Significant Differences In Heart Rate Research Articles

A Comparative Study of the Effect of Dexmedetomidine-Fentanyl and Midazolam-Ketamine Combination on the Level of Sedation in Children undergoing Bone Marrow Biopsy

Background: This study aimed to compare the effect of dexmedetomidine-fentanyl (DF) and midazolam-ketamine (MK) combination on the level of sedation in children undergoing bone marrow biopsy.
 Methods: This study was a single-blind randomized clinical trial. The patients were divided into two groups of 35. Five minutes before undergoing bone marrow biopsy, the first group underwent sedation with a combination of 0.1 mg/kg midazolam with 1 mg/kg ketamine, and the second group underwent sedation with a combination of 2 μg/kg dexmedetomidine with 1 μg/kg fentanyl. The mean arterial pressure (MAP), heart rate, SpO2, the level of sedation, and the incidence rates of complications were recorded in both groups and compared to each other.
 Results: There was no significant difference between the two groups in terms of age (P= 0.687), gender (P= 1.00), and weight (P= 0.839). However, there was a significant difference in the average length of stay in recovery (P= 0.015) and surgeon satisfaction (P= 0.000), with a longer recovery period in the midazolam-ketamine (MK) group. The Repeated measures ANOVA showed significant differences in heart rate (P= 0.008), sedation score (P= 0.038), and the percentage of oxygen saturation (P= 0.00) during surgery.
 Conclusion: The combination of dexmedetomidine and fentanyl (DF) compared to the combination of midazolam and ketamine (MK) can provide more patient sedation and surgeon satisfaction along with more stable hemodynamics for patients undergoing bone marrow biopsy.

Electrocardiogram of pigs in sagittal bipolar leads

The similarity of porcine coronary circulation with humans [15], hemodynamic parameters [16] is suitable for using the porcine heart as an experimental model of cardiovascular diseases specific to humans. Pigs are a source of human valve bioprostheses [12]. Studies of pigs as donors for xenotransplantation have shown that it is impossible to unequivocally consider the heart of a pig to be identical to a human heart. The topography of the conducting system of the pig leads to significant differences in the sequence of depolarization of the heart ventricles, which must be taken into account when conducting electrocardiographic studies [3, 4].The aim of the study was to study the amplitude-temporal characteristics of the ECG in a normal pig. ECG in pigs was recorded in sagittal bipolar trunk leads according to Roshchevsky [7]. Animals were anesthetized with 1% solution of ventranquil (0,02 ml/kg), urethane (1,5 g/kg) intramuscularly. Heart rate in anesthetized pigs varied from 74 to 194 beats/min, the animals were divided into three groups. In the first group, animals with heart rate less than 100 beats/min, in the second from 100 to 150 beats/min, in the third more than 150 beats/min.In the course of the study, it was shown that in bipolar sagittal leads, the P-wave is positive single-phase; the most common configuration of the initial ventricular activity complex is rS; The T-wave is mostly positive. In animals from groups with significant differences in heart rate on the ECG in three bipolar sagittal leads, the shape and duration of the Q, R, S waves did not differ, the duration of the PQ and QT intervals differed significantly. The duration of the corrected QTc interval in animals with different heart rates practically did not differ.

Comparison of Different Carbon Dioxide Insufflation Rates on Hemodynamic Changes in Laparoscopic Surgeries: A Randomized Controlled Trial.

Introduction The injury and detrimental effects of carbon dioxide (CO2) insufflation during laparoscopic surgeries may be due to the higher flow rates used during insufflation. The aim of our study was to study the effects of different CO2 insufflation flow rates on hemodynamic parameters in laparoscopic surgeries. The secondary objectives were to compare the patient and surgeon satisfaction scores, postoperative shoulder scores, and surgical site pain scores. Methods This prospective, randomized, double-blinded trial was commenced after institutional ethical committee approval and The Clinical TrialsRegistry- India (CTRI) registration (CTRI 2021/10/037595). Ninety patients scheduled for laparoscopic cholecystectomy were randomly divided into three groups based on CO2 insufflation flow rate by computer-generated random numbers and the sealed envelope method: Group-A: 5 L/min; Group-B: 10 L/min; and Group-C: 15 L/min. General anesthesia was standardized in all three groups. Mean arterial pressure (MAP) and heart rate were recorded at different timelines, which included the arrival in the operating room (T0), just before the induction of anesthesia (T1), at the beginning of pneumoperitoneum (T2), 10 minutes (T3), 20 minutes (T4), 30 minutes (T5), and 60 minutes (T6) after the pneumoperitoneum, at the end of the operation (T7), five minutes (T8), and 15 minutes (T9) after arriving at the recovery room. The patient and surgeon satisfaction scores were assessed on a 5-point Likert scale. The visual analog score (VAS) was used to assess the surgical site pain and shoulder pain every four hours for 24 hours. The continuous data were assessed by one-way analysis of variance (ANOVA), and the categorical data were assessed by the Chi-square test. The sample size was estimated based on a pilot study and using the G Power 3.1.9.2 Program (Universitat Kiel, Germany) calculator. Results There was an increase in the mean arterial pressure (MAP) between the groups 60 min after pneumoperitoneum creation with higher flow rates. The baseline MAP was 85.76± 10.11 in group A, 86.03± 9.79 in group B, and 88.13± 8.46 in group C. At 60 min from the creation of the pneumoperitoneum, the MAP increased significantly from 99.17 ± 9.35 in group A, 102.43 ± 8.24 in group B, to 106.83 ± 8.31 in group C. This was statistically significant with a p-value of 0.004. There was a statistically significant difference in heart rate between the groups 10 minutes after pneumoperitoneum creation. No complications were reported in any of the groups. The postoperative shoulder pain was more severe when higher flows were used at 20 and 24 hours. The surgical site pain was also significantly more for up to 12 hours following surgery with higher flows. Conclusion We conclude that low-flow CO2 insufflation during laparoscopic surgeries is associated with fewer hemodynamic changes, better patient satisfaction scores, and lower postoperative pain scores.

