Peripheral Capillary Oxygen Saturation Research Articles

A retrospective study of combination therapy with glucocorticoids and pirfenidone for PD-1 inhibitor-related immune pneumonitis.

Immune checkpoint inhibitor pneumonitis (ICIP) is thought to be a self-limiting disease; however, an effective treatment option does not currently exist. This study aimed to determine the clinical efficacy of combination therapy with glucocorticoids and pirfenidone for ICIP related to programmed cell death protein-1 (PD-1) inhibitors. We conducted a retrospective analysis of 45 patients with advanced non-small cell lung cancer who developed ICIP following PD-1 inhibitor and albumin-bound paclitaxel or carboplatin treatment at our hospital. The PD-1 inhibitor was discontinued, and glucocorticoids were used alone or in combination with pirfenidone to treat ICIP. The relevant clinical data of these patients were collected and analyzed. Compared with the glucocorticoid alone group, the glucocorticoid-pirfenidone group showed significant improvement in forced vital capacity (FVC), carbon monoxide diffusing capacity [%], peripheral capillary oxygen saturation, and 6-minute walk distance (P < .05). There were benefits with respect to the St. George's Respiratory Questionnaire score and the recurrence rate of ICIP, but there was no significant difference between the 2 groups (P > .05). Adding pirfenidone to glucocorticoid treatment was shown to be safe and may be more beneficial than glucocorticoids alone for improving pulmonary interstitial lesions, reversing ICIP, and preventing its recurrence.

Coma Care: Body Movement and Health Monitoring Coma Patient Using IoT Sensors

IoT is essential for keeping track of the health of coma patients. Through timely detection, continuous fitness monitoring can save up to 60% of human lives. The equipment is specifically made for real-time monitoring of coma patients' health indicators. The usage of IoT has made it more appropriate to identify the patient's status or condition. For obtaining the patient's body temperature, coronary pulse rate, blood pressure and oxygen saturation %, this proposed technique includes a number of smart sensors, including temperature, pulse rate, blood pressure, (peripheral capillary oxygen saturation) sensors. This system makes use of the cloud computing concept and an Arduino-UNO board as a microcontroller. Here, an sensors is being utilised to show the coma patients' movement. Vital information about the patient is sent via a cloud server to the legal person's smartphones and PCs. These documents may be preserved and examined for additional assessment and decision-making. Keywords: IoT Sensors, Body Movement Tracking, Health Monitoring, IoT in Critical Care.

The role of neutrophil to lymphocyte ratio in patients with COPD-OSA overlap syndrome.

The aim of this study is to investigate the role of the neutrophil to lymphocyte ratio (NLR) in patients diagnosed with the chronic obstructive pulmonary disease-obstructive sleep apnea (COPD-OSA) overlap syndrome and comorbid pulmonary hypertension (PH). We enrolled a consecutive of stable COPD patients and conducted spirometry measurements, nocturnal polysomnography (PSG), and echocardiography for all participants. Clinical laboratory data were collected. A total of 178 patients with stable COPD were enrolled among whom 33.14% (59/178) were diagnosed with OSA. Of the patients with overlap syndrome, 35.59% (21/59) showed comorbid PH, compared to 34.45% (41/119) in COPD patients without OSA. There was no significant difference in the occurrence of PH between COPD with and without OSA. NLR was significantly higher in patients with overlap syndrome compared to those with either disease alone. The difference in NLR between COPD-OSA patients with and without PH was not significant. Correlation analysis revealed that NLR was associated with age, total sleep time spent with oxygen saturation below 90% (T90), CRP, pulmonary artery systolic pressure (PASP), and minimum peripheral capillary oxygen saturation (SpO2min) in all COPD patients. NLR was identified as an independent factor contributing to OSA in COPD. The median cut-off value for detecting OSA in stable COPD was 2.49. However, NLR was not found to be a predictor for PH in COPD-OSA overlap syndrome. NLR can serve as a predictive marker for comorbid OSA in patients with COPD. NLR is expected to increase its clinical application as a convenient and cost-effective biomarker for COPD-OSA overlap syndrome.

