One year experience with computer-assisted propofol sedation for colonoscopy

AIM To report our one-year experience with computer assisted propofol sedation(CAPS) for colonoscopy as the first United States Medical Center to adopt CAPS technology for routine clinical use.METHODS Between September 2014 and August 2015, 2677 patients underwent elective outpatient colonoscopy with CAPS at our center. All colonoscopies were performed by 1 of 17 gastroenterologists certified in the use of the CAPS system, with the assistance of a specially trained nurse. Procedural success rates, polyp detection rates, procedure times and recovery times were recorded and compared against corresponding historical measuresfrom 2286 colonoscopies done with midazolam and fentanyl from September 2013 to August 2014. Adverse events in the CAPS group were recorded.RESULTS The mean age of the CAPS cohort was 59.9 years(48.7% male); 31.3% were ASA?Ⅰ, 67.3% ASA Ⅱ and 1.4% ASA Ⅲ. 45.1% of the colonoscopies were for screening, 31.5% for surveillance, and 23.4% for symptoms. The mean propofol dose administered was 250.7 mg(range 16-1470 mg), with a mean fentanyl dose of 34.1 mcg(0-100 mcg). The colonoscopy completion and polyp detection rates were similar to that of historical measures. Recovery times were markedly shorter(31 min vs 45.6 min, P < 0.001). In CAPS patients, there were 20(0.7%) cases of mild desaturation(< 90%) treated with a chin lift and reduction or temporary discontinuation of the propofol infusion, 21(0.8%) cases of asymptomatic hypotension(< 90 systolic blood pressure) treated with a reduction in the propofol rate, 4(0.1%) cases of marked agitation or discomfort due to undersedation, and 2 cases of pronounced transient desaturation requiring brief(< 1 min) mask ventilation. There were no sedation-related serious adverse events such as emergent intubation, unanticipated hospitalization or permanent injury. CONCLUSION CAPS appears to be a safe, effective and efficient means of providing moderate sedation for colonoscopy in relatively healthy patients. Recovery times were much shorter than historical measures. There were few adverse events, and no serious adverse events, related to CAPS.

Comparative scoping study report for the extraction of microalgae oils from two subspecies of Chlorella vulgaris

The production of microalgae as a fatty acid oil resource for use in biofuels production is a widespread research topic at the lab scale.Microalgae contain a higher lipid content on a dry-weight basis compared to oilseeds such as soybeans.Additionally,the growth and cultivation cycle of microalgae is 15 days,in comparison to soybeans,for which the cycle occurs once or twice annually.However,to date,it has been uneconomical to produce microalgae oils in a world-scale facility due to limitations in cultivating microalgae at commercial scales.Recent developments suggest that the use of heterotrophic microalgae may be economically feasible for large-scale oil production.To assess this feasibility,a comparative scoping study was performed analysing the feasibility of an industrial-scale process plant for the growth and extraction of oil from microalgae.Processes were developed at the preliminary design level using heterotrophic subspecies and autotrophic subspecies of Chlorella vulgaris.AACE Class 4 cost estimates and economic analyses were performed.This study concludes that processes based on heterotrophic microalgae are more likely to reach economic feasibility than processes using autotrophic microalgae.However,a few barriers still remain to achieving free-market economic viability.