Efficacy Evaluation of the Mahuang-Fuzi-Xixin Decoction in Combination with Shenmai Injection for Bradyarrhythmia Treatment: A Systematic Review and Meta-Analysis.

Bradyarrhythmia treatment is often not timely enough, posing a potential threat to health. It is necessary to find a strategy with stable curative effects and high safety. Mahuang-Fuzi-Xixin (MFX) decoction and Shenmai injection (SMI) are compound Chinese Patent Medicines. Recent evidence has shown that the combined use of these two drugs can effectively treat bradyarrhythmia. To evaluate the effect of MFX decoction combined with SMI on bradyarrhythmia. PRISMA was followed as the guideline for this systematic review. RevMan 5.4 software was applied for meta-analysis. Eight studies were included in the analysis, with a total of 340 patients in the intervention and control groups. The results of the meta-analysis showed that the effective rate of MFX combined with SMI treatment was higher than that of SMI alone (OR = 3.27, 95% CI (2.18, 4.89), P < 0.01); after treatment, MFX combined with SMI treatment and SMI alone had no significant difference in heart rate. In the subgroup of patients with an age less than 60, the effect of MFX combined with SMI treatment on the 24-hour mean heart rate was better than that of SMI alone (MD = 3.68, 95% CI (3.14, 4.22), P < 0.01), as did the 24-hour minimal heart rate (MD = 3.48, 95% CI (3.03, 3.93), P < 0.01). In addition, the effect of MFX combined with SMI treatment on the Traditional Chinese Medicine syndrome score (TCMSS) was significantly better than that of SMI alone (MD = -2.69, 95% CI (-3.10, -2.28), P < 0.01). In terms of safety, two adverse events were reported in the SMI combined with MFX group compared to 12 in the SMI alone group. MFX combined with SMI treatment is effective in treating bradyarrhythmia. However, the results were heterogeneous. The safety of MFX combined with SMI treatment should be verified and treated with caution.

PS-B02-12: EFFECTS OF ULTRAVIOLET LIGHT ON BLOOD PRESSURE AND LEFT VENTRICULAR FUNCTION

Ultraviolet light (UV), induces the activation of constitutive nitric oxide synthases, which produces nitric oxide (NO) of vascular relaxation factor. We hypothesize that UV-induced production of NO could have beneficial effect on hypertension. Twelve 6-week-old salt-sensitive hypertensive rats (Dahl-Iwai salt-sensitive DIS/Eis, Japan Society for the Study of Hypertension, Shizuoka, Japan) were used in this study. These rats were fed a high-salt diet containing 8%NaCl until 10 weeks of age and were then randomly divided into three groups i.e. baseline group (group non-UV), 0 h post UV (group UV 0 h), and 6 h post UV (group UV 6 h). The rats were irradiated with UVA and UVB lamps at an intensity of 100 mJ/cm2. Systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured by using tail-cuff method (BP-98A; Softron Co., Ltd., Tokyo, Japan). We evaluated left ventricular (LV) systolic and diastolic function using echocardiography with a 12 MHz transducer connected to a Xario ultrasound system (Toshiba Medical Systems Co., Tochigi, Japan). Interventricular septal thickness, LV posterior wall thickness, and LV end-diastolic and end-systolic diameters (LVDd and LVDs) were obtained from a short-axis view. Percent LV fractional shortening (%LVFS) was calculated as an index of LV systolic function. Peak flow velocities at the mitral level during rapid filling (E) and deceleration time (Dct), and peak early diastolic mitral annular velocity which indicate LV diastolic function, were measured using pulsed and tissue Doppler echocardiography. Histological skin tissue sections were fixed with 4% paraformaldehyde phosphate buffer solution for 24 h at room temperature, embedded in paraffin, sectioned transversely (thickness, 3 μm), and stained with hematoxylin-eosin to evaluate the impairments of skin. The SBP and DBP were lower in group UV 6 h than group non-UV and group UV 0 h. In contrast, there were no significant differences in heart rate and body weight among the three groups. The peak early diastolic mitral annular velocity was greater in group UV 6 h than group non-UV and group UV 0 h. LVDd, LVDs, and %LVFS were not significantly different among the three groups. We did not find the impairments in skin after UV irradiation. UVA and UVB may play an important role in regulating not only blood pressure but also LV function.

