Displaying publications 21 - 40 of 136 in total

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  1. Ramachandran S, Prakash P, Mohtar N, Kumar KS, Parumasivam T
    Pharm Dev Technol, 2023 Dec;28(10):978-991.
    PMID: 37937865 DOI: 10.1080/10837450.2023.2279691
    Tuberculosis is an airborne disease caused by the pathogen, Mycobacterium tuberculosis, which predominantly affects the lungs. World Health Organization (WHO) has reported that about 85% of TB patients are cured with the existing 6-month antibiotic regimen. However, the lengthy oral administration of high-dose anti-TB drugs is associated with significant side effects and leads to drug resistance cases. Alternatively, reformulating existing anti-tubercular drugs into inhalable nanoparticulate systems is a promising strategy to overcome the challenges associated with oral treatment as they could enhance drug retention in the pulmonary region to achieve an optimal drug concentration in the infected lungs. Hence, this review provides an overview of the literature on inhalable nano-formulations for the delivery of anti-TB drugs, including their formulation techniques and preclinical evaluations between the years 2000 and 2020, gathered from electronic journals via online search engines such as Google Scholar and PubMed. Previous in vitro and in vivo studies highlighted that the nano-size, low toxicity, and high efficacy were among the factors influencing the fate of nanoparticulate system upon deposition in the lungs. Although many preclinical studies have shown that inhalable nanoparticles increased therapeutic efficacy and minimised adverse drug reactions when delivered through the pulmonary route, none of them has progressed into clinical trials to date. This could be attributed to the high cost of inhaled regimes due to the expensive production and characterisation of the nanoparticles as well as the need for an inhalation device as compared to the oral treatment. Another barrier could be the lack of medical acceptance due to insufficient number of trained staff to educate the patients on the correct usage of the inhalation device. Hence, these barriers should be addressed satisfactorily to make the inhaled nanoparticles regimen a reality for the treatment of TB.
    Matched MeSH terms: Administration, Inhalation
  2. Teoh CY, Lim FS
    Paediatr Anaesth, 2008 Feb;18(2):119-24.
    PMID: 18184242 DOI: 10.1111/j.1460-9592.2007.02385.x
    The Proseal laryngeal mask airway (PLMA) is a relatively new supraglottic airway device with a drain tube to minimize the risk of gastric insufflation and aspiration. We compared introducer tool (IT) and gum elastic bougie (GEB)-guided techniques for insertion of the Proseal LMA in children.
    Matched MeSH terms: Anesthesia, Inhalation/instrumentation*; Anesthesia, Inhalation/methods
  3. Tee GH, Hairi NN, Nordin F, Choo WY, Chan YY, Kaur G, et al.
    Asian Pac J Cancer Prev, 2015;16(9):3659-65.
    PMID: 25987018
    BACKGROUND: Waterpipe tobacco smoking has becoming popular especially among young people worldwide. Smokers are attracted by its sweeter, smoother smoke, social ambience and the misconception of reduced harm. The objective of this study was to systematically review the effects of waterpipe tobacco policies and practices in reducing its prevalence.

    MATERIALS AND METHODS: A systematic review was conducted electronically using the PubMed, OVID, Science Direct, Proquest and Embase databases. All possible studies from 1980 to 2013 were initially screened based on titles and abstracts. The selected articles were subjected to data extraction and quality rating.

    RESULTS: Three studies met the inclusion criteria and were eligible for this review. Almost all of the waterpipe tobacco products and its accessories did not comply with the regulations on health warning labelling practices as stipulated under Article 11 of WHO FCTC. In addition, the grisly new warning labels for cigarettes introduced by Food and Drug Administration did not affect hookah tobacco smoking generally. Indoor air quality in smoking lounges was found to be poor and some hookah lounges were operated without smoke shop certification.

