Samples at different setting time were determined by glass syringe method and air bag method, and their results were analyzed. The results showed that concentrations of methane and total hydrocarbons obviously decline...Samples at different setting time were determined by glass syringe method and air bag method, and their results were analyzed. The results showed that concentrations of methane and total hydrocarbons obviously declined with the prolonging of setting time by glass syringe method, and recovery rate of sample declined to 60% after 8 h. In air bag method, analysis results of methane and total hydrocarbons were stabler, and recovery rate of sample was 93% after 8 h.展开更多
Purpose: To achieve good outcomes during aortic surgery with circulatory arrest, a secure and non-bleeding anastomosis must be achieved rapidly to ensure brain protection. We report our initial experiences with a modi...Purpose: To achieve good outcomes during aortic surgery with circulatory arrest, a secure and non-bleeding anastomosis must be achieved rapidly to ensure brain protection. We report our initial experiences with a modified Branched Graft Inverting (BGI) technique using an inserter under mild hypothermia. We aimed to reduce the surgical duration and to prevent unnecessary damage to the fragile aorta. Methods: We retrospectively reviewed patients with type A acute aortic dissection (AAD) who underwent distal anastomosis via the modified BGI technique using an inserter between January 2012 and March 2013. Open distal anastomosis was performed under mild hypothermia with right hemisphere perfusion from the right axillary artery. Results: Eight patients were enrolled. There was no mortality. Circulatory arrest time was reproducibly 20.3 ± 1.9 min, which was sufficient to complete non-bleeding distal anastomoses. The average rectal temperature during circulatory arrest was 26.5℃ ± 1.9℃. All patients were extubated the day after the operation without any neurological deficit. Conclusion: The modified BGI technique employing an inserter and mild hypothermia offered easy, secure, and reproducible distal anastomosis for ascending aortic replacement for type A acute aortic dissection. Our outcomes were favorable and support further development of this technique.展开更多
BACKGROUND Critically ill neonates and pediatric patients commonly require multiple low flow infusions.Volume limitations are imposed by small body habitus and comorbidities like cardiopulmonary disease,renal failure,...BACKGROUND Critically ill neonates and pediatric patients commonly require multiple low flow infusions.Volume limitations are imposed by small body habitus and comorbidities like cardiopulmonary disease,renal failure,or fluid overload.Vascular access is limited by diminutive veins.Maintenance fluids or parenteral nutrition in conjunction with actively titrated infusions such as insulin,fentanyl,prostaglandins,inotropes and vasopressors may necessitate simultaneous infusions using a single lumen to maintain vascular catheter patency.This requirement for multiple titratable infusions requires concentrated medications at low flows,rather than more dilute drugs at higher flows that in combination may volume overload small infants.AIM To determine whether carrier fluid reduces variability that variability of low flow drug infusions is proportional to syringe size in pediatric critical care.METHODS We assessed concentrations of orange“drug”in a 0.2 mL/h low flow clinical model with blue dyed carrier fluid at 5 mL/h,using 3-,10-,or 60-mL syringes.A graduated volumetric pipette was used to measure total flow.Mean time to target concentration was 30,21,and 46 min in 3-,10-,and 60-mL syringes,respectively(P=0.42).After achieving target concentration,more dilute drug was delivered by 60-mL(P<0.001)and 10-mL syringes(P=0.04)compared to 3-mL syringes.Drug overdoses were observed during the initial 45 min of infusion in 10-and 60-mL syringes.Total volumes infused after target concentration were less in the 60-mL condition compared to 3-mL(P<0.01)and 10-mL(P<0.001)syringes.RESULTS Linear mixed effects models demonstrated lesser delivered drug concentrations in the initial 30 min by 3-mL compared to 10-and 60-mL syringes(P=0.005 and P<0.001,respectively)but greater drug concentrations and total infused drug in the subsequent 30-60 and 60-90 min intervals with the 3-and 10-mL compared to 60-mL syringes.CONCLUSION With carrier fluid,larger syringes were associated with significantly less drug delivery,less total volume delivered,and other flow problems in our low flow drug model.Carrier fluid should not be used to compensate for inappropriately large syringes in critical low flow drug infusions.展开更多
