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Mortality and Healthcare Utilization of Patients with Compensated Hypercapnia.

Ann Am Thorac Soc 2021 May 5. Epub 2021 May 5.

University of Michigan, 1259, Ann Arbor, Michigan, United States.

Rationale: Acute hypercapnic respiratory failure has been shown to be associated with worse outcomes for various disease states, but less is known about patients with compensated hypercapnic respiratory failure. Although these patients have a normal pH, it remains unknown whether chronically elevated partial pressures of carbon dioxide (PaCO2), irrespective of etiology, put patients at risk of adverse events.

Objectives: To understand the burden of and clinical factors associated with morbidity and mortality in patients with compensated hypercapnic respiratory failure. Read More

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Can Alveolar-Arterial Difference and Lung Ultrasound Help the Clinical Decision Making in Patients with COVID-19?

Diagnostics (Basel) 2021 Apr 23;11(5). Epub 2021 Apr 23.

Emergency Medicine Unit and Emergency Medicine Postgraduate Training Program, Department of Internal Medicine, University of Pavia, IRCCS Policlinico San Matteo Foundation, 27100 Pavia, Italy.

Background: COVID-19 is an emerging infectious disease, that is heavily challenging health systems worldwide. Admission Arterial Blood Gas (ABG) and Lung Ultrasound (LUS) can be of great help in clinical decision making, especially during the current pandemic and the consequent overcrowding of the Emergency Department (ED). The aim of the study was to demonstrate the capability of alveolar-to-arterial oxygen difference (AaDO) in predicting the need for subsequent oxygen support and survival in patients with COVID-19 infection, especially in the presence of baseline normal PaO/FiO ratio (P/F) values. Read More

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ABG Assistant-Towards an Understanding of Complex Acid-Base Disorders.

J Clin Med 2021 Apr 5;10(7). Epub 2021 Apr 5.

Department of Medical Chemistry and Laboratory Medicine, Poznan University of Medical Sciences, Rokietnicka 8, 60-806 Poznan, Poland.

The ability to diagnose acid-base imbalances correctly is essential for physicians and other healthcare workers. Despite its importance, it is often considered too complex and confusing. Although most people dealing with arterial blood gases (ABGs) do not usually have problems with acid-base disorder assessment, such an analysis is also carried out by other healthcare workers for whom this can be a challenging task. Read More

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Comparative analysis of titanium clip prostheses for partial ossiculoplasty.

Am J Otolaryngol 2021 Apr 17;42(5):103062. Epub 2021 Apr 17.

Department of Otolaryngology, Head and Neck Surgery, Friedrich-Alexander University Erlangen-Nuremberg (FAU), Erlangen, Germany.

Objectives: The aim of our study was to perform a comparative analysis in our cases with titanium partial clip ossiculoplasty in terms of audiometric outcome and extrusion rates as well as to review the literature for relevant information on this surgical issue.

Materials And Methods: The records of all patients who had undergone primary partial ossiculoplasty with the implantation of a CliP® Partial Prosthesis Dresden Type (CPPDT, group A) or a CliP Partial FlexiBAL® (CPF, Group B, both Heinz Kurz GmbH, Dusslingen, Germany) between 2012 and 2020 were studied retrospectively.

Results: 274 patients made up our study sample (148 men, 126 women, male to female ratio: 1. Read More

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Residual Lung Function Impairment Is Associated with Hyperventilation in Patients Recovered from Hospitalised COVID-19: A Cross-Sectional Study.

J Clin Med 2021 Mar 3;10(5). Epub 2021 Mar 3.

Department of Medicine, Section of Internal Medicine, University of Verona and Azienda Ospedaliera Universitaria Integrata of Verona, 37126 Verona, Italy.

Patients who have recovered from COVID-19 show persistent symptoms and lung function alterations with a restrictive ventilatory pattern. Few data are available evaluating an extended period of COVID-19 clinical progression. The RESPICOVID study has been designed to evaluate patients' pulmonary damage previously hospitalised for interstitial pneumonia due to COVID-19. Read More

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Continuous positive airway pressure therapy in the management of hypercapnic cardiogenic pulmonary edema.

Monaldi Arch Chest Dis 2021 Apr 1. Epub 2021 Apr 1.

Emergency Team, CTO Hospital, Naples.