    CONCLUSIONS: Our findings revealed the availability of minimal information on the practices in controlling waterpipe smoking in reducing its prevalence. The lack of comprehensive legislations or practices in controlling waterpipe smoking warrants further research and policy initiatives to curb this burgeoning global epidemic, especially among the vulnerable younger population.
    Matched MeSH terms: Inhalation Exposure/adverse effects; Inhalation Exposure/prevention & control*
  4. Ting CY, Ahmad Sabri NA, Tiong LL, Zailani H, Wong LP, Agha Mohammadi N, et al.
    PMID: 31530230 DOI: 10.1080/10934529.2019.1665950
    While past studies have detected heavy metals in aerosols emitted from electronic cigarettes (ECIG), they have provided little information detailing the practical implications of the findings to the Malaysian population due to variations between products. The aims of this study were to analyse heavy metals of interest (HMOI) in the aerosols emitted from selected ECIG and to evaluate potential health risks by referring to the permissible daily exposure (PDE) from inhalational medications defined by the United States Pharmacopeia Chapter 232. All four HMOI were detected in aerosols emitted from the selected ECIG in Sarawak. Among the four, Cr was present at the highest median levels (6.86 ng/m3), followed by Ni (0.30 ng/m3), Pb (0.19 ng/m3) and Cd (0.01 ng/m3). Five out of 100 combinations (5%) of ECIG and ECIG liquids were found to emit Cr that exceed the recommended PDE. Future studies examining more heavy metal variants, using a larger sample size and different analytical techniques to compare various ECIGs are recommended.
    Matched MeSH terms: Inhalation Exposure/analysis*; Inhalation Exposure/standards
  5. Abdul Shakor AS, Pahrol MA, Mazeli MI
    J Environ Public Health, 2020;2020:1561823.
    PMID: 32351580 DOI: 10.1155/2020/1561823
    Particulate matter with an aerodynamic diameter of 10 μm or less (PM10) pollution poses a considerable threat to human health, and the first step in quantifying health impacts of human exposure to PM10 pollution is exposure assessment. Population-weighted exposure level (PWEL) estimation is one of the methods that provide a more refined exposure assessment as it includes the spatiotemporal distribution of the population into the pollution concentration estimation. This study assessed the population weighting effects on the estimated PM10 concentrations in Malaysia for years 2000, 2008, and 2013. Estimated PM10 annual mean concentrations with a spatial resolution of 5 kilometres retrieved from satellite data and population count obtained from the Gridded Population of the World version 4 (GPWv4) from the Centre for International Earth Science Information Network (CIESIN) were overlaid to generate the PWEL of PM10 for each state. The calculated PWEL of PM10 concentrations were then classified based on the World Health Organization (WHO) and the national Air Quality Guidelines (AQG) and interim targets (IT) for comparison. Results revealed that the annual mean PM10 concentrations in Malaysia ranged from 31 to 73 µg/m3 but became generally lower, ranging from 20 to 72 µg/m3 after population weighting, suggesting that the PM10 population exposure in Malaysia might have been overestimated. PWEL of PM10 distribution showed that the majority of the population lived in areas that complied with the national AQG, but were vulnerable to exposure level 3 according to the WHO AQG and IT, indicating that the population was nevertheless potentially exposed to significant health effects from long-term exposure to PM10 pollution.
    Matched MeSH terms: Inhalation Exposure/analysis*; Inhalation Exposure/standards
  6. Ng KT, Alston RP, Just G, McKenzie C
    Perfusion, 2018 03;33(2):148-155.
    PMID: 28985693 DOI: 10.1177/0267659117735883
    INTRODUCTION: Bispectral index (BIS) and monitoring of end-tidal concentration may be associated with a reduction in the incidence of awareness during volatile-based general anaesthesia. An analogue of end-tidal concentration during cardiopulmonary bypass (CPB) is measuring exhausted isoflurane concentration from the oxygenator as an estimate to blood and, so, brain concentration. The aim of this study was to determine the relationships between oxygenator exhaust and blood concentrations of isoflurane and the BIS score during CPB when administering isoflurane into the sweep gas supply to the oxygenator.

    METHODS: Seventeen patients undergoing elective cardiac surgery using CPB and isoflurane with BIS monitoring were recruited in a single-centre university hospital. Isoflurane gas was delivered via a calibrated vaporiser at the beginning of anaesthetic induction. Radial arterial blood samples were collected after the initiation of CPB and before aortic cross-clamping, which were analysed for isoflurane by gas chromatography and mass spectrometry. The BIS score and the concentration of exhausted isoflurane from the oxygenator membrane, as measured by an anaesthetic gas analyser, were recorded at the time of blood sampling.

