Blood Hemoglobin Oxygen Saturation Research Articles

Theoretical Evaluation of Simultaneous Optical Measurement Method for Hemoglobin Concentration, Oxygen Saturation, and Water Percentage in Blood Based on Multi-parameter Optimization

Theoretical Evaluation of Simultaneous Optical Measurement Method for Hemoglobin Concentration, Oxygen Saturation, and Water Percentage in Blood Based on Multi-parameter Optimization

Does the Anastomosis Recipient Vessel Have an Influence on Free Flap Perfusion in Microvascular Head and Neck Reconstruction-A Retrospective Analysis of 338 Cases with Comparison of Flap Perfusion between Different Arterial and Venous Recipient Vessels in Radial Free Forearm Flaps, Anterolateral Thigh Flaps, and Fibula Free Flaps.

Background: Flap perfusion is a prerequisite for microvascular free flap survival and a parameter routinely used for flap monitoring. The aim of this study was to investigate the influence of the anastomosis recipient vessel on flap perfusion. Methods: Flap perfusion was retrospectively analyzed in 338 patients who underwent head and neck reconstruction with microvascular free flaps between 2011 and 2020. The Oxygen-to-see tissue oxygen analysis system measurements for intraoperative and postoperative flap blood flow, hemoglobin concentration, and hemoglobin oxygen saturation at 8 and 2 mm tissue depths were compared between arterial anastomosis recipient vessels (external carotid artery [ECA], facial artery [FAA], lingual artery [LIA], and superior thyroid artery [STA]) and venous anastomosis recipient vessels (internal jugular vein [IJV], combination of IJV and IJV branches, IJV branches, and external jugular vein). Results: The postoperative hemoglobin concentration at 2 mm tissue depth differed significantly between arterial anastomosis recipient vessels (ECA, 41.0 arbitrary units [AU]; FAA, 59.0 AU; LIA, 51.5 AU; STA, 59.0 AU; p = 0.029). This difference did not persist in the multivariable testing (p = 0.342). No other differences in flap blood flow, hemoglobin concentration, or hemoglobin oxygen saturation were observed between the arterial and venous anastomosis recipient vessels (p > 0.05 for all). Conclusions: The arterial and venous recipient vessels used for anastomosis did not influence microvascular free flap perfusion. This underlines the capability of the studied recipient vessels to adequately perfuse free flaps, may explain the observed indifferent flap survival rates between commonly used anastomosis recipient vessels, and implies that the recipient vessel is not a confounding variable for flap monitoring with the Oxygen-to-see tissue oxygen analysis system. Further prospective studies are needed to confirm the findings.

Validation of a new 3D quantitative BOLD based cerebral oxygen extraction mapping

Quantitative BOLD (qBOLD) MRI allows evaluation of oxidative metabolism of the brain based purely on an endogenous contrast mechanism. The method quantifies deoxygenated blood volume (DBV) and hemoglobin oxygen saturation level of venous blood (Yv), yielding oxygen extraction fraction (OEF), and along with a separate measurement of cerebral blood flow, cerebral metabolic rate of oxygen (CMRO2) maps. Here, we evaluated our recently reported 3D qBOLD method that rectifies a number of deficiencies in prior qBOLD approaches in terms of repeat reproducibility and sensitivity to hypercapnia on the metabolic parameters, and in comparison to dual-gas calibrated BOLD (cBOLD) MRI for determining resting-state oxygen metabolism. Results suggested no significant difference between test-retest qBOLD scans in either DBV and OEF. Exposure to hypercapnia yielded group averages of 38 and 28% for OEF and 151 and 146 µmol/min/100 g for CMRO2 in gray matter at baseline and hypercapnia, respectively. The decrease of OEF during hypercapnia was significant (p ≪ 0.01), whereas CMRO2 did not change significantly (p = 0.25). Finally, baseline OEF (37 vs. 39%) and CMRO2 (153 vs. 145 µmol/min/100 g) in gray matter using qBOLD and dual-gas cBOLD were found to be in good agreement with literature values, and were not significantly different from each other (p > 0.1).

