SpO2 Levels Research Articles

Safety and Efficacy of Incentive Spirometer in Covid-19 Pneumonia; a Randomized Clinical Trial.

Various treatment protocols have been recommended since the beginning of the COVID-19 pandemic and have gradually evolved. This study aimed to assess the effectiveness and safety of incentive spirometer exercise (ISE) in outcomes of hospitalized patients with moderate-to-severe COVID-19 pneumonia. A 3-month single-blind, two parallel-armed randomized controlled trial was conducted at Imam Hossein Hospital, Tehran, Iran. Participants aged >18 years with documented COVID-19 pneumonia were randomly allocated to 2 groups of IS (ISE in addition to the usual treatment) and control (usual care alone). The IS group was also asked to perform ISE after discharge for three months. The primary outcomes were peripheral O2 saturation (SpO2), VBG parameters (pCO2, PH, HCO3), dyspnea level measured by Modified Borg Scale (MBS), length of hospital stay (LOS), and respiratory rate (RR). Secondary outcomes included mortality rate, intubation rate (IR), and ICU admission rate. A total of 160 eligible patients were randomly assigned to either the IS (n = 80) or control (n=80) groups. Although there were no significant differences in primary and secondary outcomes between the groups post-intervention, adjusted analysis showed that participants allocated to the IS group had significantly higher SpO2 levels and lower RR, MBS levels, and LOS. Also, the adjusted model analysis showed a marginal statistically significant difference between groups in secondary outcomes, such as IR, the 1-month mortality rate, and the 3-month mortality rate. It seems that adding the ISE to usual care in the early treatment setting of COVID-19 patients resulted in a relatively significant increase in SpO2 levels, improved respiratory status, and marginally decreased LOS. Additionally, ISE minimally reduced ICU admissions and intubation rates, with no significant impact on in-hospital or long-term mortality in patients with COVID-19 pneumonia.

Averaging Times for Pulse Oximeter Measurements - A Review of Manuscripts Published in the Top Five Sleep Medicine Journals.

Clinical management decisions often rely on a patient's SpO2 level and desaturation rate. Limitations include that measurements depend on the averaging time (AVT) used, which is particularly relevant to sleep medicine, but has yet received little attention. Cross-sectional review of studies reporting pulse oximeter saturation (SpO2) measurements published in 5 leading sleep medicine journals. All papers published between 2017 and 2023 reporting SpO2 measurements were screened regarding the AVT used. Of 193 papers identified, 151 were included; of these, only 9 studies mentioned the AVT, 4 of these were published in one journal. The AVT ranged from zero (beat-to-beat-mode) to 10s, with 3s being used most often (33.3%), followed by 2s (22.2%). The AVT is only rarely mentioned in sleep medicine papers, despite its influence on sleep study results. Reported AVTs were heterogenous. Further research is warranted to set up guidelines for using or reporting the AVT.

Comparison of Efficacy of a Novel Dual Channel Gastro Laryngeal Mask Airway versus Nasal Prongs for Airway Management in Day Care Gastrointestinal Endoscopy Procedures: A Randomised Clinical Study

Introduction: The Gastro Laryngeal Mask Airway (LMA) is a newer supraglottic airway device specifically designed for Gastroinstestinal (GI) endoscopy procedures. Hypoxia is a common complication in endoscopy procedures performed under sedation without securing the airway. The Gastro LMA allows for oxygenation, ventilation, and the passage of a gastroscope through its integrated endoscope channel. Aim: To evaluate the utility of the Gastro LMA compared to nasal prongs in maintaining oxygenation and airway control during upper GI endoscopy procedures. Materials and Methods: The present double-blinded randomised, single-centre clinical study conducted in the Department of Anaesthesiology, GCS Medical College Hospital and Research Centre, Ahmedabad, Gujarat, India included 50 adult patients scheduled for elective GI endoscopy procedures in the supine or lateral position. The patients were divided into two equal groups: Group G (Gastro LMA) and Group N (Nasal prong). Preprocedural heart rate and SpO2 levels were noted. All patients were observed for hypoxia (SpO2 <92%), bradycardia, lowest heart rate and Saturation of Peripheral Oxygen (SpO2 ) levels, conversion to endotracheal intubation, and any other intraoperative adverse events. Postoperatively, patients were observed for four hours for adverse effects and discharged after assessment using the modified Aldrete’s score. Statistical analysis was performed using Statistical Package for Social Sciences (SPSS) version 26.0, and the results were expressed as percentages, mean ± SD, and p-values. Results: Out of the 50 patients, 23 were male and 27 were female, with a median age of 59 years. The preprocedural mean lowest heart rate in Group G was 68/min, and in Group N it was 64/min. The mean lowest SpO2 during the procedure was 94% in Group N and 96% in Group G. In Group N, two patients (8%) required conversion to endotracheal intubation. One patient had a longer duration of the procedure and experienced bronchospasm, while another patient with Chronic Obstructive Pulmonary Disease (COPD) developed bronchospasm. In Group G, one patient (4%) required endotracheal intubation, possibly due to increased intrabdominal pressure caused by air insufflation in an obese patient. Conclusion: In patients undergoing gastrointestinal endoscopy procedures, the Gastro LMA appears to be effective for clinical use. It provides good airway control and enables deeper sedation without respiratory compromise. Ventilation was well maintained with minimal intraoperative and postoperative adverse events.

