IOT BASED REAL TIME TELE-HEALTHCARE SYSTEM

Tele-healthcare is need of the hour to bridge the vast healthcare gap in developing country like India. Being the second most populous country, quality healthcare facility is not easily accessible in the rural outskirts of India. In this research work the proposed system has acquired ECG, heart rate, SpO2 and body temperature data for better diagnosis and prognosis. The proposed system has been tested on the different patients belonging to different age groups and the result obtained on the health monitoring dashboard is found to be satisfactory. It also provides enhanced accessibility as multiple healthcare professionals can collaborate on the patient's data. This paper concludes with real time audio/ video connectivity, scope of interest of which is very effective and applicable in healthcare world.

Effects of passive smoking on pulmonary functions of individuals in an urban area

Background: Passive smoking is a world health problem and part of the tobacco epidemic which victimizes mostly adolescents. Research articles have addressed the relation between passive smoking and respiratory efficiency in adult population and escalated the hazard of chronic obstructive pulmonary disease and lung cancer among adult passive smokers. The present study was conducted to analyze the effects of exposure to passive smoke on pulmonary functions among nonsmoking individuals. Aim and Objectives: The study was determined to assess the effects of passive smoking on pulmonary functions among individuals in urban region. Materials and Methods: The present study was conducted on smokers, passive smokers, and nonsmokers (control), aged between 17 and 25 years. Ninety healthy individuals were placed in three different groups on the basis of questionnaire (Group A: active smoker, Group B: passive smoker, Group C: control). Study was done with the help of spirometer and pulse oximeter. Results: Forced expiratory flow25–75%, Forced expiratory volume in 1 second/Forced vital capacity % values were significantly reduced in passive smokers as compared to control individuals (P < 0.001, P < 0.05). SpO2 level was decreased in passive smokers and active smokers, but it was not statistically significant. Conclusions: The present study showed a strong association between passive smoking and pulmonary abnormalities in individuals exposed to passive smoke. Health hazards caused by passive smoking should be controlled by creating awareness and regular health check-ups among people.

Effects of different sputum suction pressure on intracranial pressure of severe craniocerebral injury patients / 中国实用护理杂志

Objective:To explore the best negative pressure standard of sputum aspiration in patients with severe craniocerebral injury, so as to achieve the best sputum aspiration effect and maintain relatively stable intracranial pressure.Methods:Totally 120 patients with severe craniocerebral injury admitted to the Department of Neurosurgery of Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School from January to December 2019 were selected by convenience sampling method. According to the random number table method, patients were divided into 4 different negative pressure sputum aspiration groups: 75 mmHg (1 mmHg=0.133 kPa) group, 100 mmHg group, 150 mmHg group, 200 mmHg group, with 30 patients in each group. The levels of intracranial pressure and SpO 2, sputum cleaning time and mucosal injury were observed and compared in 4 groups: 1 min before sputum aspiration, 1 min after sputum aspiration and during sputum aspiration. Results:Comparison of intracranial pressure and SpO 2 in sputum aspiration among the four groups: intracranial pressure in 200 mmHg group was (22.23 ± 4.80) mmHg, which was higher than 75 mmHg group (16.33 ± 2.71) mmHg, 100 mmHg group (17.70 ± 2.32) mmHg, 150 mmHg group (17.20 ± 2.11) mmHg ( q=8.29, 6.58, 7.23), and SpO 2 was 0.906 ± 0.048, which was lower than 0.956 ± 0.013, 0.946 ± 0.018, 0.952 ± 0.023 in the other three groups ( q=7.81, 6.08, 6.69), with statistical significance (all P<0.01). There were statistically significant differences in intracranial pressure ( F=10.55) and SpO 2 ( F=36.57) among the four groups 1 min after sputum aspiration ( P<0.01);the 200 mmHg group had the highest intracranial pressure (15.63 ± 3.64) mmHg; the 100 mmHg group was (12.50 ± 1.48) mmHg and 150 mmHg group was (12.60 ± 1.00) mmHg, which had lower intracranial pressure than the 75 mmHg group (14.03 ± 2.86) mmHg. The sputum cleaning time was (35.53 ± 5.71) s in 75 mmHg group which was the longest and the shortest in 200 mmHg group (24.27 ± 3.22) s, with statistical significance among the four groups ( F=47.81, P<0.01). The incidence of airway mucosal injury in 200 mmHg group was 33.33% (10/30),which was higher than that in the other three groups, and the difference was statistically significant ( χ2=15.41, P<0.01). Conclusions:For patients with severe craniocerebral injury, artificial airway sputum viscosityⅠ-Ⅱ degree, suction negative pressure of 100-150 mmHg can better maintain the stability of intracranial pressure, control the decline of SpO 2 and prevent the damage of airway mucosa, and effectively reduce the adverse effects of sputum aspiration on patients with severe craniocerebral injury.

