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A method for measuring the molecular ratio of inhalation to exhalation and effect of inspired oxygen levels on oxygen consumption.

ABSTRACT: Using a new method for measuring the molecular ratio (R) of inhalation to exhalation, we investigated the effect of high fraction of inspired oxygen (FIO2) on oxygen consumption (VO2), carbon dioxide generation (VCO2), and respiratory quotient (RQ) in mechanically ventilated rats. Twelve rats were equally assigned into two groups by anesthetics: intravenous midazolam/fentanyl vs. inhaled isoflurane. R, VO2, VCO2, and RQ were measured at FIO2 0.3 or 1.0. R error was ± 0.003. R was 1.0099 ± 0.0023 with isoflurane and 1.0074 ± 0.0018 with midazolam/fentanyl. R was 1.0081 ± 0.0017 at an FIO2 of 0.3 and 1.0092 ± 0.0029 at an FIO2 of 1.0. There were no differences in VCO2 among the groups. VO2 increased at FIO2 1.0, which was more notable when midazolam/fentanyl was used (isoflurane-FIO2 0.3: 15.4 ± 1.1; isoflurane-FIO2 1.0: 17.2 ± 1.8; midazolam/fentanyl-FIO2 0.3: 15.4 ± 1.1; midazolam/fentanyl-FIO2 1.0: 21.0 ± 2.2 mL/kg/min at STP). The RQ was lower at FIO2 1.0 than FIO2 0.3 (isoflurane-FIO2 0.3: 0.80 ± 0.07; isoflurane-FIO2 1.0: 0.71 ± 0.05; midazolam/fentanyl-FIO2 0.3: 0.79 ± 0.03; midazolam/fentanyl-FIO2 1.0: 0.59 ± 0.04). R was not affected by either anesthetics or FIO2. Inspired 100% O2 increased VO2 and decreased RQ, which might be more remarkable when midazolam/fentanyl was used.

SUBMITTER: Shinozaki K

PROVIDER: S-EPMC8211831 | biostudies-literature | 2021 Jun

REPOSITORIES: biostudies-literature

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A method for measuring the molecular ratio of inhalation to exhalation and effect of inspired oxygen levels on oxygen consumption.

Shinozaki Koichiro K Okuma Yu Y Saeki Kota K Miyara Santiago J SJ Aoki Tomoaki T Molmenti Ernesto P EP Yin Tai T Kim Junhwan J Lampe Joshua W JW Becker Lance B LB

Scientific reports 20210617 1

Using a new method for measuring the molecular ratio (R) of inhalation to exhalation, we investigated the effect of high fraction of inspired oxygen (FIO2) on oxygen consumption (VO2), carbon dioxide generation (VCO2), and respiratory quotient (RQ) in mechanically ventilated rats. Twelve rats were equally assigned into two groups by anesthetics: intravenous midazolam/fentanyl vs. inhaled isoflurane. R, VO2, VCO2, and RQ were measured at FIO2 0.3 or 1.0. R error was ± 0.003. R was 1.0099 ± 0.0023 ...[more]

PMID: 34140533

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Project description:ImportanceThe early identification of patients at high risk of clinical deterioration represents one of the greatest challenges for emergency medical services (EMS).ObjectiveTo assess whether use of the ratio of prehospital oxygen saturation measured by pulse oximetry (Spo2) to fraction of inspired oxygen (Fio2) measured during initial contact by EMS with the patient (ie, the first Spo2 to Fio2 ratio) and 5 minutes before the patient's arrival at the hospital (ie, the second Spo2 to Fio2 ratio) can predict the risk of early in-hospital deterioration.Design, setting, and participantsA prospective, derivation-validation prognostic cohort study of 3606 adults with acute diseases referred to 5 tertiary care hospitals in Spain was conducted between October 26, 2018, and June 30, 2020. Eligible patients were recruited from among all telephone requests for EMS assistance for adults who were later evacuated with priority in advanced life support units to the referral hospitals during the study period.Main outcomes and measuresThe primary outcome was hospital mortality from any cause within the first, second, third, or seventh day after EMS transport to the hospital. The main measure was the Spo2 to Fio2 ratio.ResultsA total of 3606 participants comprised 2 separate cohorts: the derivation cohort (3081 patients) and the validation cohort (525 patients). The median age was 69 years (interquartile range, 54-81 years), and 2122 patients (58.8%) were men. The overall mortality rate of the patients in the study cohort ranged from 3.6% for 1-day mortality (131 patients) to 7.1% for 7-day mortality (256 patients). The best model performance was for 2-day mortality with the second Spo2 to Fio2 ratio with an area under the curve of 0.890 (95% CI, 0.829-0.950; P < .001), although the other outcomes also presented good results. In addition, a risk-stratification model was generated. The optimal cutoff resulted in the following ranges of Spo2 to Fio2 ratios: 50 to 100 for high risk of mortality, 101 to 426 for intermediate risk, and 427 to 476 for low risk.Conclusions and relevanceThis study suggests that use of the prehospital Spo2 to Fio2 ratio was associated with improved management of patients with acute disease because it accurately predicts short-term mortality.

Project description:Respiration shapes brain activity and synchronizes sensory and exploratory motor actions, with some evidence suggesting that it also affects pupil size. However, evidence for a coupling between respiration and pupil size remains scarce and inconclusive, hindered by small sample sizes and limited controls. Given the importance of pupil size in visual perception and as a reflection of brain state, understanding its relationship with respiration is essential. In five experiments using a pre-registered protocol, we systematically investigated how respiratory phase affects pupil size across different conditions. In Experiment 1 (n = 50), we examined nasal and oral breathing at rest under dim lighting with nearby fixation points, then replicated these results under identical conditions in Experiment 2 (n = 53). Experiment 3 (n = 112) extended this to active visual tasks, while Experiment 4 (n = 57) extended this to controlled breathing at different paces under ambient lighting with distant fixation. Finally, in Experiment 5 (n = 34), individuals with isolated congenital anosmia (born without olfactory bulbs) were used as a lesion-type model during visual-auditory tasks to assess whether the respiratory-pupil link depends on olfactory bulb-driven oscillations. Across all conditions - free and controlled breathing; different tasks, lighting and fixation distances; and with and without olfactory bulbs - we consistently found that pupil size is smallest around inhalation onset and largest during exhalation. We term this effect the pupillary respiratory-phase response, the fourth known mechanism influencing pupil size, alongside the pupillary light, near fixation and psychosensory responses. KEY POINTS: The influence of respiration on pupil size dynamics has long been debated. In this study, we systematically investigated how pupil size changes across the breathing cycle through a series of five experiments, while varying tasks, lighting, fixation distance and brain region involvement. We show that pupil size is smallest around inhalation onset and largest during exhalation, with pupil dilatation occurring through most of inhalation and the early phase of exhalation, and pupil constriction occurring primarily during the latter part of exhalation. This pattern was consistent across all experimental conditions, demonstrating that it is robust and likely controlled by brainstem circuits. We term this effect the pupillary respiratory-phase response, the fourth known mechanism influencing pupil size.

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A method for measuring the molecular ratio of inhalation to exhalation and effect of inspired oxygen levels on oxygen consumption.

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A method for measuring the molecular ratio of inhalation to exhalation and effect of inspired oxygen levels on oxygen consumption.

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