Evaluating the factors affecting clinical outcomes in critically ill COVID-19 unvaccinated patients admitted to the intensive care unit in a lower-middle-income country.

COVID-19, the most destructive pandemic of this century, caused the highest mortality rate among ICU patients. The evaluation of these patients is insufficient in lower-middle-income countries with limited resources during pandemics. As a result, our primary goal was to examine the characteristics of patients at baseline as well as their survival outcomes, and propose mortality predictors for identifying and managing the most vulnerable patients more effectively and quickly. A prospective analysis of COVID-19 ICU-admitted patients was conducted in our healthcare centre in Iran, from 1 April until 20 May 2020. Ninety-three patients were included in the study, and all were unvaccinated. A multi-variate logistic regression was conducted to evaluate mortality-associated factors. There were 53 non-survivors among our ICU-admitted patients. The mean duration from symptoms' onset to hospitalization was 6.92 ± 4.27 days, and from hospitalization to ICU admission was 2.52 ± 3.61 days. The average hospital stay for patients was 13.23 ± 10.43 days, with 8.84 ± 7.53 days in the ICU. Non-survivors were significantly older, had significantly lower haemoglobin levels and higher creatine phosphokinase levels compared to survivors. They had marginally lower SpO2 levels at admission, higher vasopressor administrations, and were intubated more significantly during their ICU stay. The use of immunosuppressive drugs was also significantly higher in non-survivors. Logistic regression revealed that a one-point increase in APACHE II score at ICU admission increased mortality by 6%, and the presence of underlying diseases increased mortality by 4.27 times. The authors presented clinical mortality prediction factors for critically ill patients infected with COVID-19. Additional studies are necessary to identify more generalized mortality indicators for these patients in lower-middle-income countries.

Brain-derived neurotrophic factor in the acute and early recovery period of ischemic stroke: the role of nocturnal hypoxemia

To study the relationship between brain-derived neurotrophic factor (BDNF) and the severity of nocturnal hypoxemia in patients in the acute and early recovery period of ischemic stroke (IS). We enrolled 44 patients (27 men, 17 women), aged 18-85 years, in the acute phase of IS. At 3-month follow-up, 35 people were examined (21 men and 14 women). In the acute period, in addition to routine diagnostic procedures, respiratory monitoring was carried out, and the serum level of BDNF was measured by enzyme-linked immunosorbent assay. BDNF level was also evaluated at 3-month follow-up visit. Neurological status and its dynamics in the acute period of stroke were assessed as part of the clinical routine according to the National Institutes of Health Stroke Scale (NIHSS) at admission and discharge. We found a direct correlation between the duration of hypoxemia with SpO2 less than 90% (r=0.327, p=0.035) and less than 85% (r=0.461, p=0.003) and BDNF level in the acute phase of IS. BDNF level in the acute period of IS was negatively correlated with the minimum saturation value (r=-0.328, p=0.034). There was a direct relationship between BDNF level in the early recovery period and the duration of hypoxemia with SpO2 less than 85% (r=-0.389, p=0.028). A regression model showed that BDNF level was associated with the minimum SpO2 level. No significant associations were found with indicators of sleep-disordered breathing severity, such as the apnea-hypopnea index and the oxygen desaturation index. The severity of nocturnal hypoxemia is associated with the increase in BDNF levels both in the acute and recovery periods of IS, regardless of the presence of concomitant breathing disorders during sleep.

