi Arabia were mild in nature. This information will help reduce vaccine hesitancy and encourage further mass vaccination to combat the COVID-19 pandemic, especially as booster doses are now available. Further studies are warranted to obtain a better understanding of the association between risk factors and the experiencing of side-effects post vaccination.

Protective effect of quercetin on pulmonary dysfunction in streptozotocin-induced diabetic rats via inhibition of NLRP3 signaling pathway

Diabetes mellitus (DM) is a dysmetabolic disease characterized by chronic hyperglycemia. In the developed countries, DM is the commonest life style disease that affects both old and young age. Nod-like receptor protein-3 (NLRP3)-mediated pyroptosis may in fact aid in the development of diabetic complications. Quercetin is a natural flavonoid, can be present in natural foods and plants. Many studies have reported the antioxidant role of quercetin on different tissues, but its effects on NLRP3-mediated pyroptosis in diabetic lung are unclear. The current study aimed to assess quercetin’s protective effects on lung function, oxidative stress, and NLRP3-mediated pyroptosis in Wister rats exposed to streptozotocin (STZ)-induced DM. Forty male Wister rats were randomly allocated into four equal groups. The groups of rats were as follows: group 1 (G1) was kept under normal control conditions; G2 was injected I/P quercetin at a dose of 30 mg/kg b.wt., daily for 30 days; G3 and G4 were injected with a single dose of streptozotocin (STZ) 50 mg/kg b.wt. I/P to induce DM. After 72-h post diabetes induction, the rats of G4 were treated with quercetin as a manner in the second group. The results showed that quercetin ameliorates the pulmonary dysfunctions caused by DM through restoring the levels of glucose, insulin, and arterial blood gases, as well as the oxidative markers. Also, NLRP3-pyroptosis-mediated IL1β was inhibited. Quercetin also reduces the effect of DM on the lung by decreasing the pathological changes in the lung. In conclusion, NLRP3 inflammasome-induced pyroptosis may aggravate lung injury in diabetic rats. Quercetin has the potential to ameliorate diabetes induced pulmonary dysfunction by targeting NLRP3.

Effects of l-carnitine Administration on Sperm and Sex Hormone Levels in a Male Wistar Rat Reproductive System Injury Model in a High-Altitude Hypobaric Hypoxic Environment

The plateau environment impacts male reproductive function, causing decreased sperm quality and testosterone levels. l-carnitine can improve the semen microenvironment. However, the role of l-carnitine in a high-altitude environment remains unclear. In our study, we investigated the effects of l-carnitine administration in a male Wistar rat reproductive system injury model in the context of a simulated high-altitude environment. Rats were randomly divided into a normal control group (group A1, A2-low dose and A3-high dose) and high-altitude model groups (group B, C-low dose and D-high dose) with 20 rats in each group. With the exception of the normal control group exposed to normoxic conditions, the other groups were maintained in a hypobaric oxygen chamber that simulated an altitude of 6000 m for 28 days. In the experimental period, the low-dose groups (A2 and C) were administered 50 mg/kg l-carnitine via intraperitoneal injection once a day, and the high-dose groups (A3 and D) were given 100 mg/kg. After the feeding period, blood samples were collected to assess blood gas, serum hormone levels and oxidative stress. Sperm from the epididymis were collected to analyse various sperm parameters. After obtaining the testicular tissue, the morphological and pathological changes were observed under a light microscope and transmission electron microscopy (TEM). The impact of the simulated high-altitude environment on the rat testis tissue is obvious. Specifically, a decreased testicular organ index and altered indices of arterial blood gas and serum sex hormone levels caused testicular tissue morphological damage, reduced sperm quality, increased sperm deformity rate and altered malondialdehyde (MDA), superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) concentrations. The results demonstrate that l-carnitine can be administered as a preventive intervention to reduce the reproductive damage caused by high-altitude hypobaric and hypoxic environments and improve semen quality in a rat model.

Retracted: Effect of Noninvasive Positive Pressure Ventilation on Prognosis and Blood Gas Level in COPD Patients Complicated with Respiratory Failure.

[This retracts the article DOI: 10.1155/2022/3089227.].

Efficacy of single-and double-volume exchange transfusion for neonatal hyperbilirubinemia.

To investigate the efficacy and safety of singleand double-volume exchange transfusion for neonatal hyperbilirubinemia (HB) and compare their effects on the internal environment of newborns. The clinical data of 96 HB newborns admitted to and treated in our hospitals from January 2016 to October 2021 were retrospectively analyzed. Then, these newborns were divided into single volume group (80-110 mL/kg, n=48) and double volume group (150-180 mL/kg, n=48) by the exchange volume per unit body mass. The hematological indicators total serum bilirubin (TSB), peripheral blood red blood cell (RBC) count, white blood cell (WBC) count, platelet (PLT) count, serum albumin (ALB), prothrombin time (PT) and activated partial thromboplastin time (APTT), and changes in inner-environment indexes (blood gas, blood glucose, acid-base and electrolyte levels) were compared between the two groups of newborns before treatment and after once treatment. Additionally, the adverse reactions of exchange transfusion in the two groups of newborns were recorded.