Sitting against Lateral Position for Spinal Anaesthesia in Elderly Patients Undergoing Lower Limb Surgeries: An Observational Study

Introduction: Age-related degenerative anatomical changes may make the spinal anaesthesia difficult. Sitting position is preferable due to easy identification of landmarks whereas lateral position is easy to maintain in case of elderly premedicated patients. Aim: To compare the effects of spinal anaesthesia position (sitting versus lateral) in the elderly patients on block characteristics (sensory and motor), haemodynamic parameters, patient’s comfort and satisfaction. Materials and Methods: The present prospective observational study was conducted in the Department of Anaesthesiology and Intensive care, Adesh Institute of Medical Sciences and Research, Bathinda, Punjab, India, from November 2021 to May 2022. A total of 116 American Society of Anaesthesiologists (ASA) grade I-II patients of both sexes, age more than 70 years undergoing lower limb surgeries under spinal anaesthesia either sitting or lateral position were included in the study. These patients were divided in to two groups (sitting position-Group SP, lateral position-Group LP). Hyperbaric bupivacaine (0.5%) was injected into the subarachnoid space. After the spinal injection, assessments were made for block characteristics (sensory and motor), haemodynamic parameters and patient’s comfort and satisfaction. The discrete and categorical variables were analysed using Chi-square test. Results: The mean age of participants in Group SP and Group LP was 77.31±4.015 years and 76.69±4.901 years, respectively. Onset of sensory block after was significantly slower in Group SP (75.31±10.384 seconds) as compared to Group LP (64.23±7.758 seconds). Time required to achieve maximum level of sensory block was significantly higher in Group SP (8.11±1.416 minutes) than Group LP (6.67±1.324 minutes). There was no significant difference in Heart Rate (HR) in both groups, but there was significantly lower Systolic Blood Pressure (SBP) in Group SP than Group LP up to 12 minutes after spinal injection. However, the lateral position appears to be more comfortable for elderly patients as per the comfort score. Conclusion: Position for spinal anaesthesia, either sitting or lateral, has insignificant effects on block characteristics or on haemodynamic parameters except there was faster onset of sensory and motor block and more comfort in lateral position.

Analgesic effect of pericapsular nerve group block on elderly patients undergoing hip replacement

Background/Aim. Pericapsular nerve group block (PNGB) does not affect the motor nerve while blocking the obturator and femoral nerves. The aim of the study was to determine the application value of PNGB for hip replacement in the elderly. Methods. Ninety elderly patients who underwent hip replacement from March 2019 to October 2020 were randomly divided into the fascia iliaca compartment block (FICB) group and the PNGB group. FICB and PNGB were performed prior to subarachnoid block (SAB). Their baseline data, operation conditions, incidence of adverse reactions, visual analog scale (VAS) score, heart rate (HR), mean arterial pressure (MAP), plasma cortisol (COR), and epinephrine (E) levels were compared. Results. VAS score, E, and plasma COR levels in the PNGB group were lower than those in the FICB group at time points T2?T4 (T2: 10 min after nerve block; T3: at position changing; T4: after position changing) (p &lt; 0.001). There were no significant differences in HR and MAP between the two groups at any time point (p &gt; 0.05). In the PNGB group, the ultrasonic imaging time was shorter, the time point of pressing patient-controlled analgesia (PCA) for the first time was later, and the numbers of pressing PCA were fewer than those of the FICB group (p &lt; 0.001). No local anesthetic poisoning took place after the nerve block, and no hematoma at the puncture site, nerve injury, nausea and vomiting, dizziness, or delirium occurred. Conclusion. Both FICB and PNGB prior to SAB were highly safe for hip replacement in the elderly; however, PNGB has shorter ultrasonic imaging time, better analgesic effect, and milder oxidative stress, so it is worth applying it clinically.

EFFECT OF HIGH INTENSITY INTERVAL TRAINING ON HEART FUNCTIONS AND EFFORT CAPACITIES OF CHILD ATHLETES

The purpose of this study was to determine the effect of intense interval training on heart functions and effort capacities of child athletes. Adolescent (n: 19) footballers who play in different football clubs, whose age average is 16.8±1.2 year and also whose ages vary between 15 and 18 year participated in this study. The footballers were given a pyramidal load training with the maximal running distances of 250 meters (m) -400 m-650 m-950 m with 60% -70% -80% load intensity for 8 weeks, 3 days a week, 1 hour per day. Participator athletes were assessed by electrocardiography (ECG), echocardiography, and effort test before and after the exercises. Paired sample t-test was utilized to comparatively evaluate the pretest and posttest results in statistical analyses. Left ventricular mass (LV mass), left ventricular mass index (LV mass index), V6 derivation R wave are significantly different in the posttest (p&amp;lt;0.05). There is a statistically significant difference in heart rate and diastolic blood pressure values at rest (p&amp;lt;0.05). Duration of exercises significantly increased in the effort test (respectively 17.2+2.9; 19.6+2 minutes; p&amp;lt;0.001). There also was observed a significant difference in metabolic equality values (MET) (respectively 20.4+3.1; 22.2+2.5; p&amp;lt;0.01). There was found a significant difference in heart functions and effort capacity in child athletes at the end of intense interval training. Performance was enhanced even with 1 hour of training for 3 days a week.