    RESULTS: The mean duration of anaesthetic induction to arterial blood sampling was 90 min (95%CI: 80,100). On CPB, the median BIS was 39 (range, 7-43) and the mean oxygenator exhaust isoflurane concentration was 1.24 ± 0.21%. No significant correlation was demonstrated between BIS with arterial isoflurane concentration (r=-0.19, p=0.47) or oxygenator exhaust isoflurane concentration (r=0.07, p=0.80). Mixed-venous blood temperature was moderately correlated to BIS (r=0.50, p=0.04). Oxygenator exhaust isoflurane concentration was moderately, positively correlated with its arterial concentration (r=0.64, p<0.01).

    DISCUSSION: In conclusion, in patients undergoing heart surgery with CPB, the findings of this study indicate that, whilst oxygenator exhaust concentrations were significantly associated with arterial concentrations of isoflurane, neither had any association with the BIS scores, whereas body temperature has moderate positive correlation.

    Matched MeSH terms: Anesthetics, Inhalation/pharmacology; Anesthetics, Inhalation/therapeutic use*
  7. Moler-Zapata S, Peters MJ, Gould DW, Giallongo E, Orzol M, Ray S, et al.
    Lancet Child Adolesc Health, 2025 Jan;9(1):16-24.
    PMID: 39701658 DOI: 10.1016/S2352-4642(24)00294-3
    BACKGROUND: Peripheral oxygen saturation (SpO2) above 94% is typical in children in paediatric intensive critical care units (PICUs) who are receiving invasive ventilation and supplemental oxygen. In a previous report from the Oxy-PICU trial, we showed that lower (conservative) oxygenation targets (SpO2 88-92%) are beneficial, showing small but statistically significant differences in duration of organ support and large but non-significant cost reductions at 30 days. In this pre-specified analysis of the Oxy-PICU trial, we compare longer-term outcomes and cost-effectiveness of conservative versus liberal (SpO2 >94%) oxygenation targets in children with emergency PICU admission.

    METHODS: Oxy-PICU was a pragmatic, multicentre, open-label, randomised controlled trial in England and Scotland. Eligible children were older than 38 weeks and younger than 16 years and had been admitted for emergency care in one of 15 participating PICUs, where they received invasive respiratory support for abnormal gas exchange. Participants were randomly assigned (1:1) to either a conservative oxygenation target (SpO2 88-92%) or liberal oxygenation target (SpO2 >94%). Survival status was assessed at 90 days and 1 year, and health-related quality of life (HRQoL), quality-adjusted life-years (QALYs), health-care costs, and incremental net monetary benefit were assessed at 1 year after the index hospital admission and randomisation. HRQoL was measured with age-appropriate Paediatric Quality of Life Generic Core Scales and mapped onto the Child Health Utility 9D index score. HRQoL and survival data were combined to construct QALYs. Costs at 1 year were derived from use of hospital, outpatient, and community health services. The trial was registered in the ISRCTN registry (ISRCTN92103439).

    FINDINGS: 2040 children were enrolled between Sept 1, 2020 and May 15, 2022. 1868 (91·6%) children were included in the 90-day survival analysis; of these 930 (49·8%) had been assigned liberal oxygen and 938 (50·2%) conservative oxygen. 1867 (91·5%) children were included in the 1-year survival analysis; 930 (49·8%) had been assigned liberal oxygenation and 937 (50·2%) conservative oxygen. At 90 days, 35 (3·7%) patients in the conservative oxygenation group and 45 (4·8%) patients in the liberal oxygenation group had died (adjusted hazard ratio [aHR] 0·75 [95% CI 0·48 to 1·17]). By 1 year, 52 (5·5%) patients in the conservative oxygenation group and 66 (7·1%) patients in the liberal oxygenation group had died (aHR 0·77 [95%CI 0·53 to 1·10]). Overall, mean HRQoL, life-years, and QALYs at 1 year were similar in the two groups. The adjusted incremental effect on cost of conservative oxygenation versus liberal oxygenation was -£879 (95% CI -9036 to 7278), whereas the incremental difference in QALYs was estimated at 0·001 (-0·010 to 0·011), leading to an incremental net monetary benefit of £894 (-7290 to 9078) associated with conservative oxygenation relative to liberal oxygenation. These results did not vary by age (<12 months vs ≥12 months), comorbidity at baseline, age-adjusted heart rate, or haemoglobin level at admission and were robust to alternative assumptions.

