Reduction of glucose and insulin concentrations during in vitro incubation of whole blood (original) (raw)
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2020
Brief Communication Blood gas test is requested when a person shows either signs of imbalance in oxygen/carbon dioxide or pH, such as difficulty in breathing, shortness of breath, vomiting, suffering from respiratory illness, metabolic disorder, kidney disease, and experiencing respiratory failure, or injuries that could affect breathing, including head or neck trauma. Therefore, measuring blood gas is highly important for assessing oxygenation and acid/base situation (1-3). Patients admitted to the emergency wards with respiratory distress as their main complaint need careful examination for oxygenation status, ventilation, and acid/base balance (4, 5). Taking the arterial blood gas (ABG) test from the patient can provide valuable information for the physician. Unfortunately, ABG apparatus may not be available in all emergency wards (6-8). Arterial blood taking from the patient is time-consuming and very painful, has error probability, and needs to be repeated several times in some...
Hypoglycaemia is associated with a higher mortality in critically ill patients
2009
Quality assurance report on the use of continuous positive airway pressure and end-tidal carbon dioxide during respiratory distress in field emergency care D Lain, S Bourn P7 Cardiogenic oscillations extracted from spontaneous breathing airway pressure and flow signal are related to chest wall motility and continuous positive airway pressure
Diagnostics
Background: End-tidal carbon dioxide pressure (PetCO2) is unreliable for monitoring PaCO2 in several conditions because of the unpredictable value of the PaCO2–PetCO2 gradient. We hypothesised that increasing both the end-inspiratory pause and the expiratory time would reduce this gradient in patients ventilated for COVID-19 with Acute Respiratory Distress Syndrome and in patients anaesthetised for surgery. Methods: On the occasion of an arterial blood gas sample, an extension in inspiratory pause was carried out either by recruitment manoeuvre or by extending the end-inspiratory pause to 10 s. The end-expired PCO2 was measured (expiratory time: 4 s) after this manoeuvre (PACO2) in comparison with the PetCO2 measured by the monitor. We analysed 67 Δ(a-et)CO2, Δ(a-A)CO2 pairs for 7 patients in the COVID group and for 27 patients in the anaesthesia group. Results are expressed as mean ± standard deviation. Results: Prolongation of the inspiratory pause significantly reduced PaCO2–PetC...
Resuscitation, 1997
There is currently no practical method for determining cardiopulmonary resuscitation (CPR) efficacy in the field. We investigated the relationship between the volume of carbon dioxide (CO 2) excreted in the airway (CO2EX) when tidal volume and respiratory rate are controlled, and cardiac output (CO), an indicator of CPR efficacy, to determine the potential of CO2EX as a practical noninvasive field monitor of CPR efficacy. Thirteen mongrel dogs were anesthetized, instrumented and ventilated 13 times/min at a fixed tidal volume with an infrared airway CO 2 sensor. CO2EX= (P CO2 /bar. press.)× (tidal vol) × (breaths/min), and expressed in ml/min per kg. Sequences of control, CPR with 3-4 different compression forces, and recovery measurements were recorded 10-15 times/animal. CO2EX and CO fell simultaneously with ventricular fibrillation. CPR immediately increased CO2EX and CO. Both changed consistently and in the same direction as compression force. Return of spontaneous circulation immediately increased CO2EX and CO above controls, with a gradual return to control levels. CO2EX was always below 8 ml-CO 2 /min/kg during CPR and above this during spontaneous circulation. With alveolar ventilation controlled, CO 2 movement is regulated by CO, CO distribution and CO 2 stores shifts. Normally, CO accounts for 15% of CO2EX variability. In this study CO accounted for ]65% of CO2EX variability during CPR, indicating CO2EX changes were primarily due to CO changes. When ventilation is controlled, CO2EX during CPR reliably tracks changes in CO. Therefore, CO2EX may provide a practical noninvasive method of determining CPR efficacy as the CPR is being performed.
Acta veterinaria, 2003
The aim of the study was to assess the value of capnometry during anaesthesia with spontaneous breathing and controlled ventilation in dogs free of pulmonary disease. Ten beagle dogs were included in the study. End-tidal carbon dioxide (ETCO 2), minute respiratory volume (ME), heart rate and arterial blood gases were measured. The correlation between ETCO 2 and PaCO 2 was positive and statistically significant in both types of general anaesthesia. ME was negatively correlated with ETCO 2 and PaCO 2 , although this was statistically significant only during controlled ventilation. The PaCO 2-ETCO 2 gradient increased significantly comparing to the awake state during the experiment with controlled ventilation indicating haemodynamic depression as a consequence of deepening of anaesthesia. The results of the study demonstrated that capnometry can noninvasively provide valuable information about changes in minute respiratory volume and arterial blood gases during general anaesthesia with spontaneous breathing and controlled ventilation in dogs free of pulmonary disease. Comparable literature data imply that capnometry is equally useful in other animal species.
Prague medical report
Success of advanced cardiac life support (ACLS) depends on several factors: character and severity of the primary insult, time interval between cardiac arrest and effective basic life support (BLS) and the ensuing ACLS, patient's general condition before the insult, environmental circumstances and efficacy of BLS and ACLS. From these factors, only the efficacy of ACLS is under control of emergency personnel. The end tidal partial pressure of CO2 (P(ET)CO2) has been shown to be an indicator of the efficiency of ACLS and a general prognostic marker. In this study P(ET)CO2 was monitored during out-of hospital ACLS in three cases of cardiac arrest of different aetiology. The aetiology included lung oedema, tension pneumothorax and high voltage electric injury. P(ET)CO2 served for adjustments of ACLS. In these three cases the predictive value of P(ET)CO2 monitoring corresponded to previously reported recommendations.
