1
|
Martinsson A, Houltz E, Wallinder A, Magnusson J, Lindgren S, Stenqvist O, Thorén A. Inspiratory and end-expiratory effects of lung recruitment in the prone position on dorsal lung aeration - new physiological insights in a secondary analysis of a randomised controlled study in post-cardiac surgery patients. BJA OPEN 2022; 4:100105. [PMID: 37588783 PMCID: PMC10430825 DOI: 10.1016/j.bjao.2022.100105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 10/20/2022] [Indexed: 08/18/2023]
Abstract
Background Cardiac surgery produces dorso-basal atelectasis and ventilation/perfusion mismatch, associated with infection and prolonged intensive care. A postoperative lung volume recruitment manoeuvre to decrease the degree of atelectasis is routine. In patients with severe respiratory failure, prone positioning and recruitment manoeuvres may increase survival, oxygenation, or both. We compared the effects of lung recruitment in prone vs supine positions on dorsal inspiratory and end-expiratory lung aeration. Methods In a prospective RCT, 30 post-cardiac surgery patients were randomly allocated to recruitment manoeuvres in the prone (n=15) or supine position (n=15). The primary endpoints were late dorsal inspiratory volume (arbitrary units [a.u.]) and left/right dorsal end-expiratory lung volume change (a.u.), prone vs supine after extubation, measured using electrical impedance tomography. Secondary outcomes included left/right dorsal inspiratory volumes (a.u.) and left/right dorsal end-expiratory lung volume change (a.u.) after prone recruitment and extubation. Results The last part of dorsal end-inspiratory volume after extubation was higher after prone (49.1 a.u.; 95% confidence interval [CI], 37.4-60.6) vs supine recruitment (24.2 a.u.; 95% CI, 18.4-29.6; P=0.024). Improvement in left dorsal end-expiratory lung volume after extubation was higher after prone (382 a.u.; 95% CI, 261-502) vs supine recruitment (-71 a.u., 95% CI, -140 to -2; n=15; P<0.001). After prone recruitment, left vs right predominant end-expiratory dorsal lung volume change disappeared after extubation. However, both left and right end-expiratory volumes were higher in the prone group, after extubation. Conclusions Recruitment in the prone position improves dorsal inspiratory and end-expiratory lung volumes after cardiac surgery. Clinical trial registration NCT03009331.
Collapse
Affiliation(s)
- Andreas Martinsson
- Department of Anaesthesiology and Intensive Care Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
- Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Erik Houltz
- Department of Anaesthesiology and Intensive Care Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
- Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Andreas Wallinder
- Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
- Department of Cardiothoracic Surgery, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Jesper Magnusson
- Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
- Department of Pulmonary Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Sophie Lindgren
- Department of Anaesthesiology and Intensive Care Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
- Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Ola Stenqvist
- Department of Anaesthesiology and Intensive Care Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
- Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Anders Thorén
- Department of Anaesthesiology and Intensive Care Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
- Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| |
Collapse
|
2
|
Brady B, Li W, Farooque N, Ehrhardt C, Meyerhoff ME, Wang X. S-Nitrosothiol-Impregnated Silicone Catheter for Colorimetric Sensing of Indole and E. coli: Toward On-Body Detection of Urinary Tract Infections. ACS Sens 2022; 7:1712-1719. [PMID: 35604028 DOI: 10.1021/acssensors.2c00439] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Although there are many techniques to detect pathogenic bacteria, most of them are only suited for in vitro diagnostics. We report a urinary catheter-based colorimetric sensor for potential on-body detection of E. coli, the most prevalent bacterial species in urinary tract infections associated with the use of urinary catheters. In urine, indole is secreted by E. coli and reacts with a nitrosating agent incorporated in a silicone catheter. A red dimeric product, indoxyl red, is generated within silicone rubber to allow for color-based indole sensing with high sensitivity, linearity, and specificity. This reaction is initiated by the nitrosation reaction of indole at its C-3 position via reagents like sodium nitrite or S-nitroso-N-acetyl-penicillamine under aerobic conditions. The generated 3-nitrosoindole undergoes tautomerization, dimerization, and deoximation to form indoxyl red with high absorbance at 537 nm. In contrast to other indole sensors, the presented method can be applied in real catheters to detect indole and E. coli in biofluids such as urine. The is because (1) S-nitroso-N-acetyl-penicillamine, the nitrosating agent, can be impregnated into silicone elastomers, (2) indole from urine is extracted into silicone due to its hydrophobicity, and (3) the high acidity and oxygen solubility of silicone facilitates the sensing reaction within the silicone matrix. This silicone-based colorimetric sensor clearly differentiates E. coli below and above 105 CFU/mL, which is the threshold concentration of bacteriuria. We expect that early diagnosis of urinary tract infections using the naked eye is possible by functionalizing an exposed section of urinary catheters with the proposed molecular probe.
