Background: Diagnostic upper gastrointestinal (GI) endoscopy without sedation in selected patients has become more common over the past few years, none-the-less sedatives are avoided in the elderly. We studied the effect of rapid esophagogastroduodenoscopy (EGD) without sedation on patients with COPD to determine the critical hypoxemia during endoscopy.Materials and Methods: In a prospective study, easy EGD was performed electively in 74 patients with COPD (FEV1, FVC, and FEV1.FVC<60%) during 25 months in Masih Daneshvari Hospital. All patients had continuous monitoring and recording of arterial oxygen Saturation with pulse oximeter. Patients had similar characteristics concerning age, gender, cardiopulmonary function and other interventional factors. Hypoxemia during the procedure was also registered. It is noticeable that easy endoscopy refers to performing EGD in less than 10 minutes without sedation.Results: This study showed that during non-sedated EGD, SaO2 dropped to less than 90% in 23% (16 cases) of patients with COPD. None-the-Less following administration of oxygen during the procedure, PaO2 tended to normal values and therefore the procedure was continued without interruption in all cases.Conclusion: This study showed that easy endoscopy in COPD patients with normal cardiac function may be considered as a safe procedure with no complication.

Objective: Nasal packing is a common procedure that is used for control of nasal bleeding. On the other hand, nasal obstruction can predispose to abnormal breathing patterns during sleep which often results in hypoxemia. One of the serious complications of nasal packing is arterial O2 de-Saturation which is a major risk factor in elderly patients with cardiopulmonary disorders. The aim of the present study was to investigate the effect of postoperatively applied nasal packing on arterial oxygen Saturation during sleep among patients requiring nasal package for various indications.Subjects and Method: This study included 68 patients (49 male, 19 female; mean age 29 years, range 19 to 74 years) who required nasal packs for various indications. O2 Saturation levels was measured before insertion of nasal packing and postoperatively on the first night after surgery using Pulse oxymetry and the finding were compared statistically.Results: No significant differences were found between before and after nasal packing levels in 59 patients but in 9 patients, with previous underlying cardiopulmonaty disorder, O2 Saturation level was significantly decreased after nasal packing.Conclusion: Nasal packing can cause significant reduction of O2 Saturation in elderly patients especially in those with cardiopulmonary .disorders. It seems nasal packing has no significantly effect on arterial O2 Saturation levels in young healthy patients.

Background and Objectives: The COVID-19 pandemic has had a profound impact on societies worldwide, prompting preventive measures to mitigate its effects. Among the critical issues in managing COVID-19 patients is improving oxygenation and Saturation status. In this study, we investigated the efficacy of inhaled H2O8 administered via a nebulizer for patients in the moderate to severe inflammatory phase of COVID-19. Methods: We conducted a case-control study involving COVID-19 patients with moderate to severe pulmonary involvement admitted to the intensive care unit (ICU) between October 2021 and March 2022. Using simple random sampling, we selected 120 patients from two hospitals. These patients were divided into two groups: the intervention group received H2O8 liquid via nebulization every half hour, while the placebo group received normal saline through the same device. Results: The study recorded the proportion of males and the mean age of patients in both the treatment and placebo groups. Specifically, in the treatment group, 60. 0% were male (36 patients) with a mean age of 70. 5±13. 2 years. In the placebo group, 71. 7% were male (43 patients) with a mean age of 73. 2±11. 6 years. The P values for these comparisons were 0. 178 and 0. 233, respectively, indicating no significant differences. Additionally, no significant differences were observed based on other underlying variables between the two groups. However, when it came to SpO2 levels, there was a notable finding. Five minutes after consumption, the average SpO2 in the treatment group (H2O8) was significantly higher than in the placebo group (89. 2±4. 2 vs. 83. 4±5. 2, P < 0. 001). Two hours later, the mean SpO2 remained higher in the treatment group (85. 5±4. 3) compared to the placebo group (83. 7±5. 2), although this difference did not reach statistical significance at the 10% level (P = 0. 056). Furthermore, the study revealed that patients in the treatment group had a significantly shorter hospital stay compared to those in the placebo group (8. 4±2. 2 days vs. 9. 8±2. 0 days, P = 0. 001). Interestingly, after two hours, there was no significant statistical difference in the baseline sections, but this difference became significant at the 5% level after five minutes. Conclusion: Our findings suggest that nebulized H2O8 effectively treats moderate and severe pulmonary COVID-19 cases. This strategy not only reduces ICU hospitalization duration but also mitigates inflammation factors compared to current therapies.