    INTERPRETATION: Compared with usual care (SpO2 >94%) for invasively ventilated children who are admitted as an emergency to a PICU, conservative oxygenation (SpO2 88-92%) was not associated with differences in longer-term survival, costs, or cost-effectiveness. Taken together with previous findings of Oxy-PICU that conservative oxygenation compared with liberal oxygenation leads to better patient-centred and parent-centred outcomes at 30 days, these findings support the use of conservative oxygenation targets for this population.

    FUNDING: UK National Institute for Health and Social Care Research Health Technology Assessment Programme.

    Matched MeSH terms: Oxygen Inhalation Therapy/economics; Oxygen Inhalation Therapy/methods
  8. Oei JL, Saugstad OD, Lui K, Wright IM, Smyth JP, Craven P, et al.
    Pediatrics, 2017 01;139(1).
    PMID: 28034908 DOI: 10.1542/peds.2016-1452
    BACKGROUND AND OBJECTIVES: Lower concentrations of oxygen (O2) (≤30%) are recommended for preterm resuscitation to avoid oxidative injury and cerebral ischemia. Effects on long-term outcomes are uncertain. We aimed to determine the effects of using room air (RA) or 100% O2 on the combined risk of death and disability at 2 years in infants <32 weeks' gestation.

    METHODS: A randomized, unmasked study designed to determine major disability and death at 2 years in infants <32 weeks' gestation after delivery room resuscitation was initiated with either RA or 100% O2 and which were adjusted to target pulse oximetry of 65% to 95% at 5 minutes and 85% to 95% until NICU admission.

    RESULTS: Of 6291 eligible patients, 292 were recruited and 287 (mean gestation: 28.9 weeks) were included in the analysis (RA: n = 144; 100% O2: n = 143). Recruitment ceased in June 2014, per the recommendations of the Data and Safety Monitoring Committee owing to loss of equipoise for the use of 100% O2. In non-prespecified analyses, infants <28 weeks who received RA resuscitation had higher hospital mortality (RA: 10 of 46 [22%]; than those given 100% O2: 3 of 54 [6%]; risk ratio: 3.9 [95% confidence interval: 1.1-13.4]; P = .01). Respiratory failure was the most common cause of death (n = 13).

    CONCLUSIONS: Using RA to initiate resuscitation was associated with an increased risk of death in infants <28 weeks' gestation. This study was not a prespecified analysis, and it was underpowered to address this post hoc hypothesis reliably. Additional data are needed.

    Matched MeSH terms: Oxygen Inhalation Therapy/adverse effects; Oxygen Inhalation Therapy/methods*
  9. Kim JD, Son I, Kwon WK, Sung TY, Sidik H, Kim K, et al.
    J Korean Med Sci, 2018 01 22;33(4):e28.
    PMID: 29318795 DOI: 10.3346/jkms.2018.33.e28
    BACKGROUND: Isoflurane, a common anesthetic for cardiac surgery, reduced myocardial contractility in many experimental studies, few studies have determined isoflurane's direct impact on the left ventricular (LV) contractile function during cardiac surgery. We determined whether isoflurane dose-dependently reduces the peak systolic velocity of the lateral mitral annulus in tissue Doppler imaging (S') in patients undergoing cardiac surgery.

    METHODS: During isoflurane-supplemented remifentanil-based anesthesia for patients undergoing cardiac surgery with preoperative LV ejection fraction greater than 50% (n = 20), we analyzed the changes of S' at each isoflurane dose increment (1.0, 1.5, and 2.0 minimum alveolar concentration [MAC]: T1, T2, and T3, respectively) with a fixed remifentanil dosage (1.0 μg/min/kg) by using transesophageal echocardiography.

    RESULTS: Mean S' values (95% confidence interval [CI]) at T1, T2, and T3 were 10.5 (8.8-12.2), 9.5 (8.3-10.8), and 8.4 (7.3-9.5) cm/s, respectively (P < 0.001 in multivariate analysis of variance test). Their mean differences at T1 vs. T2, T2 vs. T3, and T1 vs. T3 were -1.0 (-1.6, -0.3), -1.1 (-1.7, -0.6), and -2.1 (-3.1, -1.1) cm/s, respectively. Phenylephrine infusion rates were significantly increased (0.26, 0.22, and 0.47 μg/kg/min at T1, T2, and T3, respectively, P < 0.001).

