Extracorporeal circulation by hemodilution technique has been currently used with its clinical safety and good peripheral tissue perfusion in open heart surgery. There is no doubt that $O_{2}$ carrying capacity of the blood is disturbed by decreased hemoglobin level resulting from hemodilution of the circulating blood. From the view point of the blood gas exchange, these experimental studies were undertaken to determined the sate limit of hemodilution in the condition of cardiopulmonary bypass with a constant perfusion flow rate. Twelve adult mongrel dogs weighing 10 to 13 Kg. were anesthetized with pentobarbital and then respiration was controlled with Harvard volume respirator using room air. The cardiopulmonary by pass was performed by use of Sarns heart lung machine (console 5000, 5 head and 2 roller pumps) and Travenol pediatric bubble oxygenator. The perfusion rate during bypass was maintained at a constant rate of 80 ml/min/Kg of body weight. The ratio of oxygen gas flow to blood flow was kept in 3 to 1 constantly. International hemodilution was attained by serial blood withdrawals and immediate infusion of equal volumes of diluants composed of Ringer's lactate, 5% dextrose in water and 25% mannitol solution, proportionally 60%, 30%, and 10%. Arterial and venous blood samples were obtained between 15 and 20 minutes following each hemodilution. Hematocrits and hemoglobin values, $PO_{2}$, $PCO_{2}$ and pH were measured. Oxygen and carbon dioxide contents oxygen consumption and carbon dioxide elimination were calculated groups according to different hematocrit values and the correlations were evaluated. Result were as follows. 1. the arterial $O_{2}$ tension and $O_{2}$ saturation were maintained at the physiological level irrespective of the hematocrit value. 2. The venous $O_{2}$ tension and $O_{2}$ saturation showed a tendency to decline with the decrease in hematocrit value and positive correlation between them (r = +0.49, r = +0.76), The mean values of venous $O_{2}$ tension and $O_{2}$ saturation, however, were not decreased when the hematocrit levels were lower than 20%. 3. The arterial $O_{2}$ content declined lineally in proportion to the fall of hematocrit level with a positive correlation between them (r = +0.95). 4. The venous $O_{2}$ contents were decreased gradually as the hematocrit value decreased with positive correlation between them ( r =+0.89). The trend of diminution of venous $O_{2}$ content, however, was became low according to progressive decrease of hematocrit level. 5. Systemic oxygen consumption was in higher range than $O_{2}$ requirement of basal metabolism when the hematocrit value was above 20%, but abruptly decreased when the hematocrit value became to below 20%. 6. The arterial $CO_{2}$ tension and $CO_{2}$ content showed trend of increasing with progressive decrease of hematocrit value but exhibited a rather broad range and there was no relationship between those value and the hematocrit value. 7. The venous $CO_{2}$ tension and $CO_{2}$ content have also no correlation with change of Ht. value but related directly to those value of arterial blood with positive correlation between them (r = +0.78, r = +0.95_. 8. A-V difference of $CO_{2}$ content and $CO_{2}$ elimination wasnot significantly influenced by Ht. value. From the results, we obtained that feasible limit in inteneional hemodilution is above the hematocrit value of 20% under the given experimental condition.
Journal of the Korean Association of Oral and Maxillofacial Surgeons
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v.25
no.4
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pp.361-366
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1999
Intermaxillary fixation is routine procedure to oral and maxillofacial area in jaw bone fracture, surgical correction of jaw deformity, osseus reconstruction of jaw. After transoral surgery, accompanied by intermaxillary fixation, dysphagia or airway obstruction may be followed due to blood clot, vomitus, or laryngeal spasm resulting from irritation by blood or secretions. Lingual or pharyngeal edema is other contributing factors of airway obstruction. In addition, intermaxillary fixation itself may cause obstruction of airway. In this study, pulmonary function test and arterial blood gas analysis were evaluated before and after intermaxillary fixation in 30 patients suffered from mandibular fractures. Comparative analysis was performed by estimated values. The results were as followed. 1. The spirometric values of FEV1, FEV1/FVC and FEF25-75% without intermaxillary fixation were reduced from 97.57%, 85.1%, 98.3,% to 71.7%, 66.5%, 61.2% with intermaxillary fixation, indicating the presence of obstructive pulmonary impairment. 2. Spirometric value of MVV, as the most influencing value of sensitive to extrapulmonary factors, was changed from 84.5% to 46.48%. 3. After intermaxillary fixation, the spirometric value of FVC, as indicator of restrictive pattern of pulmonary function, was not reduced significantly as measured from 94.47% to 89.97%. 4. $O_2$ saturation of arterial blood gas analysis without intermaxillary fixation was 97.86%. While intermaxillary fixation, $O_2$ saturation was 97.47%. The results indicate that careful airway management is mandatory undergoing intermaxillary fixation of various oral and maxillofacial surgery.