Machine learning models to evaluate mortality in pediatric patients with pneumonia in the intensive care unit.

This study aimed to predict mortality in children with pneumonia who were admitted to the intensive care unit (ICU) to aid decision-making. Retrospective cohort study conducted at a single tertiary hospital. This study included children who were admitted to the pediatric ICU at the National Taiwan University Hospital between 2010 and 2019 due to pneumonia. Two prediction models were developed using tree-structured machine learning algorithms. The primary outcomes were ICU mortality and 24-h ICU mortality. A total of 33 features, including demographics, underlying diseases, vital signs, and laboratory data, were collected from the electronic health records. The machine learning models were constructed using the development data set, and performance matrices were computed using the holdout test data set. A total of 1231 ICU admissions of children with pneumonia were included in the final cohort. The area under the receiver operating characteristic curves (AUROCs) of the ICU mortality model and 24-h ICU mortality models was 0.80 (95% confidence interval [CI], 0.69-0.91) and 0.92 (95% CI, 0.86-0.92), respectively. Based on feature importance, the model developed in this study tended to predict increased mortality for the subsequent 24 h if a reduction in the blood pressure, peripheral capillary oxygen saturation (SpO2), or higher partial pressure of carbon dioxide (PCO2) were observed. This study demonstrated that the machine learning models for predicting ICU mortality and 24-h ICU mortality in children with pneumonia have the potential to support decision-making, especially in resource-limited settings.

Predictors of mortality among inpatients in COVID-19 treatment centers in the city of Butembo, North Kivu, Democratic Republic of Congo.

Determining the risk factors for severe disease and death among hospitalized Covid-19 patients is critical to optimize health outcomes and health services efficiency, especially in resource-constrained and humanitarian settings. This study aimed to identify the predictors of mortality of Covid-19 patients in North Kivu province in the Democratic Republic of Congo.A retrospective cohort study was conducted in 6 Covid-19 treatment centers in the city of Butembo from 1 January to 31 December 2021. The time to event (death), the outcome variable, was visualized by Kaplan-Meier curves and the log-rank test was used to confirm differences in trends. Cox regression was used for all the predictors in the bivariate analysis and multivariate analysis was done using predictors found statistically significant in the bivariate analysis. The following variables were considered for inclusion to the Cox regression model: Age, Sex, Disease length, Treatment site, History of at least one co-morbidity, Body mass index, Stage according to SpO2 and the NEWS-modified score.Among the 303 participants (mean age of 53 years), the fatality rate was 33.8 deaths per 1000 patient-days. Four predictors were independently associated with inpatient death: age category (≥ 60 years) (adjusted HR: 9.90; 95% CI: 2.68-36.27), presence of at least one comorbidity (adjusted HR: 11.39; 95% CI: 3.19-40.71); duration of illness of > 5 days before hospitalization (adjusted HR:1.70, 95% CI: 1.04-2.79) and peripheral capillary oxygen saturation (SpO2) < 90% (adjusted HR = 14.02, 95% CI: 2.23-88.32). In addition to advanced age, comorbidity, and length of disease before hospitalization, ambient air SpO2 measured by healthcare providers using low-tech, affordable and relatively accessible pulse oximetry could inform the care pathways of Covid-19 inpatients in resource-challenged health systems in humanitarian settings.

Telemedical management in patients waiting for transcatheter aortic valve implantation: the ResKriVer-TAVI study design.