Collapse
Affiliation(s)
- Brock Brady
- Department of Chemistry, Virginia Commonwealth University, 1001 West Main Street, Richmond, Virginia 23284, United States
| | - Wuwei Li
- Department of Chemistry, Virginia Commonwealth University, 1001 West Main Street, Richmond, Virginia 23284, United States
| | - Nashwan Farooque
- Department of Chemistry, Virginia Commonwealth University, 1001 West Main Street, Richmond, Virginia 23284, United States
| | - Christopher Ehrhardt
- Department of Forensic Science, Virginia Commonwealth University, 1015 Floyd Avenue, Richmond, Virginia 23284, United States
| | - Mark E. Meyerhoff
- Department of Chemistry, University of Michigan, 930 North University, Ann Arbor, Michigan 48109, United States
| | - Xuewei Wang
- Department of Chemistry, Virginia Commonwealth University, 1001 West Main Street, Richmond, Virginia 23284, United States
| |
Collapse
|
3
|
Hummer EV, Soares JHN, Crockett DC, Aguiar AJA, Tran MC, Cronin JN, Brosnan RJ, Braun C, Formenti F. Continuous measurement of arterial oxygenation in mechanically ventilated horses. Equine Vet J 2021; 54:1144-1152. [PMID: 34797580 DOI: 10.1111/evj.13542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 11/01/2021] [Accepted: 11/11/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND The possibility of accurately and continuously measuring arterial oxygen partial pressure (PaO2 ) in horses may facilitate the management of hypoxaemia during general anaesthesia. OBJECTIVES The aim of this study was to evaluate the ability of a novel fibreoptic sensor to measure PaO2 (PaO2Sensor ) continuously and in real time in horses undergoing ventilatory manoeuvres during general anaesthesia. STUDY DESIGN In vivo experimental study. METHODS Six adult healthy horses were anaesthetised and mechanically ventilated in dorsal recumbency. A fibreoptic sensor was placed in one of the facial arteries through a catheter to continuously measure and record PaO2Sensor . After an alveolar recruitment manoeuvre, a decremental positive end-expiratory pressure (PEEP) titration using 20-minute steps of 5 cm H2 O from 20 to 0 cm H2 O was performed. An arterial blood sample was collected at 15 minutes of ventilation at each PEEP level for PaO2 measurement using an automated blood gas machine (PaO2Ref ). The agreement between PaO2Sensor and PaO2Ref was assessed by Pearson's correlation, Bland-Altman plot and four-quadrant plot analysis. In the last minute of ventilation at each PEEP level, a slow tidal inflation/deflation manoeuvre was performed. RESULTS The mean relative bias between PaO2Sensor and PaO2Ref was 4% with limits of agreement between -17% and 29%. The correlation coefficient between PaO2Sensor and PaO2Ref was 0.98 (P < .001). The PaO2Sensor and PaO2Ref concordance rate for changes was 95%. Measurements of PaO2Sensor during the slow inflation/deflation manoeuvre at PEEP 15 and 10 cm H2 O were not possible because of significant noise on the PaO2 signal generated by a small blood clot. MAIN LIMITATIONS Small sample size. CONCLUSION The tested fibreoptic probe was able to accurately and continuously measure PaO2Sensor in anaesthetised horses undergoing ventilatory manoeuvres. A heparinised system in the catheter used by the fibreoptic sensor should be used to avoid blood clots and artefacts in the PaO2 measurements.
