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Biosensors Mar 2024Traditional methods for measuring blood oxygen use multiple wavelengths, which produce an intrinsic error due to ratiometric measurements. These methods assume that the...
Traditional methods for measuring blood oxygen use multiple wavelengths, which produce an intrinsic error due to ratiometric measurements. These methods assume that the absorption changes with the wavelength, but in fact the scattering changes as well and cannot be neglected. We found that if one measures in a specific angle around a cylindrical tissue, called the iso-pathlength (IPL) point, the reemitted light intensity is unaffected by the tissue's scattering. Therefore, the absorption can be isolated from the scattering, which allows the extraction of the subject's oxygen saturation. In this work, we designed an optical biosensor for reading the light intensity reemitted from the tissue, using a single light source and multiple photodetectors (PDs), with one of them in the IPL point's location. Using this bio-device, we developed a methodology to extract the arterial oxygen saturation using a single wavelength light source. We proved this method is not dependent on the light source and is applicable to different measurement locations on the body, with an error of 0.5%. Moreover, we tested thirty-eight males and females with the biosensor under normal conditions. Finally, we show the results of measuring subjects in a hypoxic chamber that simulates extreme conditions with low oxygen.
Topics: Male; Female; Humans; Oxygen Saturation; Oxygen; Oximetry; Light; Biosensing Techniques
PubMed: 38534239
DOI: 10.3390/bios14030132 -
Cureus Feb 2024This study aimed to evaluate the common clinical diagnoses and treatment management of acute respiratory infections (ARIs) in children and determine when antibiotics are...
OBJECTIVES
This study aimed to evaluate the common clinical diagnoses and treatment management of acute respiratory infections (ARIs) in children and determine when antibiotics are recommended and prescribed.
METHODS
A retrospective review of medical charts was carried out at King Salman Bin Abdulaziz Medical City (KSAMC) Hospital to assess pediatric patients diagnosed with ARIs aged 0-14 years, excluding those requiring antibiotics for conditions other than ARIs. Data, including demographic diagnoses and treatment management, were extracted using consecutive sampling, and statistical analyses were conducted using Jamovi software.
RESULTS
A total of 285 pediatric patients were included, with a median age of 3 (IQR = 1-6) years and a male predominance of 59.2%. Bronchopneumonia was the most common respiratory disease, diagnosed in 39.1% of participants. The median durations for illness and hospital admission were four and three days, respectively. Clinical evaluations showed an average respiratory rate of 28±10.5 breaths per minute and a mean oxygen saturation of 96.4±3.46% through pulse oximetry. The use of antibiotics was commonly prescribed in ARI patients only when accompanied by certain bacterial infections (46.32%).
CONCLUSIONS
ARIs are a common viral health issue among children, emphasizing that not all ARIs in children are caused by bacteria and that antibiotics should only be used when there is a bacterial infection present. Enhanced diagnostic precision, patient awareness, and provider education are the global community's recommendations to prevent the presence of antibiotic resistance and the irrational use of antibiotics.
PubMed: 38529426
DOI: 10.7759/cureus.54799 -
Brain & Spine 2024Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) carries variability in arterial flow pulsatility (AFP).
Changes in autonomic function and cerebral and somatic oxygenation with arterial flow pulsatility for children requiring veno-arterial extracorporeal membrane oxygenation.
BACKGROUND
Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) carries variability in arterial flow pulsatility (AFP).
RESEARCH QUESTION
What changes in cerebral and somatic oxygenation, hemodynamics, and autonomic function are associated with AFP during VA-ECMO?
METHODS
This is a prospective study of children on VA-ECMO undergoing neuromonitoring. AFP was quantified by arterial blood pressure pulse amplitude and subcategorized: no pulsatility (<1 mmHg), minimal pulsatility (1 to <5 mmHg), moderate pulsatility (5 to <15 mmHg) and high pulsatility (≥15 mmHg). CVPR was assessed using the cerebral oximetry index (COx). Cerebral and somatic oxygenation was assessed using cerebral regional oximetry (rSO) or peripheral oxygen saturation (SpO). Autonomic function was assessed using baroreflex sensitivity (BRs), low-frequency high-frequency (LF/HF) ratio and standard deviation of heart rate R-R intervals (HRsd). Differences were assessed across AFP categories using linear mixed effects models with Tukey pairwise comparisons. Univariate logistic regression was used to explore risk of AFP with brain injuries.
