Analysis of the clinical backgrounds of patients who developed respiratory acidosis under high‐flow oxygen therapy during emergency transport

Ogino, Hirokazu; Nishimura, Naoki; Yamano, Yasuhiko; Ishikawa, Genta; Tomishima, Yutaka; Jinta, Torahiko; Takahashi, Osamu; Chohnabayashi, Naohiko

doi:10.1002/ams2.138

Cited by 4 publications

(3 citation statements)

References 24 publications

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“…In order for patients to receive HRCT after invasive mechanical ventilation (n = 5 in derivation cohort, n = 6 in validation cohort), it is necessary for a physician to be on call/available. Usually, in Taiwan hospitals, the emergency room (ER) is close to the CT room so the transport time is within 10 minutes for nearly all patients 30 . The ER is staffed by experienced emergency doctors who are on duty 24 hours a day.…”

Section: Discussionmentioning

confidence: 99%

Predictors of Initial Smear-Negative Active Pulmonary Tuberculosis with Acute Early Stage Lung Injury by High-Resolution Computed Tomography and Clinical Manifestations: An Auxiliary Model in Critical Patients

Yeh

2019

Sci Rep

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This study evaluated the diagnostic use of high-resolution computed tomography (HRCT), chest X-ray (CXR), and clinical manifestations (CM) to identify initial smear-negative (iSN) active pulmonary tuberculosis (aPTB) [iSN-aPTB] in patients with iSN-pulmonary diseases (PD) and acute lung injury (ALI). In the derivation cohort, the [iSN-PD] with ALI patients were divided into the [iSN-aPTB] (G1, n = 26) and [non-aPTB-PD] (G2, n = 233) groups. Lung morphology, number, and lobar (segmental) distribution were evaluated using CXR and HRCT. A multivariate analysis was performed to identify independent variables associated with G1, which were used to generate predictive score models for G1. The predictive model was validated in a separate population of patients (n = 372) with [iSN-PD] and (ALI). The validated model for [HRCT (CXR + Hypoalbuminemia)] had 93.5% (25.8%) sensitivity, 99.5% (89.4%) specificity, and a negative predictive value of 99.5% (93.0%). For [iSN-aPTB], the post-test probability in the derivation cohort (prevalence = 10%), validation cohort (prevalence = 8.3%), and the given prevalence (prevalence = 1%) was 88.7%, 94.4%, and 41.5%, respectively. The HRCT model effectively identified the [iSN-aPTB] subjects among the [iSN-PD] with ALI, regardless of CM. The [non-aPTB-PD] were also correctly classified by the HRCT and [CXR + Hypoalbuminemia] models.

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Section: Discussionmentioning

confidence: 99%

Predictors of Initial Smear-Negative Active Pulmonary Tuberculosis with Acute Early Stage Lung Injury by High-Resolution Computed Tomography and Clinical Manifestations: An Auxiliary Model in Critical Patients

Yeh

2019

Sci Rep

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“…Development of hypercapnia due to oxygen use may occur rapidly. [48] The common outcome is rapidly developing respiratory acidosis [34], respiratory distress, acute respiratory failure, coma, and death. Research suggests that this mechanism is relevant in UPEs and explains their occurrence in high performance aircraft.…”

Section: Respiratory Physiology Hypoventilation and Hypercapniamentioning

confidence: 99%

“…Ample evidence from critical care medicine, neonatal intensive care, flight medicine, and diving physiology support this assertion. [1][2][3][4]21,24,26,29,34,37,47,48] CO2 narcosis is a physiologic condition that results from elevated PaCO2 in arterial blood. Common symptoms are lethargy, confusion, headache, blurred vision, impaired hearing, and loss of consciousness.…”

Section: Co2 Narcosis As the Cause Of Upesmentioning

confidence: 99%

CO<sub>2</sub> Narcosis as a Root Cause of Unexplained Physiological Events in High Performance Aircraft

Bassovitch¹

2020

Preprint

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Since 1991, there has been an alarming increase in the number of unexplained physiological events (UPEs) reported and experienced by pilots of jet fighters across different fleets. The UPEs have resulted in grounding some airframes, loss of aircraft, and even loss of life. There is no single agreed-upon root cause of UPEs that has been identified, and therefore there is no reliable corrective action. This author analyzed the literature related to other industries where artificial hyperoxic gas mixes are employed and where similar adverse reports have been reported. I hypothesize that UPEs are caused by high-dose oxygen delivery in excess of officially approved oxygen schedules while airflow rates are often inadequate, at a time when the positive pressure breathing feature of their oxygen regulator is not used. In a setting where pulmonary vital capacity is adversely affected by G-maneuvers and oxygen- and G-induced atelectasis, tidal volume is reduced by flight gear, and effective gas exchange is not supported by adequate ventilation, these factors combine to produce respiratory acidosis, followed by acute respiratory distress syndrome, CO2 narcosis, and coma. Reports from field data related to incidents in F-18S/H, showing that emergency oxygen did not correct the hypoxia-like symptoms including long-lasting periods of incapacitation and prolonged headaches, lend support to our hypothesis.

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Respiratory Acid-Base Disorders and Related Risk Factors in Critically Ill Patients

Musleh

bakri

Abdel-Aziz

et al. 2020

Assiut Scientific Nursing Journal

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Background: Respiratory acid-base disorders are commonly seen in the critical care setting and can occur independently or coexist with metabolic acid-base disorders. Aim of the study: To explore the pattern of respiratory acid-base disorders and related risk factors in critically ill patients. Design: the descriptive design was utilized in this study. Setting: This study was carried out in the Trauma and general Intensive Care Unit at Assiut university hospital. Sample: fifty patients admitted to trauma and general Intensive Care Unit. Tools: Four tools were used in this study, patient assessment tool, APACHE II tool, Acid-base parameters assessment tool, and Risk factors assessment tool. Result: A total of 50 patients most of them were male with a mean age of 40.37 ± 13.86 in the survivors versus 47.75 ± 11.86 in non-survivor. APACHE II score was significant in non-survivor group confirmed by (P = 0.000), (P = 0.003) respectively.The incidences of respiratory alkalosis (52%), respiratory acidosis (24%) were higher in the survivor group. The significant risk factor was iatrogenic(drugs, mechanical ventillation). Conclusion:Respiratory acid-base disorders are common in critically ill patients mainly respiratory alkalosis and the major related risk factor was an iatrogenic.

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Analysis of the clinical backgrounds of patients who developed respiratory acidosis under high‐flow oxygen therapy during emergency transport

Cited by 4 publications

References 24 publications

Predictors of Initial Smear-Negative Active Pulmonary Tuberculosis with Acute Early Stage Lung Injury by High-Resolution Computed Tomography and Clinical Manifestations: An Auxiliary Model in Critical Patients

Predictors of Initial Smear-Negative Active Pulmonary Tuberculosis with Acute Early Stage Lung Injury by High-Resolution Computed Tomography and Clinical Manifestations: An Auxiliary Model in Critical Patients

CO<sub>2</sub> Narcosis as a Root Cause of Unexplained Physiological Events in High Performance Aircraft

Respiratory Acid-Base Disorders and Related Risk Factors in Critically Ill Patients

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