Background & Aim: Rapid breathing is an important clinical manifestation of many illnesses in young infants. Often it is the only sign of illness in this age group. The aim of this study is the evaluation of the respiratory rate as an indicator of hypoxia in infants <1 months.Patients and Methods: This observational study was conducted on 222 ill neonates who were hospitalized in Rasool- Akram NICU. Age, sex and gestational age were recorded and Respiratory Rate (RR) was counted at complete one minute when the neonate was quiet. Then oxygen Saturation (SaO2) was measured at finger or toe with a pulse oximeter by another person. Hypoxia was defined as a SaO2<=90%. RR and SaO2 were recorded by 2 fix observers who were unaware of the research. The t2-test was done to find the usefulness of the respiratory rate as indicator of hypoxia.Results: Hypoxia (SaO2<=90%) was seen in 100(45%) infants. RR and SaO2 showed a significant negative correlation.RR 60-69/min predicts hypoxia with 82/6% sensitivity, 86/4% specifity, 55/8% PPV, 96% NPV.Conclusion: These results indicated that a respiratory rate>60/min is a good predictor of hypoxia in neonates brought to emergency service of hospital for any symptoms of acute illness.

Background and Objective: Intensive anaerobic exercise is a risk factor for children with sickle cell anemia. However, it remains unclear whether anaerobic or aerobic exercises have any effect on subjects with sickle cell trait. This study conducted to determine of the effect of aerobic exercise on O2 Saturation in children with sickle cell trait.Subjects and Methods: Eighty-two healthy and trait children (age 6-18) were allocated randomly in two groups: case (41) and control (41) in this study. Anthropometrics profile and hemoglobin concentration were measured. HbS hemoglobin recognized with HPLC. All children performed a cycle ergometer 2-min exercise and 3-min rest. Before and after exercise, O2 Saturation was assessed with pulseoximetry.Results: There was no significant difference between two groups for O2 Saturation before and after exercise (P>0.05). This parameter remained normal in children with sickle cell trait.Conclusion: It seems aerobic exercise is safe for children with sickle cell trait.

Background: In patients under mechanical ventilation, the patient's position is one of the factors affecting the efficiency of respiratory gas exchange. The aim of this study was to compare the level of arterial blood gas pressure and the percentage of arterial oxygen Saturation in the supine position with the lateral position in patients with ventilator-associated pneumonia. Methods: In a clinical trial study with a sample size of 50 patients with ischemic stroke under mechanical ventilation admitted to the intensive care unit of Kashani hospital affiliated to Shahrekord University of Medical Sciences, Shahrekord, Iran, in 2019 were selected using convenience sampling method. Oxygen Saturation percentage was measured by a pulse oximeter in patients lying on their backs and then, on their sides for two hours,arterial blood pressure and carbon dioxide levels were measured with arterial blood sample by laboratory device, and recorded in the relevant checklist as well. Findings: In both supine and lateral positions, the mean arterial oxygen pressure and the percentage of hemoglobin oxygen Saturation were not significantly different (P > 0. 050),while the arterial carbon dioxide pressure in the lateral position was significantly lower than the supine position (P = 0. 008). Conclusion: The lateral position has no significant effect on the improvement of arterial blood gases and oxygen Saturation in patients with pneumonia due to mechanical ventilation,but has significantly reduce the pressure of carbon dioxide.

