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Abstract Introduction: Serum level of high-mobility group box 1 protein is reportedly correlated with the severity of obstructive sleep apnea. Objective: We tried to evaluate the possibility of using the serum high-mobility group box 1 protein level as a biologic marker in obstructive sleep apnea patients. Methods: We generated a chronic intermittent hypoxia murine model that reflected human obstructive sleep apnea. Obstructive sleep apnea patients who underwent polysomnography were prospectively enrolled. Serum samples were obtained from mice and obstructive sleep apnea patients, and the serum high-mobility group box1 protein level was measured by enzyme-linked immunosorbent assay. Results: Serum high-mobility group box 1 protein level was 56.16 ± 30.33 ng/mL in chronic intermittent hypoxia and 18.63 ± 6.20 ng/mL in control mice (p<0.05). The mean apnea-hypopnea index and respiratory disturbance index values of enrolled obstructive sleep apnea patients were 50.35 ± 27.96 and 51.56 ± 28.53, respectively, and the mean serum high-mobility group box 1 protein level was 30.13 ± 19.97 ng/mL. The apnea-hypopnea index and respiratory disturbance index were not significantly correlated with the serum high-mobility group box 1 protein level (p>0.05). Instead, this protein level was significantly correlated with lowest arterial oxygen concentration (SaO2) (p<0.05). Conclusion: High-mobility group box 1 protein may be involved in the pathogenesis of obstructive sleep apnea, and the possibility of this protein being a useful biologic marker in obstructive sleep apnea should be further evaluated.
Resumo Introdução: O nível sérico da proteína de alta mobilidade do grupo Box-1 está relacionado com a gravidade da apneia obstrutiva do sono. Objetivo: Avaliar o uso do nível sérico da proteína de alta mobilidade do grupo Box-1 como um marcador biológico em pacientes com apneia obstrutiva do sono. Método: Geramos um modelo murino de hipóxia intermitente crônica que imita a apneia obstrutiva do sono em humanos. Pacientes com apneia obstrutiva do sono que fizeram polissonografia foram incluídos prospectivamente. Amostras de soro foram obtidas de camundongos e pacientes com apneia obstrutiva do sono e o nível sérico da proteína de alta mobilidade do grupo Box-1 foi medido por enzyme-linked immunosorbent assay. Resultados: O nível sérico da proteína de alta mobilidade do grupo Box-1 foi 56,16 ± 30,33 ng/mL em hipóxia intermitente crônica e 18,63 ± 6,20 ng/mL em camundongos controle (p < 0,05). Os valores médios do índice de apneia-hipopneia e do índice de distúrbio respiratório nos pacientes com apneia obstrutiva do sono foram 50,35 ± 27,96 e 51,56 ± 28,53, respectivamente, e o nível médio da proteína de alta mobilidade do grupo Box-1 foi 30,13 ± 19,97 ng/mL. O índice de apneia-hipopneia e o índice de distúrbio respiratório não foram significantemente associados com o nível da proteína de alta mobilidade do grupo Box-1 p> 0,05). Em vez disso, esse nível de proteína foi significantemente associado com o valor mais baixo da concentração arterial de oxigênio (SaO2) (p <0,05). Conclusão: A proteína de alta mobilidade do grupo Box-1 pode estar envolvida na patogênese da apneia obstrutiva do sono e a possibilidade de que essa proteína possa ser um marcador biológico útil na apneia obstrutiva do sono deve ser avaliada mais detalhadamente.
ABSTRACT
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.
ABSTRACT
Objective To identify the association of oxygen saturation of arterial hemoglobin (SaO2) with late-onset hypertension in the Chinese Han population located in the Daxinganling area.Methods A total participants were selected by convenience sampling methods from the Daxinganling area.All data were collected from each person by the questionnaire record of physical examinations as well as biochemical index measuring.SaO2 was noninvasively measured with finger pulse oxymetry,the reported SaO2 was the average of three readings taken 10 seconds apart.Results There were significant differences for SaO2 within the population of individuals,the mean SaO2 values was 97.71%±6.14%,with range from 88% to 100%.There was association of SaO2 with sex,BMI and age.SaO2 level declined with BMI and age increasing.Particularly,it was found that the risk increasing to hypertension was marked association with SaO2 rapid drop.During the period from 40-50 years of age,SaO2 declined from 97.85% to 97.64%,The risk to hypertension increased more than 10 times(P<0.001).That implicated hypoxia mightinvolve in the etiology of hypertension.Conclusions The preliminary results demonstrated the rapid decline of SaO2 with lapse of age may be one of the major risk factors to hypertension,it may be helpful to explain late-onset hypertension to some extent at least.