Continuous positive airway pressure (CPAP) therapy or non-invasive ventilation (NIV) represent the first line therapy for acute cardiogenic pulmonary edema (CPE) together with medical therapy. CPAP benefits in acute CPE with normo-hypocapnia are known, but it is not clear whether the use of CPAP is safe in the hypercapnic patients. The aim of this study is to evaluate CPAP efficacy in the treatment of hypercapnic CPE. Read More

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Correlation of PaCO and ETCO in COPD Patients with Exacerbation on Mechanical Ventilation.

Indian J Crit Care Med 2021 Mar;25(3):305-309

Department of Pulmonary and Critical Care Medicine, PGIMS, Rohtak, Haryana, India.

Chronic obstructive pulmonary disease (COPD) patients in hypercapnic respiratory failure require multiple arterial blood gas (ABG) analysis for monitoring. It is a painful, invasive, and expensive investigation. This study was aimed at finding an agreement between end-tidal carbon dioxide (ETCO, a noninvasive modality) and arterial carbon dioxide (PaCO) in COPD patients with acute exacerbation on mechanical ventilation. Read More

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Utility of venous blood gases for the assessment of traumatic shock: a prospective observational study.

Emerg Med J 2021 Mar 31. Epub 2021 Mar 31.

Department of Trauma, Westmead Hospital, Westmead, New South Wales, Australia.

Background: ABG samples are often obtained in trauma patients to assess shock severity. Venous blood gas (VBG) sampling, which is less invasive, has been widely used to assess other forms of shock. The study aim was to determine the agreement between VBG and ABG measurements in trauma. Read More

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Cytoreductive surgery and mitomycin C hyperthermic intraperitoneal chemotherapy with CO recirculation (HIPEC-CO) for colorectal cancer peritoneal metastases: analysis of short-term outcomes.

Updates Surg 2021 Mar 29. Epub 2021 Mar 29.

Surgical Unit of Peritoneum and Retroperitoneum, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.

Peritoneal dissemination from colorectal cancer (CRC) has long been associated with unfavorable prognosis. However, in the last decades, the combination of cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) was able to obtain up to 30% 5-year survival rate in selected centers. Despite the wide diffusion of CRS and HIPEC, until now, there are no clear recommendations on the drug of choice for HIPEC nor its technique, and safety and efficacy data of HIPEC regimens and techniques are lacking. Read More

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Predictive value of stress hyperglycemia ratio for the occurrence of acute kidney injury in acute myocardial infarction patients with diabetes.

BMC Cardiovasc Disord 2021 Mar 30;21(1):157. Epub 2021 Mar 30.

Department of Cardiology, Cardiovascular Center, Beijing Friendship Hospital, Capital Medical University, Yongan Road 95, Xicheng District, 100050, Beijing, China.

Background: Acute hyperglycemia has been recognized as a robust predictor for occurrence of acute kidney injury (AKI) in nondiabetic patients with acute myocardial infarction (AMI), however, its discriminatory ability for AKI is unclear in diabetic patients after an AMI. Here, we investigated whether stress hyperglycemia ratio (SHR), a novel index with the combined evaluation of acute and chronic glycemic levels, may have a better predictive value of AKI as compared with admission glycemia alone in diabetic patients following AMI.

Methods: SHR was calculated with admission blood glucose (ABG) divided by the glycated hemoglobin-derived estimated average glucose. Read More

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Comparing Central Venous Blood Gas to Arterial Blood Gas and Determining Its Utility in Critically Ill Patients: Narrative Review.

Anesth Analg 2021 Mar 29. Epub 2021 Mar 29.

From the Department of Pulmonary and Critical Care Medicine, Albany Medical Center, Albany, New York.

Arterial blood gas (ABG) analysis is used in critical care units to determine the degree of oxygenation, adequacy of ventilation, and the presence and severity of acid-base disturbances in the body. However, arterial puncture may result in complications, and the difficulty in acquiring arterial blood may delay care. Central venous blood gas (VBG) is a potentially more accessible alternative to ABG sampling. Read More

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Silastic sheeting in staged ear surgery: Is there still a role for this procedure?

Eur Arch Otorhinolaryngol 2021 Mar 24. Epub 2021 Mar 24.

Hals-Nasen-Ohren-Universitätsklinik, University Hospital Basel, University Basel, Basel, Switzerland.

Objective: To review long-term outcomes for chronic otitis media with and without cholesteatoma in staged canal-wall-up tympanoplasty with temporary silastic sheeting and to compare hearing and recurrence results with the literature.

