Pulse oximeter tracings from a 60-year-old woman with exacerbation of chronic obstructive pulmonary disease who was admitted to the intensive care unit.

Slides:

Advertisements

Similar presentations

Suprastomal stent for management of tracheal compromise caused by subglottic and glottic stenosis. [Photo courtesy of Dr. Dana M. Thompson, Department.

Advertisements

Schematic of the Tec 6 vaporizer for desflurane

Schematic of the Tec 6 vaporizer for desflurane

This patient at 33 weeks was admitted in diabetic ketoacidosis (DKA)

Modern fluid warming systems have the capability to produce infusion rates up to 750 mL/min: A. Level 1® Fast Flow Fluid Warmer uses pressure technology.

Esophageal pressure measurements in a patient with auto–positive end-expiratory pressure (auto-PEEP). Note that an esophageal pressure decrease of approximately.

Mapleson D circuit. Note that the fresh gas inlet (FGI) is distal to the adjustable pressure-limiting (APL) valve and proximal to the patient end. (Reproduced.

The two-point calibration procedure

Comparison of lungs excised from rats ventilated with peak pressure of 14 cm H2O, zero positive end-expiratory pressure (PEEP); peak pressure 45 cm H2O,

(Copied with permission from: Latson, L. A. , & Prieto, L. R. (2007)

Vapor pressure, partial pressure, and concentration of inhaled anesthetics: The impact of atmospheric pressure on vaporizer output. Top. Variable bypass.

RIFLE criteria for acute kidney injury

Trauma bay configuration

Pathogenesis of bone diseases in chronic kidney disease

Noninvasive measurement of blood pressure

Reproduced with permission from Chang JB, Stein TA

Example of 3 different types of ultrasound probes: (A) linear transducer, small footprint, "hockey stick" probe for superficial blocks and small working.

Three different types of ultrasound probes: (A) linear transducer, small footprint, “hockey stick” probe for superficial blocks and small working areas;

Schematic of North American Dräger AV-E hanging bellows ventilator during inspiration. Solid gray area represents driving gas under pressure, which comes.

Vane anemometer. (Reproduced with permission from Morgan GE, Mikhail MS, Murray MJ. Clinical Anesthesiology. 4th ed. New York, NY: McGraw-Hill; Figure.

Relationship between duration of brachial plexus blockade of various local anesthetics and their degree of protein binding. [Reproduced with permission.

Multichannel polysomnographic recording

Source: Anesthesia Drugs and Drug Delivery Systems, Anesthesiology, 3e

Recommended algorithm for perioperative management of patients with pulmonary arterial hypertension (PAH) secondary to congenital heart disease (CHD) in.

Schematic representation of the main divisions of the respiratory tract. (Reproduced, with permission, from Junqueira LC, Carneiro J: Basic Histology:

Cardiopulmonary response to acute aerobic exercise

Guideline for contributing mechanism of pain state

In diastolic dysfunction, the diastolic pressure-volume relationship is shifted upward and to the left (dashed line), which leads to an elevated left ventricular.

Reproduced with permission from Chang JB, Stein TA

Clinical factors increasing index of suspicion for tuberculosis

Schematic diagram portraying the use of the fiber-optic bronchoscope to insert a left-side DLT. A. The DLT can be put into the trachea in a conventional.

Ejection fraction calculated using the disk summation method from 4-chamber end diastole (A), 2-chamber end diastole (B), 4-chamber end-systole (C), and.

Development of a pharmacokinetic model (using propofol as an example)

Basic biochemistry of diabetic ketoacidosis (DKA)

Pulse oximeter tracings from a 60-year-old woman with exacerbation of chronic obstructive pulmonary disease who was admitted to the intensive care unit.

EFFECTS OF INTRAPULMONARY PERCUSSIVE VENTILATION AS COMPLEMENTARY TECHNIQUE IN NONINVASIVE MECHANICAL VENTILATION DURING COPD EXACERBATIONS.

Criteria used to determine breath types during mechanical ventilation

Pedal venous pressure measurements with exercise

Fiber-optic orotracheal intubation during sedation and topical anesthesia. A. After sedation and application of topical anesthesia, an Ovassapian intubating.

(Reproduced with permission from Afifi AK, Bergman RA

(Reproduced with permission from Amato AA, Russell JA

A. Lightweight oxygen tank filled to 3000 psig can deliver 1000 L of gas at 1 atm pressure. B. Oxygen can be delivered at 50 psig via a diameter-index.

Schematic diagram showing a rigid ventilating bronchoscope system, which consists of the anesthesia circle system attached to a flexible connector that.