A study to validate thoracic trauma severity score in chest trauma patients

Background: Aim of this study was to validate thoracic trauma severity score (TTSS) in assessing the requirement of mechanical ventilation, mortality, and predicting prognosis in chest injury patients.Methods: This study was conducted in department of general surgery, Dr. S. N. Medical College, Jodhpur, Rajasthan, from December 2018 to September 2019. This was a single centred, prospective, observational study, conducted in 110 patients, aged >18 years, of isolated chest injury, excluding polytrauma patients. Data was summarized in the form of proportions, histograms and tables to show relationships of parameters with results. Data was presented as mean±SD and proportions as appropriate. Chi square test, z test or t tests were used wherever necessary for association analysis between categorical variables. Diagnostic test characteristics for mortality and complications was calculated from the ROC curves. A two sided of p values of less than 0.05 was considered statistically significant.Results: Most common mode of chest injury was blunt trauma and most common age group affected was 42-54 years. Maximum mortality was seen in TTSS between 16-20, shows higher the TTSS more the mortality. Ventilator requirement was more in high TTSS. Patients with higher TTSS had longer hospital stay as compared to patients with lower TTSS.Conclusions: On application of TTSS on admission, TTSS had direct correlation with need for oxygenation, ventilator need, duration of hospital stay, mortality or outcome in chest trauma patients. Thus we recommend TTSS as a good useful score for evaluation of prognosis, outcome and mortality in chest trauma patients.

The effects of gel-based manicure on pulse oximetry

INTRODUCTION@#Pulse oximetry is the standard monitoring technique of functional oxygen saturation (SpO). As the use of fingernail polish has been described to alter SpO readings, its removal is commonly recommended prior to measurement. Gel-based manicures have gained popularity in recent years due to their attractiveness and longevity. However, the removal of gel nail polish requires a specialised procedure. Valuable time and resources can be saved if removal can be avoided. To our knowledge, there are no available studies on the effect of gel-based manicures on pulse oximetry readings. Hence, we evaluated the effect with two oximeters, using different technology and wavelength combinations.@*METHODS@#17 healthy female adult volunteers were recruited for this single-blind randomised controlled trial. Subjects with hypothermia, hypotension, poor plethysmographic waveform and nail pathology were excluded. Colours tested were: black, purple, navy blue, green, light blue, white, yellow, orange, pink and red. Pulse oximetry was measured at 15- and 30-second intervals using two different pulse oximeters, the Philips M1191BL and Masimo SET®. Means were compared using paired t-tests.@*RESULTS@#Using the Masimo oximeter, light blue (ΔM = 0.97% ± 0.96%; p = 0.001) and orange (ΔM = 0.76 ± 1.17%; p = 0.016) gel nail polish resulted in a statistically significant increase from baseline SpO readings. With the Philips oximeter, the limits of agreement ranged from 2% for pink to 17% for black, indicating imprecision.@*CONCLUSION@#Gel-based manicures can result in overestimations of actual readings, delaying detection of hypoxaemia. Gel nail polish should be routinely removed or an alternative monitoring technique sought.