ABSTRACT
OBJECTIVE:To investigate the effect of preoperative use of high-dose simvastatin on the pulmonary artery pres-sure in congenital heart disease with left-to-right shunt. METHODS:86 patients with left-to-right shunt congenital heart disease who were planned to implement interventional occlusion therapy were randomly divided into control group(43 cases)and observa-tion group(43 cases). Patients in both groups were given digitalis,diuretics,anticoagulants and other basic treatments;On this basis, control group received Sildenafil citrate tablet,25 mg,3 times a day,orally given 1 h before a meal;observation group received Simvastatin tablet 80 mg,once every evening,orally. The treatment course for both groups was 7 d. Mean pulmonary hypertension (mPAP),N terminal prohormone brain natriuretic peptide (NT-proBNP),arterial oxygen saturation (SaO2),arterial oxygen ten-sion(PaO2),pulmonary blood circulation ratio(Qq/Qs),pulmonary pressure variation(Rp/Rs),pulmonary vascular resistance in-dex(PVRi)before and after treatment in 2 groups were observed,and related indicators of liver functions [alanine aminotransfer-ase (ALT),aspartate aminotransferase(AST)] and myocardial enzymes [lactate dehydrogenase (LDH),creatine kinase MB(CK-MB)] were detected. The incidence of adverse reactions were deteted. RESULTS:Before treatment,there were no significant differ-ences in mPAP,NT-proBNP,SaO2,PaO2,Qq/Qs,Rp/Rs,PVRi,ALT,AST,LDH and CKMB levels in 2 groups(P>0.05). Af-ter treatment,mPAP,NT-proBNP,Rp/Rs and PVRi levels were significantly lower than before,SaO2,PaO2,and Qq/Qs levels were significantly higher than before and Qq/Qs level in observation group was higher than these in control group.The difference was statistically significant(P<0.05). There was 1 patient showed severe liver injury in observation group and exited the test;the other 85 patients showed no obvious adverse reactions,with successful surgery and good prognosis. CONCLUSIONS:The preoper-ative use of high-dose simvastatin shows obvious effect on controlling mean pulmonary hypertension,reducing mPAP,NT-proB-NP,Rp/Rs and PVRi levels and increasing SaO2,PaO2,and Qq/Qs levels before operation,with good safety.
ABSTRACT
This article summarized the technique research and application status of near-infrared spectroscopy (NIRS), in order to explore hypoxia,qi-deficiency and their connections with typical symptoms. It also discussed NIRS acquired oxygen saturation (SaO2) and its relevant means and methods for information quantification ofqi-deficiency. The accurate obtained SaO2 value was applied in the association with the strength of chest distress in the subjective sensation due toqi-deficiency. According to current data, the normal value,qi-deficiency degree and uncomfortable degree of subjective sensation among patients of different altitudes and ages were summarized. It can be applied to assist TCM physicians in the quick quantification of qi-deficiency.