Jeong, Jong Tae;Yun, Su Young;Lee, Ran;Hyun, Jae Ho;Jung, Gyu Young
Clinical and Experimental Pediatrics
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v.45
no.4
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pp.449-453
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2002
Purpose : Arterial blood gas analysis is frequently performed in neonatal intensive care unit (NICU) to evaluate ventilation and the metabolic state of critically ill infants. In occasions when umbilical arterial catheterization is not available, frequent arterial puncture is mandatory. This requires some technical skill and may occasionally have side effects. So we studied the validity of capillary blood gas analysis which can be performed conveniently compared with arterial blood. Methods : Twenty-four neonates admitted to NICU during April to Aug. 2001 were studied. They were more than two weeks old without indwelling arterial catheters. Thirty-six times, simultaneous arterial, and capillary blood gases were drawn by puncture and the pH, $pCO_2$ and $pO_2$ of each sample was measured. Blood pressure and body temperature was checked before sampling to rule out impaired peripheral circulation. Capillary blood was collected from warmed heels. Results : There was a strong correlation between capillary and arterial pH(r=0.91, P<0.05). The absolute value of the difference between arterial and capillary pH was less than 0.05. Also capillary $pCO_2$ showed correlation with arterial $pCO_2$(r=0.77, P<0.05). Despite a statistically significant correlation between capillary and arterial $pO_2$(r=0.68, P<0.05), the absolute value of the difference was more than 10 mmHg in 92% of cases. Conclusion : Capillary blood gases accurately reflected arterial pH and $pCO_2$ and showed a relative correlation with $pO_2$. Capillary blood gas analysis can be a useful alternative to arterial blood when continuation of the umbilical arterial catheter is no longer available.
The present study was performed to elucidate the effect of canine electroacupuncture anesthesia on vital signs and blood gas values. Groups were divided into experimental (electroacupuncture: EA) and control (ketamine) groups. The vital signs (body temperature, respiration rate and pulse) and blood gas values (pH, $pCO_2$ and $pO_2$) of venous and arterial blood were determined. Body temperatures of EA group were significant higher than than of ketamine group at 15 min., 30 min., 45min. and 60 min. (p<0.05) after anesthesia, respectively. The respiration rates of EA group were higher than those of ketamine group, however, significant differences were not observed between both groups. The pulses of EA group were significant higher than those of ketamine group at 5 min. (p<0.05), 10 min. (p<0.01), 15 min. and 30 min. (p<0.05) after anesthesia, respectively. The arterial and venous blood pHs of ketamine group were slightly higher than those of EA group, respectively, however, no significant differences were found between both groups. Significant differences were not observed between both groups in the arterial and venous blood $pCO_2$, respectively. The arterial blood $pO_2$ of EA group was significant higher than those of ketamine group at 5 min. (p<0.05) after anesthesia. No significant differences were observed between both groups in the venous blood $pO_2$. These results suggest that the changes of vital signs and blood gas values of EA group are similar to those of ketamine group with the exception of changes in the body temperature, pulse and arterial blood $pO_2$.
The effect of cardiopulmonary bypass (CPB) on cerebral physiology during heart surgery remains incompletely understood. This study was carried out to investigate changes of cerebral metabolism and the association between the changes and clinical factors during heart surgery. Seventy adult patients (n=70) scheduled for elective cardiac surgery were participated in the present study. Middle cerebral artery blood flow velocity (V$_{MCA}$), cerebral arteriovenous oxygen content difference (C(a-v)O$_2$), cerebral oxygen extraction (COE), and modified cerebral metabolic rate for oxygen (MCMRO$_2$) were measured during six phases of the operation; Pre-CPB, CPB-10 min, Rewarm-1 (nasopharyngeal temperature 34$^{\circ}C$), Rewarm-2 (nasopharyngeal temperature 37$^{\circ}C$), CPB-off, and Post-OP (at skin closure after CPB-off). Each relationship of age, arterial blood gas parameters, or other variables to V$_{MCA}2$, C(a-v)O$_2$, COE, or MCMRO$_2$ was evaluated. V$_{MCA}$ increased (P<0.0001) whereas C(a-v)O$_2$ decreased (P<0.01) throughout the five phases of the operation compared to Pre-CPB value (control). COE diminished at CPB-10, Rewarm-1, and CPB-off (P<0.05) while MCMRO$_2$ reduced at CPB-10 and Rewarm-1 (P<0.05) compared to Pre-CPB value. Positive correlation was found between age and cerebral metabolic parameters (V$_{MCA}$, C(a-v)O$_2$, COE, or MCMRO$_2$) during CPB (range r=0.24 to 0.38, p<0.05). Four cerebral metabolic parameters had partially negative or positive correlation with arterial blood gas parameters and other variables (arterial blood pH, $O_2$ tension, $O_2$ content, $CO_2$ tension, blood pressure, blood flow, temperature, or hematocrit) during the operation. In conclusion, CPB led to marked alterations of cerebral metabolism and age, pH, and $CO_2$ tension profoundly influenced the changes during cardiac surgery.
