Browsing by Author "Bobos, Marina (59782431600)"

Purpose of Review: This review paper shows the controversies of using nitrous oxide in anesthesia of different patient populations. It provides information on nitrous oxide’s potential side effects when used in modern anesthesia during surgery. Recent Findings: The ENIGMA I and ENIGMA II studies showed a significantly increased risk of postoperative nausea and vomiting after nitrous oxide administration. The theory is that nitrous oxide administered at pediatric age may accelerate neuronal apoptosis and lead to cerebral toxicity and behavioral and learning disorders later in life. The side effects associated with the use of nitrous oxide are based on megaloblastic changes associated with vitamin B12 deficiency and reduced methionine synthesis. Summary: In recent years, there have been recommendations to eliminate nitrous oxide from medical use due to its toxicity, possible increase in morbidity and mortality, and adverse environmental effects. Nevertheless, some authors promote its use, mainly because of its analgesic effect. Nitrous oxide can be used for analgesia during epidural catheter placement, labor, and postpartum procedures because it crosses the placenta and is rapidly eliminated in newborns at the onset of respiration. Its widespread use in minor pediatric procedures has been described. Currently, there is insufficient evidence to support or refute the continued use of nitrous oxide in medical practice. Most of the available data show that nitrous oxide is obsolete as an anesthetic gas, which unfortunately reduces the need for its continued use in anesthesia. © 2023, The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.

Background: The COVID-19 pandemic revealed an unexpected pattern known as the “smoker’s paradox”, with lower rates of severe disease among smokers compared to non-smokers, highlighting the need for the specific investigation of disease progression in non-smoking populations. Objective: To identify early mortality predictors in non-smoking patients with severe COVID-19 through the evaluation of clinical, laboratory, and oxygenation parameters. Methods: This retrospective observational cohort study included 59 non-smokers hospitalized with COVID-19 between November and December 2020. Clinical parameters, laboratory findings, and respiratory support requirements were analyzed on Days 1 and 7 of hospitalization. ROC curves were constructed to assess the predictive value of the parameters. Results: The overall mortality rate was 54.2%. The seventh-day SOFA score showed the strongest predictive value (AUC = 0.902, p = 0.004), followed by pCO2 (AUC = 0.853, p = 0.012). Significant differences between survivors and non-survivors were observed in acid–base parameters, oxygenation indices, and hematological markers. Mortality rates varied significantly with ventilation type: 84.6% for IMV and 50% for NIMV, with no deaths in HFNC patients. Conclusions: Multiple parameters measured on Day 7 of hospitalization demonstrate significant predictive value for mortality in non-smoking COVID-19 patients, with the SOFA score being the strongest predictor. The type of respiratory support significantly influences outcomes, suggesting the importance of careful ventilation strategy selection. © 2025 by the authors.

Background: The COVID-19 pandemic revealed an unexpected pattern known as the “smoker’s paradox”, with lower rates of severe disease among smokers compared to non-smokers, highlighting the need for the specific investigation of disease progression in non-smoking populations. Objective: To identify early mortality predictors in non-smoking patients with severe COVID-19 through the evaluation of clinical, laboratory, and oxygenation parameters. Methods: This retrospective observational cohort study included 59 non-smokers hospitalized with COVID-19 between November and December 2020. Clinical parameters, laboratory findings, and respiratory support requirements were analyzed on Days 1 and 7 of hospitalization. ROC curves were constructed to assess the predictive value of the parameters. Results: The overall mortality rate was 54.2%. The seventh-day SOFA score showed the strongest predictive value (AUC = 0.902, p = 0.004), followed by pCO2 (AUC = 0.853, p = 0.012). Significant differences between survivors and non-survivors were observed in acid–base parameters, oxygenation indices, and hematological markers. Mortality rates varied significantly with ventilation type: 84.6% for IMV and 50% for NIMV, with no deaths in HFNC patients. Conclusions: Multiple parameters measured on Day 7 of hospitalization demonstrate significant predictive value for mortality in non-smoking COVID-19 patients, with the SOFA score being the strongest predictor. The type of respiratory support significantly influences outcomes, suggesting the importance of careful ventilation strategy selection. © 2025 by the authors.