Wavelet transform generated inherent noise reference for adaptive filtering to de-noise pulse oximeter signals

As exemplified during the COVID-19 pandemic and in post-operative intensive care units, monitoring blood oxygen saturation (SpO2) levels is crucial in terms of assessing a patient?s health condition. Due to random movements of the subject, a pulse-oximeter-driven photoplethysmographic (PPG) signal becomes noisy while recording, with motion artefacts (MAs), which will disturb the morphological features, leading to incorrect SpO2 levels. The MA noise may contain either low- or high-frequency components, resulting in a scenario with inband and out-of-band noise. The reduction of in-band noise with an adaptive filter requires a reference signal, and an additional sensor such as an accelerometer is normally used in addition to the PPG sensor to capture the MAs. The present work focuses on the generation of a reference for inherent noise using a wavelet transform (WT), thereby eliminating the need for an external sensor. The computed values of the correlation coefficient and magnitude squared coherence are used to establish the validity of the generated inherent noise reference. Our WT-driven adaptive filtering method reduces MAs, simplifies the correct approximation of the SpO2 and heart rate, and also restores the respiratory components. The de-noised PPG signals presented here and a corresponding numerical study prove the usefulness of the proposed method, which has a worstcase accuracy of 0.5% in regard to SpO2 estimations.

Acute Effects of Myofascıal Release Exercıse Periods on Circulatory Parameters in Young Archers

The aim of this study was to investigate the acute effects of different myofascial release exercise durations on heart rate, saturation and blood pressure values in young archers. For this purpose, a total of 12 young athletes aged 16-18 years were included in the study. Myofascial release exercises using foam rollers were applied to the participants on different days. The inclusion criteria were determined as being healthy, not having a chronic disease, not having any medication used continuously and being interested in active archery sport. Control (T1), experimental (T2), and experimental (T3) foam rollers for 30 seconds and 60 seconds, respectively, were applied to the young archers on different days and heart rate, SpO2 levels and blood pressure values were measured after the applications. SPSS 22.0 programme was used to analyse the data obtained. One-way analysis of variance and LSD tests for repeated measures were performed to determine the difference between the groups of the application results. As a result of the analysis, no statistical significance was found in the saturation values, diastolic and systolic blood pressure values of the groups (p>0.05). There was statistical significance between T1 and T3 groups in the heart rate in favour of T3 (p<0.05). Myofascial release exercises affected the heart rate in terms of the parameters evaluated in long-term applications. It can be said that this change is a result of the energy and effort expended.

The Accuracy of Pulse Oxygen Saturation, Heart Rate, Blood Pressure, and Respiratory Rate Raised by a Contactless Telehealth Portal: Validation Study.

The traditional measurement of heart rate (HR), oxygen saturation (SpO2), blood pressure (BP), and respiratory rate (RR) via physical examination can be challenging, and the recent pandemic has accelerated trends toward telehealth and remote monitoring. Instead of going to the physician to check these vital signs, measuring them at home would be more convenient. Vital sign monitors, also known as physiological parameter monitors, are electronic devices that measure and display biological information about patients under constant monitoring. The purpose of this study was to validate the accuracy of the pulse SpO2, HR, BP, and RR raised by Docsun Telehealth Portal by comparing it with approved medical devices. This is a noninvasive, self-check, system-based study conducted to validate the detection of vital signs (SpO2, HR, BP, and RR) raised by Docsun Telehealth Portal. The input for software processing involves facial screening without any accessories on the face, scanning directly through the software application portal. The participant's facial features are detected and screened for the extraction of necessary readings. For the validation of HR, SpO2, BP, and RR measurements, the main outcomes were the mean of the absolute difference between the respective investigational devices and the reference values as well as the absolute percentage difference between the respective investigational devices and the reference values. If the HR was within ±10% of the reference standard or 5 beats per minute, it was considered acceptable for clinical purposes. The average absolute difference between the Docsun Telehealth Portal and the reference values was 1.41 (SD 1.14) beats per minute. The mean absolute percentage difference was 1.69% (SD 1.37). Therefore, the Docsun Telehealth Portal met the predefined accuracy cutoff for HR measurements. If the RR was within ±10% of the reference standard or 3 breaths per minute, it was considered acceptable for clinical purposes. The average absolute difference between the Docsun Telehealth Portal and the reference values was 0.86 breaths per minute. The mean absolute percentage difference was 4.72%. Therefore, the Docsun Telehealth Portal met the predefined accuracy cutoff for RR measurements. SpO2 levels were considered acceptable if the average absolute difference between the Docsun Telehealth Portal and the reference values was ±3%. The mean absolute percentage difference was 0.59%. Therefore, the Docsun Telehealth Portal met the predefined accuracy cutoff for SpO2 measurements. The Docsun Telehealth Portal predicted systolic BP with an accuracy of 94.81% and diastolic BP with an accuracy of 95.71%. The results of the study show that the accuracy of the HR, BP, SpO2, and RR values raised by the Docsun Telehealth Portal, compared against the clinically approved medical devices, proved to be accurate by meeting predefined accuracy guidelines.

Prospective clinical validation of the Empatica EmbracePlus wristband as a reflective pulse oximeter.