RESULTS
Among fifty-three children, comparisons of moderate to high pulsatility were associated with reductions in rSO (p < 0.001), SpO 2 (p = 0.005), LF/HF ratio (p = 0.028) and an increase in HRsd (p < 0.001). Reductions in BRs were observed across comparisons of none to minimal (P < 0.001) and minimal to moderate pulsatility (p = 0.004). Comparisons of no to low pulsatility were associated with reductions in BRs (p < 0.001) and ABP (p < 0.001) with increases in SpO (p < 0.001) and HR (p < 0.001). Arterial ischemic stroke was associated with higher pulsatility (p = 0.0384).
CONCLUSION
During VA-ECMO support, changes toward high AFP are associated with autonomic dysregulation and compromised cerebral and somatic tissue oxygenation.
PubMed: 38510614
DOI: 10.1016/j.bas.2023.102731 -
PloS One 2024To evaluate the maternal-fetal hemodynamic effects after osteopathic manipulative treatment by measuring vital signs and Doppler velocimetry in third-trimester pregnant...
OBJECTIVE
To evaluate the maternal-fetal hemodynamic effects after osteopathic manipulative treatment by measuring vital signs and Doppler velocimetry in third-trimester pregnant women.
MATERIALS AND METHODS
This is a prospective study with pregnant women undergoing outpatient follow-up and hospitalized in a ward at Instituto Fernandes Figueira/Fiocruz, between August 2021 to August 2022, during the SARS-CoV-2 pandemic. This study was registered in REBEC under Register Number RBR-9q7kvg and approved by the ethics committee under number 32216620.0.0000.5269. The study population was composed of 51 pregnant women between 28 and 40 weeks of gestation, over 18 years of age, allocated in a single group. Pregnancies with multiple fetuses, malformations, premature rupture of the membrane, and active labor were excluded. The procedures evaluated maternal-fetal hemodynamics using three consecutive measures of ultrasound examination with Doppler velocimetry, and three maternal vital signs measured by an electronic blood pressure monitor.
RESULTS
Most vital signs changed after osteopathic treatment. However, only the systolic blood pressure (109.92 ±14.42 to 110.71±12.8, p = 0.033), diastolic blood pressure (79.8±11.54 to 77.57±9.44, p = 0.018) and heart rate (87.59±11.93 to 81.12±10.26, p = 0.000) in the sitting position, systolic blood pressure (110.75±13.26 to 108.59±13.07; p = 0.034) in the supine, and heart rate (83.22±11.29 to 80.39±11.0; p = 0.013) in left lateral decubitus reached statistical significance. The oximetry measures (98.55±0.64 to 98.67±0.68; p = 0.098) stayed stable during all three positions. All artery values remained stable after treatment, and no statistically significant difference was recorded in the artery results.
CONCLUSION
Responses to osteopathic treatment in women in the third trimester of pregnancy did not affect uteroplacental and fetoplacental circulation. However, some maternal vital signs had statistically significant results, with a decrease in diastolic blood pressure and heart rate, and an increase in systolic blood pressure in the sitting position, a decrease of heart rate in the left lateral decubitus position, and systolic blood pressure in the supine position. All the results observed were maintained in the normal parameters. The study responses attest to the safety of using the osteopathic manipulative treatment for the fetus and for pregnant women with comorbidities.