Collapse
Affiliation(s)
- Emma V Hummer
- William Pritchard Veterinary Medical Teaching Hospital, University of California Davis, Davis, California, USA
| | - Joao H N Soares
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California Davis, Davis, California, USA
| | | | - Antonio J A Aguiar
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California Davis, Davis, California, USA.,Departamento de Cirurgia e Anestesiologia Veterinária, Faculdade de Medicina Veterinária e Zootecnia, UNESP - Univ. Estadual Paulista, Botucatu, São Paulo, Brazil
| | - Minh C Tran
- Nuffield Division of Anaesthetics, University of Oxford, Oxford, UK.,Department of Engineering Science, University of Oxford, Oxford, UK
| | - John N Cronin
- Centre for Human and Applied Physiological Sciences, King's College London, London, UK.,Department of Anaesthetics, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Robert J Brosnan
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California Davis, Davis, California, USA
| | - Christina Braun
- Anaesthesiology and Perioperative Intensive Care, Vetmeduni Vienna, Vienna, Austria
| | - Federico Formenti
- Nuffield Division of Anaesthetics, University of Oxford, Oxford, UK.,Centre for Human and Applied Physiological Sciences, King's College London, London, UK
| |
Collapse
|
4
|
Pla L, Berdún S, Mir M, Rivas L, Miserere S, Dulay S, Samitier J, Eixarch E, Illa M, Gratacós E. Non-invasive monitoring of pH and oxygen using miniaturized electrochemical sensors in an animal model of acute hypoxia. J Transl Med 2021; 19:53. [PMID: 33541374 PMCID: PMC7863274 DOI: 10.1186/s12967-021-02715-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Accepted: 01/23/2021] [Indexed: 12/02/2022] Open
Abstract
Background One of the most prevalent causes of fetal hypoxia leading to stillbirth is placental insufficiency. Hemodynamic changes evaluated with Doppler ultrasound have been used as a surrogate marker of fetal hypoxia. However, Doppler evaluation cannot be performed continuously. As a first step, the present work aimed to evaluate the performance of miniaturized electrochemical sensors in the continuous monitoring of oxygen and pH changes in a model of acute hypoxia-acidosis. Methods pH and oxygen electrochemical sensors were evaluated in a ventilatory hypoxia rabbit model. The ventilator hypoxia protocol included 3 differential phases: basal (100% FiO2), the hypoxia-acidosis period (10% FiO2) and recovery (100% FiO2). Sensors were tested in blood tissue (ex vivo sensing) and in muscular tissue (in vivo sensing). pH electrochemical and oxygen sensors were evaluated on the day of insertion (short-term evaluation) and pH electrochemical sensors were also tested after 5 days of insertion (long-term evaluation). pH and oxygen sensing were registered throughout the ventilatory hypoxia protocol (basal, hypoxia-acidosis, and recovery) and were compared with blood gas metabolites results from carotid artery catheterization (obtained with the EPOC blood analyzer). Finally, histological assessment was performed on the sensor insertion site. One-way ANOVA was used for the analysis of the evolution of acid-based metabolites and electrochemical sensor signaling results; a t-test was used for pre- and post-calibration analyses; and chi-square analyses for categorical variables. Results At the short-term evaluation, both the pH and oxygen electrochemical sensors distinguished the basal and hypoxia-acidosis periods in both the in vivo and ex vivo sensing. However, only the ex vivo sensing detected the recovery period. In the long-term evaluation, the pH electrochemical sensor signal seemed to lose sensibility. Finally, histological assessment revealed no signs of alteration on the day of evaluation (short-term), whereas in the long-term evaluation a sub-acute inflammatory reaction adjacent to the implantation site was detected. Conclusions Miniaturized electrochemical sensors represent a new generation of tools for the continuous monitoring of hypoxia-acidosis, which is especially indicated in high-risk pregnancies. Further studies including more tissue-compatible material would be required in order to improve long-term electrochemical sensing.