ABSTRACT
BACKGROUND: Bronchofiberscopy is a procedure with a chance of airway irritation and it may cause pathophysiologic changes of respiratory system. So we tried to evaluate the influence of bronchofibercopy on O2 saturation, ABGA and PET by patient's basal status and procedure type. METHOD: O2 saturation was measured every 1 minute from the left index finger tip with percutaneous oximetry. ABGA was done before and right after the bronchofiberscopy and PFT was done before and within 10 minutes after the bronchofiberscopy. RESULTS: The mean time for bronehofiberscopy procedure was 14.5mim and SaO2 maximally fall to 89.0 below 8% of the baseline after mean time of 8.4mm, which was recorvered at the end of the procedure. SaO2 change amount was 8.4% on Non-O2 supply group, which was lower compared to 6.4% of the O2-supply group without statistically significance. Biopsy Group and BAL group showed more SaO2 fall than washing only group. The level of PaO2 and FEV1 of the patient didn's influence significantly on SaO2 fall during the procedure. ABGA taken before and after the bronchofiberscopy showed mild fall of Pa02 and mild rise of PaCO2. Whereas PET showed decrease of FEV1(P<0.05) and increase of RV without changes in airway resistance and pulmonary diffusion capacity. Comparing before and after the bronchofiberscopy, the washing group showed no significant changes on PET, while the biopsy group and the BAL group showed increase of RV & decrease of FEV1 after the bronchofiberscopy. BAL group showed more changing tendency rather than biopsy group although not statistically significant. CONCLUSION: Bronchofiberscopy is considered as a relatively safe procedure, but it would be better to be done with O2 supply especially in the patient with low PaO2 and in the case of biopsy and BAL
Subject(s)
Humans , Airway Resistance , Biopsy , Diffusion , Fingers , Oximetry , Respiratory SystemABSTRACT
To find out the predictors of nocturnal arterial oxygen desaturation in patients with respiratory diseases, transcutaneous oxygen saturation(StcO2) monitoring studies using a pulse oximeter were performed during sleep in 20 patients. StcO2 was decreased more than 4% from the baseline value in 18 patients(90%) and more than 10%('Desaturator') in 8(40%). Five of the seven patients(71.4%) with awake PaO2<60mmHg and three of the thirteen patients(23.1%) with awake PaO2≥60mmHg were 'desaturators'. The awake PaO2/FIO2 and PaO2/PAO2 could distinguish 'desaturator' from 'nondesaturator, and PaO2, SaO2 or StcO2 could not. These results suggest that the nocturnal oxygen desaturation depends on the severity of the underlying disease rather than the baseline PaO2. Anthropomorphic and lung function factors could not separate between 'desaturator' and 'non-desaturator', and about a quarter of patients with a wake PaO2≥60mmHg developed significant desaturation. Therefore, it is necessary to monitor the nocturnal arterial oxygen saturation in patients with respiratory diseases regardless of their severity of airflow obstruction or awake PaO2.
Subject(s)
Humans , Lung , OxygenABSTRACT
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.
Subject(s)
Adult , Humans , Anesthesia , Anesthesia, Epidural , Anesthesia, Spinal , Arterial Pressure , Dilatation , Epidural Space , Fingers , Foot , Hand , Heart Rate , Hyperemia , Lidocaine , Lower Extremity , Oximetry , Oxygen , Reference Values , Reflex , Skin Temperature , Sympathectomy , Tetracaine , Toes , VasoconstrictionABSTRACT
The purpose of this study was to determine the frequency and severity of arterial oxygen desaturation during and after endotracheal suctioning in a group of ventilator-dependent patients and to evaluate the efficacy of several maneuvers designed to minimize desaturation. All patients were ventilated with volume-typed ventilator and a synchronized intermittent mandatory ventilation(SIMV) mode was utilized. In a given patint, each study consisted of four seperate passes of the suction catheter. The oxygen status of the patient was monitored with a digital pulse oxymeter. The mean baseline SaO2 for the group with each suctioning technique was very similar and did not differ significantly. When patints were suctioned off the ventilator without extra breaths, a significant drop occurred in the mean SaO2 And when the patients were suctioned with prebreaths and postbreaths off the ventilator or were maintained on the ventilator and suctioned through the swivel adaptor, there was a significant desaturation with all three methods. However, the mean desaturation of 0.8 percent with the swivel adaptor was significantly less(p<0.05) than the mean desaturation with any of the other three methods.