Topics: Female; Pregnancy; Humans; Adolescent; Adult; Pregnancy Trimester, Third; Pregnant Women; Prospective Studies; Manipulation, Osteopathic; Hemodynamics
PubMed: 38507460
DOI: 10.1371/journal.pone.0300514 -
Journal of Applied Biomedicine Mar 2024COVID-19 is a viral disease notorious for frequent worldwide outbreaks. It is difficult to control, thereby resulting in overload of the healthcare system. A possible...
BACKGROUND
COVID-19 is a viral disease notorious for frequent worldwide outbreaks. It is difficult to control, thereby resulting in overload of the healthcare system. A possible solution to prevent overcrowding is rapid triage of patients, which makes it possible to focus care on the high-risk patients and minimize the impact of crowding on patient prognosis.
METHODS
The triage algorithm assessed self-sufficiency, oximetry, systolic blood pressure, and the Glasgow coma scale. Compliance with the triage protocol was defined as fulfillment of all protocol steps, including assignment of the correct level of care. Triage was considered successful if there was no change in the scope of care (e.g., unscheduled hospital admission, transfer to different level of care) or if there was unexpected death within 48 hours.
RESULTS
A total of 929 patients were enrolled in the study. Triage criteria were fulfilled in 825 (88.8%) patients. Within 48 hours, unscheduled hospital admission, transfer to different level of care, or unexpected death occurred in 56 (6.0%), 6 (0.6%), and 5 (0.5%) patients, respectively. The risk of unscheduled hospital admission or transfer to different level of care was significantly increased if triage criteria were not fulfilled [13.1% vs. 76.1%, RR 5.8 (3.8-8.3), p < 0.001; 0.5% vs. 5.2%, RR 11.4 (2.3-57.7), p = 0.036, respectively].
CONCLUSION
The proposed algorithm for triage of patients with proven COVID-19 is a simple, fast, and reliable tool for rapid sorting for outpatient treatment, hospitalization on a standard ward, or assignment to an intensive care unit.
Topics: Humans; COVID-19; Triage; Emergency Service, Hospital; Hospitalization; Intensive Care Units
PubMed: 38505971
DOI: 10.32725/jab.2024.006 -
International Journal of Applied &... 2024Respiratory complications in liver cirrhosis can occur due to various mechanisms, such as ascites causing restricted lung expansion and opening of intrapulmonary...
BACKGROUND AND AIM
Respiratory complications in liver cirrhosis can occur due to various mechanisms, such as ascites causing restricted lung expansion and opening of intrapulmonary vascular shunts due to high portal pressures. We aimed to study the effects of the liver dysfunction on the lungs by evaluating arterial blood gas (ABG) and pulmonary function test (PFT) of all study subjects.
SUBJECTS AND METHODS
A cross-sectional study was done between August 2020 and September 2022. Diagnosed cases of the liver cirrhosis were enrolled in the study after informed consent and were subjected to the following investigations: chest X-ray, oximetry, spirometry, diffusing capacity of the lung for carbon monoxide (DLCO), two-dimensional echocardiography, and ABG analysis (ABGA). The cases were divided into three groups based on their Child-Pugh staging, and statistical analysis was done on the collected data.
RESULTS
A total of 64 (53 males and 11 females) patients with an average age of 49.82 ± 9.89 years were studied. Alcoholism was the most common cause of cirrhosis in males. Breathlessness (65.6%) and pleural effusion (26.6%) were the most common respiratory symptoms and signs, respectively. Seventeen patients had hepatic hydrothorax, eight patients had hepatopulmonary syndrome (HPS), and six patients had portopulmonary hypertension. Low pH (17.2%) and oxygen partial pressure (PaO) (20.3%) were the most common ABGA findings. The pH, PaO, forced expiratory volume in 1 s (FEV)/forced vital capacity (FVC), and DLCO were significantly low in Child Pugh Stage C ( < 0.05). The pH, pO, HCO, FEV, FVC, FEV/FVC, and DLCO were significantly lower in patients with HPS ( < 0.05).
CONCLUSION
Metabolic acidosis and low FEV/FVC and DLCO were the common findings in study subjects. Pulmonary dysfunction was common in advanced liver cirrhosis. Patients with HPS had worse ABG and PFT parameters than those without HPS.