Collapse
Affiliation(s)
- Laura Pla
- BCNatal
- Fetal Medicine Research Center (Hospital Clínic and Hospital Sant Joan de Déu), Universitat de Barcelona, Barcelona, Spain
| | - Sergio Berdún
- BCNatal
- Fetal Medicine Research Center (Hospital Clínic and Hospital Sant Joan de Déu), Universitat de Barcelona, Barcelona, Spain
| | - Mònica Mir
- Centro de Investigación Biomédica en Red en Bioingeniería, Biomateriales Y Nanomedicina (CIBER-BBN), Monforte de Lemos 3-5, Pabellón 11, 28029, Madrid, Spain.,Nanobioengineering Group, Institute for Bioengineering of Catalonia (IBEC) Barcelona Institute of Science and Technology (BIST), 12 Baldiri Reixac 15-21, 08028, Barcelona, Spain.,Department of Electronics and Biomedical Engineering, University of Barcelona, Martí I Franquès 1, 08028, Barcelona, Spain
| | - Lourders Rivas
- Nanobioengineering Group, Institute for Bioengineering of Catalonia (IBEC) Barcelona Institute of Science and Technology (BIST), 12 Baldiri Reixac 15-21, 08028, Barcelona, Spain
| | - Sandrine Miserere
- Nanobioengineering Group, Institute for Bioengineering of Catalonia (IBEC) Barcelona Institute of Science and Technology (BIST), 12 Baldiri Reixac 15-21, 08028, Barcelona, Spain
| | - Samuel Dulay
- Nanobioengineering Group, Institute for Bioengineering of Catalonia (IBEC) Barcelona Institute of Science and Technology (BIST), 12 Baldiri Reixac 15-21, 08028, Barcelona, Spain
| | - Josep Samitier
- Centro de Investigación Biomédica en Red en Bioingeniería, Biomateriales Y Nanomedicina (CIBER-BBN), Monforte de Lemos 3-5, Pabellón 11, 28029, Madrid, Spain.,Nanobioengineering Group, Institute for Bioengineering of Catalonia (IBEC) Barcelona Institute of Science and Technology (BIST), 12 Baldiri Reixac 15-21, 08028, Barcelona, Spain.,Department of Electronics and Biomedical Engineering, University of Barcelona, Martí I Franquès 1, 08028, Barcelona, Spain
| | - Elisenda Eixarch
- BCNatal
- Fetal Medicine Research Center (Hospital Clínic and Hospital Sant Joan de Déu), Universitat de Barcelona, Barcelona, Spain.,Institut D'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Barcelona, Spain.,Centre for Biomedical Research On Rare Diseases (CIBER-ER), Barcelona, Spain
| | - Miriam Illa
- BCNatal
- Fetal Medicine Research Center (Hospital Clínic and Hospital Sant Joan de Déu), Universitat de Barcelona, Barcelona, Spain. .,Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain.
| | - Eduard Gratacós
- BCNatal
- Fetal Medicine Research Center (Hospital Clínic and Hospital Sant Joan de Déu), Universitat de Barcelona, Barcelona, Spain.,Institut D'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Barcelona, Spain.,Centre for Biomedical Research On Rare Diseases (CIBER-ER), Barcelona, Spain.,Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain
| |
Collapse
|
5
|
Tretter V, Zach ML, Böhme S, Ullrich R, Markstaller K, Klein KU. Investigating Disturbances of Oxygen Homeostasis: From Cellular Mechanisms to the Clinical Practice. Front Physiol 2020; 11:947. [PMID: 32848874 PMCID: PMC7417655 DOI: 10.3389/fphys.2020.00947] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Accepted: 07/14/2020] [Indexed: 12/22/2022] Open
Abstract
Soon after its discovery in the 18th century, oxygen was applied as a therapeutic agent to treat severely ill patients. Lack of oxygen, commonly termed as hypoxia, is frequently encountered in different disease states and is detrimental to human life. However, at the end of the 19th century, Paul Bert and James Lorrain Smith identified what is known as oxygen toxicity. The molecular basis of this phenomenon is oxygen's readiness to accept electrons and to form different variants of aggressive radicals that interfere with normal cell functions. The human body has evolved to maintain oxygen homeostasis by different molecular systems that are either activated in the case of oxygen under-supply, or to scavenge and to transform oxygen radicals when excess amounts are encountered. Research has provided insights into cellular mechanisms of oxygen homeostasis and is still called upon in order to better understand related diseases. Oxygen therapy is one of the prime clinical interventions, as it is life saving, readily available, easy to apply and economically affordable. However, the current state of research also implicates a reconsidering of the liberal application of oxygen causing hyperoxia. Increasing evidence from preclinical and clinical studies suggest detrimental outcomes as a consequence of liberal oxygen therapy. In this review, we summarize concepts of cellular mechanisms regarding different forms of disturbed cellular oxygen homeostasis that may help to better define safe clinical application of oxygen therapy.
Collapse
Affiliation(s)
- Verena Tretter
- Department of Anaesthesia, General Intensive Care and Pain Therapy, Medical University Vienna, Vienna, Austria
| | | | | | | | | | | |
Collapse
|
6
|
do Nascimento LMS, Bonfati LV, Freitas MLB, Mendes Junior JJA, Siqueira HV, Stevan SL. Sensors and Systems for Physical Rehabilitation and Health Monitoring-A Review. SENSORS (BASEL, SWITZERLAND) 2020; 20:E4063. [PMID: 32707749 PMCID: PMC7436073 DOI: 10.3390/s20154063] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Revised: 07/09/2020] [Accepted: 07/12/2020] [Indexed: 01/03/2023]
Abstract
The use of wearable equipment and sensing devices to monitor physical activities, whether for well-being, sports monitoring, or medical rehabilitation, has expanded rapidly due to the evolution of sensing techniques, cheaper integrated circuits, and the development of connectivity technologies. In this scenario, this paper presents a state-of-the-art review of sensors and systems for rehabilitation and health monitoring. Although we know the increasing importance of data processing techniques, our focus was on analyzing the implementation of sensors and biomedical applications. Although many themes overlap, we organized this review based on three groups: Sensors in Healthcare, Home Medical Assistance, and Continuous Health Monitoring; Systems and Sensors in Physical Rehabilitation; and Assistive Systems.