The majority of patients with severe aortic stenosis (AS) planned for transcatheter aortic valve implantation (TAVI) are elective outpatients. During the COVID-19 pandemic, the time between the heart team's decision and TAVI increased due to limited healthcare resources. We therefore implemented telemedical approaches to identify AS patients at risk for clinical deterioration during the waiting time. The purpose of the prospective, randomized, controlled ResKriVer-TAVI study (DRKS00027842) is to investigate whether a digital concept of telemedical interventional management (TIM) in AS patients waiting for TAVI improves the clinical outcomes. In the present article, we report the study protocol of the ResKriVer-TAVI trial. ResKriVer-TAVI will enroll AS patients planned for elective TAVI. Randomization to the TIM group or standard care will be made on the day of the heart team's decision. TIM will include a daily assessment of weight, blood pressure, a 2-channel electrocardiogram, peripheral capillary oxygen saturation, and a self-rated health status until admission for TAVI. TIM will allow optimization of medical therapy or an earlier admission for TAVI if needed. Standard care will not include any additional support for patients with AS. All patients of the TIM group will receive a rule-based TIM including standard operating procedures when a patient is crossing prespecified values of a vital sign. The primary endpoint consists of days lost due to cardiovascular hospitalization and death of any cause within 180 days after the heart team's decision. Major secondary endpoints include all-cause mortality within 365 days, the number of telemedical interventions, and adherence to TIM. Follow-up visits will be conducted at admission for TAVI as well as 6 and 12 months after the heart team's decision. ResKriVer-TAVI will be the first randomized, controlled trial investigating a telemedical approach before TAVI in patients with AS. We hypothesize that primary and secondary endpoints of AS patients with TIM will be superior to standard care. The study will serve to establish TIM in the clinical routine and to increase the resilience of TAVI centers in situations with limited healthcare resources.

Enhancing physiological recovery and subsequent exercise performance in the heat using a phase-change material cooling blanket

This study aimed to assess the effect of a phase-change material (PCM) cooling blanket for cooling between exercise bouts on recovery of physiological parameters and subsequent exercise performance in the heat. Eighteen male volunteers were recruited to participate in human trials involving two exhaustive treadmill running bouts (Bout1 for 3 km and Bout2 for 1.5 km) in a climate chamber (temperature = 33 °C; relative humidity = 40%). Participants were randomly subjected to one of two cooling conditions for a 10-min period between exercise bouts: CON: natural cooling; 10-min PCM: with a PCM cooling blanket for 10 min. Several physiological parameters including mean skin temperature (Tskin), oral temperature (Toral), core temperature (Tcore), heart rate (HR), mean arterial pressure (MAP), respiratory rate (RR), peripheral capillary oxygen saturation (SpO2), average running speed and rating of perceived exertion (RPE) scale score were analyzed. The results showed that compared to the CON group, participants in the 10-min PCM group had a significant lower Tskin, Tcore, HR and RR at post-cooling, as well as greater reductions in mean skin temperature (ΔTskin) and core temperature (ΔTcore) from post-Bout1 to post-cooling. Additionally, the 10-min PCM group exhibited significantly lower peak Tcore, peak HR and RPE scale score during Bout2, while the average running speed during Bout2 was significantly higher. The present study suggests that cooling with a PCM cooling blanket can enhance physiological recovery and subsequent exercise performance in the heat.

Erector spinae muscle-based nomogram for predicting in-hospital mortality among older patients with severe community-acquired pneumonia

BackgroundNo multivariable model incorporating erector spinae muscle (ESM) has been developed to predict clinical outcomes in older patients with severe community-acquired pneumonia (SCAP). This study aimed to construct a nomogram based on ESM to predict in-hospital mortality in patients with SCAP.MethodsPatients aged ≥ 65 years with SCAP were enrolled in this prospective observational study. Least absolute selection and shrinkage operator and multivariable logistic regression analyses were used to identify risk factors for in-hospital mortality. A nomogram prediction model was constructed. The predictive performance was evaluated using the concordance index (C-index), calibration curve, net reclassification improvement (NRI), integrated discrimination improvement (IDI), and decision curve analysis.ResultsA total of 490 patients were included, and the in-hospital mortality rate was 36.1%. The nomogram included the following independent risk factors: mean arterial pressure, peripheral capillary oxygen saturation, Glasgow Coma Scale score (GCS), lactate, lactate dehydrogenase, blood urea nitrogen levels, and ESM cross-sectional area. Incorporating ESM into the base model with other risk factors significantly improved the C-index from 0.803 (95% confidence interval [CI], 0.761–0.845) to 0.836 (95% CI, 0.798–0.873), and these improvements were confirmed by category-free NRI and IDI. The ESM-based nomogram demonstrated a high level of discrimination, good calibration, and overall net benefits for predicting in-hospital mortality compared with the combination of confusion, urea, respiratory rate, blood pressure, and age ≥ 65 years (CURB-65), Pneumonia Severity Index (PSI), Acute Physiology and Chronic Health Evaluation II (APACHEII), and Sequential Organ Failure Assessment (SOFA).ConclusionsThe proposed ESM-based nomogram for predicting in-hospital mortality among older patients with SCAP may help physicians to promptly identify patients prone to adverse outcomes.Trial registrationThis study was registered at www.chictr.org.cn (registration number Chi CTR-2300070377).