Correlación de SpO2/FiO2 versus PaO2/FiO2 para monitoreo de la oxigenación en pacientes con trauma de tórax / Correlation of SPO2/FiO2 versus PaO2/FiO2 for oxigenation monitoring in patients with thorax trauma / Correlação de SPO2/FiO2 versus PaO2/FiO2 para monitoração de oxigenação em pacientes com trauma tórax

Resumen: Introducción: La monitorización de la oxigenación se ha realizado tradicionalmente mediante índices como PaO2/FiO2, que requieren de toma de gasometrías para su determinación. La tendencia de una monitorización mínimamente invasiva propone utilizar la saturación de pulso en el índice SpO2/FiO2 con el mismo fin. El índice SpO2/FiO2 tiene ventajas: obtención rápida y no requiere de gasometría. Rice y cols. hicieron la comparación SpO2/FiO2 y PaO2/FiO2, demostrando la validación del índice Patrick y cols. lo incorporaron a la escala SOFA, Kigali mostró la importancia de monitoreo mínimamente invasivo con SpO2/FiO2 y USG pulmonar en SDRA, proponiendo una clasificación comparable con la de Berlín. Objetivos: Demostrar que existe correlación entre SpO2/FiO2 versus PaO2/FiO2 para monitoreo de la oxigenación en los pacientes con trauma de tórax. Material y métodos: Se realizó un estudio observacional, descriptivo, longitudinal y ambispectivo en 25 pacientes ingresados con diagnóstico de trauma de tórax entre enero de 2016 y abril de 2017 en el servicio de cuidados intensivos, de los cuales se excluyeron cinco pacientes. Se realizó un análisis estadístico utilizando correlación bivariada de Pearson y, si ésta fuera significativa, una correlación lineal para determinar el grado de la misma. Se realizó determinación de medias de edad, género, tipo de trauma, días de ventilación mecánica y defunción. Los resultados se analizaron con el programa estadístico SPSS versión 21.0. Conclusiones: Existe desde el ingreso una correlación lineal significativa entre ambos índices, dicha correlación es mayor de 60% desde el ingreso; sin embargo, adquiere mayor significancia estadística con un grado de correlación hasta de 90% a partir de las 24 horas y hasta el fin del estudio. Consideramos, por tanto, una prueba útil y significativa para valorar la oxigenación en pacientes con trauma de tórax.

Abstract: Introduction: Traditionally, oxygenation monitoring has been performed using indices such as PaO2/FiO2, which requires the determination of gasometry. The trend of minimally invasive monitoring proposes to use pulse saturation in the SpO2/FiO2 index for the same purpose. The SpO2/FiO2 index has advantages: rapid obtaining and not requiring gasometry. Rice performed the SpO2/FiO2 and PaO2/FiO2 comparison demonstrating index validation, Patrick incorporates it into the SOFA scale, Kigali shows the importance of minimally invasive monitoring with SpO2/FiO2 and pulmonary USG in ARDS by proposing a comparable classification with that of Berlin. Objectives: To demonstrate that there is a correlation between SpO2/FiO2 vs PaO2/FiO2 for monitoring of oxygenation in patients with chest trauma. Material and methods: An observational, descriptive, longitudinal, ambispective study was performed in 25 patients admitted with a diagnosis of chest trauma between January, 2016 and April, 2017, in the Intensive Care service, of which 5 patients were excluded. A statistical analysis was performed using Pearson's bivariate correlation, and if a linear correlation was significant to determine the degree of correlation. Determination of means of age, gender, type of trauma, mechanical ventilation and death were determined. The results were analyzed with the statistical program SPSS version 21.0. Conclusions: There is a significant linear correlation between the two indexes, a correlation that is greater than 60% from the time of admission, but it acquires the highest statistical significance with a degree of correlation up to 90% from 24 hours to the end Of the study. We therefore consider a useful and significant test to assess oxygenation in patients with chest trauma.