Article type: Original Article Background: Patients undergone mechanical ventilation need rapid and reliable evaluation of their respiratory status. Monitoring of End-tidal carbon dioxide (ETCO 2) as a sur-rogate, noninvasive measurement of arterial carbon dioxide (PaCO 2) is one of the methods used for this purpose in intubated patients. Objectives: The aim of the present trial was to study the relationship between end-tidal CO 2 tensions with PaCO 2 measurements in mechanically ventilated patients. Materials and Methods: End-tidal carbon dioxide levels were recorded at the time of arterial blood gas sampling. Patients who were undergoing one of the mechanical ventilation methods such as: synchronized mandatory mechanical ventilation (SIMV), continuous positive airway pressure (CPAP) and T-Tube were enrolled in this study. The difference between ETCO 2 and PaCO 2 was tested with a paired t-test. The correlation of end-tidal carbon dioxide to (ETCO 2) CO 2 was obtained in all patients. Results: A total of 219 arterial blood gases were obtained from 87 patients (mean age, 71.7 ± 15.1 years). Statistical analysis demonstrated a good correlation between the mean of ETCO 2 and PaCO 2 in each of the modes of SIMV, CPAP and T-Tube; SIMV (42.5 ± 17.3 and 45.8 ± 17.1; r = 0.893, P < 0.0001), CPAP (37 ± 9.7 and 39.4 ± 10.1; r = 0.841, P < 0.0001) and T-Tube (36.1 ± 9.9 and 39.4 ± 11; r = 0.923, P < 0.0001), respectively. Conclusions: End-tidal CO 2 measurement provides an accurate estimation of PaCO 2 in mechanically ventilated patients. Its use may reduce the need for invasive monitoring and/or repeated arterial blood gas analyses.
Health in Emergencies & Disasters Quarterly
Background: Measuring end-tidal carbon dioxide (ETCO2) can be a non-invasive, fast, and reliable method to predict partial pressure of carbon dioxide (PaCO2) in patients with respiratory distress. This method, which can be a suitable substitute to measure PaCO2, is being used in many emergency rooms and operating rooms in developed countries, but its exact relationship with PaCO2 has not been confirmed yet. This study aims to investigate the relationship between PaCO2 and ETCO2 in patients with respiratory distress referred to the emergency. Materials and Methods: Arterial blood gases were measured in patients referred to the emergency room of Hazrat Rasool Akram (PBUH) Hospital with the main complaint of respiratory distress, and the ETCO2 of the patient was measured simultaneously with a capnograph. At the same time, the blood pressure and body temperature of the patients were also measured. The obtained information was collected in a sheet and statistically analyzed using SPSS so...
Zagazig University Medical Journal
Background: In this study, we investigated the ability of end tidal carbon dioxide pressure (P ET CO 2) to monitor the changes in cardiac output (CO) induced by fluid challenge and to predict fluid responsiveness. Patients and Methods: We conducted our study upon 38 shocked patients requiring fluid challenge (FC). Hemodynamic variables, central venous pressure (CVP), End-tidal CO 2 , arterial and venous blood gas analysis and cardiac output were recorded before and after fluid challenges. Fluid responders were identified when cardiac output increased more than 15% after fluid challenge, cardiac output (CO) was estimated by measuring left ventricular outflow tract velocity-time integral (LVOT VTI) by transthoracic doppler echocardiography. Results: Twenty-one (55.3%) patients were fluid responders. Fluid challenge induced increase in CO and P ET CO 2 was moderately correlated (r = 0.5; P 0.002). The area under receiver operating characteristic (ROC) curve of Δ P ET CO 2 was 0.89±0.05 CI (81-98) with an increase ≥ 3.13% in P ET CO 2 can predict fluid responsiveness with 85.7% sensitivity and 88.3% specificity. No other clinical or hemodynamic variables can predict fluid responsiveness. The area under ROC curve of ΔCVP was 0.48±0.1 CI (32-64) with an increase ≥ 2cmH 2 O in CVP can predict fluid responsiveness with 38% sensitivity and 76.5% specificity. Conclusions: Our findings indicate that induced changes in P ET CO 2 during fluid challenge could be used to monitor changes in cardiac output (CO) for prediction of fluid responsiveness in mechanically ventilated shocked patients, under stationary minute ventilation and steady CO2 production.
International journal of emergency medicine, 2012
The aim of this study was to determine the usefulness of end tidal carbon dioxide (ETCO2) monitoring in hypotensive shock patients presenting to the ED. This was a prospective observational study in a tertiary ED. One hundred three adults in shock with hypotension presenting to the ED were recruited into the study. They were grouped according to different types of shock, hypovolemic, cardiogenic, septic and others. Vital signs and ETCO2 were measured on presentation and at 30-min intervals up to 120 min. Blood gases and serum lactate levels were obtained on arrival. All patients were managed according to standard protocols and treatment regimes. Patient survival up to hospital admission and at 30 days was recorded. Mean ETCO2 for all patients on arrival was 29.07 ± 9.96 mmHg. Average ETCO2 for patients in hypovolemic, cardiogenic and septic shock was 29.64 ± 11.49, 28.60 ± 9.87 and 27.81 ± 7.39 mmHg, respectively. ETCO2 on arrival was positively correlated with systolic and diastoli...