    CONCLUSION: Isoflurane increments (1.0-2.0 MAC) dose-dependently reduced LV systolic long-axis performance during cardiac surgeries with a preserved preoperative systolic function.

    Matched MeSH terms: Anesthetics, Inhalation/administration & dosage*; Anesthetics, Inhalation/pharmacology
  10. Wong HL, Garthwaite DG, Ramwell CT, Brown CD
    Environ Sci Pollut Res Int, 2017 Dec;24(34):26444-26461.
    PMID: 28948535 DOI: 10.1007/s11356-017-0064-5
    This study investigated changes over 25 years (1987-2012) in pesticide usage in orchards in England and Wales and associated changes to exposure and risk for resident pregnant women living 100 and 1000 m downwind of treated areas. A model was developed to estimate aggregated daily exposure to pesticides via inhaled vapour and indirect dermal contact with contaminated ground, whilst risk was expressed as a hazard quotient (HQ) based on estimated exposure and the no observed (adverse) effect level for reproductive and developmental effects. Results show the largest changes occurred between 1987 and 1996 with total pesticide usage reduced by ca. 25%, exposure per unit of pesticide applied slightly increased, and a reduction in risk per unit exposure by factors of 1.3 to 3. Thereafter, there were no consistent changes in use between 1996 and 2012, with an increase in number of applications to each crop balanced by a decrease in average application rate. Exposure per unit of pesticide applied decreased consistently over this period such that values in 2012 for this metric were 48-65% of those in 1987, and there were further smaller decreases in risk per unit exposure. All aggregated hazard quotients were two to three orders of magnitude smaller than one, despite the inherent simplifications of assuming co-occurrence of exposure to all pesticides and additivity of effects. Hazard quotients at 1000 m were 5 to 16 times smaller than those at 100 m. There were clear signals of the impact of regulatory intervention in improving the fate and hazard profiles of pesticides used in orchards in England and Wales over the period investigated.
    Matched MeSH terms: Inhalation Exposure/adverse effects; Inhalation Exposure/analysis
  11. Liew RP
    Med J Malaysia, 1973 Mar;27(3):182-7.
    PMID: 4268920
    Matched MeSH terms: Anesthesia, Inhalation
  12. Hopkin DAB
    Matched MeSH terms: Anesthesia, Inhalation
  13. Lew YS
    Singapore Med J, 2000 Aug;41(8):398-400.
    PMID: 11256348
    One lung anaesthesia in paediatric patients may not always be achievable by bronchial blockade or double lumen tube intubation due to inadequate experiences or facilities. We attempted to isolate right lung by selectively intubating the left bronchus with single lumen tube on a 10 kg child. Optimal surgical condition and satisfactory oxygenation achieved but complicated with severe respiratory acidosis. The possible causes for hypercapnea in this child were discussed.
    Matched MeSH terms: Anesthesia, Inhalation/adverse effects*; Anesthesia, Inhalation/instrumentation; Anesthesia, Inhalation/methods*
  14. Sallih ASM, Wee MW, Zaki RA, Hng SY, Eg KP, Nathan AM, et al.
    Pediatr Pulmonol, 2023 Jun;58(6):1784-1797.
    PMID: 37014160 DOI: 10.1002/ppul.26403
    BACKGROUND: Few studies have examined the impact of Coronavirus disease 2019 (COVID-19) infection on children with chronic lung disease (CLD).

    OBJECTIVE: To perform a systematic review and meta-analysis to determine the prevalence, risk factors for contracting COVID-19, and complications of COVID-19, in children with CLD.

    METHODS: This systematic review was based on articles published between January 1, 2020 and July 25, 2022. Children under 18 years old, with any CLD and infected with COVID-19 were included.

