Use of Tissue Oxygen Saturation Levels as a Vital Sign in the ED Triage
Sadiye Yolcu, Adem Kaya
J Clin Exp Invest 2019;10(2):em00723.
https://doi.org/10.5799/jcei/5832
Research Article
[Abstract]
[PDF]
[References]
ABSTRACT
Objectives: The utilization of vital signs as triage tools remains a mainstay ofemergency patients. The evolution of monitoring technologies, including the noninvasive tissue oxygen saturation devices has improved our ability to monitor the critically ill patients. The aim of the present study was to determine the tissue oxygen saturation (StO2) levels of the patients as a vital sign during emergency triage.
Methods: Approximately 30-35 patients present to our emergency department each day and the triage of these patients are performed by a nurse at admission time. A three level system (1: red, 2: yellow, 3: green) is used to determine the triage level of the patients presenting to our department. We examined 150 patients during five days. Age gender, triage levels and hospitalization status of the patients were noted. For the StO2 level measurement, an Inspectra device was placed to the right thenar muscle for 10 s and mean of the first, fifth and 10th second values were noted at the admission time.
Results: In our study 73 females (48.6%), 77 males (51.4%) totally 150 patients were included. We determined a significant difference between green and yellow (p=0.00), green and red (p=0.00), yellow and red (p=0.001) according to StO2 levels. We couldn’t find a significant difference between females and males in triage groups (p=0.13 for green, p=0.71 for yellow, p=0.86 for red). There was correlation between StO2 - triage level (p=0.00, r=0.609) and StO2-hospitalization status (p=0.00, r=0.449).
Conclusion: StO2 level measurement may be helpful in determining the triage level of the patients presenting to the ED.
Keywords: emergency, tissue oxygen saturation, triage
Keywords: emergency, tissue oxygen saturation, triage
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Value of Extracellular High Mobility Group Box 1 (HMGB1) in the Clinical Context of Immune Thrombocytopenia
Elif G Umit, Mehmet Baysal, Volkan Bas, Hasan Goze, Veysi Asoglu, Onur Kirkizlar, Ahmet Muzaffer Demir
J Clin Exp Invest 2019;10(2):em00724.
https://doi.org/10.5799/jcei/5833
Research Article
[Abstract]
[PDF]
[References]
ABSTRACT
Introduction: High mobility group box 1 protein (HMGB1) is a non-histone chromosomal protein with dual activity. First within the nucleus, binds to DNA and acts as a regulator and second, outside the cell, interacts with receptors for inflammation as a signal molecule. We aimed to investigate and contribute to the value of extracellular HMGB1 in clinical context of ITP and to flourish future clinical directions to this biomarker.
Methods: 50 newly diagnosed and treatment naive patients with ITP and 30 healthy controls were enrolled in our study.
Results: Age or gender were not related with HMGB1 levels in patients and controls. Platelet levels were significantly related with HMGB1. Especially in patients with platelet counts below 30.000/mm3 highest levels of HMGB1 were observed. Regarding clinical presentation, bleeding was related with low platelet counts and high HMGB1 levels. Response to corticosteroids was observed to be better in patients with high HMGB1 levels.
Conclusion: As a sample of autoinflammatory disorders, we observed a relation with extracellular HMGB1 levels and platelet levels in ITP patients. Corticosteroid response and HMGB1 relation supports the assumption of the value of HMGB1 as a potential surrogate of inflammation. This view should be evaluated with larger scale studies.
Keywords: immune thrombocytopenia, inflammation, cytokine
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Investigation of Elastic Properties of Aorta in Patients with Coronary Slow Flow
Macit Kalçık, Mahmut Yesin, Ahmet Güner, Emrah Bayam, Tolga Doğan, Mucahit Yetim, Lütfü Bekar, Oğuzhan Çelik
J Clin Exp Invest 2019;10(2):em00725.
https://doi.org/10.5799/jcei/5834
Research Article
[Abstract]
[PDF]
[References]
ABSTRACT
Objective: Coronary slow flow (CSF) phenomenon is characterized by delayed opacification of coronary vessels in a normal coronary angiogram. Although clinical and pathological features have been previously described, the underlying pathophysiology has not been fully understood yet. Aortic elastic properties have a predictive value in detecting early stages of atherosclerosis. In this study, we aimed to the evaluate the elastic properties of ascending aorta in patients with CSF.
Materials and Methods: This single-center study enrolled 50 angiographically identified patients with CSF (23 female, mean age: 51.6 ± 9.7 years), along with 50 controls (19 female, mean age: 53.5 ± 8.7 years) with normal coronary flow. The quantitative measurement of coronary blood flow was performed using the thrombolysis in myocardial infarction frame count method. Aortic elastic parameters including aortic strain, aortic distensibility, aortic stiffness index and aortic compliance were calculated using M-mode echocardiography derived aortic diameters using accepted formulae.
Results: There was no significant difference in terms of clinical, demographic, echocardiographic and laboratory parameters between the patients with CSF and the controls. The hemodynamic parameters including aortic pulse pressure, aortic mean pressure, aortic fractional pulse pressure and aortic pulsatility index were similar between patients with CSF and controls. Systolic and diastolic aortic diameters and pulsatile aortic diameter change were similar between the groups. There was also no significant difference in terms of aortic strain, aortic distensibility, aortic stiffness index and aortic compliance between the groups.
Conclusion: The results demonstrated that there was no significant difference in terms of hemodynamic parameters and elastic properties of ascending aorta between CSF patients and control group with a similar risk profile and demographic characteristics. Further large scale studies are required to determine the relationship between CSF and elastic properties of aorta.
Keywords: aortic stiffness index, coronary angiography, coronary slow flow, echocardiography
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