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As the consciousness level had not been improving up until then, and SPO 2 levels had begun to decline, the decision was made to change the endotracheal tube and re-intubate him with suspicion of upper airway obstruction

This amino acid can also be converted into fumaric acid and acetoacetate, thereby participating in the tricarboxylic acid cycle and providing energy for various biochemical reactions, such as oxidative stress regulation [56]

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Melasma: clinical diagnosis and management options

Dubner R

40 , 174179, doi: 10.1016/j.bcmd.2007.09.001 (2008)