Subject(s)
Humans , Catheters , Oxygen , Suction , Ventilators, MechanicalABSTRACT
Combining benzodiazepine with opioid has been used for analgesia and sedation during spinal anesthesia, but many authors have warned that combined administration of these drugs produces potent drug interaction that places patients at high risk for hypoxemia and apnea. This study was undertaken to observe the effect of combined use of diazepam with fentanyl on hemodynamic response and change in SaO in twenty healthy adult patients undergone elective surgery with spinal anesthesia. All of the patients were divided into the control and experimental group, and whom spinal anesthesia with 0.5% tetracaine the 12 mg and epinephrine 0.2 mg, were performed. To the control(Group I) and experimental group(Group 2) the combined dose of diazepam 0. 075 mg/kg with fentanyl 1 ug/kg, and diazepam 0.15 mg/kg with fentanyl 2 ug/kg, were given, respectively, by intravenous injection 1 hour after spinal anesthesia started. Blood pressure, heart rate and SaO2 of the two groups were compared at the time before administration of study drugs and 1 min, 2 min, 2 min, 4 min, 5 min, 10 min, 30 min and 60 min after administration of study drugs. The results were as follows. 1) SaO2 was significantly decreased in group 2 than Group 1 after study drugs were administed intravenously. 2) In both group, decrease in SaO2 was significant at the first 5 minutes after intravenous administration of study drugs. 3) SaO2 fell to 90% of the control value after the administration of study drugs in 6 patients of Group 2(60%). 4) Hemodynamic changes after intravenous administration of study drugs were statistically significant but not so clinically in both group. We concluded that combined intravenous administration of benzodiazepine and opioid under spinal anesthesia requires the careful monitoring of hemodynamic response and ventilatory status continuosly with those monitoring devices already in use and pulse oximeter. Availiability of skilled anesthesiologists for airway management and administration of supplemental oxygen are very important in combined intravenous administration of benzodiazepine and opioid.
Subject(s)
Adult , Humans , Administration, Intravenous , Airway Management , Analgesia , Anesthesia, Spinal , Hypoxia , Apnea , Benzodiazepines , Blood Pressure , Diazepam , Drug Interactions , Epinephrine , Fentanyl , Heart Rate , Hemodynamics , Injections, Intravenous , Oxygen , TetracaineABSTRACT
To investigate the incidence of hypoxemia which was defined as arterial blood oxygen saturation (SaO2) of 90% or less following general endotracheal anesthesia, 112 adult patients were randomly allocated to one of 8 groups aceording to oxygen administration or not. SaO2 was continually measured during postanesthetic period using a pulse oximeter (Nellcor, N-100 C, USA). The incidence of hypoxemia was lower in oxygen administration groups (5%) than in no administration groups (14%) in the recovery room. The mean discharge time of oxygen administration groups in the recovery room (37.9 min) was significantly shorter than that of no administration groups (45.6 min) (P=0.003). There were two cases of hypoxemia during transfer of patients from the operating room to the recovery room. The incidence of hypoxemia in oxygen administration groups (9%) was lower than no oxygen administration groups (71%) during 5 minutes after endotracheal extubation. It was coneluded that the incidence of hypoxemia can be reduced by administrating oxygen during postanesthetic period. Therefore, it is recommended that oxygen should be administered to all postoperative patients for prevention of hypoxemia following general endotracheal anesthesia.
Subject(s)
Adult , Humans , Airway Extubation , Anesthesia , Hypoxia , Incidence , Operating Rooms , Oxygen , Recovery RoomABSTRACT
The post operative hypoxemia may delay the recovery from surgical damage, exacerbate organ dysfunction and contribute the mortality. The old patients are increased in the medical situation nowadays, the incidence of perioperative complications are also increased including post anesthetic hypoxemia. Herein we analysed the post operative hypoxemia in transference of the operated patient to the recovery room using pulse oximeter. During the period of 9 months from Mar. 1988, 32 patients with over 60 years old and ASA class 2 or 3 were included in this study. Hypoxemia was defined as less than 90% SaO2, (arterial oxygen partial pressure (PaO2 = 58 mmHg)). SaO2of the patient who breathed the room air for 5 min. after extubation (group 3) and just arrived at PAR (group 4) was significantly lower than preoperative SaO2(p<0.05). Hypoxemia occured in 18.8% of the patients in group 3 and 25% in group 4. During the short term period as transfering the operated patients to the recovery room the incidence of hypoxemia increased by 6.2%. There was no significance in change of pulse rate or systolic blood pressure statistically. Because surprising high incidence of hypoxemia in geriatric patients, the monitoring of the SaO2 and oxygen supply are mandatory in the high risk patients during postoperative transfer to the PAR.