Respiratory diseases such as chronic obstructive pulmonary disease, obstructive sleep apnea syndrome, and COVID-19 may cause a decrease in arterial oxygen saturation (SaO2). The continuous monitoring of oxygen levels may be beneficial for the early detection of hypoxemia and timely intervention. Wearable non-invasive pulse oximetry devices measuring peripheral oxygen saturation (SpO2) have been garnering increasing popularity. However, there is still a strong need for extended and robust clinical validation of such devices, especially to address topical concerns about disparities in performances across racial groups. This prospective clinical validation aimed to assess the accuracy of the reflective pulse oximeter function of the EmbracePlus wristband during a controlled hypoxia study in accordance with the ISO 80601-2-61:2017 standard and the Food & Drug Administration (FDA) guidance. Healthy adult participants were recruited in a controlled desaturation protocol to reproduce mild, moderate, and severe hypoxic conditions with SaO2 ranging from 100% to 70% (ClinicalTrials.gov registration #NCT04964609). The SpO2 level was estimated with an EmbracePlus device placed on the participant's wrist and the reference SaO2 was obtained from blood samples analyzed with a multiwavelength co-oximeter. The controlled hypoxia study yielded 373 conclusive measurements on 15 subjects, including 30% of participants with dark skin pigmentation (V-VI on the Fitzpatrick scale). The accuracy root mean square (Arms) error was found to be 2.4%, within the 3.5% limit recommended by the FDA. A strong positive correlation between the wristband SpO2 and the reference SaO2 was observed (r = 0.96, P < 0.001), and a good concordance was found with Bland-Altman analysis (bias, 0.05%; standard deviation, 1.66; lower limit, -4.7%; and upper limit, 4.8%). Moreover, acceptable accuracy was observed when stratifying data points by skin pigmentation (Arms 2.2% in Fitzpatrick V-VI, 2.5% in Fitzpatrick I-IV), and sex (Arms 1.9% in females, and 2.9% in males). This study demonstrates that the EmbracePlus wristband could be used to assess SpO2 with clinically acceptable accuracy under no-motion and high perfusion conditions for individuals of different ethnicities across the claimed range. This study paves the way for further accuracy evaluations on unhealthy subjects and during prolonged use in ambulatory settings.

Effect of Wearing a Face Mask on the 6-Minute Walk Test in Healthy Volunteers

Objective: This study aimed to examine the influence of wearing different types of face masks on the results of the 6-Minute Walk Test (6MWT) in a cohort of healthy volunteers. Materials and Methods: Volunteers were partitioned into three groups (each comprising 36 individuals) with different mask-wearing conditions: NIOSH-approved N95 mask, and double-mask scenarios featuring two layers of surgical mask, and a combination of a surgical mask covered by a cloth face mask. Each participant performed two rounds of the 6MWT, one while wearing a mask and another without. Various metrics, such as the six-minute walk distance (6MWD), oxygen saturation (SpO2), and dyspnea and fatigue scores, were measured. Results: No significant differences were found in the 6MWD results between the mask-wearing and non-mask-wearing scenarios across all the mask types.Strong positive correlations were also established between the 6MWD results in the mask-wearing and non-mask-wearing conditions. However, a small cohort experienced dyspnea significantly more when wearing double surgical masks compared to not wearing a mask. Additionally, there were no major deviations in SpO2 levels or fatigue scores regardless of the type of mask used. Conclusion: The study indicated that wearing an N95 mask, or double surgical masks, or cloth-over-surgical face masks did not significantly influence the outcomes of the 6MWT in healthy individuals. However, caution is advised in the case of wearing double surgical masks, as this may induce a greater sense of dyspnea. This suggests that face masks can be worn safely during physical fitness and pulmonary function assessments, aligning with their essential role in viral spread prevention in daily life.

Association between transcutaneous oxygen saturation within 24 h of admission and mortality in critically ill patients with non-traumatic subarachnoid hemorrhage: a retrospective analysis of the MIMIC-IV database.