Efficacy of low-dose intravenous dexamethasone for prolongation of analgesia in supraclavicular block

BackgroundSupraclavicular block is a common technique for analgesia for upper limb surgeries. Because of short duration of analgesia with bupivacaine alone various additive have been used to prolong the action of bupivacaine. We conducted a prospective, randomized, double blind controlled trial. All patients were assessed for onset and duration of sensory and motor block, and postoperative pain relief.The present study was aimed to evaluate the efficacy of intravenous dexamethasone with supraclavicular block for prolongation of analgesia in patients posted for upper limb surgeries.ResultsFifty patients belonging to American Society of Anesthesiologist physical status I–II were divided into two groups (25 in each). A mixture of bupivacaine 0.5% (15 ml) + lignocaine-adrenaline 1.5% (15 ml) were given in both the groups by ultrasound guided supraclavicular block and 2 ml of IV normal saline in group C and 2 ml (8 mg) of IV dexamethasone in group D were given. The mean onset time of sensory and motor block was 8.68 ± 1.81 min and 11.12 ± 1.58 min in group D and 11 ± 2.34 min and 13.2 ± 1.65 min in group C respectively. The duration of sensory and motor block in group D (843.6 ± 62.56 and 576.8 ± 70.40) min were prolonged than to group C (281.28 ± 22.42 and 204.2 ± 12.96) min where P < 0.0001.The duration of analgesia in group D was (895.6 ± 43.98 min) as compared to group C (324.4 ± 27.36 min). At the end of 4 h, the difference of the mean VAS score was statistically significant in both the groups (P < 0.05). There was no statistically significant difference in heart rate and systolic blood pressure in both the groups.ConclusionsIntravenous dexamethasone significantly prolong the duration of analgesia in supraclavicular block without the side effects.

Designing Physical Education Courses Based on Musical Environment: Using Spinning as an Example.

The design of physical education (PE) lessons is an ongoing research project that encompasses elements such as teaching ideas, teaching objectives and teaching methods. Music is regarded as the pinnacle form of beauty and combining it with PE not only improves the effectiveness of PE lessons, but also increases the artistry of PE lessons. The purpose of this study is to examine the combination of music and cycling lessons in order to determine the effectiveness of cycling lessons in a musical environment. For study one, 95 undergraduate students were randomly selected to participate in the experiment in two conditions (M age = 20.00 years, SD = 1.00 years): (1) with music, (2) without music. For study two, 10 students were randomly selected to cycle in three study conditions: (1) synchronous music, (2) asynchronous fast music and (3) asynchronous slow music. Heart rate (HR), rating of perceived exertion (RPE), Exercise-Induced Feeling Inventory (EFI) and sport performance were measured. There were significant differences in HR, RPE, EFI and exercise performance between the two conditions with and without music, and the group with music performed higher than the group without music. In study two, ratings of perceived exertion were significantly lower for the synchronous music condition at 25, 30 min of the steady state portion of the cycling trials. No significant difference between conditions were found in HR, EFI and sport performance. An innovative fundamental model for teaching physical education courses in a musical environment was developed, including five sections: (1) selection of teaching mode, (2) setting of teaching objectives, (3) teaching process and content arrangement, (4) teaching evaluation and (5) precautions. With the addition of a musical environment, sport performance can be enhanced by triggering students' emotions and cognition.

MONITORAMENTO CARDIOVASCULAR NO TREINO DE ATLETAS CORREDORES DE LONGA DISTÂNCIA

ABSTRACT Introduction Strengthening research on cardiac function risk assessment in running sports is beneficial to prevent sport-related cardiovascular injuries and sudden deaths in sports. Objective To study changes in cardiovascular response in athletes after long-distance running. Methods Changes in cardiovascular response indicators of long-distance runners before and after the five-kilometer race were monitored. Analyzed indices included heart rate, blood pressure, hemoglobin, and a cardiac function index. Results There were no statistically significant differences in heart rate, blood pressure, and hemoglobin levels before and after the long-distance run (P&gt;0.05). There was no significant difference in the proportion of sinus arrhythmia before and after long-distance running (P&gt;0.05). Conclusion Long-distance running did not cause abnormal changes in blood indicators. No cardiovascular discomfort or changes in the electrocardiogram, heart rate, blood pressure, hemoglobin, and cardiac function index were reported. These young men were not enlisted, despite undergoing adaptive training. In conclusion, the five-kilometer run is safe for young men in the reserve. Evidence Level II; Therapeutic Studies - Investigating the result.