Flap perfusion monitoring with an attached surface probe in microvascular reconstruction of the oral cavity

ObjectivesPostoperative flap monitoring is essential in oral microvascular reconstruction for timely detection of vascular compromise. This study investigated the use of attached surface probes for the oxygen-2-see (O2C) analysis system (LEA Medizintechnik, Germany) for intraoral flap perfusion monitoring.Materials and methodsThe study included 30 patients who underwent oral reconstruction with a microvascular radial-free forearm flap (RFFF) or anterolateral thigh flap (ALTF) between 2020 and 2022. Flap perfusion was measured with attached (3-mm measurement depth) and unattached surface probes (2- and 8-mm measurement depths) for the O2C analysis system at 0, 12, 24, 36, and 48 h postoperatively. Flap perfusion monitoring with attached surface probes was evaluated for cut-off values for flap blood flow, hemoglobin concentration, and hemoglobin oxygen saturation indicative of vascular compromise and for accuracy and concordance with unattached surface probes.ResultsThree RFFFs were successfully revised, and one ALTF was unsuccessfully revised. The cut-off values indicative of vascular compromise for flap perfusion monitoring with attached surface probes were for RFFF and ALTF: blood flow < 60 arbitrary units (AU) and < 40AU, hemoglobin concentration > 100AU and > 80AU (both > 10% increase), and hemoglobin oxygen saturation < 40% and < 30%. Flap perfusion monitoring with attached surface probes yielded a 97.1% accuracy and a Cohen’s kappa of 0.653 (p < 0.001).ConclusionsFlap perfusion monitoring with attached surface probes for the O2C analysis system detected vascular compromise accurately and concordantly with unattached surface probes.Clinical relevanceAttached surface probes for the O2C analysis system are a feasible option for intraoral flap perfusion monitoring.

Everything About Pulse Oximetry-Part 1: History, Principles, Advantages, Limitations, Inaccuracies, Cost Analysis, the Level of Knowledge About Pulse Oximeter Among Clinicians, and Pulse Oximetry Versus Tissue Oximetry.

Purpose: Pulse oximetry is a noninvasive medical technique that measures the amount of oxygen in a person's blood by shining light through their skin. It is widely used in medical care and is considered as important as the 4 traditional vital signs. In this article, it was aimed to review all aspects of pulse oximetry in detail. Materials and Methods: The international and national reliable sources were used in the literature review for critical data analysis. A total of 13 articles including 9 reviews, 1 comparative clinical research, 1 cost-saving quality improvement project, 1 cross-sectional and multicenter descriptive study, and 1 questionnaire study were used for the preparation of this part of the review. Results: The history, principles, advantages, limitations inaccuracies, cost analysis, the level of knowledge about pulse oximeter among clinicians, and pulse oximetry versus tissue oximetry were all reviewed in detail. Conclusion: The device has a significant impact on modern medicine, allowing continuous monitoring of hemoglobin oxygen saturation in arterial blood. Oximeters are valuable in managing oxygen levels in respiratory and nonrespiratory diseases and have become an essential tool in hospital settings. Detecting low levels of oxygen saturation early can alert patients to seek medical attention promptly. It is crucial to comprehend the working and limitations of pulse oximetry technology to ensure patient safety.

Pulse Oximeter And Different Skin Tones In Pakistan.