Resumo: Introdução: Tradicionalmente, o monitoramento da oxigenação tem sido realizado por meio de índices como PaO2/FiO2, que exigem o uso de gasometrias para sua determinação. A tendência do monitoramento minimamente invasivo propõe o uso da saturação de pulso no índice SpO2/FiO2 para o mesmo fim. O índice SpO2/FiO2 apresenta vantagens: obtenção rápida e não requerer gasometria. Rice fez a comparação SpO2/FiO2 e PaO2/FiO2 demonstrando a validação do índice, Patrick incorpora na escala SOFA, Kigali mostra a importância da monitorização minimamente invasiva com SpO2/FiO2 e USG pulmonar na SDRA, propondo uma classificação comparável à de Berlim. Objetivos: Demonstrar que há correlação entre a SpO2/FiO2 e a PaO2/FiO2 no monitoramento da oxigenação em pacientes com trauma torácico. Material e métodos: Estudo observacional, descritivo, longitudinal, ambispectivo, realizado em 25 pacientes admitidos com diagnóstico de trauma torácico, entre janeiro de 2016 e abril de 2017, na Unidade de Terapia Intensiva, dos quais 5 pacientes foram excluídos. Uma análise estatística foi realizada usando a correlação bivariada de Pearson, e se esta fosse significativa, uma correlação linear para determinar o grau de correlação da mesma. Determinamos as médias de idade, sexo, tipo de trauma, dias de ventilação mecânica e morte. Os resultados foram analisados com o programa estatístico SPSS versão 21.0. Conclusões: Existe uma correlação linear significativa entre os dois índices, tal correlação é maior que 60% desde a internação, mas adquire a maior significância estatística com um grau de correlação de até 90% a partir das 24 horas e até final do estudo. Portanto, consideramos um teste útil e significativo para avaliar a oxigenação em pacientes com trauma torácico.

Evaluación de conocimientos sobre oxigenoterapia y lectura del flujómetro en el personal de salud de pediatría del Hospital Universitario San Ignacio, Bogotá, Colombia / Knowledge Evaluation of Oxygen Therapy and Flowmeter's Reading among Health Workers in the Pediatric Unit at Hospital Universitario San Ignacio, Bogotá, Colombia

Introducción: el oxígeno (O2) es un medicamento que puede generar efectos adversos. Discrepancias en la lectura del flujómetro y metas de saturación de oxígeno (SpC>2) pueden repercutir en la toma de decisiones clínicas, paraclínicas y estancia hospitalaria de pacientes pediátricos. Objetivo: evaluar conocimientos sobre SpO2, efectos adversos del O2 y lectura del flujómetro en el personal de salud del Departamento de Pediatría del Hospital Universitario San Ignacio, Bogotá, Colombia. Métodos: estudio transversal, mediante encuesta autodiligenciada en una muestra por conveniencia durante diciembre de 2016 y enero de 2017. Evaluación de conocimientos sobre oxigenoterapia, SpC>2, efectos adversos y lectura del flujómetro mediante fotografías de flujómetros del hospital con diferente fracción inspirada de oxígeno (FiC>2). Resultados: de 259 personas, el 77% respondió la encuesta. El 22% de los participantes respondió que la SpC>2 aumenta o se mantiene igual cuando el niño duerme; el 78% sabía de complicaciones del uso prolongado de O2, y el 67%, las relacionadas con la administración de una FiC>2 mayor a la necesaria. Con relación a la población neonatal, el 10% consideró que se deben buscar metas de SpO2 iguales o superiores al 96%; entre el 9% y el 19% de las lecturas en las diferentes fotografías de flujómetros fueron respuestas incorrectas. Discusión: es necesario reforzar conceptos actualizados sobre oxigenoterapia, con énfasis en metas de saturación, efectos adversos y lectura de flujómetro mediante campañas educativas periódicas.