In critically ill patients, transcutaneous oxygen saturation (SpO2) upon admission is typically associated with in-hospital mortality. Nevertheless, the available information for patients with non-traumatic subarachnoid hemorrhage (SAH) is limited. In our study, our objective was to assess the correlation between SpO2 levels and mortality among patients diagnosed with severe SAH. In this study, we extracted data from the Medical Information Marketplace in Intensive Care (MIMIC-IV) database, which comprises information on critically ill patients. By employing matching ICD-9 and ICD-10 codes, we identified 3,328 patients diagnosed with SAH. Every individual who was admitted to the intensive care unit (ICU) had their SpO2 data and various covariates, including age, sex, diagnosis, and duration of stay, recorded upon admission. Subsequently, the patients were categorized into three distinct groups according to their SpO2 levels: low (≤95%), moderate (95-98%), and high (≥98%). To investigate the association between percutaneous oxygen saturation and mortality in patients with severe SAH, logistic regression, and cubic spline models were utilized. The main outcomes of interest were 28- and 90-day mortality rates. Additionally, subgroup analyses were conducted to evaluate these correlations and assess the consistency of interactions. A cohort of 864 patients diagnosed with non-traumatic SAH was included in this study. The correlation between SpO2 and mortality displayed a U-shaped curve when utilizing a finite cubic spline function (non-linearity < 0.001), with the nadir in the probability of in-hospital death at 96%. Mortality at 28 and 90 days showed an inverse correlation with SpO2 < 96% (adjusted odds ratio [OR], 0.8; 95% confidence interval [CI], 0.67-0.95, and 0.76; 95% CI, 0.6-0.96). Conversely, there was a positive correlation between percutaneous oxygen saturation (SpO2) levels of ≥96% and mortality rates at both 28 and 90 days (adjusted OR, 1.17; 95% CI, 1.02-1.35 and 1.2; 95% CI, 1.05-1.39). In patients with severe subarachnoid hemorrhage, the association between SpO2 and mortality at 28 and 90 days demonstrated a U-shaped pattern. When SpO2 levels were between 95 and 98%, both short- and long-term mortality rates were at their lowest. Patients with significant subarachnoid hemorrhage had a lower chance of survival when their SpO2 values were either high or low.

A COMPARISON OF MIDAZOLAM AND MINI DOSE SUXAMETHONIUM TO FACILITATE LARYNGEAL MASK AIRWAY INSERTION DURING PROPOFOL ANESTHESIA

This study aimed to compare the effectiveness of two different drug combinations used for general anesthesia during laryngeal mask airway (LMA) insertion. One group received Propofol-Midazolam (PM), and the other Propofol-Suxamethonium (PS). The study assessed pre-insertion conditions like mouth opening, gagging, coughing, patient movements, and laryngospasm, as well as hemodynamic parameters such as systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP) and heart rate (HR) in both groups. It also studied patient responses after LMA insertion, including apnea, cyanosis, desaturation (SpO₂ &lt; 90%), aspiration/regurgitation, and airway injury. The primary objectives of the study were to compare the ease and success of LMA insertion when using Propofol with Midazolam and Propofol with low-dose suxamethonium and to compare variations in hemodynamic and the occurrence of complications during and after LMA insertion. The study included 110 male and female patients aged 18-40, classified as ASA 1 &amp; 2, and scheduled for surgery under general anesthesia. The patients were randomly assigned to the PM and PS groups, and non-probability sampling was employed. In the PM group, patients were given intravenous midazolam (0.04 mg/kg) four minutes before induction with propofol (2.5 mg/kg), while in the PS group, patients received suxamethonium (0.1 mg/kg) 30 seconds after induction with propofol (2.5 mg/kg). Nalbuphine (0.1 mg/kg) was administered to all patients as an analgesic before surgery. The adequacy of anesthesia was assessed by the loss of response to verbal commands and the absence of excitatory movements. Patients were evaluated for their response to LMA insertion attempts, including the absence of excitatory movements, mouth opening, and the number of attempts required. Patient responses to gagging, coughing, movements, laryngospasm, desaturation, and apnea duration were noted. Hemodynamic changes before induction, as well as before and after LMA insertion, were recorded. Data was entered into SPSS version 15, and the mean standard deviation was calculated for age, weight, SBP, DBP, MAP, HR, SpO₂, and apnea duration. Qualitative and quantitative data were analyzed using the chi-square test and t-test, respectively, with significance set at a p-value &lt; 0.05. Laryngeal masks were successfully inserted into the hypopharynx in the first attempt in 100% of patients in both the PM and PS groups. Gagging and patient movements were observed in only 4 (7.27%) out of 55 patients in the PM group. Hemodynamic variations more significant than 20% from baseline (before anesthesia induction) were compared before and after LMA insertion. Significant differences between the PM and PS groups were observed in SBP, DBP, MAP, and HR (p &lt; 0.05). The apnea duration was 2.10 ± 1.51 minutes in the PM group and 1.01 ± 0.49 minutes in the PS group, with a significant p-value of 0.044. However, there were no cases of SpO₂ falling below 90% in either group. The study concluded that midazolam and a small dose of suxamethonium during propofol anesthesia were comparable in terms of ease and success of LMA insertion. The PM group exhibited better hemodynamic stability than the PS group, except for apnea duration, which was shorter in the PS group. There was no significant difference in SpO₂ levels between the two groups.