COVID 19 Related Multisystem Inflammatory Syndrome in Children Admitted to PICU in Ain Shams University Hospitals

Background Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is typically very mild and often asymptomatic in children. A complication is the rare multisystem inflammatory syndrome in children (MIS-C) associated with COVID-19, presenting 4–6 weeks after infection as high fever, organ dysfunction, and strongly elevated markers of inflammation. Aim of the Work To evaluate the clinical profiles and risk factors for pediatric multisystem inflammatory syndrome in children with COVID-19 admitted to PICU. Patients and Methods This was a cross sectional study conducted on 45 patients admitted to pediatric intensive care unit (PICU) from June 2020 to August 2020, they were diagnosed as MIS-C cases according to CDC definition for MIS-C, using a score to assess hyperinflammatory syndrome, all patients were subjected to the following:(demographic data, clinical signs &amp; symptoms at presentation, sequential organ failure assessment (SOFA) score and laboratory investigations. Results In our study MIS-C patients presented with 100% Kawasaki disease(KD)-like symptoms and 62.2% gastrointestinal symptoms in addition to fever with shock or cardiac dysfunction. Our patients presented with the following vital data: 100% were tachycardic and hypotensive according to centiles, peripheral capillary oxygen saturation (spo2) mean 94.5(2) %, fever of mean 39(0.6) degree celsius and SOFA score mean of 9(2). KD-like features were variably seen in patients (skin rash in 55.6%, conjunctivitis in 46.7% and Cardiovascular abnormalities were seen in 100% e.g. (myocardial dysfunction, valvular regurgitation, coronary dilatation, pericardial effusion and shock). In our patients, 13 patients (28.9%) had comorbid conditions, like (hematologic e.g. ALL, Cardiac e.g. ASD&amp;VSD, Endocrinologic e.g. Diabetes mellitus), 4 of them died revealing comorbidities as a cause of higher mortality with significant p value (0.028). 39 patients (86.7%) were discharged and 6 patients (13.3%) died. Conclusion MIS-C is a hyper-infammatory syndrome affecting multiple organs and is triggered by SARS-CoV-2 infection. It is usually seen 2–4 weeks following infection. comorbidities significantly affected the short term outcome of the disease.

The severity of acute hypoxaemia determines distinct changes in intracortical and spinal neural circuits.

The purpose of this study was to examine how two common methods of continuous hypoxaemia impact the activity of intracortical circuits responsible for inhibition and facilitation of motor output, and spinal excitability. Ten participants were exposed to 2h of hypoxaemia at 0.13 fraction of inspired oxygen ( clamping protocol) and 80% of peripheral capillary oxygen saturation ( clamping protocol) using a simulating altitude device on two visits separated by a week. Using transcranial magnetic and peripheral nerve stimulation, unconditioned motor evoked potential (MEP) area, short-interval intracortical inhibition (SICI) and intracortical facilitation (ICF), and F-wave persistence and area were assessed in the first dorsal interosseous (FDI) muscle before titration, after 1 and 2h of hypoxic exposure, and at reoxygenation. The clamping protocols resulted in differing reductions in by 2h ( clamping protocol: 81.9±1.3%, clamping protocol: 90.6±2.5%). Although unconditioned MEP peak to peak amplitude and area did not differ between the protocols, SICI during clamping was significantly lower at 2h compared to clamping (P=0.011) and baseline (P<0.001), whereas ICF was higher throughout the clamping compared to clamping (P=0.005). Furthermore, a negative correlation between SICI and (rrm =-0.56, P=0.002) and a positive correlation between ICF and (rrm =0.69, P=0.001) were determined, where greater reductions in correlated with less inhibition and less facilitation of MEP responses. Although F-wave area progressively increased similarly throughout the protocols (P=0.037), persistence of responses was reduced at 2h and reoxygenation (P<0.01) during the clamping protocol compared to the clamping protocol. After 2h of hypoxic exposure, there is a reduction in the activity of intracortical circuits responsible for inhibiting motor output, as well as excitability of spinal motoneurones. However, these effects can be influenced by other physiological responses to hypoxia (i.e., hyperventilation and hypocapnia). NEW FINDINGS: What is the central question of this study? How do two common methods of acute hypoxic exposure influence the excitability of intracortical networks and spinal circuits responsible for motor output? What is the main finding and its importance? The excitability of spinal circuits and intracortical networks responsible for inhibition of motor output was reduced during severe acute exposure to hypoxia at 2 h, but this was not seen during less severe exposure. This provides insight into the potential cause of variance seen in motor evoked potential responses to transcranial magnetic stimulation (corticospinal excitability measures) when exposed to hypoxia.

