Clinical Signs Of Hypoxia Research Articles

Drowning Induced Acute Respiratory Distress Syndrome (ARDS): A Case Report

Introduction: Drowning is still one of the leading causes of accidental deaths worldwide while Acute Respiratory Distress Syndrome (ARDS) is the main component of drowning pathophysiology. During drowning which often leads to aspiration, pneumonitis may develop an inflammatory response and release of inflammatory mediators and activation of immune mediated responses. This cascade of events causes the development of Acute Respiratory Distress Syndrome, (ARDS). Case: We received a case of a male patient in the emergency room having a history of an accidental fall in the well and drowning for 5 minutes. When rescued he was conscious and after an hour, he developed cough and breathlessness. On arrival, his routine clinical examination and laboratory and radiological investigation were performed and in view of Acute Respiratory failure patient was shifted to the intensive care unit for further managementas. As per his chest radiogram with clinical signs of hypoxia he immediately required endotracheal intubation and mechanical ventilation. Result and Conclusion: Appropriate invasive mechanical ventilation and sound intensive care with judicial use of antibiotics can benefit such cases of drowning and ARDS.

CARP EDEMA VIRUS DISEASE IN SERBIA - DISEASE OUT OF CONTROL

A poxvirus named carp edema virus (CEV), is the causative agent of carp edema virus disease (CEVD), which is an emerging disease of global concern that may cause high rates of morbidity and mortality in ornamental koi and common carp and. Common carp (Cyprinus carpio) is the most important fish species for warm‐water aquaculture in Serbia. CEVD was first time detected in Serbia in 2017. During 2017-2020 period, increasing number of CEVD outbreaks in carp farms is reported. Carp were collected from farms in different regions of Serbia from 2017 to 2020. The fish were sampled for disease diagnosis because they exhibited lethargy and anorexia, which eventually led to mortality. Mortality started with clinical signs of hypoxia while fish swam slowly without escaping reactions. The gills were pale and covered with a thick mucus layer. In advanced cases, the lesions in the gills turned into a necrotizing form. A moderate to high amount of opportunistic freshwater bacteria were isolated from gills of diseased fish. By performing real-time PCR, CEV was detected in 38 samples of diseased carps from 21 carp farms. These outbreaks further confirm the spread of CEVD and the need for practitioners to be vigilant for outbreaks of this disease. To prevent further spreading of the disease, it is very important to introduce CEV testing before fish movement. To avoid further transmission of the virus to common carp populations in Serbia, testing of CEV should become part of fish disease surveillance programs. Fish health service should be aware of the presence of CEV in Serbia which may result in high losses in carp aquaculture. Action should be taken also to prevent transmission of CEV to carp populations in open waters.

Double-blind placebo-controlled provocation study in patients with subjective Multiple Chemical Sensitivity (MCS) and matched control subjects

Introduction. Multiple Chemical Sensitivity (MCS) is an acquired disorder with recurrent symptoms referable to multiple organ systems. No widely accepted test of physiologic function correlates with symptoms and it has not been recognized as a distinct entity by the scientific community. Few double-blind placebo-controlled studies have been done. The objectives of this study were to test two hypotheses: that patients with MCS can distinguish reliably between solvents and placebo, and that there are significant differences in objective biological and neuropsychological parameters between solvent and placebo exposures. Methods. Twenty patients with MCS and 17 controls underwent six exposure sessions (solvent mixture and clean air in random order, double-blind) in a challenge chamber. Positive reactions were defined as subjective perception of being exposed to solvents, blood pressure or heart rate change of ≥ 10%, rash or clinical signs of hypoxia, or symptom severity rise after exposure. Results. No differences between the groups with regard to sensitivity, specificity, and accuracy were found. Cognitive performance was not influenced by solvent exposure, and did not differ between the groups. There was no difference between the groups in serum cortisol levels measured before and after exposures. Conclusion. The hypotheses were not confirmed.

