PubMed · 7883327
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P M Nair. 1994. Neonatal ventilation--teething problems.. https://pubmed.ncbi.nlm.nih.gov/7883327/
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The objective of this prospective, consecutive, randomized, controlled study was to investigate the effects of mask physiotherapy on postoperative complications after heart surgery. Sixty-six low-risk male patients undergoing coronary artery by-pass graft surgery were evaluated. The patients were treated with routine chest physiotherapy alone or supplied with either positive expiratory pressure (PEP), or inspiratory resistance-positive expiratory pressure (IR-PEP). Postoperative pulmonary complications were assessed by forced vital capacity (FVC), arterial oxygen tension (PaO2), and chest X-ray examination. There was an almost equal decrease and subsequent rise in spirometric and blood gas values in all three groups, but patients treated with the PEP mask had a borderline significantly higher increase in PaO2 from day three to day six compared with patients treated with no mask. There was an almost equal frequency of atelectasis in the three treatment groups. It is concluded that no significant differences in outcome were found between the three groups.
Cerebrospinal fluid (CSF) gas tension measurements have been used as a marker of cerebral oxygenation in animal models and in human studies. Discrepancies in the measurement of PCO2 and PO2 in non-blood solutions by standard blood gas analyzers have been described. The CSF is a physiological non-blood fluid with an ability to carry only dissolved O2 or CO2. The aim of this experiment was to determine the bias and precision of CSF pCO2 and pO2 measurements of a contemporary blood gas analyzer and a continuous gas sensor. CSF from human patients was tonometered to known PCO2 and PO2 using standard calibration gases in a bubble tonometer. Following equilibration, a continuous measurement of the partial pressure of gases in the CSF in the tonometer solution was made using a calibrated Paratrend 7 gas sensor (Biomedical Sensors, Bucks., UK) inserted into the equilibration chamber of the tonometer and continuous CSF pH, PCO2 and PO2 measurements recorded at 1-min intervals. After equilibration, a 3-ml CSF sample was aspirated anaerobically from the tonometer and analysed in duplicate using an ABL 620 (Radiometer, Copenhagen) blood gas analyser. The measured pCO2 and pO2 from the ABL 620 blood gas analyser and the Paratrend 7 sensor were paired with the expected values to calculate bias and precision. Small offsets in PCO2 and large offsets in PO2 measurement were seen with the ABL 620 blood gas analyser. This study brings into question clinical decisions based on CSF PO2 measurements. The implications for calibrating CSF sensors against CSF gas measurements are discussed.
UNLABELLED: The effect of blood transfusion to maintain a preset packed cell volume (PCV) level in preterm ventilated infants has been investigated. Fifty infants, median gestational age 26 (range 23-33) weeks and postnatal age 4 (1-29) days, transfused a median of 15 ml/kg of blood in response to a PCV < or = 40% were retrospectively identified and their medical records reviewed to determine the change in PCV and haemoglobin resulting from the transfusions. In addition, their mean airway pressure (MAP) was noted and, as an index of oxygenation, their oxygenation index (OI), alveolar/arterial oxygen gradient (AaDO2) and arterial/alveolar (a/A) ratio calculated 12 h, 6 h and immediately prior to the transfusion and immediately post, 12, 18 and 24 h after the transfusion. The transfusion improved the PCV and haemoglobin (P < 0.0001). No significant changes in MAP or level of oxygenation were experienced in the 12 h prior to the transfusion. Post transfusion, despite no significant change in MAP, the AaDO2 OI and a/A ratios compared to immediately prior to the transfusion were significantly better at 12, 18 and 24 h. CONCLUSION: It is useful to transfuse ventilated preterm infants to maintain their PCV above a preset level.