Increase In O2 Saturation Research Articles

Value of Adding Nebulized Magnesium Sulphate to Rescue Medications in Acute Exacerbation of Chronic Obstructive Pulmonary Disease in Patients Admitted to Emergency Room

Abstract Introduction Chronic Obstructive Pulmonary Disease (COPD) is a common, preventable and treatable disease that is characterized by persistent respiratory symptoms and airflow limitation that is due to airway and/or alveolar abnormalities usually caused by significant exposure to noxious particles or gases, Nebulized magnesium is attractive as a therapeutic option because it is easily administered, relatively cheap and has minimal side effects. In light of some evidence for an effect when nebulized in severe exacerbations of asthma, the similarities between asthma and chronic obstructive pulmonary disease (COPD) (especially with regard to bronchodilator therapy) and the practical advantages of administration via nebuliser, we sought to focus on the nebulized route of delivery in acute exacerbations of chronic obstructive pulmonary disease (AECOPD). Objective The aim of this work was to evaluate the effect of administration of nebulized magnesium sulphate in the management of acute exacerbations of chronic obstructive pulmonary disease. Patient and methods The study was conducted upon 100 patients with acute exacerbation of COPD randomly divided into two groups, 50 patients for each group who admitted to emergency room with acute exacerbation of Chronic Obstructive Pulmonary Disease in Mansoura chest diseases hospital From January 2019 to June 2019, All patients randomly divided into two groups, Patients of group A: included 50 patients received 2.5 mg salbutamol (2.5 ml), mixed with 500 mg isotonic magnesium sulphate(5 ml), Patients of group B: included 50 patients received 2.5 mg salbutamol mixed with 2.5 ml isotonic saline. Treatment for all patients were given via nebulizer. Results There were no significant differences between group I who received nebulized magnesium sulphate + salbutamol and group II who received nebulized salbutamol regarding pulmonary functions (FEV1, FVC and FEV1/FVC), before and after treatment. After treatment there is a significant increase in O2 saturation, PO2 and Serum Mg(more in group I who received nebulized magnesium sulphate + salbutamol than group II who received nebulized salbutamol) and no significant difference between the two groups as regard PH, PCO2, HCO3, and CRP. There is significant change in pulmonary functions ( FEV1, FVC and FEV1/FVC), PO2, and O2 Saturation after treatment and no significant change in PH, PCO2, HCO3, serum Mg and CRP, in patients received salbutamol nebulizer. There is significant change in pulmonary functions ( FEV1, FVC and FEV1/FVC), PO2, O2 Saturation and serum Mg after treatment and no significant change in PH, PCO2, HCO3, and CRP in patients received Magnesium sulphate + salbutamol nebulizer. Conclusion Adding nebulized magnesium sulphate as an adjuvant to salbutamol treatment in the setting of AECOPD has no effect on FEV1, FVC&FEV1/FVC. Nebulized magnesium sulphate+ salbutamol provides nearly equal response to nebulized salbutamol in the treatment of Acute Exacerbation of Chronic Obstructive Pulmonary Disease in adults. So we do not recommend routine using of nebulizeld magnesium sulphate as an adjuvant to salbutamol treatment in the setting of AECOPD.

Evaluation of Right Ventricular Outflow Tract Stenting as Palliative Treatment in Severely Cyanotic Tetralogy of Fallot: A Systematic Review and Meta-Analysis of Observational Studies.

