RESUMEN
Background: The bulk of oxygen in blood is normally transported as oxyhemoglobin. The amount of oxyhemoglobin is often expressed as percentage saturation (Spo2). Objective(s): Oxygen saturation is one of the vitals monitored in clinical practice and also the most important vital monitored in COVID-19patients since it's the oxygen saturation which gets depleted in these patients. COVID pandemic has taken heavy toll on health and life of the people and since different people respond to COVID-19 differently so the response is multifactorial. The exposure to lower oxygen levels may have important clinical consequences, particularly in physiologic processes like respiratory drive, which are dependent on PO2 in the blood. Hence our aim is to study the effect of BMI and Hb on oxygen saturation (SPO2). Method(s): A descriptive cross-sectional study was conducted in Department of Physiology, SKIMS-Medical College. Data was collected by using self-administered questionnaire followed by anthropometric measurement. Body Mass Index (BMI) by Quetelet's index and Haemoglobin (Hb) concentrations by Sahli's method were assessed. Pulse oximetry was done to know the oxygen saturation. Result(s): The students with high BMI show negative correlation with oxygen saturation while as Hb with oxygen saturation shows positive correlation. These results have important clinical implications while treating patients with high BMI or low Hb. Copyright © 2023, Institute of Medico-legal Publication. All rights reserved.
RESUMEN
Results of invasive positive pressure ventilation (IPPV) in COVID-19 patients with Severe Acute Respiratory Distress Syndrome are discouraging despite its prompt use. However noninvasive positive pressure ventilation (NIPPV) is yet not a common practice internationally because of lack of global evidence advocating its effective use in severe cases of ARDS as well as dreadful concern about aerosol generation especially in patients having COVID-19 infection. Objective: To determine whether, NIPPV application is effective and safe in COVID-19 Patients. Methods: One hundred and thirty hemodynamically stable patients with severe CARDS as per Berlin definition (PaO2/FiO2 ratio <= 100mm Hg), having GCS > 13, respiratory breathing index (RBI) < 105, and without any systemic complication were selected. They were managed with NIPPV in Corona Intensive Care Unit of Mayo Hospital/King Edward Medical University Lahore. A little innovation was done with the application of a specific orofacial interface, fitted with heat and moist exchanger (HME) at the interface and viral/bacterial filters at the expiratory limb of ventilatory circuit. Favorable outcome has been observed in 64% of treated cases in terms of improvement in PaO2/FiO2 ratio, thus abating severity of ARDS from severe to mild category, in an average time span of 6 days. Remaining 36% of patients progressed to IPPV with definitive airway. During study period, 4.2% of healthcare workers (HCW) got infected with COVID-19. Associated complications of NIPPV application were claustrophobia (13.8%), nasal crusting (6.9%), aspiration (6.1%) and barotrauma (0.7%). Conclusion: In carefully selected patients, use of noninvasive positive pressure ventilation with the application of HME and viral/bacterial filters is an effective, preferable and safe modality of choice to provide respiratory support, thus obviating the need for IPPV. However further larger studies are needed to confirm our recommendations.