Sources: (1) Global Strategy for the diagnosis Management and Prevention of COPD, Global initiative for Chronic Obstructive Lung Disease (GOLD)

The processing of microRNA that is involved in gene regulation by RNA interference. (Reprinted with permission from Brooker RJ: Genetics: Analysis & Principles,

Survival rates for patients with AJCC stages I–IV melanoma

Copyright © 2017 McGraw-Hill Education. All rights reserved

Major cerebral veins and venous sinuses subject to thrombotic occlusion. (Used with permission from Waxman S. Clinical Neuroanatomy. 26th ed. New York,

Schema depicting chronic obstructive pulmonary disease (COPD)

Measurement and Mechanism of Pulsus Paradoxus A, The examiner inflates the sphygmomanometer cuff fully, listens for Korotkoff sounds as the cuff is slowly.

Algorithm for iron therapy in management of anemia of CKD

Posteroanterior chest x-ray film in a man with acute pulmonary edema resulting from left ventricular failure. Note the bat’s wing density, cardiac enlargement,

A summary of the metabolism of glucose in: (1) the cytoplasm, and in the mitochondria by (2) pyruvate breakdown, (3) the Krebs or citric acid cycle, and.

Small bowel obstruction

Close-up views of the tips of a "cutting-tip" spinal needle: A

Aminoacyl-tRNA synthetase "charges" a tRNA molecule by catalyzing the attachment of the correct amino acid. (Reprinted with permission from Brooker RJ:

Number of uninsured persons in the United States, 1980 to 2014 (U. S

Chest radiograph cardiac enlargement, with prominence of the pulmonary artery, right atrium, and right ventricle, in a patient with primary pulmonary hypertension.

J. R. Masclans, M. Pérez, J. Almirall, L. Lorente, A. Marqués, L

Evolution of ventilatory settings in randomised controlled trials investigating noninvasive ventilation in stable or post-exacerbation chronic obstructive.

Chart 1: Oxygen prescription for acutely hypoxaemic patients in hospital. Chart 1: Oxygen prescription for acutely hypoxaemic patients in hospital. ABG,

Capnography and Patient Safety for Endoscopy

acute, chronic, or acute on chronic.

Acute Respiratory Failure

Quantifying Pulsus Paradoxus

Oximeters CHEST Volume 94, Issue 5, Pages (November 1988)

Correlation between inspiratory capacity (IC)/total lung capacity (TLC) ratio and oxygen pulse at peak exercise in chronic obstructive pulmonary disease.

Pulse oximetry tracings from a 60-y-old woman with a COPD exacerbation who was admitted to the ICU in ventilatory failure. Pulse oximetry tracings from.

Clinical findings in patients with chronic obstructive pulmonary disease according to the Global Initiative for Chronic Obstructive Lung Disease (GOLD)

Distribution and change of the underlying disease in patients discharged with home mechanical ventilation (n = 854). ♦: chronic obstructive pulmonary disease;

Presentation transcript:

Pulse oximeter tracings from a 60-year-old woman with exacerbation of chronic obstructive pulmonary disease who was admitted to the intensive care unit in ventilatory failure. A. The patient's pulse oximetry tracing at the time of admission reveals respiratory variability in the pulse oximeter plethysmography tracing. Measured pulsus paradoxus at this time was 16 mm Hg. B. The patient's pulse oximetry tracing after 12 hours of aggressive therapy. Pulsus paradoxus at this time was 8 mm Hg. Note the absence of respiratory waveform variation (RWV) in the baseline of the oximeter tracing after clinical improvement in airflow and resolution of elevated pulsus paradoxus. (Reproduced with permission from Longnecker D, Brown D, Newman M, Zapol W. Anesthesiology. 2nd ed. New York, NY: McGraw-Hill; 2012; reproduced from Hartert TV, Wheeler AP, Sheller JR. Use of pulse oximetry to recognize severity of airflow obstruction in obstructive airway disease: correlation with pulsus paradoxus. Chest. 1999; Feb;115(2):475-481.) Source: Pulse Oximetry, Capnography, and Transcutaneous Monitoring, Essentials of Mechanical Ventilation, 3e Citation: Hess DR, Kacmarek RM. Essentials of Mechanical Ventilation, 3e; 2014 Available at: http://accessanesthesiology.mhmedical.com/DownloadImage.aspx?image=/data/books/1679/hes_ch28_f001.png&sec=110081928&BookID=1679&ChapterSecID=110081909&imagename= Accessed: January 03, 2018 Copyright © 2018 McGraw-Hill Education. All rights reserved