Determination of Waste Management Workers’ Physical and Psychological Load: A Cross-Sectional Study Using Biometric Data

Waste management workers experience high stress and physical strain in their work environment, but very little empirical evidence supports effective health management practices for waste management workers. Hence, this study investigated the effects of worker characteristics and biometric indices on workers' physical and psychological loads during waste-handling operations. A biometric measurement system was installed in an industrial waste management facility in Japan to understand the actual working conditions of 29 workers in the facility. It comprised sensing wear for data collection and biometric sensors to measure heart rate (HR) and physical activity (PA) based on electrocardiogram signals. Multiple regression analysis was performed to evaluate significant relationships between the parameters. Although stress level is indicated by the ratio of low frequency (LF) to high frequency (HF) or high LF power in HR, the results showed that compared with workers who did not handle waste, those who did had lower PA and body surface temperature, higher stress, and lower HR variability parameters associated with higher psychological load. There were no significant differences in HR, heart rate interval (RRI), and workload. The psychological load of workers dealing directly with waste was high, regardless of their PA, whereas others had a low psychological load even with high PA. These findings suggest the need to promote sustainable work relationships and a quantitative understanding of harsh working conditions to improve work quality and reduce health hazards.

Abstract 12865: Is Atrial Fibrillation in HFpEF a Distinct Endotype? Insights From Multiparametric MRI and Circulating Fibroinflammatory Markers

Introduction: Heart failure with preserved ejection fraction (HFpEF) and atrial fibrillation (AF) frequently occur in parallel. Whether this coexistence is associated with distinct alterations in myocardial remodelling and mechanics is not known. Methods: Adults with heart failure with an LV EF greater than 50% on echocardiography were prospectively recruited as part of the DIAMOND HFpEF study (NCT03050593). Participants underwent phenotyping including a panel of 49 fibroinflammatory plasma biomarkers, echocardiography and comprehensive stress cardiac MRI (CMR). Between group comparisons were adjusted for age, sex, ethnicity, body mass index (BMI), diabetes, systolic blood pressure and estimated glomerular filtration rate (eGFR). Results: 136 participants were included: sinus rhythm (n=75) and AF (n=61). Patients with AF were older (76 vs. 70 years), less ethnically diverse (minority ethnicity 7 vs. 24%) and had a lower prevalence of diabetes (36 vs. 61%). There were no significant differences in heart rate, blood pressure, BMI, eGFR, HbA1c, E/e’ or B-type natriuretic peptide, but AF patients had higher NTproANP (7704 vs. 5749pg/mL) and shorter E deceleration time (211±60 vs. 259±78ms). On CMR, ventricular volumes, mass, stress myocardial blood flow and myocardial fibrosis were similar, but those in AF had increased atrial volume (61±30 vs. 39±15mL/m 2 ), reduced systolic function (LV EF 63±8 vs. 68±8%; global longitudinal strain 13.6±2.9 vs. 14.7±2.4%, p=0.003) but higher diastolic strain rate (0.73±0.28 vs. 0.53±0.17/s, p&lt;0.001). Patients with AF had higher levels of syndecan-1, matrix metalloproteinase-2, proBNP and angiopoietin-2, but lower level of interleukin-8 (p&lt;0.05 for all; Figure 1). Conclusions: In HFpEF, AF is associated with lower systolic function but higher diastolic strain rate and a different fibroinflammatory profile compared to sinus rhythm. These findings may suggest that some patients with AF and HFpEF have a distinct endotype.

Value of high-flow oxygen therapy after weaning for successful extubation of critical ill patients with mechanical ventilation