Introduction: Supplemental oxygen is considerad a pharmaceutical drug; therafora, it can produce adverse effects. Lack of consensus regarding the reading of oxygen flowmeters and peripheral oxygen saturation (SpC>2) goals can influence clinical and paraclinical decisions and hospital stay length. Objective: To assess knowledge on oxygen therapy, adverse effects, SpC>2 goals and oxygen flowmeter's reading among personnel in the Pediatric Unit at Hospital Universitario San Ignacio, Bogotá, Colombia. Methodology: Cross-sectional study derived from convenience sampling through a self-applied poli between December 2016 and January 2017. The poli evaluated topics on supplemental oxygen therapy fundamentáis and adverse effects, SpC>2 goals and flowmeter readings through flowmeters photographs indicating a specific ffaction of inspirad oxygen (FÍO2). Results: Response rate was 77% from 259 subjects. 22% considered that the oxygen saturation either increases or remains the same during sleep periods in children. 78% participants knew at least one complication associated to prolonged oxygen therapy and 67% due to supplementary oxygen concentration greater than required amounts. In neonatal population, 10% considered oxygen saturation efectos adversos y lectura de flujómetro mediante campañas educativas periódicas.

ARDS severity identification based on noninvasive parameter SpO2/FiO2 / 医疗卫生装备

Objective To explore the relationship between SpO2/FiO2(S/F) and PaO2/FiO2(P/F) so as to determine the possibility of ARDS severity identification based on noninvasive parameters. Methods The physiological parameters of corresponding patients were acquired from Medical Information Mart for Intensive Care (MIMIC-Ⅲ),and then divided into a training set and a test set randomly.In the training set the linear relationship between lg(S/F)and lg(P/F)was established with generalized linear regression model,and a log linear regression model was formed with the optimal regression equation;the linear relationship between lg(S/F)and lg(P/F)was compared with that between S/F and P/F.In the test set,the two models were compared on the identification of ARDS in case P/F values were 100(mild ARDS),200(moderate ARDS)and 300(severe ARDS)respectively.Results In the training set(n=61 634)the linear relationship between lg(S/F)and lg(P/F)was deduced as lg(S/F)=1.277+0.437×lg(P/F) (r=0.66,P<0.000 1),and the S/F thresholds in case P/F values were 100,200 and 300 respectively were 131,201 and 271.In the test set (n=26 758)the identification effect was verified with the acquired S/F thresholds,which proved better than that of traditional regression model.Conclusion Noninvasive parameter SpO2/FiO2can replace PaO2/FiO2for the auxiliary diagnosis of ARDS in case the result of blood gas analysis is absent.

Effect of simulated microgravity on peripheral oxygen saturation in rats / 生物医学工程学杂志

To study the effect of microgravity on peripheral oxygen saturation (SpO ) in rats, tail-suspended rats were applied to simulate microgravity environment. SpO and arterial oxygen saturation (SaO ) were measured by pulse oximeter and arterial blood gas analyzer (ABGA) respectively on the 14th day, 21st day and 28th day in tail-suspended group and control group. Paired -test shows that SpO was significantly lower than SaO in tail-suspended group on the 14th day ( < 0.05), the 21st day ( < 0.05) and the 28th day ( < 0.01). The ANOVA results shows that modeling time had significant effect on SpO value but no effect on SaO value in tail-suspended group. These results indicate that pulse oximeter may be not suitable for oxygen saturation test in microgravity environment.

Evaluation of multiple oxygenation indexes in acute respiratory distress syndrome / 军事医学

Acute respiratory distress syndrome(ARDS)and acute lung injury are grave syndromes associated with high morbidity of the mortality.Currently,the criteria for the classification of the severity of ARDS are the PaO 2/FiO2values, while OI,S/F and OSI values are also used as ancillary diagnostic and grading criteria for ARDS.In this review,we sum-marize the effects of four indicators on the diagnosis and severity of ARDS patients,their respective strengths and weaknes-ses,and predit the future development of the classification of severity of ARDS.