The Present study attempted to analyze the fate of CO diffused into the circulating blood through the alveoli. Dogs were induced to CO poisoning by rebreathing CO gas mixture contained in Krog's spirometer, by closed circuit method, for 60 minutes. The spirometer was filled initially with 282 ml of CO and 20 liters of air and oxygen, so the composition of gases were arranged as 1.4% in CO and 50% in $O_2$ at the begining of the rebreathing. Oxygen was added corresponding to the utilization of $O_2$ by the animal in proceeding of the experiment. At 60th minutes of CO rebreathing, the concentration of CO in arterial blood and in mixed venous blood were analysed and compared with each other after the CO contents were corrected with the hematocrit measured in the arterial and mixed venous blood. The distribution of CO gas to other tissues was estimated by the analysis of CO diffused into the cystic bile and into the peritoneal gas pocket which was formed by injection of 300 ml air into the peritoneal cavity prior to the CO gas rebreathing. The blood volume was measured by dilution method using $^{51}Chromium$ tagged red cells. CO amount vanished in the animal body was calculated by subtraction of total CO content in blood stream and the CO remained in closed circuit breathing system from the CO amount given to the breathing system at the begining of the experiment. Results obtained are summarized as follows: 1. The content of CO corrected by the hematocrit value was slightly less in mixed venous blood than in arterial blood. The amount of CO diffused into the cystic bile and into the peritoneal cavity was averaged to 0.1% and 0.4% of the CO amount in 100 ml of blood, respectively. 2. For 60 minutes of CO rebreathing, CO-hemoglobin saturation reached about 77% at the 60th minutes, CO amount vanished in the experimental animal averaged 36.1 ml/dog/hr., or 21% of the total CO volume in the blood stream. The average vanishing rate of CO during 60 minutes of CO rebreathing per kg of body weight was 2.71 ml/hr. Production of CO measured in ten dogs under hypoxic condition averaged 0.023 ml/kg/hr. The major part of the CO vanished in the dogs seemed to be oxidized to $CO_2$ by various tissues of the animal. The conclusion might be delivered as such oxidation of CO to $CO_2$ by animal tissues can play a role in part of the process of recovery and protection of animal from CO-poisoning.
Lee, Joon-Bae;Shon, Sung Kun;Woo, Sang Hee;Park, Se Yeon;Hwang, Jung Ho;Kwon, O-Seong;Kim, Nam Yi;Paeng, Ki Jung
Analytical Science and Technology
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v.29
no.2
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pp.73-78
/
2016
Hydrogen cyanide (HCN) is an extremely toxic gas frequently produced during the incineration of plastics, such as acrylonitrile-butadiene-styrene (ABS). A victim of a fire who has inhaled smoke could have cyanide in the blood. Therefore, cyanide could be a good marker for a post-mortem examination of a fire as well as carboxyhemoglobine (COHb) test of blood samples. For a particular fire case, a burned body with a suicide note was found inside a burned vehicle. Even though the COHb value is conclusive evidence, measuring the COHb for denatured blood might be difficult due to severe thermal denaturation or the formation of methemoglobin (MetHb). To overcome this difficulty, cyanide could be used as an indicator when investigating the death of a fire victim. In this study, gas chromatography/mass spectrometry (GC/MS) was adopted to measure the levels of cyanide in the blood through derivatization with pentafluorobenzyl bromide (PFBBr) under cation surfactant by scan and SIM mode. The concentration of cyanide in the blood of heart blood and brain of the victim was found to be 0.36 µg/mL and 1.20 µg/mL respectively, which was higher than the average value (0.041 µg/mL) found in the blood of 14 people who smoked.