To investigate the value of high-flow oxygen therapy after weaning in successful extubation of critically ill patients with mechanical ventilation. A retrospective study was conducted. The weaned patients who were older than 18 years old and underwent mechanical ventilation for the first time due to cerebrovascular accidents, surgical operations, cardiovascular diseases, and pneumonia admitted to the department of critical care medicine of Zhejiang Hospital from January 2018 to June 2020 were enrolled. Among the patients, 40 cases received high-flow oxygen therapy after weaning, and 37 cases received Venturi combined with the humidifier. The patient's gender, age, primary disease, severity score, duration of mechanical ventilation before weaning, heart rate (HR), blood pressure, pulse oxygen saturation (SpO2) at 0, 6, 12, 18, and 24 hours after weaning, and pH value, arterial partial pressure of oxygen (PaO2), arterial partial pressure of carbon dioxide (PaCO2) at 6, 12, 18, and 24 hours after weaning, the rate of performing mechanical ventilation after weaning, extubation time after weaning, and the rate of reintubation after extubation for 72 hours were collected. There was no significant difference in baseline data such as gender, age, primary disease, severity score, and duration of mechanical ventilation before weaning between the two groups. After weaning, the vital signs of the two groups were stable, and there was no significant difference in HR, systolic blood pressure (SBP), diastolic blood pressure (DBP) or SpO2 at each time point between the two groups. After weaning, the pH of arterial blood gas analysis in the two groups and the fluctuations of PaO2 and PaCO2 in the high-flow group were not obvious. In the Venturi group, PaO2 gradually decreased after weaning, PaCO2 increased significantly at 12 hours, and slowly decreased after 12 hours. The PaO2 from 6 hours and PaCO2 from 12 hours in the high-flow group were significantly lower than those in the Venturi group, and continued to 24 hours [PaO2 (mmHg, 1 mmHg ≈ 0.133 kPa): 112.34±38.25 vs. 156.76±68.44 at 6 hours, 110.92±38.66 vs. 150.64±59.07 at 12 hours, 111.12±36.77 vs. 141.30±39.05 at 18 hours, 110.82±39.37 vs. 139.65±41.50 at 24 hours; PaCO2 (mmHg): 41.30±7.51 vs. 47.42±7.54 at 12 hours, 40.97±6.98 vs. 45.83±8.63 at 18 hours, 40.10±7.06 vs. 46.14±9.15 at 24 hours, all P < 0.01]. The rate of performed mechanical ventilation after weaning and the rate of reintubation after extubation for 72 hours in the high-flow group were significantly lower than those in the Venturi group [17.5% (7/40) vs. 40.5% (15/37), 6.2% (2/32) vs. 31.8% (7/22), both P < 0.05], and the extubation time after weaning was significantly shorter than that in the Venturi group (hours: 22.43±11.72 vs. 28.07±10.42, P < 0.05). Using high-flow oxygen therapy to the extubation process of critically ill mechanical ventilation patients can reduce the incidence of carbon dioxide retention and the rate of performed mechanical ventilation after weaning, shorten the extubation time after weaning, and reduce the rate of reintubation after extubation for 72 hours.

ANALGESIC ЕFFECT OF 25% GLUCOSE AND NON-NUTRITIVE SUCKING IN TERM NEWBORNS – COMPATIVE ANALYSIS

Non-nutritive sucking and oral uptake of glucose 25% are often non-pharmacological methods used to manage procedural pain in newborns. Aim: To compare the effect of using non-nutritive suction (NNS) and Sol.Glucosae 25% for reducing/eliminating neonatal pain due to heel prick. Material and methods: Term infants were studied: group (A), NNS, n = 40, and group (B) oral uptake of Sol.Glucosae 25%, n = 40. The severity of procedural pain was assessed using the Neonatal Facial Coding System (NFCS) scale: 30 seconds before the procedure, at the 30th second and at the 5th minute after the procedure. Physiological pain markers were monitored at these intervals: respiratory, heart rate, transcutaneous saturation (tSpO2), arterial blood pressure. Results and Discussion: Newborns in a group (B) had a lower evaluation at the 5th minute compared to those treated with non-nutritive suckling(A). There are significant differences in heart rate, breathing frequency and before the procedure. The intake of Sol. Glucose 25% compared to NNS causes a higher heart rate and a decrease in at the 30th second after the painful procedure. In contrast to the heart rate, for respiratory rate and tSpO2 at 5th min. we reported lower than the norms in both groups A and B. Conclusion: Unlike NNS, glucose intake eliminates pain within 5 minutes after a heel prick. Excluding arterial blood pressure, all other physiological pain markers undergo changes before the procedure but not after it.

Active warm-up and time-of-day effects on repeated-sprint performance and post-exercise recovery.

This study investigated the effects of both an active warm-up and the time-of-day variation on repeated-sprint performance. A second objective was to compare the post-exercise recovery between theexperimentalconditions. Eleven male participants performed ten maximal cycling sprints (6s each, with a 30-s interval between them) in the morning and late afternoon, either after a warm-up or control condition. The warm-up consisted of cycling for 10min at 50% of the peak aerobic power. Rest measurements of rectal, muscle, and skin temperatures were higher in the afternoon compared to the morning (p < 0.05), with no significant differences in heart rate (p = 0.079) and blood lactate concentration (p = 0.300). Warm-up increased muscle temperature, heart rate, and lactate, and reduced skin temperature (all p < 0.001), though no significant differences were observed for rectal temperature (p = 0.410). The number of revolutions (p = 0.034, ηp2 = 0.375), peak (p = 0.034, ηp2 = 0.375), and mean (p = 0.037, ηp2 = 0.365) power of the first sprint (not the average of ten sprints) were higher in the afternoon compared to the morning, regardless of warm-up. However, beneficial performance effects of warming up were evident for the first (p < 0.001) and the average of ten sprints (p < 0.05), regardless of time of day. More remarkable changes during the 60-min post-exercise were observed for rectal temperature (p = 0.005) and heart rate (p = 0.010) in the afternoon than in the morning. Warming-up and time-of-day effects in enhancing muscular power are independent. Although warm-up ensured further beneficial effects on performance than the time-of-day variation, a faster post-exercise recovery was observed in the late afternoon.