Methods: Retrospective data analysis of all patients suffering from chronic otitis media with or without cholesteatoma (COMC/COM) and treated by staged canal-wall-up (CWU) technique with silastic insertion between 1992 and 2012. Literature analysis in PubMed 1990-2017. Read More

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Linking prokaryotic community composition to carbon biogeochemical cycling across a tropical peat dome in Sarawak, Malaysia.

Sci Rep 2021 Mar 19;11(1):6416. Epub 2021 Mar 19.

Sarawak Tropical Peat Research Institute, Lot 6035, Kuching-Samarahan Expressway, 94300, Kota Samarahan, Sarawak, Malaysia.

Tropical peat swamp forest is a global store of carbon in a water-saturated, anoxic and acidic environment. This ecosystem holds diverse prokaryotic communities that play a major role in nutrient cycling. A study was conducted in which a total of 24 peat soil samples were collected in three forest types in a tropical peat dome in Sarawak, Malaysia namely, Mixed Peat Swamp (MPS), Alan Batu (ABt), and Alan Bunga (ABg) forests to profile the soil prokaryotic communities through meta 16S amplicon analysis using Illumina Miseq. Read More

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Clinical Utility of Arterial Blood Gas Test in an Intensive Care Unit: An Observational Study.

Indian J Crit Care Med 2021 Feb;25(2):172-175

Department of Critical Care Medicine, St. John's Medical College and Hospital, Bengaluru, Karnataka, India.

Background: Arterial blood gas (ABG) analysis is a common test ordered in critically ill patients. Often, it is performed very frequently without influencing patient care. Hence, we decided to check the utility of the ABG test in our intensive care unit (ICU). Read More

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February 2021

The utility of arterial blood gas parameters and chest radiography in predicting appropriate intubations in burn patients with suspected inhalation injury-A retrospective cohort study.

Burns 2021 Feb 27. Epub 2021 Feb 27.

Department of Anaesthetics and Critical Care, West Midlands Burn Centre, Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham NHS Foundation Trust, UK. Electronic address:

Background: This study evaluates the utility of arterial blood gas (ABG) parameters and chest radiography in predicting intubation need in patients with burn injuries with suspected inhalation injury.

Methods: Patients with suspected inhalation injury admitted to a single centre, Burn Intensive Care Unit, between April 4th 2016 and July 5th 2019, were included. Admission ABG parameters and chest radiograph opacification were compared with whether the patient received an appropriate intubation: defined as intubation for a duration of over 48 h. Read More

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February 2021

Automatic real-time analysis and interpretation of arterial blood gas sample for Point-of-care testing: Clinical validation.

PLoS One 2021 10;16(3):e0248264. Epub 2021 Mar 10.

External Consultant, Ingeniero de Caminos, Canales y Puertos e Ingeniero Técnico de Obras Públicas.

Background: Point-of-care arterial blood gas (ABG) is a blood measurement test and a useful diagnostic tool that assists with treatment and therefore improves clinical outcomes. However, numerically reported test results make rapid interpretation difficult or open to interpretation. The arterial blood gas algorithm (ABG-a) is a new digital diagnostics solution that can provide clinicians with real-time interpretation of preliminary data on safety features, oxygenation, acid-base disturbances and renal profile. Read More

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Impact of Arterial Carbon Dioxide and Oxygen Content on Cerebral Autoregulation Monitoring Among Children Supported by ECMO.

Neurocrit Care 2021 Mar 9. Epub 2021 Mar 9.

Brain Physics Laboratory, Division of Neurosurgery, Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK.

Background: Cerebral autoregulation (CA) impairment is associated with neurological complications among children supported by extracorporeal membrane oxygenation (ECMO). Severe variations of arterial CO (PaCO) and O (PaO) tension after ECMO onset are common and associate with mortality and poor neurological outcome. The impact of gas exchange on CA among critically ill patients is poorly studied. Read More

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Evaluation of the effect of melatonin in patients with COVID-19-induced pneumonia admitted to the Intensive Care Unit: A structured summary of a study protocol for a randomized controlled trial.

Trials 2021 Mar 8;22(1):194. Epub 2021 Mar 8.

Department of Pharmacology and Toxicology, Faculty of Pharmacy, Hormozgan University of Medical Sciences, Bandar Abbas, Iran.

Objectives: We investigate the effects of melatonin, compared to the usual therapeutic regimen on clinical symptoms and laboratory signs in severely ill patients with confirmed COVID-19 who are admitted to the Intensive Care Unit (ICU).