Madam, A recent retrospective cohort study found that 3069 patients of Asian, Black, and Hispanic racial origin were associated with lower average oxygen delivery rates than white patients using the pulse oximeter in the intensive care unit.[1] It is well known that these readings are affected by skin melanin pigmentation, which affects light absorption and scattering, resulting in unreliable readings in non-white patients.[1] This can increase the risk of hidden hypoxemia, which is established as falsely elevated SpO2 readings, usually 92% or greater when the blood haemoglobin oxygen saturation is &lt; 88%.[2] This, in turn, is associated with higher mortality rates.[2] The Pakistani population has a variety of skin tones making this a concerning matter for people of all age groups. According to data analyzed from 18 different hypoxemic studies over the last three years which included studies analyzing the performance of pulse oximeter brands, employing both transmission and reflectance, with 3 sensor types (reusable finger clip, disposable adhesive finger, disposable adhesive forehead) found a slight positive bias in readings on skin with darker pigmentation.[3] The current ongoing situation with COVID-19 makes it even more important to investigate the matter of the pulse oximeter’s performance. A retrospective study on 117 COVID-19 patients found that those with increased fibrinogen, increased ferritin and decreased lymphocyte count were risk factors for those with significant difference (&gt;4%) in SpO2 and SaO2 suggesting that the pulse oximeter alone isn't enough to accurately and precisely assess COVID-19 patients with those conditions.[4] It is also important to note that the performance of the pulse oximeter devices differ in a clinical vs ideal laboratory setting.[3] During the pandemic in Pakistan, many hospitals and homes have used the pulse oximeter as a reliable portable device without being aware of the discrepancies in the precision of its readings. The Pakistani population should have a pulse oximeter device that works ideally in all settings and on a variety of skin tones to reflect the diversity of its population. The regulatory agencies and leading hospitals in Pakistan should analyse and change their standards for measuring the accuracy and precision of the pulse oximeter on patients with darker pigmentation, especially in low-perfusion and hypoxemic states.[3]

Ventilatory function and oxygen delivery at high altitude in the Himalayas

This study aimed to evaluate changes in lung function assessed by spirometry and blood gas content in healthy high-altitude sojourners during a trek in the Himalayas. A group of 19 Italian adults (11 males and 8 females, mean age 43 ± 15 years, and BMI 24.2 ± 3.7 kg/m2) were evaluated as part of a Mount Everest expedition in Nepal. Spirometry and arterial blood gas content were evaluated at baseline in Kathmandu (≈1400 m), at the Pyramid Laboratory - Observatory (peak altitude of ≈5000 m), and on return to Kathmandu 2–3 days after arrival at each site. All participants took 250 mg of acetazolamide per os once daily during the ascent. We found that arterial hemoglobin saturation, O2 and CO2 partial pressures, and the bicarbonate level all decreased (in all cases, p < 0.001 with R2 =0.70–0.90), while pHa was maintained stable at the peak altitude. Forced vital capacity (FVC) remained stable, while forced expiratory volume in 1 s (FEV1) decreased (p = 0.010, n2p =0.228), resulting in a lower FEV1/FVC ratio (p < 0.001, n2p =0.380). The best predictor for acute mountain sickness was the O2 partial pressure at the peak altitude (p = 0.004, R2 =0.39). Finger pulse oximetry overestimated peripheral saturation relative to arterial saturation. We conclude that high-altitude hypoxia alters the respiratory function and the oxygen saturation of the arterial blood hemoglobin. Additionally, air rarefaction and temperature reduction, favoring hypoxic bronchoconstriction, could affect respiration. Pulse oximetry seems not enough to assist medical decisions at high altitudes.

Evaluation of oxygen saturation as an indicator for tracheal intubation in patients with COVID-19: a prospective cohort study

Background. Since the beginning of COVID-19 pandemic, the importance of clinical criteria for tracheal intubation in critically ill patients with respiratory failure became more noteworthy, especially in resource limitations. The objective was to evaluate the importance of hemoglobin oxygen saturation as a criterion for tracheal intubation in patients with COVID-19. Materials and methods. This is a multi-center, prospective, observational cohort study. We included 117 patients with COVID-19 who needed respiratory support between March to June 2021. Patients were intubated by the protocol of each institution participating in the study and the anesthesiologist’s clinical judgement. Signs of respiratory failure, methods of respiratory support and patient outcome were recorded. Results. Among 117 studied cases, 100 patients had hemoglobin oxygen saturation of 60–90 % in whom 58 were intubated. During hospitalization, 56 intubated patients and 14 non-intubated patients died (96.6 % Vs. 33.3 %). Conclusion. Arterial blood hemoglobin oxygen saturation of 60–90 could not be the correct key to unlock the problem of intubation decision in patients with COVID-19. Therefore, hemoglobin oxygen saturation should not be solely regarded as an indication for intubation in COVID-19.