Rate of perceived exertion and cardiovascular response of community dwelling older adults to six-minute walk test

Objectives: This study was designed to determine the rate of perceived exertion, cardiovascular responses of community dwelling older adults to six minutes' walk (6MWT) and possible gender difference.&#x0D; Methods: One hundred and three apparently healthy community dwelling older adults, aged 60 years and above participated in the study. Rate of perceived exertion (RPE) and cardiovascular responses (blood pressure, peripheral capillary oxygen saturation (SPO2 ) and pulse rate) were measured pre and post 6MWT.&#x0D; Results: There was a significant increase (p = 0.01) in RPE among all participants after the 6MWT. There was no significant difference (p&gt;0.05) in all the cardiovascular parameters pre and post 6MWT but with a significant difference in SPO2 between male and female participants. &#x0D; Conclusion: Among older adults, rate of perceived exertion after a 6MWT was sort of hard with possible influence on the Systolic Blood Pressure following 6MWT. Female participants showed higher oxygen saturation than males.

Non-invasive arterial blood pressure measurement and SpO2 estimation using PPG signal: a deep learning framework

BackgroundMonitoring blood pressure and peripheral capillary oxygen saturation plays a crucial role in healthcare management for patients with chronic diseases, especially hypertension and vascular disease. However, current blood pressure measurement methods have intrinsic limitations; for instance, arterial blood pressure is measured by inserting a catheter in the artery causing discomfort and infection.MethodPhotoplethysmogram (PPG) signals can be collected via non-invasive devices, and therefore have stimulated researchers’ interest in exploring blood pressure estimation using machine learning and PPG signals as a non-invasive alternative. In this paper, we propose a Transformer-based deep learning architecture that utilizes PPG signals to conduct a personalized estimation of arterial systolic blood pressure, arterial diastolic blood pressure, and oxygen saturation.ResultsThe proposed method was evaluated with a subset of 1,732 subjects from the publicly available ICU dataset MIMIC III. The mean absolute error is 2.52 ± 2.43 mmHg for systolic blood pressure, 1.37 ± 1.89 mmHg for diastolic blood pressure, and 0.58 ± 0.79% for oxygen saturation, which satisfies the requirements of the Association of Advancement of Medical Instrumentation standard and achieve grades A for the British Hypertension Society standard.ConclusionsThe results indicate that our model meets clinical standards and could potentially boost the accuracy of blood pressure and oxygen saturation measurement to deliver high-quality healthcare.

The Effects of Anti-platelets and Micronutrients in the Recovery of COVID-19 Patients: A Review.

