Video

Patient with moderate to severe emphysema on CXR, but without chronic hypercapnia and is normally with a baseline SpO2 94% on room air and no shortness of breath even on exertion. Patient has difficult to manage hypertension and is on several types of antihypertensives. Patient comes in with sudden onset hypoxemia (SpO2 83%), severe shortness of breath, and hypertension. VBG PCO2 32 mmHg (hyperventilating). Supplemental oxygen is applied, but because of the COPD only enough oxygen is applied to keep SpO2 88% even though the patient is having to work so hard hyperventilating to maintain the 88%. Patient remains severely short of breath and hypocapneic for the next 36 hours (peripheral PCO2 low 30's). Right heart cath several days later shows severe pulmonary hypertension. My question is: Does our fear of giving oxygen to patients with COPD (even without chronic hypercapnia), cause us to potentially cause enough hypoxic damage to parts of the pulmonary vasculature to cause permanent pulmonary hypertension?

Thank you for the explanation! ❤

Well, I just got my Apple series watch nine and Apple has discontinued blood oxygen. Do you no longer have that I have an Apple series 7 that does have it on there but what do you suggest let’s say from Amazon or manufacture for the fingertip is a good O2 sensor.???

Great job

rishi hello is there an email to ask individual questions for your *opinion* ? regarding PICC LINE

Rightnow its showing 89% is it good ?

Living at high altitude/elevation causes this. Not healthy.

Apple Watch is saying resting heart rates of 57 and I’m not an athlete and o2 of 93 should I call the dr

that was interesting

Fun-Fact : The sensor apple uses in their watches were stolen from a Medical company, Masimo laboratories.😂 But got Caught Red-Handed now

👉 I'll bet you got a lot of "beeps" from the people behind you while you practiced! (Did you mute the scream from your patient?)

Wonderful info. Thanks! I wonder why Apple lost their lawsuit to Masimo for theft of their patent on the "light emitting technology" that was invented & patented by Masimo? Maybe Masimo also invented the reflectance technology you're speaking about as well?

Hi, great video. I have sleep apnea and use a CPAP nightly and I also live at altitude (7500 ft). Do you have an opinion about the pending Masimo Freedom watch as it relates to its tech, accuracy, and providing more reliable data vs. other watch brands? Thanks!

THIS is the video I was looking for. I would like to add that for a Mac, you will need to double click on the folder to add it, rather than click on the first file within the folder.

Real time please with ultrasound

Well I thank you for the video but this isnt Linux and Linux Handbrake is nothing like this for whatever version I just installed Feb 2024. I thought It would be similar but not only do these people who write these programs make them as impossible to figure out, with every last otherwise easy fto do feature buried 20 layers deep through multiple illogical processes, they cant even make the program look and operate the same. Did they ever hear of C++, so it easily compiles to any platform. They truly are idiots. Im done with handbrake. I'm not great at python but I could write a script to call ffmpeg and do it 10, 0000 times faster than I ever will try to uncover the mysterious of the deep with handbrake. Whatever happened to File->Open and use Shift-Enter or Ctrl-Enter to grab the files you want. What is WRONG with these people. ARRRRR!

How come you’re wearing medical scrubs at home

Your content was excellent. You presented it well, and I wish you well in all your endeavors. I'm sure I speak for many people when I say, "It was helpful. Thank you.

Can you tell me anything about percardial cyst surgery per thoracic reg and laproscopy to resection .

The problem of a well saturated anaemic person is not isolated to Apple’s reflectance oxymetry. I think this should’ve been made clearer in the video because some may think that they can rely on an oximeter more than an Apple Watch, even though the watch is always on their wrist and just as valid as an occasionally used finger tip oximeter.

Thank you Doctor. Greatly appreciate this video.

My Apple Watch shows an 84-88% oxygen level during 3am-7:00 am. Not sure it’s accurate.

Toxicologist here to say Dr. Kumar is WRONG about what SpO2 measures. The SpO2 in pulse oximeters is NOT a measure of the oxygen bound to Hb. SpO2 is actually a measure of the sum of oxygen and carbon monoxide bound to Hb, because pulse oximeters with 2 wavelengths cannot tell them apart (COHb also peaks at 660nm). This is not a big error if you are healthy with normal COHb around 1%. But arterial COHb may be 5%, 10%, 20% or more from either exogenous (inhaled) and/or endogenous (internal) sources of CO exposure (as in COVID) -- in which case your actual oxygen level would be that much lower. Only pulse CO oximeters with more wavelengths, such as Masimo's RAD57, can distinguish COHb and O2Hb, but they cost $5000 to $10000. (I have no affiliation) The correct way to describe any pulse ox SpO2 display is as a measure of the total O2 and CO bound to arterial Hb. If normally low methemoglobin is >1%, it also may be misread as SpO2. Since the SpO2 value is always closer to the saturation pressure of all bound Hb than to the pressure of O2Hb alone, it is more accurate to think (and speak) of SpO2 as SpHb.

Thanks

I just stick to a good picketer over any watch

Oh well, I guess that's another one the adage creators got wrong. An Apple a day may not keep the doctor away, make sure your Apples are ripe! Thanks, Doc. This one is for you🍎!

This video really helped. Thank you . saved me soooooo much time.

Very helpful and beautifully explained! Many thanks.

Extremely helpful video, thank you !!! Could someone explain to me where would O2 generate high paO2 in the alveoli? Would that be in the upper alveoli? If there is lack of ventilation, not sure how does the O2 reach the basal alveoli. Thank you again:)

Thank you so much!

Thanks

Your eyes lit up once you spoke about what technology can do but also that we need not to put all our faith in the flashy apple waches but check into a drs now and again😊

Handbrake is awesome. Thanks man 👨

Remove static and rust grinder internals! Great idea!

Why no updates on this channel

This is interesting to me but you lost me throwing around all the specific names of devices and instruments. I hear the words but don't know what they mean. Sorry.

Worst video...no use

Finally!! Thanks a million!! There are a lot of tutorials but mostly for Windows and those for Mac a bit useless...

I get it the other way around. My watch gives a 94 and my finger monitor gives me 98. So, what’s up with that?

❤

Hi! My watch says I'm between 80% and 100% today. Am I need to worry about that? The everyday average is 92%.

You'll never convince the brainwashed followers of the Apple Cult that anything could be wrong with any Apple product. Their former cult leader died because he only ate fruit and ignored his doctors. Apple Cult members don't see a doctor as long as their watch tells them they're doing OK. And then they die, just like their guru.

Thank you! Very informative

Listening only is kind of boring !!!!!

Thanks for sharing , Dr !, However, it would be more interesting and helpful if you gphave some more short clips to demo what you are talikng about !

Outstanding

Excellent video! Had an aortic valve replaced 10 years ago.

omg thank you it worked

I went in by ambulance for a heart attack. It was determined I would need an emergency triple bypass. I'm almost glad I didn't have much time to think about anything that was getting ready to happen. But then again, I went in not knowing much about what was about to happen.

Sir pls give me a option to buy it in india pls i m also an anaesthesiologist🙏🙏