Collapse
Affiliation(s)
- Lucas Medeiros Souza do Nascimento
- Graduate Program in Electrical Engineering (PPGEE), Federal University of Technology of Parana (UTFPR), Ponta Grossa (PR) 84016-210, Brazil; (L.M.S.d.N.); (L.V.B.); (M.L.B.F.); (H.V.S.)
| | - Lucas Vacilotto Bonfati
- Graduate Program in Electrical Engineering (PPGEE), Federal University of Technology of Parana (UTFPR), Ponta Grossa (PR) 84016-210, Brazil; (L.M.S.d.N.); (L.V.B.); (M.L.B.F.); (H.V.S.)
| | - Melissa La Banca Freitas
- Graduate Program in Electrical Engineering (PPGEE), Federal University of Technology of Parana (UTFPR), Ponta Grossa (PR) 84016-210, Brazil; (L.M.S.d.N.); (L.V.B.); (M.L.B.F.); (H.V.S.)
| | - José Jair Alves Mendes Junior
- Graduate Program in Electrical Engineering and Industrial Informatics (CPGEI), Federal University of Technology of Parana (UTFPR), Curitiba (PR) 80230-901, Brazil;
| | - Hugo Valadares Siqueira
- Graduate Program in Electrical Engineering (PPGEE), Federal University of Technology of Parana (UTFPR), Ponta Grossa (PR) 84016-210, Brazil; (L.M.S.d.N.); (L.V.B.); (M.L.B.F.); (H.V.S.)
| | - Sergio Luiz Stevan
- Graduate Program in Electrical Engineering (PPGEE), Federal University of Technology of Parana (UTFPR), Ponta Grossa (PR) 84016-210, Brazil; (L.M.S.d.N.); (L.V.B.); (M.L.B.F.); (H.V.S.)
| |
Collapse
|
7
|
McCabe MM, Hala P, Rojas-Pena A, Lautner-Csorba O, Major TC, Ren H, Bartlett RH, Brisbois EJ, Meyerhoff ME. Enhancing analytical accuracy of intravascular electrochemical oxygen sensors via nitric oxide release using S-nitroso-N-acetyl-penicillamine (SNAP) impregnated catheter tubing. Talanta 2019; 205:120077. [PMID: 31450395 DOI: 10.1016/j.talanta.2019.06.077] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2019] [Revised: 06/19/2019] [Accepted: 06/20/2019] [Indexed: 12/21/2022]
Abstract
Implantable medical devices are an integral part of primary/critical care. However, these devices carry a high risk for blood clots, caused by platelet aggregation on a foreign body surface. This study focuses on the development of a simplified approach to create nitric oxide (NO) releasing intravascular electrochemical oxygen (O2) sensors with increased biocompatibility and analytical accuracy. The implantable sensors are prepared by embedding S-nitroso-N-acetylpenacillamine (SNAP) as the NO donor molecule in the walls of the catheter type sensors. The SNAP-impregnated catheters were prepared by swelling silicone rubber tubing in a tetrahydrofuran solution containing SNAP. Control and SNAP-impregnated catheters were used to fabricate the Clark-style amperometric PO2 sensors. The SNAP-impregnated sensors release NO under physiological conditions for 18 d as measured by chemiluminescence. The analytical response of the SNAP-impregnated sensors was evaluated in vitro and in vivo. Rabbit and swine models (with sensors placed in both veins and arteries) were used to evaluate the effects on thrombus formation and analytical in vivo PO2 sensing performance. The SNAP-impregnated PO2 sensors were found to more accurately measure PO2 levels in blood continuously (over 7 and 20 h animal experiments) with significantly reduced thrombus formation (as compared to controls) on their surfaces.