Background The change in venous oxygen Saturation occurs earlier, and even its reduction is faster than arterial oxygen Saturation. The aim of this study was to validate SvO2 and PvO2 for O2 content measurement in children hospitalized with respiratory distress. Materials and Methods In this cross-sectional study, 80 children who were admitted with respiratory distress were included in the study according to the study inclusion and exclusion criteria. Baseline characteristics such as age and gender were recorded in the data collection form, designed by the researcher. In order to determine the amount of SaO2 and PaO2 the arterial blood sample was prepared, venous blood sample was prepared to determine the amount of hemoglobin, SvO2 and PvO2. The gold standard for the determination of O2 content was the arterial blood sample. All samples were examined by a blood gas analyzer and then calculated using the formula of O2 content values. For SvO2 and PvO2 validation, we used diagnostic analysis methods including sensitivity, specificity, positive and negative predictive values. Cut-point value for SvO2 and PvO2 were 76. 50 and 44. 30, respectively. Results In this study, the patients’ mean age was 5. 15 ± 4. 20 years. 62. 5% (n=50) were male and 38. 5% (n=30) were female. The values of arterial and venous O2 content were 14. 13 ± 3. 05 and 11. 95 ± 3. 04 from a total of 80 patients. SvO2 and PvO2 for measuring O2 content had a sensitivity of 80. 5 and 71. 80%, respectively, and specificity of 80. 5 and 78%, respectively. Conclusion SvO2 and PvO2 have good validity for evaluating O2 content in patients admitted to PICU. So that SvO2 had a sensitivity and specificity of over 80%, and PvO2 had a sensitivity and specificity of over 70%.

Background & Aim: Asthma is the most common respiratory tract disease. One of the drugs prescribing in the patients with asthma is inhalation spray or inhaler that is used with or without spacer. The effect of spacer on improving patients with asthma has always been under discussion. Hence, the aim of the current study was to determine the effectiveness of using inhaler on arterial O2 Saturation (SaO2) with and without a spacer in patients with asthma. Materials & Methods: This study was an interventional– experimental research that was conducted at hospitals affiliated to Kermanshah University of Medical Sciences in 2016. Sampling was done by random sampling method and 60 patients were selected and included in two groups, i. e. with spacer and without spacer. The data was collected within three consecutive days using questionnaire and data recording forms. The analyses were performed using SPSS 21 by two-way analysis of variance and independent t-test. Results: The average oxygen Saturation in the asthmatic group increased from 87. 7667 ± 6. 03257 on the first day to 88. 9 ± 5. 86251 on the third day; and in the asthmatic group, it increased from 89. 9667 ± 5. 01366 on the first day to 94. 8 ± 3. 38760 on the third day. Between the levels of time, there was a significant difference between the two groups in asthmatic and non-asthmatic groups (P < 0. 001). Conclusion: Given the results obtained from this study, it seems that using spacer with inhaler has a significantly positive impact on pulmonary function improvement and increasing blood oxygen Saturation

Background & Aim: Preterm infants born at less than 34 weeks postconceptional age are not as neurologically mature as their term counterparts and thus have difficulty coordinating sucking, swallowing and breathing. As a result, they are traditionally gavage fed until they are able to oral feed successfully. The aim of study was to evaluate comparative effect of orogastric and breast feeding on oxygen Saturation in very low birth weight infant (<1500gm).Patients and Methods: In this clinical trial all babies admitted in the Neonatal Research Center of Imamreza Hospital, Mashhad during a 4 months period were elected. Criteria for entrance to study included birth weight ≤ 1500 grams, exclusive breastfeeding, having no special problem after 48 hours, receiving only routine care and intake of milk was 100cc/kg/day. Each neonate received two rounds of orogastric and breast feeding in the morning and in the afternoon, during which mean oxygen Saturation was measured by pulse-oxymetry. During the study the heart rate and temperature of the neonates were monitored, and in case of hypothermia, bradycardia (less than 100 per minute) or apnea the feeding was discontinued and the study was repeated the following day. Data analysis was carried out using SPSS and EPI. For comparison & averages of qualitative and quantitative data one-way variance test and for studying the relation between qualitative data Chi Square test was used.Results: Fifty neonates were studied. The average birth weight was 1267.20±165.42 grams and average gestational age was 31.81±1.92 and female/male ratio was 1.2. There was no significant statistical difference in arterial oxygen Saturation in orogastric and breast feeding in the morning and in the afternoon. (p=0.16 in the morning and p=0.6 in the afternoon). There was no complication of apnea, hypothermia or bradycardia.Conclusion: There was no significant statistical difference between the two methods in arterial oxygen Saturation. It seems that oral feeding (which is a natural route) and skin contact between the mother and neonate causes a strong emotional bonding between the two and brings about better social adaptation for the neonate. Also shorter period of stay in hospital is more preferred, and breast feeding should be started at the earliest possible time after birth.