PubMed: 38504842
DOI: 10.4103/ijabmr.ijabmr_367_23 -
Sleep & Breathing = Schlaf & Atmung Jun 2024Obstructive sleep apnoea (OSA) is common, yet often undiagnosed. Self-administered, overnight pulse oximetry (OPO) could screen for OSA in asymptomatic, older...
PURPOSE
Obstructive sleep apnoea (OSA) is common, yet often undiagnosed. Self-administered, overnight pulse oximetry (OPO) could screen for OSA in asymptomatic, older populations. However, the inter-night variability of OPO in an asymptomatic, older population is unknown. We determined the inter-night variability of home OPO parameters in an older population and correlated with sleep questionnaires.
METHODS
Participants > 50 years without a diagnosis of OSA undertook home OPO for three consecutive nights and completed two sleep questionnaires (STOP-BANG (SBQ) and Epworth Sleepiness Score (ESS)). Analysis was performed with linear mixed models and Spearman's correlation coefficient.
RESULTS
There was no difference in oxygen desaturation index (ODI), MeanSpO, MinimumSpO, and time spent with SpO2 < 90% (T90) across two or three nights (P ≥ 0.282). However, the variability of all parameters across nights increased with the magnitude of departure from normal values (P ≤ 0.002). All OPO parameters were associated with age (P ≤ 0.034) and body mass index (P ≤ 0.049). There was a weak correlation between three OPO parameters and SBQ (absolute ρ = 0.22 to 0.32; P ≤ 0.021), but not ESS (P ≥ 0.254).
CONCLUSION
Inter-night variability of home OPO was minimal when values were near-normal in an older population. However, as values depart from normal, the inter-night variability increases, indicating the need for multiple night recordings. Low correlation to sleep questionnaires suggest the need for more robust OSA questionnaires in an asymptomatic population.
Topics: Humans; Oximetry; Male; Female; Sleep Apnea, Obstructive; Middle Aged; Aged; Mass Screening; Surveys and Questionnaires; Polysomnography
PubMed: 38504043
DOI: 10.1007/s11325-024-03016-1 -
American Journal of Veterinary Research Jun 2024To compare the accuracy of doppler ultrasound (DOP) and pulse oximeter plethysmography (POP) in the measurement of systolic arterial pressure (SAP) to invasive blood... (Comparative Study)
Comparative Study
Doppler ultrasound is more accurate than pulse oximeter plethysmography in the measurement of systolic arterial pressure from the median caudal artery in anesthetized dogs.
OBJECTIVE
To compare the accuracy of doppler ultrasound (DOP) and pulse oximeter plethysmography (POP) in the measurement of systolic arterial pressure (SAP) to invasive blood pressure (IBP) in anesthetized dogs.
ANIMALS
40 client-owned healthy dogs > 10 kg.
METHODS
Dogs were anesthetized for surgical procedures in dorsal recumbency. Invasive blood pressure was measured from a dorsal pedal artery. DOP and POP device probes were placed over the median caudal artery with a flow-occluding cuff for noninvasive blood pressure measurement. Systolic arterial pressure measured by DOP, loss of pulse oximeter plethysmograph (POPL), and return of pulse oximeter plethysmograph (POPR) were compared to SAP measured by IBP. A linear mixed model was used to determine correlation. Bland-Altman analyses were performed to determine bias, SD, and limits of agreement. The accuracy of DOP and POP was compared to IBP across different tensive states.
RESULTS
Conditional R2 values for DOP, POPL, and POPR versus IBP were 0.92, 0.85, and 0.87, respectively (all P < .001). The biases for DOP, POPL, and POPR compared to IBP were +7.6 ± 13.1, +3.9 ± 14.4, and +8.6 ± 15.2 mm Hg (bias ± SD), respectively. Limits of agreement (lower, upper) were (-18.1, +33.3), (-24.3, +32.1), and (-21.2, +38.4) mm Hg for DOP, POPL, and POPR, respectively. DOP and POP overestimated SAP during hypotension (SAP < 90 mm Hg), DOP to a lesser magnitude.