Background: Tetralogy of Fallot (ToF) is a cardiac malformation that accounts for up to 1/10 of all congenital diseases. Although surgical repair serves as a treatment of choice, it cannot be performed unless weight and anatomical key factors are favorable. The stenting of the right ventricular outflow tract (RVOT) has become an alternative palliative procedure for ToF as an option to alleviate infundibular obstruction with minimal invasion. Methods: A literature search was conducted through 7 databases, followed by the screening and independent assessment of 6 final studies, using the Newcastle-Ottawa Quality Assessment Scale (NOS). Analysis was then conducted using inverse variance analysis, and cumulative data were presented with forest and funnel plots. Results: Studied patients were referred for RVOT stenting due to the marked obstruction of the pulmonary blood flow, a low birth weight, or a small pulmonary artery size. The analysis revealed a significant increase in O2 saturation (mean difference [MD=18%; 13–23.78). The same trend was observed concerning an increase in the Nakata index (MD=54.59; 10.05–99.14), the right pulmonary artery diameter (MD=2.28; 1.20–3.36), and the left pulmonary artery diameter (MD=1.77; 0.22–3.32). Several complications were found, including tricuspid regurgitation and frequent premature beats. Conclusion: RVOT stenting is considered a feasible palliative treatment for ToF, with its high effectiveness in improving patients’ condition, especially their pulmonary flow. While complications are scarce, several conditions should be noted, particularly for fatal complications. Finally, this study has limitations as catheterization details in studies and diverse infants’ conditions may have caused potential bias

Assessment of the effects of the “Active Neonates” technique (AN-t) on premature neonates in NICU during afive-day physiotherapy intervention period

Aim: To record the effects of AN-t on the body growth and function of the cardiovascular and respiratory system of preterm infants during the first 5 days period of the study. Material - Method: 24 preterm infant, with gestational age ≤ 32 weeks(after parental consent) were grouped equally into the Intervention (IG) (n = 12) and Control (CG) (n = 12) group with 1: 1 representation for gestational age and birth weight. On the IG an original standardized intervention protocol (AN-t), specifically designed for the study,was appliedbeyond the daily conventional clinical care. Results: There was a twofold change in the daily weight gain rate between the intervals (I1) and (I2) , before and during the intervention period respectively, with p = 0.033 in favor of IG. Statistical significance was also observed in the reduction of heart rate at the end of each session compared to the start in both morning (p = 0.006) and afternoon (p = 0.002) sessions. Similar significance was recorded to the increase in O2 saturation at the end of each session (morning- afternoon) with p = 0.003. Conclusions: The intervention protocol (AN-t) seems to be safe as an intervention protocol in order to promote active motion in premature medically stable neonates, since no disturbing signs from the respiratorycardiovascular system were presented. Furthermore A.N-t seems to favor neonatal growth but the responsiblemechanisms for this observation are not yet elucidated. keywords : Preterm neonates, kinesthetic stimuli, compressions, daily weight gain rate,

Venular oxygen saturation is increased in young patients with type 1 diabetes and mild nonproliferative diabetic retinopathy.

To clarify how early in the development of diabetic retinopathy (DR) can oxygen (O2 ) saturation changes be detected. Retinal oximetry was performed in a cross-sectional study, involving 14- to 30-year-old individuals: 185 with type 1 diabetes (T1D) and 94 controls. The subjects were divided into four groups according to the grade of DR. One-way ANOVA and post hoc tests were used to test for differences in the mean O2 saturations between the groups. Fifty-eight (31 %) of the T1D patients had nonproliferative DR. There was no significant difference in O2 saturations between controls and T1D patients with no DR. Arteriolar and venular O2 saturations in T1D patients were significantly higher in moderate/severe DR than in no DR (p=0.009 and p>0.001), while venular O2 saturation was significantly higher in mild DR than in no DR (p=0.013). Increase in venular O2 saturation could not be detected before mild retinopathy had developed, and the retinal O2 saturation increase was measurable on the venular side first. Our results suggest that the increase in O2 saturation is likely a consequence of DR.

Role of the tongue base suspension suture with The Repose System bone screw in the multilevel surgical management of obstructive sleep apnea.