Impacts of vascular comorbidities on free flap perfusion in microvascular head and neck reconstruction

PurposeArterial hypertension (AHTN), type 2 diabetes mellitus (DM), and atherosclerotic vascular disease (ASVD) are common vascular comorbidities in patients undergoing reconstruction of the head and neck region with a microvascular free flap. These conditions may affect flap perfusion (microvascular blood flow and tissue oxygenation), which is a prerequisite for flap survival and thus reconstruction success. This study aimed to investigate the impacts of AHTN, DM, and ASVD on flap perfusion.MethodsData from 308 patients who underwent successful reconstruction of the head and neck region with radial free forearm flaps, anterolateral thigh flaps, or fibula free flaps between 2011 and 2020 were retrospectively analyzed. Flap perfusion was measured intraoperatively and postoperatively with the O2C tissue oxygen analysis system. Flap blood flow, hemoglobin concentration, and hemoglobin oxygen saturation were compared between patients with and without AHTN, DM, and ASVD.ResultsIntraoperative hemoglobin oxygen saturation and postoperative blood flow were lower in patients with ASVD than in patients without ASVD (63.3% vs. 69.5%, p = 0.046; 67.5 arbitrary units [AU] vs. 85.0 AU, p = 0.036; respectively). These differences did not persist in the multivariable analysis (all p > 0.05). No difference was found in intraoperative or postoperative blood flow or hemoglobin oxygen saturation between patients with and without AHTN or DM (all p > 0.05).ConclusionPerfusion of microvascular free flaps used for head and neck reconstruction is not impaired in patients with AHTN, DM, or ASVD. Unrestricted flap perfusion may contribute to the observed successful use of microvascular free flaps in patients with these comorbidities.

Embedded System for the Analysis of Thermal Properties of Hemoglobin

A novel embedded photoacoustic system design is described and a calculation method is proposed to determine the blood hemoglobin oxygen saturation through the thermal properties of different skin color types. A heat equation model allows a calculation procedure to determine the reflection and transmitted thermal wave amplitude for obtaining a depth profile, depending on the modulation frequency at the air-skin-subcutaneous tissue interface. Our reflection-mode photoacoustic technique involves the use of a 445 nm pulsed-laser light spot on subcutaneous tissue to obtain amplitude and phase from signals for different skin color types. The transmission and reflection temperature coefficients are fitted through a heat propagation model to estimate the thermal wave properties of blood hemoglobin. Nonlinearly amplified photoacoustic signals are modeled from the microphone and their stability analyzed by a bode diagram, as to consider overheated hemoglobin background. An dedicated electronic embedded system is thus integrated, including memory, processor and preprocessor, to provide a simple measurement technique, as compared to conventional instruments.

Impact of age on microvascular free flap perfusion in head and neck reconstruction

Aging is associated with structural and functional cardiovascular changes that may affect microvascular free flap perfusion, which is a prerequisite for flap viability and flap success. This study is aimed to investigate the impact of age on flap perfusion. Intraoperative and postoperative flap perfusion of 348 patients who underwent successful reconstruction with a radial free forearm flap (RFFF), anterolateral thigh flap (ALTF), or fibular free flap (FFF) was retrospectively analyzed and compared between older (>70 years) and younger patients (≤70 years) using the Mann-Whitney test and linear regression models. Intraoperative flap blood flow and hemoglobin concentration (55.5 arbitrary units [AU] vs 69.3 AU, P=.004; 42.5 AU vs 47.3 AU, P=.016, respectively) were reduced in ALTFs in older patients compared with younger patients. These 2 differences did not persist in multivariable testing (P=.097 and P=.323, respectively). No other differences were observed between the older and younger patients in terms of intraoperative and postoperative flap blood flow, hemoglobin concentration, and hemoglobin oxygen saturation in RFFFs, ALTFs, and FFFs (all P > .05). Age has no impact on microvascular free flap perfusion in RFFFs, ALTFs, and FFFs. This could contribute to the observed equal success of free flaps in older patients.