Collapse
Affiliation(s)
- M M McCabe
- Department of Chemistry, University of Michigan, Ann Arbor, MI, USA
| | - P Hala
- Department of Surgery, University of Michigan Medical Center, Ann Arbor, MI, USA; Department of Cardiology, Na Homolce Hospital, Prague, Czech Republic; Department of Physiology, First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - A Rojas-Pena
- Department of Surgery, University of Michigan Medical Center, Ann Arbor, MI, USA
| | - O Lautner-Csorba
- Department of Surgery, University of Michigan Medical Center, Ann Arbor, MI, USA
| | - T C Major
- Department of Surgery, University of Michigan Medical Center, Ann Arbor, MI, USA
| | - H Ren
- Department of Chemistry, University of Michigan, Ann Arbor, MI, USA
| | - R H Bartlett
- Department of Surgery, University of Michigan Medical Center, Ann Arbor, MI, USA
| | - E J Brisbois
- Department of Materials Science and Engineering, University of Central Florida, Orlando, FL, USA.
| | - M E Meyerhoff
- Department of Chemistry, University of Michigan, Ann Arbor, MI, USA.
| |
Collapse
|
8
|
Skowno JJ. Hemodynamic monitoring in children with heart disease: Overview of newer technologies. Paediatr Anaesth 2019; 29:467-474. [PMID: 30667124 DOI: 10.1111/pan.13590] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Revised: 12/26/2018] [Accepted: 01/14/2019] [Indexed: 12/21/2022]
Affiliation(s)
- Justin J Skowno
- Department of Anaesthesia, The Children's Hospital at Westmead, Sydney, NSW, Australia.,Discipline of Child and Adolescent Health, Faculty of Medicine and Health, The University of Sydney, NSW, Australia
| |
Collapse
|
9
|
Formenti F, Bommakanti N, Chen R, Cronin JN, McPeak H, Holopherne-Doran D, Hedenstierna G, Hahn CEW, Larsson A, Farmery AD. Respiratory oscillations in alveolar oxygen tension measured in arterial blood. Sci Rep 2017; 7:7499. [PMID: 28878215 PMCID: PMC5587703 DOI: 10.1038/s41598-017-06975-6] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Accepted: 06/20/2017] [Indexed: 01/02/2023] Open
Abstract
Arterial oxygen partial pressure can increase during inspiration and decrease during expiration in the presence of a variable shunt fraction, such as with cyclical atelectasis, but it is generally presumed to remain constant within a respiratory cycle in the healthy lung. We measured arterial oxygen partial pressure continuously with a fast intra-vascular sensor in the carotid artery of anaesthetized, mechanically ventilated pigs, without lung injury. Here we demonstrate that arterial oxygen partial pressure shows respiratory oscillations in the uninjured pig lung, in the absence of cyclical atelectasis (as determined with dynamic computed tomography), with oscillation amplitudes that exceeded 50 mmHg, depending on the conditions of mechanical ventilation. These arterial oxygen partial pressure respiratory oscillations can be modelled from a single alveolar compartment and a constant oxygen uptake, without the requirement for an increased shunt fraction during expiration. Our results are likely to contribute to the interpretation of arterial oxygen respiratory oscillations observed during mechanical ventilation in the acute respiratory distress syndrome.
Collapse
Affiliation(s)
- Federico Formenti
- Nuffield Division of Anaesthetics, University of Oxford, Oxford, United Kingdom. .,Faculty of Life Sciences and Medicine, King's College London, London, United Kingdom.
| | - Nikhil Bommakanti
- Nuffield Division of Anaesthetics, University of Oxford, Oxford, United Kingdom
| | - Rongsheng Chen
- Nuffield Division of Anaesthetics, University of Oxford, Oxford, United Kingdom
| | - John N Cronin
- Faculty of Life Sciences and Medicine, King's College London, London, United Kingdom
| | - Hanne McPeak
- Nuffield Division of Anaesthetics, University of Oxford, Oxford, United Kingdom
| | | | | | - Clive E W Hahn
- Nuffield Division of Anaesthetics, University of Oxford, Oxford, United Kingdom
| | - Anders Larsson
- Department of Surgical Sciences, University of Uppsala, Uppsala, Sweden
| | - Andrew D Farmery
- Nuffield Division of Anaesthetics, University of Oxford, Oxford, United Kingdom
| |
Collapse
|
10
|
Checketts MR, Jenkins B, Pandit JJ. Implications of the 2015 AAGBI recommendations for standards of monitoring during anaesthesia and recovery. Anaesthesia 2017; 72 Suppl 1:3-6. [DOI: 10.1111/anae.13736] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Affiliation(s)
| | | | - J. J. Pandit
- Nuffield Department of Anaesthetics; Oxford University Hospitals NHS Foundation Trust; Oxford UK
| |
Collapse
|