Effect of a lower target oxygen saturation range on the risk of hypoxaemia and elevated NEWS2 scores at a university hospital: a retrospective study.

Background: The optimal target oxygen saturation (SpO) range for hospital inpatients not at risk of hypercapnia is unknown. The objective of this study was to assess the impact on oxygen usage and National Early Warning Score 2 (NEWS2) of changing the standard SpO target range from 94-98% to 92-96%.

Methods: In a metropolitan UK hospital, a database of electronic bedside SpO measurements, oxygen prescriptions and NEWS2 records was reviewed.

Obesity: A critical risk factor in the COVID-19 pandemic.

Obesity is an emerging independent risk factor for susceptibility to and severity of coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). Previous viral pandemics have shown that obesity, particularly severe obesity (BMI > 40 kg/m ), is associated with increased risk of hospitalization, critical care admission and fatalities. In this narrative review, we examine emerging evidence of the influence of obesity on COVID-19, the challenges to clinical management from pulmonary, endocrine and immune dysfunctions in individuals with obesity and identify potential areas for further research.

Impairment of high-density lipoprotein resistance to lipid peroxidation and adipose tissue inflammation in obesity complicated by obstructive sleep apnea.

Context: Obstructive sleep apnea (OSA) complicates morbid obesity and is associated with increased cardiovascular disease incidence. An increase in the circulating markers of chronic inflammation and dysfunctional high-density lipoprotein (HDL) occur in severe obesity.

Objective: The objective of the study was to establish whether the effects of obesity on inflammation and HDL dysfunction are more marked when complicated by OSA.

There is another way: empowering frontline staff caring for acutely unwell adults.

Quality Problem Or Issue: It is estimated that only 17% of patients survive an in-hospital cardiac arrest. Medical evidence indicates that many patients show signs of deterioration during the 24 h period prior to their cardiac arrest.

Initial Assessment: At Salford Royal NHS Foundation Trust (SRFT) 135 patients (outside critical care areas) suffered a cardiac arrest between March 2007 and April 2008.

A crossover study of short burst oxygen therapy (SBOT) for the relief of exercise-induced breathlessness in severe COPD.

Background: Previous small studies suggested SBOT may be ineffective in relieving breathlessness after exercise in COPD.

Methods: 34 COPD patients with FEV1 <40% predicted and resting oxygen saturation ≥93% undertook an exercise step test 4 times. After exercise, patients were given 4 l/min of oxygen from a simple face mask, 4 l/min air from a face mask (single blind), air from a fan or no intervention.

Survey of major complications of intercostal chest drain insertion in the UK.

Background: Following reports from the National Patient Safety Agency of deaths and serious harm from intercostal chest drains (ICD) we conducted a national survey among chest physicians of their experience of harm associated with ICD.

Methods: A questionnaire was sent to 198 UK chest physicians at 148 acute hospital trusts, enquiring about current practice and any adverse incidents related to chest drains from 2003 to 2008.

Results: 101 of 148 trusts (68%) replied.

Acceptance, effectiveness and safety of continuous positive airway pressure in acute stroke: a pilot study.

Objectives: To evaluate the acceptance, effectiveness in preventing upper airways obstruction, and haemodynamic effects of continuous positive airway pressure (CPAP) in acute stroke.

Methods: Twelve patients (4 M, and 8 F; mean (SD), 75.2 (5.

Anthracofibrosis, bronchial stenosis with overlying anthracotic mucosa: possibly a new occupational lung disorder: a series of seven cases From one UK hospital.

Anthracofibrosis, which was recently defined as bronchial stenosis with overlying anthracotic mucosa, has been infrequently reported in Asia as a complication of tuberculosis (TB). It has not been reported in the United Kingdom or the United States, or, to our knowledge, in non-Asian patients. We have identified seven cases of patients presenting to a single teaching hospital in the northwest of England over a 13-year period.

PHOX2B mutation-confirmed congenital central hypoventilation syndrome: presentation in adulthood.

Congenital central hypoventilation syndrome (CCHS) typically presents in the newborn period. A case series of five adults is presented, each heterozygous for a documented polyalanine expansion mutation in the PHOX2B gene and evidence of nocturnal alveolar hypoventilation. All cases had symptoms in childhood, but survived to adulthood without ventilatory support.

Effect of upper airway obstruction on blood pressure variability after stroke.

Approx. 60% of acute stroke patients have periods of significant UAO (upper airway obstruction) and this is associated with a worse outcome. UAO is associated with repeated fluctuation in BP (blood pressure) and increased BP variability is also associated with a poor outcome in patients with acute stroke.