    RESULTS: Ten articles involving children with asthma and four involving children with cystic fibrosis (CF) were included in the analyses. The prevalence of COVID-19 in children with asthma varied between 0.14% and 19.1%. The use of inhaled corticosteroids (ICS) was associated with reduced risk for COVID-19 (risk ratio [RR]: 0.60, 95% confidence interval [CI]: 0.40-0.90). Uncontrolled asthma, younger age, AND moderate-severe asthma were not significant risk factors for contracting COVID-19. Children with asthma had an increased risk for hospitalization (RR: 1.62, 95% CI: 1.07-2.45) but were not more likely to require assisted ventilation (RR: 0.51, 95% CI: 0.14-1.90). The risk of COVID-19 infection among children with CF was <1%. Posttransplant and cystic fibrosis-related diabetes mellitus (CFRDM) patients were at an increased risk for hospitalization and intensive care treatment.

    CONCLUSION: Hospitalizations were higher in children with asthma with COVID-19 infection. However, using ICS reduced the risk of COVID-19 infection. As for CF, postlung transplantation and CFRDM were risk factors for severe disease.

    Matched MeSH terms: Administration, Inhalation
  15. Muthuraju S, Islam MR, Pati S, Jaafar H, Abdullah JM, Yusoff KM
    Int J Neurosci, 2015;125(9):686-92.
    PMID: 25180987 DOI: 10.3109/00207454.2014.961065
    Dopamine (DA) is one of the key neurotransmitters in the striatum, which is functionally important for a variety of cognitive and motor behaviours. It is known that the striatum is vulnerable to damage from traumatic brain injury (TBI). However, a therapeutic approach has not yet been established to treat TBI. Hence, the present work aimed to evaluate the ability of Normobaric hyperoxia treatment (NBOT) to recover dopaminergic neurons following a fluid percussion injury (FPI) as a TBI experimental animal model. To examine this, mice were divided into four groups: (i) Control, (ii) Sham, (iii) FPI and (iv) FPI+NBOT. Mice were anesthetized and surgically prepared for FPI in the striatum and immediate exposure to NBOT at various time points (3, 6, 12 and 24 h). Dopamine levels were then estimated post injury by utilizing a commercially available ELISA method specific to DA. We found that DA levels were significantly reduced at 3 h, but there was no reduction at 6, 12 and 24 h in FPI groups when compared to the control and sham groups. Subjects receiving NBOT showed consistent increased DA levels at each time point when compared with Sham and FPI groups. These results suggest that FPI may alter DA levels at the early post-TBI stages but not in later stages. While DA levels increased in 6, 12 and 24 h in the FPI groups, NBOT could be used to accelerate the prevention of early dopaminergic neuronal damage following FPI injury and improve DA levels consistently.
    Matched MeSH terms: Oxygen Inhalation Therapy/methods*
  16. Chiu CL, Chan YK, Ong G, Delilkan AE
    Med J Malaysia, 1999 Sep;54(3):346-51.
    PMID: 11045061
    This open labelled, randomised, controlled study was designed to compare the induction and recovery characteristics of sevoflurane and halothane anaesthesia in children. Forty American Society of Anaesthesiologist (ASA) physical status class 1 or 2 children (aged 1-10 year, weighed less than 25 kg) scheduled for elective urological procedure lasting less than one hour were allocated randomly to receive either sevoflurane (group S, n = 20) or halothane (group H, n = 20). The induction time in children receiving sevoflurane was significantly shorter than in those receiving halothane (mean (SD) 46 (13.6) second vs 69 (19.4) seconds, p < 0.005). The emergence from anaesthesia was also faster in children receiving sevoflurane than in those receiving halothane (mean (SD) 9 min (4.3 min) vs 21 min (8.9 min), p < 0.001). No major adverse effects were encountered in each group. We concluded that sevoflurane is comparable to halothane in Malaysian children.
    Matched MeSH terms: Anesthetics, Inhalation*
  17. Wang CY, Ling LC, Cardosa MS, Wong AK, Wong NW
    Anaesthesia, 2000 Jul;55(7):654-8.
    PMID: 10919420