The comparison and selection for saturated pulse oximetry sensor / 中国医学装备

Objective:To expound the importance of blood oxygen saturation index, and to analyze the detection method of oxygen saturation index. Besides, to provide scientific and reasonable basis for use and selection of clinical saturated pulse oximetry(SpO2) sensor. Methods: To adopt pertinence detection method to test six kinds of SpO2 sensors (included the original import, original domestic, import commission processing, domestic commission processing, integrated mode sensor and one-time sensor), and to detect and analyze their specifications.Results: The experiment results of six kinds of SpO2 sensor were analyzed, and their main characteristics were obtained. And then, different sensor was recommended to different department or situation according to the actual situation of different hospital.Conclusion: Various clinical department and requirement can give full play to the advantages of various types of sensor, fast detect blood oxygen index for patients, reasonably allocate SpO2 sensor, reduce using cost and improve diagnosis level, at the same time, effectively carry through adjuvant therapy after they select the most suitable SpO2 sensor.

Embolismo de líquido amniótico / Amniotic fluid embolism

Se valoró un caso de una femenina quien es internada por embarazo en vías de prolongación para inducción del mismo, posterior a su labor presenta sangrado transvaginal abundante por lo que es ingresada a sala de operaciones, no se le encuentra sitio de sangrado, le realizan histerectomía y fallece; es enviada para su respectiva autopsia, se determina como causa de muerte: embolismo de líquido amniótico. Este artículo pretende revisar la etiología de esta patología, fisiopatología, criterios diagnósticos del mismo, factores de riesgo, diagnósticos diferenciales y su tratamiento.

A case of a female who is hospitalized for pregnancy-way extension for induction thereof, after their work presents TVB abundant so it is entered into operating room were assessed, you will not find the bleeding site, we performed hysterectomy and dies; is sent to the respective autopsy determined the cause of death: amniotic fluid embolism. This article reviews the etiology of this pathology, pathophysiology, diagnostic criteria thereof, risk factors, differential diagnosis and treatment.

Cardiac Magnetic Resonance Imaging Using Multi-physiological Intelligent Trigger System

PURPOSE: We proposed a multi-physiological signals based real-time intelligent triggering system(MITS) for Cardiac MRI. Induced noise of the system was analyzed. MATERIALS AND METHODS: MITS makes cardiac MR imaging sequence synchronize to the cardiac motion using ECG, respiratory signal and second order derivative of SPO2 signal. Abnormal peaks due to arrhythmia or subject's motion are rejected using the average R-R intervals and R-peak values. Induced eddy currents by gradients switching in cardiac MR imaging are analyzed. The induced eddy currents were removed by hardware and software filters. RESULTS: Cardiac MR images that synchronized to the cardiac and respiratory motion are acquired using MITS successfully without artifacts caused by induced eddy currents of gradient switching or subject's motion or arrhythmia. We showed that the second order derivative of the SPO2 signal can be used as a complement to the ECG signals. CONCLUSION: The proposed system performs cardiac and respiratory gating with multi-physiological signals in real time. During the cardiac gating, induced noise caused by eddy currents is removed. False triggers due to subject's motion or arrhythmia are rejected. The cardiac MR imaging with free breathing is obtained using MITS.

Research on design and clinical application of a detection equipment used in arteriosclerosis / 中国医学装备

Objective: To design device to measure D/T index which is used for evaluation of arteriosclerosis. Methods:By calculating the detected date of blood pressure values, pulse pressure, pulse rate, pulse patterns and SpO2 on the extremities, we get a set of analytical data in the system in order to analyze the arteriosclerosis situations. Results: The device use the ECG signal as it based and modulated signal, the computer process the date of blood pressure and SpO2, then output the result by the display and printing systems. Conclusion:The device provides an effective noninvasive detection means for extremity vascular.