Whole-brain 3D mapping of oxygen metabolism using constrained quantitative BOLD

Quantitative BOLD (qBOLD) MRI permits noninvasive evaluation of hemodynamic and metabolic states of the brain by quantifying parametric maps of deoxygenated blood volume (DBV) and hemoglobin oxygen saturation level of venous blood (Yv), and along with a measurement of cerebral blood flow (CBF), the cerebral metabolic rate of oxygen (CMRO2). The method, thus should have potential to provide important information on many neurological disorders as well as normal cerebral physiology. One major challenge in qBOLD is to separate deoxyhemoglobin's contribution to R2′ from other sources modulating the voxel signal, for instance, R2, R2′ from non-heme iron (R′2,nh), and macroscopic magnetic field variations. Further, even with successful separation of the several confounders, it is still challenging to extract DBV and Yv from the heme-originated R2′ because of limited sensitivity of the qBOLD model. These issues, which have not been fully addressed in currently practiced qBOLD methods, have so far precluded 3D whole-brain implementation of qBOLD. Thus, the purpose of this work was to develop a new 3D MRI oximetry technique that enables robust qBOLD parameter mapping across the entire brain. To achieve this goal, we employed a rapid, R2′-sensitive, steady-state 3D pulse sequence (termed ‘AUSFIDE’) for data acquisition, and implemented a prior-constrained qBOLD processing pipeline that exploits a plurality of preliminary parameters obtained via AUSFIDE, along with additionally measured cerebral venous blood volume. Numerical simulations and in vivo studies at 3 T were performed to evaluate the performance of the proposed, constrained qBOLD mapping in comparison to the parent qBOLD method. Measured parameters (Yv, DBV, R′2,nh, nonblood magnetic susceptibility) in ten healthy subjects demonstrate the expected contrast across brain territories, while yielding group-averages of 64.0 ± 2.3 % and 62.2 ± 3.1 % for Yv and 2.8 ± 0.5 % and 1.8 ± 0.4 % for DBV in cortical gray and white matter, respectively. Given the Yv measurements, additionally quantified CBF in seven of the ten study subjects enabled whole-brain 3D CMRO2 mapping, yielding group averages of 134.2 ± 21.1 and 79.4 ± 12.6 μmol/100 g/min for cortical gray and white matter, in good agreement with literature values. The results suggest feasibility of the proposed method as a practical and reliable means for measuring neurometabolic parameters over an extended brain coverage.

ДИНАМИКА МАРКЕРОВ ФУНКЦИИ ЭНДОТЕЛИЯ, ПРО- И ПРОТИВОВОСПАЛИТЕЛЬНЫХ ЦИТОКИНОВ В ЗАВИСИМОСТИ ОТ ВЫРАЖЕННОСТИ ХРОНИЧЕСКОЙ ДЫХАТЕЛЬНОЙ НЕДОСТАТОЧНОСТИ У ПАЦИЕНТОВ С ХРОНИЧЕСКОЙ ОБСТРУКТИВНОЙ БОЛЕЗНЬЮ ЛЕГКИХ

The publication is devoted to the study of markers of endothelial function, pro- and anti-inflammatory cytokines in patients with chronic obstructive pulmonary disease depending on the severity of chronic respiratory failure and disorders of arterial blood hemoglobin oxygen saturation. The authors established a decrease in the activity of cellular immunity, insufficient activation of humoral immunity, decrease in antioxidant protection and anti-inflammatory activity of the immune system. Signs of the key link in the development of atherosclerosis – endothelial dysfunction – were revealed in patients with COPD. The results of the study suggest that the degrees of chronic respiratory failure are interrelated with the stages of atherosclerotic process development. Disturbances of hemoglobin saturation of arterial blood with oxygen and pronounced degrees of chronic respiratory failure are considered as factors contributing to the stage of atheromatosis, which underlies the formation of unstable atherosclerotic plaque.