Effectiveness of Hyperbaric Oxygen Therapy in SARS-CoV-2 Pneumonia: The Primary Results of a Randomised Clinical Trial.

Mortality in COVID-19 is mainly associated with respiratory failure, cytokine storm, and macrophage activation. Oxygenation and anti-inflammatory effects of Hyperbaric Oxygen Therapy (HBOT) suggest that it is a promising adjunct treatment for COVID-19. Repeated sessions of HBO with standard COVID-19 therapy were used to reduce the inflammation and increase oxygenation. We evaluated the safety and efficacy of HBOT in avoiding the replacement ventilation and/or ECMO and its effect on the inflammatory process. Twenty-eight moderate-to-severe COVID-19 patients were randomized into control or HBOT group. HBOT patients participated in 5 hyperbaric sessions (60 min). Before and after each session blood gas levels and vital parameters were monitored. Blood samples were collected for extended biochemical tests, blood morphology and immunological assays. There were 3 deaths in the control, no deaths in the HBOT group. No adverse events leading to discontinuation of HBOT were observed and patients receiving HBOT required lower oxygen delivery. We observed decrease in CRP, ferritin and LDH and increase in CD3 in HBOT group compared to control. This study confirmed the feasibility and safety of HBOT in patients with COVID-19 and indicated HBOT can lead to alleviation of inflammation and partial restoration of T cell responses.

Altered blood gas tensions of oxygen and carbon dioxide confound coronary reactivity to apnea

PurposeArterial blood gases change frequently during anesthesia and intensive care. Apnea can occur during diagnostic exams and airway and surgical interventions. While the impact of blood gas levels on coronary blood flow is established, their confounding effect on coronary vasoreactivity in response to an apneic stimulus, especially in coronary artery disease, is not known.MethodsSix anesthetized control swine and eleven swine with coronary artery stenosis were examined. Nine different blood gas levels from a combination of arterial partial pressure of oxygen (70, 100, and 300 mmHg) and carbon dioxide (30, 40, and 50 mmHg) were targeted. Apnea was induced by halting controlled positive pressure ventilation for 3–30s, while the left descending coronary artery flow was measured and reported relative to apnea duration, and at the adjusted mean (12s).ResultsAt normoxemic-normocapnic blood gas levels, apnea increased coronary blood flow in proportion to the duration of apnea in the control (r = 0.533, p &amp;lt; 0.001) and stenosed groups (r = 0.566, p &amp;lt; 0.001). This culminated in a 42% (95% CI: 27–58) increase in controls (p &amp;lt; 0.001) and, to a lesser extent, 27% (15–40) in the presence of coronary artery stenosis (p &amp;lt; 0.001). Vasoreactivity was augmented by mild-hypoxemic levels [81% (65–97), and 66% (53–79) increase in flow respectively, p &amp;lt; 0.001 vs. normoxemia], but markedly reduced during hyperoxia (7.5% (−8.2–23) and 0.3% (−12–13), respectively, p &amp;lt; 0.001 vs. normoxemia).ConclusionAlterations of blood oxygen and carbon dioxide affect coronary vascular reactivity induced by apnea in swine, which was attenuated further in the presence of coronary stenosis. Especially hyperoxia significantly reduces coronary blood flow and blunts coronary vascular reactivity.

Correlation of Mean pH, HCO3 and CO2 Between Arterial Blood Gases and Venous Blood Gases in Critically Ill Patients

Objective: To determine the correlation of mean pH, HCO3 and CO2 between arterial and venous blood specimens in critically ill patients.&#x0D; Study Design: Cross-sectional study.&#x0D; Place and Duration of Study: Department of Chemical Pathology and Endocrinology, Armed Forces Institute of Pathology (AFIP), Rawalpindi, from Apr to Oct 2015.&#x0D; Methodology: Forty critically ill patients admitted to the Intensive Care Unit were selected. Analysis of arterial blood gases followed by venous blood gases of the same patient was carried out after collection in lithium heparin tubes. Specimens were analyzed on COBAS 221 fully automated ABGs and an electrolyte analyzer.&#x0D; Results: Out of 40 patients, 30 (75%) were males. The average age was 57.78±7.64 years. The p-value of pH and HCO3 was 0.259 and 0.921, respectively. The CO2 in VBGs was 58.10±11.35 mm Hg versus 36.32±6.69 mm Hg in ABG, with a p-value of 0.001, which was statistically significant.&#x0D; Conclusion: In critically ill patients, pH and HCO3 levels of venous blood gases were comparable with ABG. VBG CO2 was significantly higher than ABGs.