The influence of different operative approaches on perioperative respiratory and cardiac function of patients with gastric cardia carcinoma / 中国综合临床

Objective To investigate the effect of different operative approaches on perioperative respiratory and cardiac function of patients with gastric cardia carcinoma. Methods The perioperative changes of SpO2 ,Breath Rate (BR) and Heart Rate(HR) of patients with gastric cardia carcinoma underwent surgical therapies through transthoracic ( n = 30 ), transabdominal ( n = 37 ) or trans-thoracoabdominal ( n = 10 )approaches were compared respectively. Results On the postoperative 1st,2nd,4th and 7th day,the changes of BR in transthoracic (5. 20 ± 0. 96,5. 17 ± 1. 58,3.93 ± 1.53,2. 63 ± 1.25 )/min and trans-thoracoabdominal (5.80 ±0. 79,6. 10 ± 1.20,4. 80 ± 1.32,3.00 ± 1.49)/min approach groups were significantly greater than that of transabdominal group (4. 35 ± 1.06,3.89 ±0. 99,2. 24 ± 1.30,1.16 ±0. 65)/min (Ps ＜0. 05). At the meanwhile, the changes of SpO2 at 2nd, 4th postoperative day of transthoracic ( [ 8. 30 ± 1.95 ] %, [ 7.23 ±2. 01 ] % ) and trans-thoracoabdominal ( [ 8.60 ± 1.43 ] %, [ 7. 70 ± 2. 11 ] % ) approach groups were significantly greater than that of transabdominal group ( [ 7. 08 ± 1.82 ] %, [ 6.24 ± 1.88 ] % ) ( Ps ＜ 0. 05 ), but there were no significant differences observed among three groups on the postoperative 1st,7th day. On the postoperative 1 st,2nd and 4th day, the changes of HR of transthoracic ( 18.00 ± 3.79,13.47 ± 4. 42,8. 60 ±4. 13 )/min and trans-thoracoabdominal ( 19. 80 ± 4. 96,14. 80 ± 3.33,8.70 ± 3.47)/min approach groups were significantly greater than that of transabdominal group ( 13.62 ± 4. 00,10. 84 ± 4. 16,6. 32 ± 2. 53 )/min, too (Ps ＜0. 05) ,but no differences were observed among three groups on the postoperative 7th day (Ps ＞0. 05).Coniclusion Transthoracic,transabdominal and trans-thoracoabdominal approachs resulted in different effects on respiratory and cardiac function in patients with gastric cardia carcinoma.

The Clinical Application of SpO_2-Allen's Test in Radial Artery Cannulation for Invasive Blood Monitor / 医学研究杂志

Objective To observe the safety and efficiency of SpO_2 -Allen's test in peri -puncture radial artery cannulation for invasive blood monitor. Methods 50 patients were selected for the radial artery cannulation in surgical intensive care unit(SICU). All of them were still sober. All of the patients were examined by SpO_2 -Allen's test and Allen's test before radial artery cannulation, 3 days after puncture and after pulling out the cannula. Resluts The results of Allen's test of 42 patients were negative,while those of 49 patients were negative in SpO_2 - Allen's test. Statistics difference existed between group of SpO_2 - Allen's text and group of Allen's text(P

The Influence of Patient Controlled Analgesia on the Recovery of Muscle Power and Respiratory Function following Intraoperative Muscle Relaxants / 대한마취과학회지