The Repose System (tongue base suspension) is a new, minimally invasive technique for tongue base suspension in the treatment of obstructive sleep apnea. The purpose of this project was to describe our preliminary experience using this tongue base suspension system in conjunction with uvulopalatopharyngoplasty (UPPP) in the multilevel surgical approach to the management of obstructive sleep apnea (OSA). We conducted a retrospective analysis of 19 consecutive patients undergoing UPPP and The Repose System tongue base suspension for the management of obstructive sleep apnea during a 1-year period (1998 through 1999). Fifteen patients (11 men and 4 women) had complete preoperative and postoperative polysomnographic data. A 46% reduction in the preoperative respiratory disturbance index (RDI) (38.7 +/- 12.3) versus the postoperative RDI (21.0 +/- 7.4, P < 0.05) was demonstrated at a mean of 3.8 months after surgery. The apnea index demonstrated a 39% reduction. The surgical cure rate was 20% (3 of 15 patients). The Repose System in conjunction with UPPP has been shown to produce significant reductions in the RDI and apnea index as well as a significant increase in O2 saturation. Despite the improvement in these objective parameters, the overall surgical cure rate was only 20% (3 of 15 patients) in this retrospective series. Further research is warranted to define the role of The Repose System in the management of obstructive sleep apnea patients with multilevel airway obstruction.

Estudo angiográfico comparativo da artéria pulmonar no pré e pós-operatório de pacientes submetidos a operação de derivação cavopulmonar bidirecional

INTRODUCTION: This study analyzed the alterations in the pulmonary artery (PA) diameters after bilateral cavopulmonary derivation (BCPD). MATERIAL AND METHODS: Eighteen patients submitted to BCPD in the period from March 1990 to January 1997, with available cineangiographic examinations in the pre- and postoperative period, were included. Measurements in right pulmonary artery (RPA) and left pulmonary artery (LPA) were performed at three sites: at the origin, immediately before bifurcation and at the beginning of the inferior lobe artery. The diameters of each site were indexed with respect to body surface or diameter of the aorta at the level of the diaphragm. Angiographic and oximetric data were submitted to statistical analysis. RESULTS: On analyzing absolute diameters, it was observed that most suffered a non-significant increase in the postoperative period, while the LPA diameter presented a decrease. The total indexes I e III presented a significant decrease in the postoperative period, this reduction of the total index II being non-significant. Analysis of the postoperative follow-up variable showed a significant reduction in the total indexes in patients with a postoperative follow-up less than 23,6 months. Presence of additional blood flow elicited an increase in RPA I and III indexes and a small reduction in the other. The PA measurements indexed with respect to the diameter of the aorta showed a behavior similar to those with respect to body surface. In the absence of collateral venous circulation (CVC) a significant increase in O2 saturation was observed. On the other hand, its presence elicited a non-significant increase during the period of observation.

Somatic reflexes and blood oxygenation under positive intrapulmonic pressure.

Abrupt or gradual application of positive intrapulmonic pressure (20 cm H2O) in young adult men caused an augmentation of the patellar reflex, an increased respiratory minute-volume and a shift from abdominal to thoracic breathing; all of which persisted throughout the period of increased pressure. In controlled ventilation and frequently also in free breathing, positive intrapulmonic pressure caused a predominant decrease, following an inconstant and transient initial increase in O2 saturation of the blood in the tissues as determined by continuous oximeter readings from the ear. This decreased O2 saturation is explained not only by the diminished blood flow but also by the finding that in dogs under constant ventilation in air, positive intrapulmonic pressure decreased oxygenation of the blood in the lungs. It is concluded that the augmentation of the knee-jerk induced by positive intrapulmonic pressure is due in large part to the resultant diminished blood flow and decreased oxygenation of the blood in the lungs, and that the attendant hypo-oxia and increased acid metabolites may potentiate the reflex through an anticholinesterase action on the neuromyal junction and possibly also central nervous structures. The increased respiration induced by positive intrapulmonic pressure is a counterpart of, and has etiological factors in common with, the augmentation of the patellar reflex. Submitted on April 18, 1956