…Peripheral venous cannula, saline flush. ECG monitoring, pulse oximetry and blood pressure measurement throughout the test. Oxygen, suction, a bag and mask, and access to…

…basic principles of exercise test protocols will also be discussed in this article. Metabolic equivalent (MET): measuring oxygen consumption Estimation of oxygen consumption is central…

…intermediate pre test probability of coronary artery disease. Assessment of exercise capacity and symptoms in known heart disease. Risk assessment after myocardial infarction or before…

…are taken immediately, treatment is given, and the test is performed later. Contraindications Known hypersensitivity to tetracosactide or ACTH. Marked atopic disease, particularly severe asthma…

…etc. Exercise stress testing may also be referred to as exercise ECG or exercise tolerance test . Because the vast majority of all exercise stress tests…

ECG Exercise stress test Physiological principles of exercise stress testing, myocardial ischemia and ischemic symptoms Understanding the basic principles of exercise physiology is essential to…

…a rule out test in this group if those modalities are accessible. It may nevertheless remain useful when imaging is unavailable, or in individuals with…

…adequate treadmill test but can undergo pharmacological stress Local expertise and adequate echocardiographic facilities are available Risk stratification is required in established or suspected CAD…

…absolute lack of oxygen (Heusch et al). Ischemic myocardium exhibits wall motion abnormalities In the setting of ischemia, myocardial contractility is downregulated or completely ceased…

…MINOCA may result from a mismatch between myocardial oxygen supply and demand. The clinical history should therefore be examined for potential physiological or systemic stressors…

…receive enough oxygen to preserve some pupillary reflex. Importantly, pupillary size and reactivity are influenced by factors beyond neural activity. Systemic catecholamines released or administered…

…The purpose of the stress test is to increase the myocardial workload (and thus the oxygen demand) in order to provoke ischemia in myocardium supplied…

…be used for selection with an unknown time of onset when MRI is immediately available and does not delay treatment Saturation Give oxygen in hypoxia…

…detected early in infancy or childhood. For obvious reasons, more complex defects are typically diagnosed earlier. Defects resulting in reduced oxygen saturation are generally detected…

…volumes, which satisfy the body's oxygen demand despite smaller ejection fractions. In general, individuals with small ventricular volumes tend to have high ejection fractions…

…too little oxygen but that the prescription has no target — the nasal cannula stays in place for days without anyone asking why, or the patient…

…review on this topic [1]. References [1] G Heusch. Myocardial Ischemia: Lack of Coronary Blood Flow or Myocardial Oxygen Supply/Demand Imbalance? Circ Res. 2016…

CPR Hypoxia and asphyxiation Hypoxia refers to a reduced partial pressure of oxygen in the blood. Asphyxia is characterized by insufficient ventilation, leading to hypoxia…

…and peripheral oedema. Previous hypercapnia, NIV or invasive ventilation. Home oxygen and the patient's usual saturation. Previous exacerbations and hospital admissions. Current inhaled treatment…

…increases cardiac output, and lowers pulmonary artery pressure without increasing myocardial oxygen consumption. The inotropic effect of levosimendan is not affected by the concurrent use…

…vascular tone or both, and the appropriate action differs fundamentally between these cases. Pressures in the heart and pulmonary circulation Flow, resistance and oxygen transport…

…oxygen transport and haemostatic capacity, but it cannot compensate for an uncontrolled source of bleeding. Minimise the time to surgery, endoscopy, an obstetric procedure or…

…minutes Duration of action 2 to 4 hours Delivery IV Dose Can be given as repeated intravenous bolus injections or as a constant dose infusion…

…Lowers blood pressure, reduces heart rate, myocardial oxygen consumption and myocardial contractility. Less pronounced blood pressure lowering effect than esmolol and labetalol. Time to onset…

…and/or the coronary microcirculation. These abnormalities may produce a transient mismatch between myocardial oxygen demand and coronary blood supply, resulting in myocardial hypoperfusion or…

…and end organ perfusion caused by cardiac insufficiency. Sustained hypoperfusion reduces oxygen and nutrient delivery and, when severe or prolonged, produces multiorgan dysfunction and death…

…precipitous drop in haemoglobin, or a sustained tachyarrhythmia—may result in insufficient blood flow to meet the increased myocardial oxygen demand, precipitating Type 2 MI…

…Image acquisition and evaluation Stress Imaging : Initially performed using exercise or pharmacologic agents to elevate myocardial oxygen demand (or simulate increased demand using vasodilatory agents)…

…3. Give oxygen in hypoxaemia. 4. Start an inhaled short acting β2 agonist immediately. 5. Add ipratropium in a severe or life threatening attack. 6…

…metabolic disturbance? Calculate the delta gap or delta ratio 6 Does the result fit the patient? If not, check the sample type, supplemental oxygen, sampling…

…or other extracorporeal therapy (requires a large bore dialysis catheter, not an ordinary triple lumen catheter). Measurement of central venous pressure and central venous oxygen…