Journal of the Korean Applied Science and Technology
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v.32
no.3
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pp.394-404
/
2015
This study investigated the pharmacodynamics of betaine on the blood profile and short chain fatty acid levels in meat ducks exposed to heat wave. 400 heads of Cherry valley (Anasplatyrhynchos) meat ducks were completely randomized to 5 treatments (4 repetitions each), and were raised for 42 days. They were grouped into T1 (heat wave control group without betaine), T2 (betaine 400 ppm), T3 (betaine 800 ppm), T4 (betaine 1200 ppm), and T5 (normal control group without betaine). Compared to T1, the betaine addition groups showed higher body weight gain at shipment, with T3 showing the highest significant difference. For hematological indictors measured (red blood cells and platelets), the betaine addition groups showed significantly higher values than the heat wave control group. The pH of the former was lower but their electrolytes ($K^+$, $P^+$, and $Cl^-$) were significantly higher compared to the latter. For blood gas concentration, the former showed a significantly higher value than the latter. For the total short chain fatty acids, acetic acid, and propionic acid, the betaine addition groups and group fed broiler-high temperature diet showed higher values than the heat wave control group. On the other hand, the former showed significantly lower values in butyric acid, isobutyric acid, valeric acid, and isovaleric acid than the latter group. These results suggest that betaine has the pharmacodynamics that mediate heat stress, via the maintenance and control of the blood profile, osmotic pressure, gas concentration, and short chain fatty acid, of meat ducks under heat wave.
Studies of blood gas and lung histopathology were done in 10 dogs after intrapericardlal aorto-right pulmonary arterial anastomosis with proximal ligation of the right pulmonary antery. Among the 5 expired during or after operation, in 3 cases, the causes of the death were due to surgical bleeding and, in 2 cases, acute cardiopulmonary insufficiency because of large anastomosis stoma measured respectively 7mm and 10mm. In the 5 of survivals, one was sacrificed because of empyema at postoperative 7 days and 2 were at postoperative one month and remained 2 at postoperative 3 month respectively. The following observations were made. 1.In every survival, continuous machinary murmur was auscultated and the angiograms of all long term survivals showed the good patency of the anastomosis stoma. 2.After the ligation of the right pulmonary artery, the values of $PO_2$ and $PCO_2$ in arterial and venous blood were generally decreased comparing with the preoperative values. The mean value of $P_aO_2$ noted $83.30{pm}11.875$[p<0.01]. After the shunts operation with ligation of the right pulmonary artery, the immediate values of PH, $PO_2$ and $PCO_2$showed no significant changes comparing with that of right pulmonary artery ligation only. In the cases of survivals more than one month, the values of $PO_2$ and $PCO_2$ in the arterial and venous blood were generally higher than that of ligation of the right pulmonary artery only. The $P_aO_2$ value noted $103.750{pm}7.395$[p<0.01]. The mean values of $P_aO_2$, $PCO_2$ and PH in the arterial and venous blood almost returned to that of preoperative studies. 3.In the specimens of lung from the cadavors expired due to acute cardiopulmonary insufficiency after the operation, there were massive congestion, hemorrhage in the alveolar spaces and bronchioles. In specimens obtained at postoperative one month, there were dilatation of alveolar spaces with partial rupture, slight congestion, and alveolar wall thickening in the lung parenchyme, but there was no significant changes in pulmonary vasculature except dilation of pulmonary capillaries. In the specimens obtained at postoperative three months, the alveolar walls were more thickened in the lung parenchyme than the finding of the specimens obtained at postoperative one month. In the wall of pulmonary capillaries, there was only slight thickening with connective tissue proliferatlon.
The temperature-corrected values of blood gas analysis were compared to uncorrected values in 40 cases of open heart surgery under moderate hypothermic cardiopulmonary bypass. The results were as follows. 1. The corrected value of pH was significantly higher than uncorrected value, and it's relationship was ${\Delta}pH=-0.015$${\Delta}Temp+0.005$(r=0.81, P<(0.01). 2. The corrected value of $PCO_2$ was lower than uncorrected value, and it's relationship was ${\Delta}PCO_2=1.11$${\Delta}Temp+1.81$(r=0.50, P<0.01). 3. The corrected value of $PO_2$ was lower than uncorrected value, and it' s relationship was ${\Delta}PO_2=5.21$${\Delta}Temp-1.45$(r=0.32, P<0.01). But there was no clinical significance. 4. The corrected values of $HCO_{3^-}$, base excess, $CO_2$ content and oxygen saturation were similar with uncorrected values. In summery, the values of pH and $PCO_2$were significantly changed by temperature-correction. Because of the neutral point of water (pH=pOH) rises as temperature falls and it change in parallel with the changes in blood pH, a corrected pH of 7.4, $PaCO_2$ of 40mmHg during deep hypothermia would reflect a profound respiratory acidosis. Therefore, the use of the uncorrected value at $37^{\circ}C$ is more preferable and valid means of assessing acid-base management regardless of actual patient temperature.
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