Trial Design: This is a single-center, open-label, randomized, clinical trial with a parallel-group design. This study is being conducted at Shahid Mohammadi Hospital, Bandar Abbas, Iran. Read More

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Which Glucose Parameter Best Predicts Poor Outcome after Mechanical Thrombectomy for Acute Large Vessel Occlusion Stroke?

Intern Med J 2021 Mar 4. Epub 2021 Mar 4.

Department of Neurology and Neuroscience, The First Hospital of Jilin University, Changchun, Jilin, China.

Background: Hyperglycemia is related to adverse outcomes in patients with acute ischemic stroke treated by mechanical thrombectomy (MT).

Aim: To compare the predictive ability of admission blood glucose (ABG), fasting blood glucose (FBG), and glycated hemoglobin (HbA1c) in patients with acute large vessel occlusion (ALVO) stroke undergoing MT.

Methods: The study retrospectively analyzed the data of 329 consecutive acute stroke patients treated by MT. Read More

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Hyperventilation Leading to Transient T-wave Inversion Mimicking Unstable Angina.

Cureus 2021 Jan 29;13(1):e12980. Epub 2021 Jan 29.

Cardiology, 7 Air Force Hospital, Kanpur, IND.

T-wave inversion in ECG is very frequent and concerning finding as it is often associated with life-threatening conditions. There are numerous conditions mentioned in the literature for transient T-wave inversion such as acute coronary syndrome, cardiac memory T-wave, subarachnoid hemorrhage, electroconvulsive therapy, hyperventilation and indeterminate origin. Hyperventilation is already known as a cause of transient T-wave inversion; however, it is often forgotten in modern clinical settings. Read More

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January 2021

Outcomes in Revision Stapes Surgery.

Otolaryngol Head Neck Surg 2021 Feb 9:194599821991479. Epub 2021 Feb 9.

Department of Neurotology, Michigan Ear Institute, St John Providence Hospital, Michigan, USA.

Objectives: To compare audiometric outcomes and complication rates between primary and revision stapes surgical cases.

Study Design: Retrospective cohort study.

Setting: Large single-institution database. Read More

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February 2021

Audiometric Outcomes Following Transmastoid and Middle Cranial Fossa Approaches for Repair of Cerebrospinal Fluid Otorrhea.

Otol Neurotol 2021 03;42(3):424-430

Department of Head and Neck Surgery, Kaiser Permanente San Diego, California.

Objective: Describe audiometric outcomes following transmastoid and middle cranial fossa (MCF) approaches for repair of cerebrospinal fluid (CSF) otorhinorrhea.

Study Design: Retrospective case series.

Setting: Tertiary skull base referral center. Read More

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Reference intervals for venous blood gas measurement in adults.

Clin Chem Lab Med 2021 Apr 3;59(5):947-954. Epub 2020 Dec 3.

Department of Chemical Pathology, NSW Health Pathology, Prince of Wales Hospital, Sydney, Australia.

Objectives: Venous blood gas (VBG) analysis is becoming a popular alternative to arterial blood gas (ABG) analysis due to reduced risk of complications at phlebotomy and ease of draw. In lack of published data, this study aimed to establish reference intervals (RI) for correct interpretation of VBG results.

Methods: One hundred and 51 adult volunteers (101 females, 50 males, 18-70 years) were enrolled after completion of a health questionnaire. Read More

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Clinical Utility of Venous Blood Gas Analysis for the Evaluation of Psychogenic Hyperventilation in the Emergency Department.

Cureus 2020 Dec 25;12(12):e12273. Epub 2020 Dec 25.

Division of General Medicine, Center for Community Medicine, Jichi Medical University School of Medicine, Shimotsuke, JPN.

Background Patients with psychogenic hyperventilation frequently visit emergency departments (EDs). Arterial blood gas (ABG) analysis is performed to evaluate patients with dyspnea. This may show respiratory alkalosis in patients with hyperventilation. Read More

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December 2020

Frequency-Specific Analysis of Hearing Outcomes Associated with Ossiculoplasty Versus Stapedotomy.

Ann Otol Rhinol Laryngol 2021 Jan 29:3489421990164. Epub 2021 Jan 29.

Section of Otolaryngology-Head and Neck Surgery, University of Chicago, Chicago, IL, USA.

Objective: Surgery on the ossicular chain may impact its underlying mechanical properties. This study aims to investigate comparative differences in frequency-specific hearing outcomes for ossiculoplasty versus stapedotomy.