The 1995 mass mortality of pilchard: no role found for physical or biological oceanographic factors in Australia

An unprecedented mass mortality of pilchard, Sardinops sagax, occurred in Australia in 1995, spreading east and west from the Great Australian Bight at approximately 0á5 m s-1 and 0·3 m s-1 respectively to span the 6000-km range of the species from Noosa, Queensland, to Geraldton, Western Australia. Mortalities with the same clinical signs of hypoxia also occurred in New Zealand. Upwelling and phytoplankton blooms preceded the first mortalities, leading to widely publicized speculation that environmental stress caused the mortalities. However, upwellings as strong as in February 1995 off Eyre Peninsula occur as often as once every three or four years, and environmental conditions surrounding mortalities elsewhere were normal. Phytoplankton blooms were absent through much of the range; where they did accompany mortalities they were of widely differing species. Hence, the hypothesis that environmental stress caused the mortalities is quite confidently rejected. The hypothesis that ocean currents were a vector of an aeteological agent is also rejected, since the Leeuwin and East Australian currents were both flowing strongly against the spread of mortalities. Other potential vectors exist, however, so the hypothesis that an introduced pathogen was responsible cannot be rejected.

An�sthesiologisches und intensivmedizinisches Management bei schwer brandverletzten Kindern der Zeugen Jehovas

A 3.5-year-old girl suffered from a thermal injury affecting 37% of the body surface area. The parents, being Jehovah's witnesses, refused permission for their child to receive blood transfusions. As the haemoglobin level was only 7.5% and a necrectomy was planned, the patient was likely to need blood transfusions. Indications for transfusion were defined as clinical signs of hypoxia and/or cardiovascular instability. A judicial declaration was proposed. Hb decreased during the therapy. To stimulate the erythropoiesis erythropoietin and iron were administered. During the clinical course the anaemia worsened. First, a conservative treatment with polyvidoniodine ointment for tanning was started, to avoid an operation during the acute phase after the injury, as in this case it was thought a blood transfusion would definitely be necessary. On the 19th day after the injury a necrectomy of 10% of the body surface was necessary because of fever and leucocytosis not responding to antibiotics. The most likely cause of the symptoms was an infection of the burned area. Hb was 4.6 g/dl%. General anaesthesia was performed with midazolam, ketamine and vecuronium and mechanical ventilation. No blood transfusion was required during the operation. Vital signs were stable during the preoperative period, during anaesthesia and following the operation. There were no signs of tissue hypoxia. Peripheral oxygen saturation ranged between 98% and 100%, lactate and arterial blood gas samples were normal, and the child was awake and cooperative before and after anaesthesia. The lowest Hb was 3.3 g/dl on the 22th day after injury (3rd postoperative day). In this phase the patient was still playing and riding a tricycle. On the 45th day after injury the child was discharged home with Hb of 10.9 g/dl and reticulocytosis of 33%.

Noninvasive methods for estimating in vivo oxygenation.

Clinical signs of hypoxia and hyperoxia are nonspecific and unreliable, yet both are potentially injurious. Noninvasive methods of oxygen assessment fill the gap between clinical observation and invasive tests, helping physicians deliver sufficient oxygen with minimum toxicity. Potential sites for oxygen measurement vary between the blood and the mitochondria; each method measures at a different site and detects different types of hypoxia and hyperoxia. Thus, values obtained by two different methods are not equivalent, giving each method unique strengths and weaknesses. We review two clinical methods (pulse oximetry and transcutaneous oximetry), as well as four experimental methods (near-infrared spectrophotometry, magnetic resonance spectroscopy, magnetic resonance saturation imaging, and time-of-flight absorbance spectrophotometry). The principles of each method and the clinical situations in which each succeeds or fails are discussed. A fundamental understanding of each method can help in deciding which methods, if any, are appropriate for a given patient and how best to correct observed oxygenation problems once they are discovered.