ДИФФЕРЕНЦИАЛЬНАЯ ДИАГНОСТИКА ХРОНИЧЕСКОЙ СЕРДЕЧНОЙ НЕДОСТАТОЧНОСТИ И ХРОНИЧЕСКОЙ ДЫХАТЕЛЬНОЙ НЕДОСТАТОЧНОСТИ У ПАЦИЕНТОВ С ХРОНИЧЕСКОЙ ОБСТРУКТИВНОЙ БОЛЕЗНЬЮ ЛЕГКИХ

Chronic respiratory failure (CRF) has traditionally been considered to be the main cause of death in patients with chronic obstructive pulmonary disease (COPD). However, modern epidemiological studies have shown that the leading causes of death in patients with COPD are CHD and CHF. Aim: to study the prevalence of CRF and CHF in patients with COPD, to determine the informative value of clinical symptoms in their diagnosis, to work out an algorithm of differential diagnosis of CRF and chronic heart failure (CHF). Methods: subjects – 100 men with COPD. The median age was 67 years. We performed clinical and laboratory examinations. COPD syndrome was diagnosed upon EchoCG and NT-proBNP results. CRF syndrome was diagnosed by the results of exercise testing with simultaneous measurement of arterial blood hemoglobin oxygen saturation. Results: CHF was established in 45.0% of patients, and right ventricular failure was diagnosed in 42.0% of cases. Patients with CHF and decreased left ventricular EF, whose prognosis could be improved by evidence-based treatment developed at the present stage, comprised only 12.0%. We revealed the correlation of CHF syndrome with CRF and with disorders of arterial blood hemoglobin oxygen saturation: CHF NYHA III is associated with CRF IIIB and any disorders of arterial blood hemoglobin oxygen saturation, while CHF NYHA II and NYHA I are respectively associated with CRF IIIA and CRF IIB as well as with a decrease in arterial blood hemoglobin oxygen saturation both on exertion and at rest. The informative value of clinical symptomatology was assessed in COPD patients for the diagnosis of CHF and CRF syndromes: the probability of CHF diagnosis based on clinical symptoms is 79.0% and for CRF – 88.0%. A symptom score scale and an algorithm for the diagnosis of CHF and CRF were developed.

The Effectiveness of Fried Catfish Cake In Increasing Hemoglobin Levels And Oxygen Saturation In Blood In Pregnant Women

&lt;p&gt;Iron deficiency anemia mainly affects pregnant women, lactating women and women of childbearing age in general. Many things change in pregnant women in the third trimester of pregnancy. In the third trimester, blood volume is still increasing so pregnant women need foods rich in iron and vitamin C for good iron absorption. Catfish is one of the foodstuffs that is easy to serve and the price is cheaper than other fish. The nutritional content of catfish will increase with the right way of processing. Fresh catfish contains 1.0 mg of iron. After frying, it becomes 1.2 mg. With the condition of pregnant women who are prone to anemia, pregnant women must fulfill their nutrition by adding additional food, which can be in the form of snacks made from catfish so that their fe needs will be met. Catfish, apart from being processed into meatballs, can also be processed into the fried catfish cake. Quasi-experimental research type &lt;em&gt;non randomized pre test post test&lt;/em&gt;. The research subjects were pregnant women in the third trimester. The analysis of this study used the &lt;em&gt;Paired t test&lt;/em&gt;. Results: the results of research that has been conducted regarding differences in Hb levels in pregnant women in the third trimester before and after being given fried catfish cake, it was found that there were differences in Hb levels before and after treatment, this result was evidenced by the results of the t statistical test where the t&lt;em&gt;count&lt;/em&gt; was 10,816 with a significance level of ρ&lt;em&gt;&lt;sub&gt;value&lt;/sub&gt;&lt;/em&gt; of 0.000, there is a significant difference because ρ&lt;em&gt;&lt;sub&gt;value&lt;/sub&gt;&lt;/em&gt; is smaller than α (0.05). Meanwhile, for oxygen saturation with the Wilcoxon test statistic, the Z value is -3.345 with a significance level of ρ&lt;em&gt;&lt;sub&gt;value&lt;/sub&gt;&lt;/em&gt; of 0.001, Thus before and after treatment there is a significant difference because the value is smaller than α (0.05). The brain of fried catfish cake is effective in increasing hemoglobin levels and oxygen saturation in the blood in third trimester pregnant women.&lt;/p&gt;&lt;p&gt; &lt;/p&gt;&lt;p&gt; &lt;/p&gt;

