08 Sep

Evaluation of Cardiopulmonary Risk under Midazolam Sedation: Results (Part 2)

The magnitude of alterations in pH and PaC02 was relatively slight. Only three patients had a PaC02 greater than 60 mm Hg at the end of bronchoscopy. Development of ARDS was not associated with a higher PaC02 at the end of the procedure. When patients were analyzed according to their PEEP level, the mean PaC02 was found to be 39.8 ±7.6 mm Hg among those 23 patients with PEEP and was 41.8 ± 8.5 mm Hg for the 84 others (NS). Changes in pH could be mostly explained by acute respiratory acidosis (Fig 2), and a linear relationship was evidenced between the relative variations of [H *] and PaC02 (r = 0.87). At the end of fiberoptic bronchoscopy, the pH lay within the 95 percent confidence limits of acute respiratory acidosis in 86 patients, while combined metabolic acidosis was apparent in the 21 others. In an attempt to study the relationships between the degree of induced hypoxemia and clinical variables, including the bronchoscopic procedure, we used a linear regression analysis. The following tabulation shows the main relations between changes in Pa02 and clinical variables, listing the F value for each factor:

Baseline PaO,

39.3

Use of PEEP

25.9

Change in PaC()2

35.8

Radiologic score

1.6

Peak inspiratory airway pressure at control time*, cm H2O 1.6

Baseline pH

* 1.6

Absence of chronic pulmonary disease

1.3

Presence of ARDS

1.3

Figure_2

Figure 2. Changes in PaC02 and [IP] (mean ± 2 SEM) during study. Sequential times are the same as in Figure 1. Value for T2 was omitted because of similarity toT,. Asterisks indicate significant differences vs any other time (p<0.01). Your shopping for best quality medications is going to be pleasant and very affordable every time: make sure of it yourself when you visit the best pharmacy to buy Xopenex for Asthma as this is the kind of experience every patient is looking forward to.

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