CLINICAL RELEVANCE
DOP measured from the median caudal artery may be acceptable for SAP measurement in dorsally recumbent, healthy anesthetized dogs > 10 kg. POP was determined an unacceptable method.
Topics: Animals; Dogs; Oximetry; Ultrasonography, Doppler; Plethysmography; Male; Blood Pressure Determination; Anesthesia; Female; Arterial Pressure; Arteries
PubMed: 38503051
DOI: 10.2460/ajvr.23.11.0263 -
Aging Brain 2024To evaluate the phenomenological significance of cerebral blood pulsatility imaging in aging research.
PURPOSE
To evaluate the phenomenological significance of cerebral blood pulsatility imaging in aging research.
METHODS
N = 38 subjects from 20 to 72 years of age (24 females) were imaged with ultrafast MRI with a sampling rate of 100 ms and simultaneous acquisition of pulse oximetry data. Of these, 28 subjects had acceptable MRI and pulse data, with 16 subjects between 20 and 28 years of age, and 12 subjects between 61 and 72 years of age. Pulse amplitude in the circle of Willis was assessed with the recently developed method of analytic phase projection to extract blood volume waveforms.
RESULTS
Arteries in the circle of Willis showed pulsatility in the MRI for both the young and old age groups. Pulse amplitude in the circle of Willis significantly increased with age (p = 0.01) but was independent of gender, heart rate, and head motion during MRI.
DISCUSSION AND CONCLUSION
Increased pulse wave amplitude in the circle of Willis in the elderly suggests a phenomenological significance of cerebral blood pulsatility imaging in aging research. The physiologic origin of increased pulse amplitude (increased pulse pressure vs. change in arterial morphology vs. re-shaping of pulse waveforms caused by the heart, and possible interaction with cerebrospinal fluid pulsatility) requires further investigation.
PubMed: 38495808
DOI: 10.1016/j.nbas.2024.100111 -
Scientific Reports Mar 2024Sleep-disordered breathing (SDB) is prevalent among professional drivers. Although SDB is a known risk factor for truck collisions attributed to microsleep-related...
Sleep-disordered breathing (SDB) is prevalent among professional drivers. Although SDB is a known risk factor for truck collisions attributed to microsleep-related behaviors at the wheel (TC-MRBs), the usefulness of overnight pulse oximetry for predicting TC-MRBs is debatable. This retrospective study assessed the association between overnight pulse oximetry parameters, the Epworth Sleepiness Scale (ESS), and TC-MRBs, confirmed by dashcam footage. This study included 108 matched professional truck drivers (TC-MRBs: N = 54; non-TC-MRBs: N = 54), with a mean age and body mass index of 41.9 ± 11.3 years and 23.0 ± 3.7 kg/m, respectively. Night-time drivers, 4% oxygen desaturation index (ODI), and nadir oxygen saturation (SpO) were associated with TC-MRBs (odds ratio [95% confidence interval]: 25.63 [5.88-111.77], p < 0.0001; 2.74 [1.02-7.33], p = 0.045; and 3.87 [1.04-14.39], p = 0.04, respectively). The area under the curve of 4% ODI and nadir SpO for TC-MRBs were 0.50 and 0.57, respectively. In conclusion, night-time driving, 4% ODI, and nadir SpO were significantly associated with TC-MRBs in professional truck drivers. However, the sensitivity of overnight pulse oximetry parameters to predict TC-MRBs in a real-world application was poor. Therefore, combining subjective and objective assessments such as dashcam video footage may be needed to achieve high accuracy for predicting TC-MRBs among professional truck drivers.
Topics: Humans; Retrospective Studies; Truck Drivers; Motor Vehicles; Sleep Apnea Syndromes; Oximetry; Risk Factors; Oxygen
PubMed: 38493230
DOI: 10.1038/s41598-024-57021-1