The Impact of Neck Cooling on Serum Oxidant/Antioxidant Status and HSP70 Levels during High-Intensity Cycling.

Numerous studies have been conducted in an attempt to discover cooling strategies that can be effective in improving exercise performance. However, the mechanism by which neck cooling relieves exercise-induced physiological stress and the optimal cooling temperature are unclear. This study aimed to investigate the effects of neck cooling at different temperatures during high-intensity cycling on body temperature, physiological variables, oxidant/antioxidant status, heat shock protein (HSP) 70 levels, and exercise performance in adolescent athletes. Seven well-trained male adolescent cyclists (age, 17.00 ± 0.76 years; athletic career, 3.86 ± 0.90 years) participated in three exercise trials involving three cooling regimens: control (CON), low-temperature (7 °C) neck cooling (LNC), and mixed-temperature (14 + 20 °C) neck cooling (MNC). The experimental condition used a cross-over design to minimize adaption to the repetitive cycling trials. Cycling consisted of a 20 km warm-up session and a two 2 km race session. Neck cooling at different temperatures was administered for 20 min during each rest period: after the warm-up, after the first 2 km race, and after the second 2 km race. Blood samples were taken to assess serum malondialdehyde (MDA), superoxide dismutase (SOD), and HSP70 levels. In addition, tympanic temperature (Tty), thermal sensation (TS), heart rate (HR), and the saturation of percutaneous oxygen (SpO2) were measured before, immediately after, and 24 h after exercise. As a measure of cycling performance, the race record and speed were measured in the first and second 2 km races. In all trials, Tty, TS, HR, MDA, SOD, and HSP70 levels significantly increased (p < 0.05), and SpO2 levels significantly decreased (p < 0.05). TS significantly decreased 24 h after exercise compared to that immediately after exercise in the LNC and MNC trials (p < 0.05). Serum HSP70 levels were significantly higher 24 h after exercise (0.87 ± 0.10 ng/mL) than immediately after exercise (0.79 ± 0.04 ng/mL) in the CON trial (p < 0.05). Twenty-four hours after exercise, the CON (0.87 ± 0.10 ng/mL) trial showed significantly higher serum HSP70 levels than the LNC (0.73 ± 0.01 ng/mL) trial (p < 0.05). There was no significant difference in cycling race record or speed between the trials (p > 0.05). Our findings suggest that neck cooling can induce a positive effect on thermal perception during recovery after cycling and that neck cooling at a relatively low temperature may be more effective in reducing exercise-induced HSP70 expression.

Abstract 12720: A Nationwide Multi Center Study From China, Comparing Long-Term and Standard Cardiopulmonary Resuscitation: Epidemiology, Risk Factors, and Outcomes

Introduction: The association between the duration of cardiopulmonary resuscitation (CPR) and patient outcomes remains largely unknown. Hypothesis: long-term CPR (LCPR) may benefit certain group of patients. Methods: In this retrospective cohort study, data from the Chinese Emergency Triage Assessment and Treatment database 1.0 (CETAT 1.0) were utilized. The study included CA patients admitted to 14 teaching hospitals in 7 provinces between July 2015 and July 2020. Patients were categorized into SCPR and LCPR groups based on the duration of resuscitation, where SCPR referred to CPR duration less than 60 mins, and LCPR referred to CPR duration equal to or more than 60 mins. The primary outcome measured was ROSC rates between the two groups, while the secondary and tertiary outcomes was 24-hour and 7-day survival rates. A multivariate logistic regression model was employed to analyze the factors influencing ROSC between groups. Results: A total of 529 patients were enrolled in the study, with 372 in the SCPR group and 157 in the LCPR group. Among them, 126 (33.9%) patients in the SCPR group and 56 (35.7%) in the LCPR group achieved ROSC without statistically difference between groups. Furthermore, 31 patients (8.3%) in the SCPR group and 7 patients (4.5%) in the LCPR group survived at 24 hours, while 13 patients (3.5%) in SCPR and 4 patients (2.5%) in LCPR group survived at 7 days, both without statistical difference. Factors associated with SCPR operation included Lower BMI, previous hypertension, daytime admission, hands-only compression, and ventilation. SpO2 and P ET CO2 were independent factors associated with ROSC, Moreover, in both groups higher SpO2 and P ET CO2 levels were associated with a higher rate of ROSC, suggesting that for this specific patient cohort, longer duration of CPR should be considered. Conclusions: Longer duration of CPR may need to be emphasize for certain group of patients, particularly those with high SpO2 and PET CO2 during CPR.