COVID-19 or coronavirus disease is a pneumonia-like condition caused by the SARS-CoV2 virus. Many mutations of this virus have emerged throughout the two-year period of this pandemic. However, clinical presentations, diagnostic methods, and treatment of COVID-19 remain relatively unchanged. Various substances have been assessed for their functions as COVID-19 immunomodulators. Said substances in this article include aspirin, vitamin C, vitamin D3, zinc, and selenium. Aspirin was found to reduce mortality risk and embolism events. Vitamin C did not seem to improve mechanical ventilation-free days but did improve oxygenation (PaO2/FiO2), peripheral capillary oxygen saturation (SpO2), and body temperature in severe COVID-19 patients. Vitamin D3 was not significantly different compared to placebo in improving mortality in hospitalized patients. However, respiratory tract infection (COVID-19 included) events were lower in individuals given vitamin D3 compared to those who were not. Zinc combined with ascorbic acid caused a quick reduction in symptoms but was not significant compared to zinc alone, ascorbic acid alone, or standard care. Individuals with lower levels of selenium were found to have worse outcomes of COVID-19 compared to those with high levels of selenium. However, further studies, especially clinical trials, are needed. Asprinol is a drug that contains vitamins and minerals plus aspirin which are suggested to help alleviate symptoms and improve outcomes of COVID-19. This review aims to assess the efficacy of asprinol contents in COVID-19 patients.

Epidemiological Profile of Hospitalized Patients with Cystic Fibrosis in Brazil Due to Severe Acute Respiratory Infection during the COVID-19 Pandemic and a Systematic Review of Worldwide COVID-19 in Those with Cystic Fibrosis.

Since the onset of the coronavirus disease, COVID-19 pandemic, concern arose for those who might be at higher risk of a worse COVID-19 prognosis, such as those with cystic fibrosis (CF). In this context, we evaluated the features of hospitalized patients with CF due to severe acute respiratory infection (SARI) in Brazil and we also performed a systematic review including all the studies published from the beginning of the first case of COVID-19 (17 November 2019) to the date of this search (23 May 2022) which included, concomitantly, patients with CF and COVID-19 in the worldwide population. In our Brazilian data, we evaluated the period from December 2019 to March 2022, and we included 33 demographical and clinical patients' features. We classified the patients into groups: (G1) SARI due to another viral infection than severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (23; 5.4%), (G2) SARI due to an unknown etiological agent (286; 67.1%), and (G3) SARI due to SARS-CoV-2 infection (117; 27.5%). The individuals in G3 tended to be older, especially over 50 years old, and presented a higher prevalence of dyspnea, peripheral capillary oxygen saturation (SpO2) <95%, and cardiopathy. The highest prevalence for intensive care unit (ICU) treatment (52; 44.4%) and invasive mechanical ventilation (29; 24.8%) was for patients in G3. Almost half of the patients in G3 died (51; 43.6%); in contrast, none in G1 died. However, we observed 43 (15.0%) deaths in G2. In addition, 12 (4.2%) and one (0.9%) death not associated with SARI occurred, respectively, in the G2 and G3. The patients who died due to SARS-CoV-2 infection had a higher frequency of SpO2 <95% (46; 90.2%), ICU treatment (34; 66.7%), and invasive mechanical ventilation (27; 52.9%) when compared to those who recovered. The systematic review comprised a total of 31 papers published as observational studies. These studies comprised 661,386 patients in total, including children, adults, and elderly age groups. However, only 19,150 (2.9%) patients were diagnosed with CF and, from these patients, 2523 (0.4%) were diagnosed with both CF and COVID-19. It was observed that the most common outcome was the need for hospitalization (n = 322 patients with CF), and the need for oxygen support (n = 139 patients with CF). One hundred patients with CF needed intensive care units, fifty patients needed non-invasive mechanical ventilation support, and only three patients were described as receiving invasive mechanical ventilation support. Deaths were described in 38 patients with CF. Importantly, lung-transplanted patients with CF represented an increased risk of death in one publication; in accordance, another study described that lung transplantation and moderate to severe lung disease were independent risk factors for severe outcomes after SARS-CoV-2 infection. In contrast with the literature, in conclusion, Brazilian patients in G3 presented a severe phenotype, even though most of the other studies did not observe worse outcomes in patients with CF and COVID-19.