Subject(s)
Humans , Middle Aged , Hypoxia , Blood Pressure , Heart Rate , Incidence , Mortality , Oxygen , Partial Pressure , Recovery RoomABSTRACT
We have studied the effect of sedation with diazepam on arterial oxygen saturation during spinal anestheia in two groups of patients: Group I: Received diazepam (0.2 mg/kg i.v.) after the level of spinal anesthesia was determined, and breathed the room air. The level of sedation was controlled such that the patient was drowsy but aroused easily and capable of communication. An additional dose of diazepam was given when required. (n=15) Group II: Received diazepam (0.2 mg/kg i.v.) in the same manner as Group I but with supplementary oxygen inhalation (3l/min) through the nasal catheter. (n = 15) The results were as follows: Two of 15 patients of Group I who were given sedation during spinal anesthesia and who breathed room air developed moderate hypoxemia, with a SaO2 of 88-89%. There were no episodes of hypoxemia in Group II patients who received supplementary oxygen inhalation. We concluded that oxygen should be administered routinely to patients receving diazepam as a sedative during spinal anesthesia for the prevention of hypoxemia, unless a pulse oximeter is available to monitor SaO2.
Subject(s)
Humans , Anesthesia, Spinal , Hypoxia , Catheters , Diazepam , Inhalation , OxygenABSTRACT
Intrathecal meperidine produces a profound analgesia, because meperidine has a high lipid solubility and a structure similar to local anesthetics. This study was undertaken to evaluate the anesthetic effect and complications of intrathecal meperidine anesthesia and the effect of added epinephrine. Two percent meperidine 30 mg (Group I) and 2% meperidine 30 mg with 0.3 mg epinephrine (Group II) in 20% D/W were injected intrathecally in each of 30 cases scheduled for simple and short surgical procedures. The results are as follows: 1) Systolic blood pressure and pulse rate decreased significantly from 10 minutes to 1 hour after intrathecal meperidine injection, compared with the value before anesthetic administration, but did not require special medical treatment. 2) The onset time of block of T, sensory dermatome in the meperidine injection group (Group 1) and the added epinephrine mixed injection group (Group II), were 5.3+/-1.4 minutes and 6.6+/-2.1 minutes, and duration were 58.5+/-10.5 minutes and 74.1+/-16.4 minutes respectively. Therefore, the onset time of motor nerve blok were 5.5+/-2.6 minutes and 8.9+/-1.6 minutes, and then their duration were 65.7+/-11.4 minutes and 79.7+/-13.4 minutes respectively. 3) PaO decreased and PaCO2 increased significantly 1 hour after meperidine injection without any serious problem. 4) Complications, such as nausea, pruritus and urinary retention, were observed in many patients without any serious problem.
Subject(s)
Humans , Analgesia , Anesthesia , Anesthetics , Anesthetics, Local , Blood Pressure , Epinephrine , Heart Rate , Meperidine , Nausea , Pruritus , Solubility , Urinary RetentionABSTRACT
The arterial oxygen saturation (SaO2) changes during transportation of postanesthetic patients from operating room to recovery room were measured by pulse oximeter. Fourty-one ASA PS I premedicated children were studied. SaO2 was recorded on operating room under administration of 100% oxygen (T2), transportation one minute (T2), two minutes (T2), three minutes (T2), on arrival in the recovery room (R0), One minute (R1 ) and two minutes (R2) in the recovery room under administration of oxygen via nasal cannula or catheter through endotracheal tube. The significant difference between the extubated group (group 1) and the intubated group (group 2) was not found. The proportion of children with SaO2<95% (PaO2<75mmHg) on arrival in the recovery room with room air inhalation were 13 cases (31.7%). It is concluded that children receiving anesthesia can become hypoxemic during postanesthetic transportation with room air inhalation and in the recovery room.