The Effect of Patients’ Position on Arterial Oxygenation During One-Lung and Two-Lung Ventilation in Thoracic Surgery: Smoker vs. Nonsmoker Patients (A Pilot Study)

Background: One-lung ventilation (OLV) is often required to facilitate surgical exposure. Hypoxemia is a common disorder during thoracic surgery. Objectives: We studied whether changing from the supine to the lateral position during OLV and two-lung ventilation (TLV) in thoracic surgery would affect positions on arterial oxygen pressure (PaO2) in two groups of smokers and nonsmokers. Methods: This single-blinded prospective observational pilot study was conducted on patients who underwent thoracotomy under general anesthesia. The effect of lateral and supine PaO2 was investigated in 15 patients with a history of smoking (≥ 40 packs/year) and 15 patients without. The data were analyzed via descriptive and inferential statistics in SPSS v. 19. Results: Arterial oxygen pressure did not significantly differ between the two groups in the supine TLV (P = 0.98), supine OLV (P = 0.16), lateral TLV (P = 0.06), and lateral OLV (P = 0.31). However, the PaO2 level was higher in smokers than in nonsmokers (except during supine TLV). Changing the position from supine to lateral caused a relative decrease in PaO2 (except during TLV in smokers) during TLV and OLV. This reduction in PaO2 levels was less in smokers (72.12) than in nonsmokers (95.28). Oxygen saturation (SpO2) levels were the same in all positions regardless of whether they were a smoker or nonsmoker. Conclusions: Changing the position from supine to lateral had no significant effects on PaO2 and SpO2 levels in smoker and nonsmoker patients during OLV and TLV in thoracic surgery.

Motor units involvement in diaphragm and intercostal muscles during supine and prone posture, and its relationship with oxygen saturation and perfusion index in healthy young female adults

Objectives: Due to gravity and non-gravity variables, human posture influences the distribution of ventilation and perfusion. Gravity enhances the air exchange and posture has an impact on the respiratory muscles’ activity. The goal of the study was to determine the role of neuromuscular activities in respiratory muscles throughout various respiratory states and postures, as well as the degree to which two different lying positions affected the perfusion index (PI) and oxygen saturation (SpO2) level in young, healthy female adults. Materials and Methods: Thirty sedentary healthy female college students, age ranges from 18 to 25 years having no history of pulmonary or neuromuscular diseases voluntarily cooperated and participated in this study. Each participant’s diaphragm and intercostal muscles underwent surface electromyography in the supine and prone postures. The heart rate (HR), SpO2, and PI were measured. Results: When in the supine position, the diaphragm and intercostal muscles both had greater mean root mean square and maximum voluntary contraction values, which is statistically significant (P &lt; 0.05). However, HR, SpO2 level, and PI between supine and prone postures show negligible changes. Conclusion: According to this study, prone posture is advantageous to supine posture since it requires less motor unit activation for proper breathing. Contrarily, the increases in chest cavity capacity are insufficient for the healthy adult female’s calm breathing to result in an increase in SpO2 and PI.

A Comparison of Laryngospasm in "No Touch" and "Head Down Deep Extubation": A Randomized Clinical Trials

Background: Tonsillectomy and adenotonsillectomy are simple surgical procedures that can cause laryngospasm as complications which blocks airflow causing serious issues. The laryngospasm incidence decreases in patients undergoing deep extubation. Present study aimed to compare laryngospasm in innovative method of head down deep extubation with No Touch method.&#x0D; Methods: Forty-two patients were enrolled in the study in (23 females and 19 males) between the ages of 5 up to 15 who were referred for tonsillectomy or adenotonsillectomy. The patients were divided into two randomized No Touch (n=21) and head down deep extubation (n=21) intervention groups according to permuted block randomization. All patients received standard general anesthesia. The first group received the no-touch extubation and the second group received head down deep extubation method. The duration of surgery, Time interval between the injection of reverse drugs and the return of spontaneous breathing (TRDRSB), time interval between anesthesia drug withdrawal and extubation (TIDWE), SPO2, incidence of laryngospasm, and cough were recorded and graded according to their severity at 0, 5, 10, 15 minutes and 2 hours after extubation, respectfully.&#x0D; Results: The age, weight, gender and duration of surgery, TRDRSB was not statistically different between the two groups but TIDWE showed a significant difference between groups (P&lt;0.001). The SPO2 levels in 0, 5, 10, 15 minutes, and 2 hours after surgery were not significantly different between the “no touch” and “head down deep extubation” groups as well as the severity of coughing and laryngospasm. However, the rate of laryngospasm and cough in "No touch" group was higher than " head down deep extubation " group.&#x0D; Conclusion: HDDE is an innovative technique that it seems in comparison to No Touch method can reduce the incidence of laryngospasm. However, further comprehensive trials are needed to confirm these findings.