Behavioural and Physiological Effects of Oral Midazolam Premedication in Paediatric Dental General Anaesthesia: A Pilot Study

Children undergoing anesthesia, including dental treatment under general anesthesia (DGA), tend to develop severe preoperative anxiety. Oral Midazolam is one of the many premedications used in controlling behavior and reducing anxiety in children before general anesthesia. This study is aimed to evaluate the effect of oral midazolam premedication on recovery behavior and physiologic effects of children undergoing DGA. It involved thirty uncooperative children aged from 2 to 11 years old. Group I (n = 15): children received 0.5 mg/kg midazolam orally, while Group II (n = 15): children who did not receive any premedication. Their peripheral capillary oxygen saturation, respiratory rate, and heart rate were measured upon arrival at the post-anesthesia care unit. The recovery behavior was evaluated using the Modified Houpt Behavior Rating Scale. Fisher's Exact test and Mann-Whitney test were used for data analysis. There are no significant differences in both groups' post-behavior and physiologic parameters (p&gt;0.05). However, children in Group II reported tachycardia (13.3%, n= 2), hypoxemia (13.3%, n= 2), and bradypnea (13.3%, n= 2), compared to one case of bradypnea (6.7%) in Group I at 30 minutes. Although there were no significant differences between both groups (p&gt;0.05), Group I showed less movement and no crying reaction but was more awake—no significant association of premedication oral midazolam with successful recovery behavior (p=0.381). One child in Group II had an episode of vomiting. An interesting pattern of improved recovery behavior and physiology was identified among children receiving oral midazolam premedication. More research with a bigger sample size is needed to investigate the effect of oral Midazolam in pediatric DGA and to determine the optimal effect of premedication.

The effect of APRV-LTV mechanical ventilation mode on SpO2 and ventilation indices in patients with COVID-19

Background &amp; Aim: Mechanical ventilation is a life-saving method for acute respiratory distress syndrome. The present study aimed to investigate the impact of airway pressure release ventilation-low tidal volume mode on COVID-19 patients’ peripheral capillary oxygen saturation and ventilation indices.&#x0D; Methods &amp; Materials: This clinical trial was conducted on 70 COVID-19 patients hospitalized in the Intensive care unit in Qom, Iran. Patients were selected using convenience sampling and randomly allocated to intervention and control groups. In the control group, patients were ventilated using synchronized intermittent mandatory ventilation mode, and in the intervention group, patients were ventilated using airway pressure release ventilation-low tidal volume mode. Patients’ peripheral capillary oxygen saturation and ventilation indices were checked and recorded before and after the intervention. The data were analyzed using SPSS 11.5.&#x0D; Results: According to the results of the repeated-measures ANOVA test before the intervention and the 2 and 4 hours after the intervention, there were no significant differences between the intervention and control groups regarding the fraction of inspired oxygen, volume minute per minute, and peripheral capillary oxygen saturation (P&gt;0.05). However, in the intervention group compared to the control group, the mean of PIP was significantly reduced (P&lt;0.05).&#x0D; Conclusion: In patients with COVID-19, the two modes of mechanical ventilation, APRV, and control, had no significant differences in the fraction of inspired oxygen, volume minute per minute, and peripheral capillary oxygen saturation. However, the mean peak inspiratory pressure reduction in the intervention group was greater than that in the control group. Considering that several factors can affect peripheral capillary oxygen saturation and ventilation indices, these results should be considered with caution.

PRE-DISCHARGE SYSTOLIC BLOOD PRESSURE IN HOSPITALIZED COVID-19 PATIENTS IS AN INDEPENDENT PREDICTOR OF IMROVEMENT IN 6-MINUTE WALK TEST DURING 1-MONTH FOLLOW-UP