Methods: A retrospective chart review was conducted on subjects who underwent ossiculoplasty with partial ossicular replacement prosthesis (PORP) or laser stapedotomy with self-crimping nitinol/fluoroplastic piston, and achieved closure of postoperative pure tone average air-bone gap (PTA-ABG) ≤ 15 dB. Read More

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January 2021

Clinical and diagnostic findings in COVID-19 patients: an original research from SG Moscati Hospital in Taranto Italy.

J Biol Regul Homeost Agents 2021 Jan-Feb;35(1):171-183

SET-118, Department of Pre-hospital and Emergency, SG Giuseppe Moscati Hospital, Taranto, Italy.

The coronavirus disease 2019 (COVID-19) pandemic is a worldwide medical challenge due to the scarcity of proper information and remedial resources. The ability to efficiently avoid a further SARS-CoV-2 pandemic will, therefore, depend on understanding several factors which include host immunity, virus behavior, prevention measures, and new therapies. This is a multi-phase observatory study conducted in the SG Moscati Hospital of Taranto in Italy that was converted into COVID-19 Special Care Unit for SARS-Co-V2 risk management. Read More

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Validation of a Portable Blood Gas Analyzer for Use in Challenging Field Conditions at High Altitude.

Front Physiol 2020 8;11:600551. Epub 2021 Jan 8.

Department of Respiratory Medicine, Sleep Disorders Center, University Hospital of Zürich, Zurich, Switzerland.

Background: Novel, portable blood gas analyzers (BGAs) may serve as essential point-of-care tools in remote regions, during air travel or in ambulance services but they have not been extensively validated.

Research Question: We compared accuracy of a portable BGA to a validated stationary device.

Methods: In healthy individuals and patients with chronic obstructive pulmonary disease participating in clinical field studies at different altitudes, arterial blood samples were obtained at rest and during exercise in a hospital at 760 m and in a high altitude clinic at 3100 m. Read More

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January 2021

Endoscopic tympanoplasty type I for tympanic perforations: analysis of prognostic factors.

Eur Arch Otorhinolaryngol 2021 Jan 12. Epub 2021 Jan 12.

Otorhinolaryngology-Head and Neck Surgery Department, University Hospital of Modena, Via del Pozzo 71, 41100, Modena, Italy.

Purpose: To assess the anatomical and functional outcomes of endoscopic transcanal tympanoplasty type I for tympanic membrane perforations.

Methods: Eight hundred thirty-five patients who underwent tympanoplasty between January 2011 and January 2019 were selected. Patients with tympanic membrane perforation treated with a transcanal endoscopic tympanoplasty type 1 and a follow-up period longer than 6 months have been retrospectively reviewed. Read More

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January 2021

End-tidal CO and transcutaneous CO : Are we ready to replace arterial CO in awake children?

Pediatr Pulmonol 2021 Feb 31;56(2):486-494. Epub 2020 Dec 31.

Sleep Unit, Pulmonology Department, Hospital de Pediatría Prof. Dr. J. P. Garrahan, Buenos Aires, Argentina.

Introduction: Arterial blood gas analysis (ABG) is the gold standard test for carbon dioxide measurement. End-tidal PCO (PetCO ) and transcutaneous PCO (PtcCO ) are noninvasive alternative methods.

Objective: To examine the use of PetCO and PtcCO as PaCO surrogates in awake children. Read More

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February 2021

Hypercapnia and hyperlactatemia were positively associated with higher-grade arrhythmias during peak exercise in horses during poor performance evaluation on a high-speed treadmill.

Vet J 2020 Dec 9;266:105572. Epub 2020 Nov 9.

Department of Clinical Studies, New Bolton Center, University of Pennsylvania, 382 West Street Rd., Kennett Square, PA 19348, USA.

Cardiac arrhythmias are common in horses during exercise, especially immediately post-exercise. The objectives of this study were to: (1) describe the frequency and type of cardiac arrhythmias detected in horses during incremental high-speed treadmill exercise testing (ITET); (2) determine if arterial blood gas (ABG) changes at peak and immediately post-exercise were associated with arrhythmias; and (3) determine whether upper or lower airway disease was associated with exercising cardiac arrhythmias. Horses (n = 368) presenting for an ITET underwent resting and exercising upper airway endoscopy, resting, exercising and post-exercise electrocardiography, resting and post-exercise echocardiography and exercising ABG. Read More

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December 2020