Surgical component of lateral and central breast cancer treatment

Aim. To improve the results of the surgical component in the treatment of a nodular form of breast cancer with lateral and central localization by analyzing hemoglobin oxygen saturation of arterial blood in the foci of breast cancer, regional lymph nodes and resection line of the breast.&#x0D; Methods. The study involved 175 patients with a nodular form of breast cancer with lateral and central localization (T23N12M0), including 86 in the main group and 89 in the comparison group. In the main group, hemoglobin oxygen saturation in arterial blood of the foci of breast cancer, parenchyma, pectoral muscles and regional lymph nodes was examined for spread of cancer during surgery for nodular breast cancer by using a device developed by us (patent RU 2581266). This examination was not performed in the comparison group. Histopathological examination of resection specimens revealed confirmation of the main foci of breast cancer and the presence of metastases in the regional lymph nodes and pectoral muscles of the breast. Statistical analysis of the data was performed by using the Statistica 10 software. The arithmetic mean, the standard error of the mean and the standard deviation were calculated for the quantitative indicators.&#x0D; Results. In the main group, 86 patients had no recurrence and metastases in the follow-up, while in the comparison group, cancer recurrence was identified in 89 patients and metastases was found during cytological and histological studies in 9 patients.&#x0D; Conclusion. Determination of hemoglobin oxygen saturation of arterial blood during surgery in the subclavian, axillary and subscapular lymph nodes as well as in the pectoralis major and minor muscles allows clarifying the distribution of breast cancer, specifying the scope of the operation and improving the results of the surgical component of breast cancer treatment (T23N12M0).

Repeatability and accuracy of fingertip pulse oximeters for measurement of hemoglobin oxygen saturation in arterial blood and pulse rate in anesthetized dogs breathing 100% oxygen.

To evaluate the repeatability and accuracy of fingertip pulse oximeters (FPO) for measurement of hemoglobin oxygen saturation in arterial blood and pulse rate (PR) in anesthetized dogs breathing 100% O2. 29 healthy client-owned anesthetized dogs undergoing various surgical procedures. In randomized order, each of 7 FPOs or a reference pulse oximeter (PO) was applied to the tongue of each intubated anesthetized dog breathing 100% O2. Duplicate measurements of oxygen saturation (Spo2) and PR were obtained within 60 seconds of applying an FPO or PO. A nonparametric version of Bland-Altman analysis was used. Coefficient of repeatability was the interval between the 5th and 95th percentiles of the differences between duplicate measurements. Bias was the median difference, and the limits of agreement were the 5th and 95th percentiles of the differences between each FPO and the PO. Acceptable values for the coefficient of repeatability of Spo2 were ≤ 6%. Agreements were accepted if the limits of agreement had an absolute difference of ≤ ± 3% in Spo2 and relative difference of ≤ ± 10% in PR. Coefficient of repeatability for Spo2 was acceptable for 5 FPOs, but the limits of agreement for Spo2 were unacceptable for all FPOs. The limits of agreement for PR were acceptable for 2 FPOs. Results suggested that some FPOs may be suitable for accurately monitoring PRs of healthy anesthetized dogs breathing 100% O2, but mild underestimation of Spo2 was common.

Early rehabilitation in patients following colorectal resection: effectiveness of yogic breathing and manual therapy vs conventional care