…against hypercapnia SpO₂ 88–92% Hypoxaemic failure without hypercapnia CPAP or high flow nasal oxygen 5–10 cmH₂O According to oxygenation requirement SpO₂ 92–96…

…several non pharmacological measures at the same time, and use drugs only in severe agitation or marked distress. Delirium is an acute neuropsychiatric syndrome and…

…Inadequate oxygenation despite maximal oxygen or non invasive ventilation. Inadequate ventilation with a rising pCO₂ and respiratory acidosis, or a markedly increased work of breathing…

…Comment : : : MAP ≥ 65 mmHg 80–85 mmHg in chronic hypertension or when there are signs of inadequate perfusion Urine output 0.5 mL/kg/h…

…Suction and give oxygen as needed. Intubate for a threatened airway, a marked risk of aspiration, or failure that is not rapidly reversed by an…

…agitation, drowsiness or a reduced GCS Respiration A respiratory rate of at least 22/min, increased work of breathing, a new oxygen requirement, a saturation…

…therapy. I C Symptom relief Symptom Management Recommendation Level of evidence Hypoxia Oxygen is indicated if SaO2 < 90% or PaO2 < 60 mmHg. I…

…from acute coronary atherothrombosis, oxygen supply–demand imbalance, direct myocardial injury, systemic illness, structural heart disease, or several mechanisms acting simultaneously. Acute myocardial infarction Acute…

…control. Proposed mechanisms include: Reduction in glomerular hypertension and hyperfiltration Decreased tubular energy demand and oxygen consumption Natriuresis and diuresis Reduction in plasma volume, preload…

…Type Mechanism or setting Type 1 Acute atherothrombotic MI, usually related to plaque rupture or erosion Type 2 MI caused by oxygen supply–demand imbalance…

…the left ventricle during diastole. The hemodynamic consequences of aortic regurgitation depend on whether the condition develops acutely or gradually. Acute aortic regurgitation Acute aortic…

…g) or an epinephrine infusion (0.01 to 0.10 μg/kg/min). Pediatric dosage : 0.01 mg/kg. Administer 100% oxygen promptly and…

…and can guide resuscitative efforts. If the patient presents with hypotension or has a lactate level exceeding 4 mmol/l, commence an intravenous fluid resuscitation…

…Heated intravenous fluids (crystalloids). Heated and moistened oxygen. Warm covers. Heat fan. Remove any cold or damp textiles. Administer cardiopulmonary resuscitation (CPR) following standard protocols…

…adjust vascular tone in response to myocardial oxygen demand, and myogenic responses, where vascular smooth muscle constricts or dilates in response to changes in intraluminal…

…is most pronounced and extends towards the penumbra zone (the outermost and less ischemic area), which may receive oxygen from collateral vessels. In cardiac arrest…

…within the subendothelial space, LDL C particles undergo oxidative modification by reactive oxygen species (ROS) and enzymes such as myeloperoxidase and lipoxygenase. Oxidized LDL (oxLDL…

…near the ventricular cavity, and it may to some extent receive oxygen from the blood in the ventricular cavity. The right bundle branch then runs…

…Myocardial oxygen demand Myocardium can only function under aerobic conditions (oxygen is required for ATP synthesis [ATP is the primary energy source in all cells…

…membrane potentials in the ischemic area. Myocardial cells are capable of normalizing their membrane potentials immediately as oxygen becomes available. Recall that ST segment elevations…

…the left ventricle has the highest oxygen demand. The right ventricle and the atria work against much lower resistances and therefore have lower oxygen demands…

…or circulatory compromise, or a rapidly progressive multisystem reaction Intramuscular adrenaline immediately Severe anaphylaxis Hypoxia, marked bronchospasm, stridor, hypotension, collapse or impaired consciousness Adrenaline, oxygen…

…since ingestion, and both can harm the patient through aspiration. Contact your national or regional poison control centre before you decide, not afterwards. Indications Medicinal…

…Anticoagulant treatment is not in itself a bar to vaccination. Relative: Lymphoedema or previous axillary clearance on the same side. A paretic limb — poorer absorption…

…with inotropic and vasopressor effects, and they often need to be combined in order to optimise or correct the haemodynamics. Most agents exert both vasopressor…

…asthma. Severity in COPD Arterial blood gas Type 1 respiratory failure: PaO₂ < 8 kPa with a normal or low PaCO₂ — a problem of oxygenation…

…aiming for within 60 minutes 8 Give oxygen, fluid and a vasopressor according to the sepsis pathway when needed 9 Contact the haematologist or oncologist…

…started in an opioid naive patient, or when a conversion between drugs is made without reduction for incomplete cross tolerance. Indications Acute severe nociceptive pain…

…stopped for coughing, chest pain, or when the volume limit is reached. Indications Diagnostic aspiration: a new pleural effusion of unclear cause. An effusion not…