BACKGROUND: Residual muscle paralysis after anesthesia is reduced with the advent of intermediate-acting neuromuscular blocking drugs, yet the incidence is as high as about 10 percent. Opioids in patient-controlled analgesia (PCA) may cause respiratory depression and other problems after anesthesia. The purpose of this study is to evaluate the influence of PCA on the SPO2, TOF ratio, head-lift and tongue protrusion during recovery room stay following intraoperative muscle relaxants. METHODS: 120 patients aged from 20 to 65 in ASA class I and II were divided into control or PCA groups. All patients received rocuronium (0.9 mg/kg) or atracurium (0.5 mg/kg) for tracheal intubation, and maintenance of relaxation was done with atracurium 0.2 mg/kg/hr during inhalation anesthesia. Reversal of block was done with pyridostigmine 0.15 mg/kg and glycopyrrolate 0.2 mg. SpO2, TOF ratio, 5 sec-head lift, tongue protrusion tests were evaluated in the recovery room. RESULTS: IV-PCA did not influence the incidence of residual block, SPO2, TOF ratio during recovery room stay for 20 minutes, but influenced negatively 5 sec-head lift test, tongue protrusion test only immediately after arrival at the recovery room. CONCLUSIONS: Since IV-PCA decreased the ability to perform head-lift and tongue protrusion early postoperatively, it is recommended that patients with IV-PCA should be carefully managed against the risk of aspiration or upper respiratory obstruction during their early recovery room stay.

Design of SpO_2 Measuring and Analysis System Based on LabVIEW / 医疗卫生装备

Objective To design and develop a kind of SpO2 detection and analysis system based on LabVIEW. Methods Pulse signal process and SpO2 calculation were achieved by designing a control system based on TI Company's MSP430FG439 MCU and using the digital signal process and graphic controls of the LabVIEW software. The design project and the realization way were given out by discussing the software of LabVIEW. Results The system could acquire, display and process pulse signal and calculate SpO2. Conclusion The system carries out a new way to design medical monitor equipment. Furthermore, it provides a shortcut for special analysis of the SpO2 and pulse signal in clinic.

Differences of SpO2 at between Hand and Foot During Spinal and Lumbar Epidural Anesthesia / 대한마취과학회지

Pulse oxymetry noninvasively estimates arterial oxygen saturation (SaO2) spectrophoto- metically by processing a pulse added light absorbance signal from transilluminsted tissue and provides continuous information. So the device is rapidly becoming a standard in clini- cal monitoring. Preganglionic sympathetic denervation during spinal and lumbar epidural anesthesia causes dilatation of both resistance and capacitance veasels of the lower limbs, with a reflex increase in efferent sympathetic activity above the level of the block. Skin temperature elevation corresponds with the upper limit of diminished sympathetic activity and is in agreement with the view that skin temperature increase is a useful indicator of sympathetic blockade. Pulse oximetry is dependent upon the presence of a pulsating vascular bed. The signal detection will be impaired in the presence of vasoconstriction or venous congestion, conditions which occur in spinal and lumbar epidural anesthesia. We compared the oximetric measurements (SpO2) at the hand and the foot with arterial oxygen saturation (SaO2) during spinal and lumbar epidural anesthesia. After administration of a crystalloid solution, 10 patients recieved 7-10mg of 0.5% tetracaine into the subarachoid space and 10 patients recieved 10-20ml of 2% lidocaine into the lumbar epidural space in 20 adult patients, scheduled for operation. Two temperature probes and two pulse oximeter probes were applied to the finger snd toe of the patients, and the temperature and SpO2, values were recorded continuously. Arterial oxygen saturation (SaO2) was measured using M288 before and 30 min after the onset of sensory block. In all patients, intraoperative decreasing of heart rate and arterial blood pressure was 15% from baseline. During anesthesia, the decreasing of temperature reeorded from sympathetically unaffected areas could be related to vasoconstriction, counterbalancing sympathetic block. But no significant differences were detected between SaO2, and SpO2, basal values recorded from the hand and foot before anesthesia. After the onset of spinal and lumbsr epidural anesthesia, SpO, values recorded from tbe hand were not changed aignificantly. Otherwise significant differences in SaO2 were detected between two groups before and 30 min after anesthesis, because the age in lumbar epidural group (63.8+/-90.1) was older than the age in spinal group (44.6+/-121.1). Therefore, we concluded that SaO2 must be confirmed when there are clinically significant changes during spinal and lumbar epidural anesthesia, although SpO2 in hand are neither changed nor decreaaed below normal range.