Effects of Glucose Fluctuations on Electrocardiogram Readings and the Development of Ventricular Arrhythmia in Diabetic Rats

Objective: Many studies have shown that blood glucose fluctuations (GFs) are more harmful to patients with diabetes mellitus (DM) than sustained hyperglycemia. However, the effect of GF on electrocardiogram (ECG) parameters and vulnerability to ventricular tachycardia/fibrillation (VT/VF) remains poorly characterized. This study aimed to assess the effect of GF on ECG parameters and induction of VT/VF in streptozotocin (STZ)-induced diabetic Sprague-Dawley rats. Methods: Male Sprague-Dawley rats were injected with STZ and randomly divided into 3 treatment groups: controlled STZ-induced diabetic rats (C-STZ) (n = 10); uncontrolled STZ-induced diabetic rats (U-STZ) (n = 10); and STZ-induced diabetic rats with glucose fluctuations (GF-STZ) (n = 10). After 12 weeks, baseline ECG recordings were taken and a VT/VF test was performed with the administration of caffeine and dobutamine. Hematoxylin &amp; eosin and masson staining were used to evaluate pathological cardiac changes after intervention. Results: No significant difference in heart rate, RR interval, P wave (duration and height), PR segment, PR interval, QRS wave duration, and T wave height was observed among the 3 groups (P &gt; 0.05). Compared with the C-STZ group, the U-STZ and GF-STZ groups both had a longer T wave duration ((62.41 ± 2.38) ms vs. (78.37 ± 4.64) ms and (96.06 ± 4.60) ms, P &lt; 0.05), QT interval ((83.66 ± 2.31) ms vs. (101.75 ± 4.56) ms and (119.14 ± 4.88) ms, P &lt; 0.05), and QTc interval ((77.45 ± 1.36) ms vs. (91.36 ± 3.49) ms and (104.55 ± 3.01) ms, P &lt; 0.05), all of which were longest in the GF-STZ group (P &lt; 0.05). Additionally, the GF-STZ group had the highest VT/VF occurrence and duration and the highest arrhythmia score. Conclusion: This study revealed GF can significantly prolong the QT interval, QTc interval, and T wave duration, as well as increase vulnerability to VT/VF in rats, which may be an important electrophysiological mechanism of GF-related ventricular arrhythmia.

Evidence For Sustained Physiological Adaptation From A Single Exercise Bout At Simulated Altitude

Intermittent exposures to normobaric or hypobaric hypoxia have been used to provide enhancements to oxygen delivery capabilities in athletes and in some patient populations as well as in the pre-acclimatization of individuals. The body is capable of very rapid adjustments to this type of environmental stress. However, it is somewhat unclear if an acute exposure to this type of environmental stress is enough to produce evidence of adaptations. PURPOSE: To examine evidence for physiological adaptation after a single bout of exercise at simulated altitude (Stratosphere Hypobaric Training Chamber) as determined from heart rate (HR), peripheral oxygen saturation (SpO2) and the ratio of hemoglobin O2 (oxygen) saturation in the circulating peripheral blood relative to HR (SpO2/HR) response. METHODS: 11 subjects (6 male, 5 female, age 36.5 ± 12.9 yrs, height 173.6 ± 9.2 cm, weight 75.7 ± 14.5 kg) completed 2 hypobaric chamber visits. During both visits, subjects performed a 30 min bout of exercise on a cycle ergometer at the same simulated altitude (2 km n = 1, 3 km n = 2, 4 km n = 8). Based on subjects previous VO2max test results, the exercise was divided into a light to moderate intensity for the first 15 min (target 50-60% WMax), immediately followed by a higher intensity (target 70-80% WMax) for the second 15 min. There was an average of 10 ± 6 days between each testing visit. Statistical analyses included paired samples t-test (p ≤ 0.05). RESULTS: There were no significant changes in workload (p = 0.28) or SpO2 (p = 0.67) between the two visits. However, there was a significant difference in HR (p < 0.001) and SpO2/HR (p < 0.001). There was an average decrease in HR of 19 bpm (12%) from visit 1 (155 ± 17 bpm) to visit 2 (136 ± 26 bpm), along with a 16% average increase in SpO2/HR from visit 1 (0.55 ± 0.06) to visit 2 (0.64 ± 0.13). The average workload across both intensity levels and altitudes were 97 ± 38 W for Visit 1 and 103 ± 39 W for Visit 2, with an average SpO2 of 84 ± 5% for both visits. CONCLUSION: These findings indicate an adaptive response to a short aerobic exercise bout during simulated altitude exposure that appears to be sustained greater than one week after the initial visit. Whether this is linked to oxygen sensing, neurally mediated or suggests early adjustments in oxygen delivery pathways is unclear, but appear unrelated to age, sex or fitness level.