Introduction Early rehabilitation programs have become an important focus of perioperative management after colorectal surgery with aims of improving patient care, reducing complication rates, and shortening hospital stay following colorectal surgery. The aim of this study is to evaluate the efficacy and safety of Yogic Breathing and Manual Diaphragm Release Technique in early rehabilitation of patients following surgery to remove colorectal cancer. Methods A total of 40 patients with colorectal cancer who underwent colorectal resection were randomly assigned to receive either the experimental protocol (experimental group, EG: n 20 average age 66,5 years) or the stansard postoperative care (standard group, SG: n 20 average age 66 years). In all subjects, postoperative outcomes after seven sessions were: peripheral oxygen saturation of capillary blood hemoglobin (SpO2), heart rate (HR), Activities of Daily Living (ADL), Short-Form 12 (SF-12) questionnaire, Visual Analogue Scale (VAS) and pulmonary functionality (spirometer). Results The length of postoperative hospital stay and ventilation hours were shorter in patients receiving the experimental protocol compared with those receiving the conventional postoperative care. A better pulmonary functionality, which is fundamental for reducing lung complications, was recorded in patients receiving the experimental program than in those receiving conventional care mainly in the percentage of Forced Expiratory Volume in 1st second. A significantly improvement of SPO2 and a greater decrement of HR was observed in the EG. To compare with SG, SF12 score after experimental protocol showed an improvement of quality of live. There was no significant difference in ADL score when the two groups were compared. Patients who received the experimental protocol compared with those receiving the standard postoperative care showed a significantly reduction of discomfort after surgery. Conclusion Our experience demonstrated that there is the place for cooperation between Yogic Breathing and Manual Diaphragm Release Technique after colorectal surgery. The comparison between the groups showed that the SG has been in a favorable clinical condition to prevent PPCs than the CG group. Thus, this new approach could be used as a component of the management of patients who have undergone colorectal surgery for cancer.

Experience in Applying Hyperbaric Oxygen Therapy Using Portable Pressure Chambers for the Treatment of Patients with the Novel Coronavirus Infection COVID-19

This communication presents the experience of using mobile pressure chambers in patients with the confi rmed novel coronavirus infection in hospital settings. The obtained preliminary results indicate positive antihypoxic effects of hyperbaric oxygen therapy (HBO) applied in the form of increased saturation. After a session of HBO, patients demonstrated an increase in the oxygen saturation of capillary blood hemoglobin at the average level of 3.71 points. Differences between SatO2 levels prior to and following HBO treatment were signifi cant in the CT2, CT3 and CT4 groups (p0.05). As expected, the effi cacy of HBO in terms of the oxygen saturation of capillary blood hemoglobin was the greatest in the patient groups showing pronounced clinical and radiological changes in the lungs.

Effect of non-steroidal anti-inflammatory drugs on glomerular filtration rate and urinary N-acetyl-β-D-glucosaminidase activity in cats after dental surgery

ObjectiveTo compare the effects of meloxicam or carprofen on glomerular filtration rate (GFR), and to evaluate the effect of meloxicam on urinary N-acetyl-β-D-glucosaminidase (NAG) activity, of cats after dental surgery. Study designRandomized, blinded, controlled trial. AnimalsA total of 24 mixed breed cats. MethodsCats were randomly assigned to one of three groups (n = 8 per group): meloxicam (0.2 mg kg–1); carprofen (4 mg kg–1); or saline (2 mL). Acepromazine (0.04 mg kg–1) and buprenorphine (0.02 mg kg–1) were administered intramuscularly as preanaesthetic medication. Test drugs were injected subcutaneously at the time of preanaesthetic medication. Anaesthesia was induced with intravenous propofol and maintained with isoflurane in oxygen. Mean arterial blood pressure (MAP), respiratory rate (fR), heart rate (HR) and haemoglobin oxygen saturation values (SpO2) were recorded. All cats underwent ultrasonic dental scaling with polishing. Teeth extraction involved mucosal flap creation, removal of alveolar bone and flap closure. Plasma iohexol clearance (ICL), a measure of GFR, was estimated before and 24 hours after anaesthesia induction in all cats. Urinary NAG index was estimated in saline and meloxicam groups at the same time points as GFR. Between-group and -time point differences in GFR and NAG index were compared using mixed model analyses. Data are presented as mean ± standard deviation (p < 0.05). ResultsThere was no significant difference in plasma ICL rate (range: from 1.22 ± 0.05 to 1.27 ± 0.04 mL kg minute–1) between groups or between time points. Urinary NAG index (range: from 1.0 ± 0.19 to 1.36 ± 0.29 Units gram–1) was not significantly different between meloxicam and saline groups. MAP, HR, fR and SpO2 did not differ significantly between groups. Conclusions and clinical relevanceMeloxicam and carprofen appeared to produce nonsignificant effects on GFR, and meloxicam did not affect the urinary NAG activity, of cats after dental surgery.