Objective: To study the relation of hypertensive status and systolic blood pressure (SBP) pre-discharge values to the dynamics of functional re-conditioning as assessed by 6-minute walk distance during the 1-month follow-up after hospitalization for COVID-19. Design and method: 6-minute walk distance (6MWD) was assessed pre-discharge in 176 patients hospitalized for COVID-19 (40% hypertensive, 47% male, mean age 53,2 ± 13,5 years) using the 20 m walkway and an extended protocol that included monitoring of peripheral pulse and capillary blood oxygen saturation (SpO2) every 30 seconds via bluetooth-connected pulse oximeter. The repeated evaluation was performed after 1 month of follow-up. Results: Hypertensive participants were characterised by older age (57,8±11,8 vs 50,7±13,9, p &lt; 0,001), higher weight and body mass index (31,7±5,3 vs 27,4±4,4 kg/m2, p &lt; 0,001). As a result, 6MWD in them was shorter (378±57 vs 418±75 m, p = 0,001) but no difference in reached percent of predicted distance (6MWD%) was detected (63,0±8,5 vs 63,2±11,1 %, p = 0,939). The described relation persisted at 1 month, with no difference in absolute (72±43 vs 68±43 m, p = 0,324) and percentage gain of 6MWD (12,8±6,6 vs 11,2±7,5 %, p = 0,266) between groups. Multiple regression analysis has allowed to build the model that accounted for 94% of variability in the 6MWD% gain between visits (85% for dedicated hypertensive cohort model). After adjustment for age, sex, height, weight, Remdesivir treatment, minimal SpO2 levels during acute COVID-19, changes of SpO2 and pulse rate throughout the 6MWT, SBP remained a potent independent predictor of 6MWD% gain, with 10 mmHg higher values at baseline evaluation being associated with 21,5% lesser 6MWD% gain in hypertensive subjects and 8,2% lesser – in normotensives. Conclusions: Hypertensive status did not have an impact on 6MWD% in pre-discharge COVID-19 patients. Moderate-to-high quality multiple regression models have demonstrated an independent role of SBP, demographic and anthropometric data, changes of SpO2 and pulse rate throughout the 6MWT in prediction of 6MWD% gain during 1 month after discharge, both in hypertensive and normotensive patients.

Evaluation of Peripheral Capillary Oxygen Saturation and Pulmonary Functions of Subjects Exposed to Soot in Yenagoa, Bayelsa State Nigeria

The present study reports for the first time, the effects of soot exposure on peripheral capillary oxygen saturation and pulmonary functions among residents of Yenagoa, Bayelsa State. In the present study, peripheral capillary oxygen saturation level and respiratory indices ie pulmonary functions were evaluated among soot exposed residents in Yenagoa, Nigeria and the values compared with apparently healthy residents of a less polluted region in the same city. A total of 300 subjects within the ages of 18 to 65 consisting of 200 subjects living within soot exposed areas and 100 subjects who live 2km away from the polluted environment. Using questionnaires, personal data of each participant were collected. The questionnaire focused on sex, age, height and weight, duration of stay in Yenagoa, oxygen saturation level, respiratory indices, pulse rate, smoking habit, pregnancy and lung conditions. Hospital scale balance and calibrated metre rule were used to collect their anthropometric data while oxygen saturation, pulse rate and respiratory indices were measured using Sp-10 pocket spirometer and Pulse oximeter.The results from the study population shows a significant decrease in PEFR, FEF and pulse rates of exposed subjects compared with the control. Meanwhile no statistical differences were observed in BMI, FVC, FEV1and oxygen saturation level between the exposed and the control subjects except the BMI of the exposed subjects across their various age groups. There was a negative correlation observed in the plot against age and BMI versus respiratory indices. This study shows that the subjects living within soot polluted environment possess lower lung function indices compared with those living two kilometres away from the polluted environment, in Yenagoa, Nigeria.

Evaluation of Peripheral Capillary Oxygen Saturation and Pulmonary Functions of Subjects Exposed to Soot in Yenagoa, Bayelsa State Nigeria

Evaluation of Peripheral Capillary Oxygen Saturation and Pulmonary Functions of Subjects Exposed to Soot in Yenagoa, Bayelsa State Nigeria

Evaluation of Peripheral Capillary Oxygen Saturation and Pulmonary Functions of Subjects Exposed to Soot in Yenagoa, Bayelsa State Nigeria

Evaluation of Peripheral Capillary Oxygen Saturation and Pulmonary Functions of Subjects Exposed to Soot in Yenagoa, Bayelsa State Nigeria