Effectiveness of low-dose ketamine versus lignocaine pre-treatment to prevent propofol injection pain and hemodynamic instability in adult elective surgical patients at Tikur Anbessa specialized hospital, 2022: A prospective observational cohort study

BackgroundPropofol is the most commonly used general anesthesia induction agent. It has injection pain and hemodynamic changes as a major drawback. These side effects are clinically undesirable because they can cause agitation and hinder the smooth induction of anesthesia. Determining the best method to reduce this effect is paramount important. This study aimed to compare the effectiveness of low dose ketamine versus lignocaine pre-treatment to prevent propofol injection pain and hemodynamic changes among study participants. MethodsAn institutional prospective cohort study was conducted on 82 (n1 = n2 = 41) adult elective surgical patients who took general anesthesia induction by propofol at our hospital from 01-Jan-2022 to30 Mar-2022. A systematic random sampling technique was used to select study participants. The pain was scored using a verbal rating scale and mean arterial pressure, heart rate and oxygen saturation was recorded during induction using a questionnaire. An independent samples t-test or chi-square test were used as appropriate. A P-value of < 0.05 was considered as statistically significant. ResultsTwo groups of 41 (LDK = low dose ketamine = Ld = Lignocaine = 41) patients were studied and the incidence of pain after pre-treatment with Low-dose ketamine (4.9%) group was significantly lower than lignocaine (22%) group (p = 0.023). The mean pain score after pre-treatment with low-dose ketamine group was significantly lower than the lignocaine group (p = 0.024). However, there was no statistically significant difference in heart rate, mean arterial pressure, and oxygen saturation (SpO2) between the groups. Conclusion and recommendationPre-treatment with a low dose of ketamine significantly reduces the incidence of propofol injection pain. We recommend its routine use before propofol injection ,and a multi-center more controlled study.

Effects of serial and acute enteric-coated sodium bicarbonate supplementation on anaerobic performance, physiological profile, and metabolomics in healthy young men.

BackgroundPrevious studies have reported that sodium bicarbonate ingestion may enhance high-intensity exercise performance and cause severe gastrointestinal distress. However, enteric-coated sodium bicarbonate may reduce gastrointestinal symptoms of sodium bicarbonate after oral administration. This remains to be confirmed. This study aimed to verify the effects of serial and acute enteric-coated sodium bicarbonate supplementation on anaerobic performance, physiological profile, and metabolomics in healthy young men.MethodsHealthy young males (n = 12) ingested 0.2 g/kg body mass of enteric-coated sodium bicarbonate (ES) in serial enteric-coated sodium bicarbonate (SES, continuous ES supplementation for 5 days) and acute enteric-coated sodium bicarbonate (AES, acute ES supplementation before exercise) or a placebo (PL) in a randomized crossover design. After each supplement protocol, the participants completed four Wingate anaerobic tests (WAT). The first three Wingate tests (testing anaerobic capacity) were performed with a 5-min passive recovery between each. After the third Wingate test, participants were required to complete a 50-min recovery followed by a fourth WAT test (testing the recovery of anaerobic capacity after 50-min intervals). Blood lactate (BLA), heart rate (HR), and ratings of perceived exertion (RPE) were measured in all conditions during the test, as was the subjective gastrointestinal–symptoms assessment questionnaire (GSAQ). Mean power (MP) and peak power (PP) were recorded after four WATs. Urine samples were collected before the test and 50 min after the 3rd WAT.ResultsSerial enteric-coated sodium bicarbonate supplementation improved anaerobic capacity in the third bout of WATs, as observed based on an increase in mean power (SES vs. PL (613 ± 57 vs. 542 ± 64 W), P = 0.024) and peak power (SES vs. PL (1,071 ± 149 vs. 905 ± 150 W), P = 0.016). Acute ES supplementation did not affect anaerobic capacity. The occurrence of gastrointestinal symptoms after enteric-coated sodium bicarbonate supplementation was minimal and no difference compared to placebo in the current study. In particular, serial enteric-coated sodium bicarbonate supplementation had no gastrointestinal side effects before the test. The AES and SES groups had a trivial effect on blood lactate compared to the PLA group. There was no significant difference in HR and RPE among the three groups. Based on targeted metabolomics analysis, the 50 min after the third WAT, the levels of lactate (P < 0.001), L-Malic acid (P < 0.05), and oxaloacetate (P < 0.05) were significantly higher in the SES group than in the PL group. Compared with the AES group, the levels of lactate and fumarate in the SES group were significantly increased (P < 0.05).ConclusionsOur study indicates that serial enteric-coated sodium bicarbonate supplementation positively improves anaerobic performance among healthy young men. However, acute ingestion of enteric-coated sodium bicarbonate did not improve anaerobic exercise performance. Either with serial or acute supplementation doses, enteric-coated sodium bicarbonate produced fewer gastrointestinal symptoms and no difference compared to placebo, especially with no gastrointestinal side effects after serial supplementation. Serial and acute supplementation of enteric-coated sodium bicarbonate might tend to promote lactate clearance. Furthermore, serial enteric-coated sodium bicarbonate ingestion may cause changes in the metabolism of lactate, L-Malic acid, oxaloacetate, and fumarate 50 min after exercise, which presumably may promote the tricarboxylic acid cycle and lactate clearance.