    In Study A, the incidence of arterial oxygen desaturation was studied using pulse oximetry (SaO2) in 100 sedated and 100 nonsedated patients breathing room air who underwent diagnostic upper gastrointestinal endoscopy. Hypoxia (SaO2 92% or less of at least 15 s duration) occurred in 17% and 6% of sedated patients and nonsedated patients, respectively (p < 0.03). Mild desaturation (SaO2 94% or less and less than 15 s duration) occurred in 47% of sedated patients compared with 12% of nonsedated patients (p < 0.001). In Study B, the effects of supplementary oxygen therapy and the effects of different pre-oxygenation times on arterial oxygen saturation (SaO2) in sedated patients were studied using pulse oximetry. One hundred and twenty patients who underwent diagnostic upper gastrointestinal endoscopy with intravenous sedation were studied. Patients were randomly allocated to one of four groups: Group A (n = 30) received no supplementary oxygen while Groups B-D received supplementary oxygen at 4 1 x min(-1) via nasal cannulae. The pre-oxygenation time in Group B (n = 30) was zero minutes, Group C (n = 30) was 2 min and Group D (n = 30) was 5 min before sedation and introduction of the endoscope. Hypoxia occurred in seven of the 30 patients in Group A and none in groups B, C and D (p < 0.001). We conclude that desaturation and hypoxia is common in patients undergoing upper gastrointestinal endoscopy with and without sedation. Sedation significantly increases the incidence of desaturation and hypoxia. Supplementary nasal oxygen at 4 1 x min(-1) in sedated patients abolishes desaturation and hypoxia. Pre-oxygenation confers no additional benefit.
    Matched MeSH terms: Oxygen Inhalation Therapy/methods*
  18. Cheong KF, Teh TS
    Med J Malaysia, 2001 Dec;56(4):446-50.
    PMID: 12014764
    The effects of 2% and 4% sevoflurane in oxygen and nitrous oxide for induction of anaesthesia in 60 unpremedicated elderly patients was compared to those obtained during an intravenous Thiopentone induction. Intravenous induction induced anaesthesia in 27 +/- 5 seconds, significantly faster than a 2% or 4% sevoflurane induction (109 +/- 36 and 71 +/- 24 seconds respectively). One patient in both the thiopentone and 2% sevoflurane groups, and 2 patients in the 4% sevoflurane group coughed during induction. The postinduction reduction in mean arterial pressure was greatest in the thiopentone group followed by the 4% and the 2% sevoflurane groups. Heart rate changes were minimal in all groups. We conclude that 2% or 4% sevoflurane offered suitable conditions for induction of anaesthesia in the elderly with minimal cardiovascular derangement.
    Matched MeSH terms: Anesthetics, Inhalation/pharmacology*
  19. Teoh SL, Boo NY, Ong LC, Nyein MK, Lye MS, Au MK
    Eye (Lond), 1995;9 ( Pt 6):733-7.
    PMID: 8849541
    One hundred and thirteen consecutive infants with a very low birthweight of less than 1500 g were followed prospectively for 6 months to determine the incidence of retinopathy of prematurity (ROP) and associated risk factors. Of this group, 36 (31.9%) infants developed ROP (13 infants had stage 1 ROP, nine had stage 2, six had stage 3, six had stage 4, and two had cicatricial stage ROP). Stepwise logistic regression analysis of various potential risk factors (birthweight, gestation, duration of oxygen therapy, duration of ventilation, highest documented PaO2 and exchange transfusion) showed that only two risk factors were significantly associated with the development of ROP. These risk factors were: the duration of oxygen therapy (p = 0.0005) and exchange transfusion during the neonatal period (odds ratio 5.754, 95% confidence interval 1.002 to 32.997, p = 0.049). The equation of the regression model is: log (odds of developing ROP) = -0.8395 + 0.1447 (OXY)- 0.8750 (ET), where OXY is the duration of oxygen therapy in days, ET = -1 when there was a history of exchange transfusion, and ET = 1 when there was no history of exchange transfusion.
    Matched MeSH terms: Oxygen Inhalation Therapy*
  20. Tan KK, Lee JK, Tan I, Sarvesvaran R
    Burns, 1993 Aug;19(4):360-1.
    PMID: 8357487
    A 27-year old male sustained a 60 per cent TBSA burn with inhalation injury following a road traffic accident. He developed respiratory distress on day 3 postburn, and was intubated and ventilated. He was noted to have greenish aspirate from his trachea on day 17 of ventilation. He succumbed from sepsis and died on day 21 post injury. At post-mortem, a large tracheo-oesophageal fistula (TOF) was found at the level of the cuff of the nasotracheal tube.
    Matched MeSH terms: Burns, Inhalation/complications*
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