جستجوی مقالات مرتبط با کلیدواژه "blood gases" در نشریات گروه "پزشکی"

Respiratory diseases are the most common cause of death in the pediatric population and acute or progressive respiratory failure, which requires mechanical ventilation, is the most common cause of children’s hospitalization in the intensive care unit. Despite advances in recent decades regarding the treatment of acute respiratory diseases in children and innovative settings in mechanical ventilation, there are no clear and comprehensive guidelines for the use of mechanical ventilation in children. This research aimed to evaluate the correlation between oxygenation and ventilation indices in predicting the duration of mechanical ventilation in children aged two months to 14 years old admitted to PICU. In this cross-sectional study, 56 patients were included. The required information was extracted from the patients' clinical records and entered into the prepared questionnaires. They included age, sex, and diagnosis, duration of intubation, extubation time, mechanical ventilation parameters, and blood gas parameters. Patients' blood and ventilation data were collected and calculated from the first day of mechanical ventilation until 7 days later to calculate Oxygenation (OI) and Ventilation (VI) indices. Pneumonia, the most common cause of hospitalization in the intensive care unit and the need for intubation, was present in our population (82%) due to aspiration and Covid-19 disease. There was a significant relationship between higher levels of FiO2 and longer duration of patients' intubation (P <0.001). The amount of PIP in each of the first days of intubation was significantly correlated with the duration of the study. A significant direct relationship was found between the ventilation index and oxygenation index. (P <0.05) Except for the sixth day, oxygenation index and duration of intubation were significantly correlated. (P <0.05) This means that along with the increase in oxygenation index, the duration of intubation was also increased. Ventilation index and duration of intubation were also significantly correlated, except on the fourth and fifth days (P <0.05). None of the extubated patients required re-intubation. Eventually, a very weak statistical correlation was found between the intubation period and the final result in the form of discharge and recovery of the patient or his death. Using variables such as gender, PIP and oxygenation, and ventilation indices, in the early days of mechanical ventilation, the prognosis of these patients and better management of their treatment can be judged. It is, finally, emphasized that further studies on larger populations, with more variables and long-term follow-ups are required.

A single episode of breath holding (BH) is known to elevate the blood pressure and regular breathing exercise lowers the blood pressure. This prompted us to investigate how a series of BH epochs would affect the cardiovascular system.

To observe arterial blood pressure (ABP) and heart rate (HR) changes associated with a series of “BH epochs” following maximum inspiration and maximum expiration and find the underlying mechanisms for the change by auntonomic activity.

Thirty-five healthy young adults were instructed to hold their breath repetitively, for 5 minutes, in two patterns, one following maximum inspiration and other following maximum expiration. ABP and ECG (for Heart Rate Variability) were continuously recorded at rest and during both the maneuvers. Capillary blood gases (BG) were analysed at baseline and at the break point of the last epoch of BH.

ABP rose significantly at the breakpoint during both the maneuvers. No change in HR was observed.   There was significant fall in PO2 from 94.7(4.1) mmHg at baseline to 79.1(9.0) mmHg during inspiratory and 76.90(12.1) mmHg during expiratory BH. Similarly, SPO2 decreased from 96.3(1.9)% at baseline to 95.4(1.5)% and 94.5(2.7)% during inspiratory and expiratory BH respectively. Rise in PCO2 from 39.5(3.1)mmHg at baseline to 42.9(2.7)mmHg and 42.1(2.8)mmHg during inspiratory and expiratory BH respectively was observed. There was no significant correlation between blood gases and arterial blood pressure. Among HRV parameters, a significant decrease in SDNN, RMSSD, HFnu, total power and SD1/SD2 and significant increase in LFnu, LF/HF and SD2 was observed during both BH patterns.

Rhythmic BH patterns affect the cardiovascular system in similar way as a single episode of BH. Sympathetic over activity could be the postulated mechanism for the same.