Postresuscitation oxygen reserve index-guided oxygen titration in out-of-hospital cardiac arrest survivors: A randomised controlled trial

Background and purposeHyperoxia after return of spontaneous circulation is potentially harmful, and oxygen titration in a prehospital setting is challenging. This study aimed to compare outcomes of oxygen reserve index-supported prehospital oxygen titration during prehospital transport with those of standard oxygen titration. Methods and trial designWe enrolled patients who experienced return of spontaneous circulation after cardiac arrest in a prospective randomized study. Patients were randomly divided (1:1) to undergo oxygen titration based on the oxygen reserve index and SpO2 (intervention) or SpO2 only (control). FIO2 titration targeted SpO2 level maintenance at 94–98%. The primary outcome was the normoxia index, reflecting the proportion of both hyperoxia- and hypoxia-free time during prehospital intervention. ResultsA total of 92 patients were included in the study. The mean normoxia index was 0.828 in the control group and 0.847 in the intervention group (difference = 0.019 [95 % CI, −0.056–0.095]), with no significant difference between the groups. No significant differences were found in the incidence of hypoxia or hyperoxia between groups. No difference was found in the mean PaO2 at hospital admission (116 mmHg [IQR: 89–168 mmHg] in the control group vs 115 mmHg [IQR: 89–195 mmHg] in the intervention group; p = 0.86). No difference was observed in serum neuron-specific enolase levels 48 h post-ROSC after adjustment for known confounders. ConclusionOxygen reserve index- combined with pulse oximetry-based prehospital oxygen titration did not significantly improve the normoxia index compared with standard oxygen titration based on pulse oximetry alone (NCT03653325).

Effect of Powerlifting Exercises on Various Cardiovascular Parameters in Obese Individuals

Powerlifting is an individual endeavor that involves three attempts at lifting the heaviest possible weights in three key lifts: the Squat, Bench Press, and Deadlift. Compared to their lean counterparts, obese individuals tend to have higher cardiac output and lower total peripheral resistance, primarily due to increased stroke volume rather than heart rate changes. The primary objective of this study is to investigate the impact of powerlifting exercises on various cardiovascular parameters in obese individuals. This research employs a single-blinded, randomized controlled trial conducted at a CSJ Sports Rehab Centre, Bangalore, to recruit participants. Individuals with a BMI exceeding 30 and an age range of 25 to 42 years, exclusively male participants, and Regular engagement in gym activities for a minimum of three months. Thirty six individuals included in the study, and they were randomly divided into two groups.&#x0D; The Intervention Group engaged in 30 minutes of Powerlifting exercises and 30 minutes of supervised fitness exercises. Meanwhile, the Control Group participated in 30 minutes of supervised fitness exercises and 30 minutes of aerobics. Participants' abdominal pressure, heart rate, respiratory rate, and SpO2 levels were continuously monitored using pressure biofeedback equipment and a pulse oximeter. This study utilizes SPSS software version 24.0 for statistical analysis. Descriptive data are presented as the range, mean, and standard deviation. This study identified the Z score for the Intra-abdominal pressure as 2.041 (P=0.05), Heart rate as 2.9070 (P=0.05), Respiratory rate 5.109 (P=0.05), and SpO2 as 0.585 (P=0.05). In conclusion, this study shows that the effects of powerlifting exercises revealed a noteworthy decrease in abdominal pressure, heart rate, respiratory rate, and SpO2 levels among obese participants.

IoT-based health care system for emotional and heart rate monitoring

An IoT-based remote health monitoring system helps patient’s especially older adults and non-communicable disease (NCD) patients to get medical assistance or advice without being physically present in the hospital or medical centre. This system provides regular health monitoring from anywhere by having access to the Internet. One of the important elements is the physiological parameters which indicate the health status of the monitored patients. Literature study shows that most of the previous works monitor blood pressure, respiratory rate, temperature, ECG, blood oxygenation, diabetes, and hypertension. There have been little works paid attention to measuring the emotional level of the patient. Therefore, this paper explains the development of an IoT-based health monitoring system that measures the emotional level of the patient apart from other essential physiological parameters. The system consists of a microcontroller, two sensors, a wireless communication module, and an IoT cloud display, focusing on measuring the heart rate, body temperature, SpO2, and emotional level. For the heart rate and body temperature readings, the measurements acquired from the developed system show a close agreement with those of the established brand ROSSMAX with an error of less than 5%. For the emotional level test, there are 83.3% out of twelve subjects agree that the GSR value shows her feeling.