BACKGROUND Knee and hip osteoarthritis affects millions of people around the world and is expected to rise even more in frequency as the population ages.Joint arthroplasty is the surgical management of choice in these...BACKGROUND Knee and hip osteoarthritis affects millions of people around the world and is expected to rise even more in frequency as the population ages.Joint arthroplasty is the surgical management of choice in these articulations.Heterotopic ossi-fication and radiolucent lines formation are two frequent problems faced in hip and knee replacements respectively.Some studies show that the usage of pulsed lavage may prevent their formation.AIM To compare pulsed lavage to standard lavage in joint arthroplasty.METHODS PubMed,Cochrane,and Google Scholar(page 1-20)were searched till December 2023.Only comparative studies were included.The clinical outcomes evaluated were the heterotopic ossification formation in hip replacements,radiolucent lines formation,and functional knee scores in knee replacements.RESULTS Four studies met the inclusion criteria and were included in this meta-analysis.Pulsed lavage was shown to reduce the formation of radiolucent lines(P=0.001).However,no difference was seen in the remaining outcomes CONCLUSION Pulsed lavage reduced the formation of radiolucent lines in knee replacements.No difference was seen in the remaining outcomes.Furthermore,the clinical significance of these radiolucent lines is poorly understood.Better conducted randomized controlled studies and cost-effectivity studies are needed to reinforce these findings.展开更多
基金Supported by Shantou Environmental Protection Science and Technology Project of 2018
文摘Samples at different setting time were determined by glass syringe method and air bag method, and their results were analyzed. The results showed that concentrations of methane and total hydrocarbons obviously declined with the prolonging of setting time by glass syringe method, and recovery rate of sample declined to 60% after 8 h. In air bag method, analysis results of methane and total hydrocarbons were stabler, and recovery rate of sample was 93% after 8 h.
文摘Purpose: To achieve good outcomes during aortic surgery with circulatory arrest, a secure and non-bleeding anastomosis must be achieved rapidly to ensure brain protection. We report our initial experiences with a modified Branched Graft Inverting (BGI) technique using an inserter under mild hypothermia. We aimed to reduce the surgical duration and to prevent unnecessary damage to the fragile aorta. Methods: We retrospectively reviewed patients with type A acute aortic dissection (AAD) who underwent distal anastomosis via the modified BGI technique using an inserter between January 2012 and March 2013. Open distal anastomosis was performed under mild hypothermia with right hemisphere perfusion from the right axillary artery. Results: Eight patients were enrolled. There was no mortality. Circulatory arrest time was reproducibly 20.3 ± 1.9 min, which was sufficient to complete non-bleeding distal anastomoses. The average rectal temperature during circulatory arrest was 26.5℃ ± 1.9℃. All patients were extubated the day after the operation without any neurological deficit. Conclusion: The modified BGI technique employing an inserter and mild hypothermia offered easy, secure, and reproducible distal anastomosis for ascending aortic replacement for type A acute aortic dissection. Our outcomes were favorable and support further development of this technique.
基金Supported by NIH National Center for Advancing Translational Sciences(NCATS)UCLA CTSI,No.UL1TR001881.
文摘BACKGROUND Critically ill neonates and pediatric patients commonly require multiple low flow infusions.Volume limitations are imposed by small body habitus and comorbidities like cardiopulmonary disease,renal failure,or fluid overload.Vascular access is limited by diminutive veins.Maintenance fluids or parenteral nutrition in conjunction with actively titrated infusions such as insulin,fentanyl,prostaglandins,inotropes and vasopressors may necessitate simultaneous infusions using a single lumen to maintain vascular catheter patency.This requirement for multiple titratable infusions requires concentrated medications at low flows,rather than more dilute drugs at higher flows that in combination may volume overload small infants.AIM To determine whether carrier fluid reduces variability that variability of low flow drug infusions is proportional to syringe size in pediatric critical care.METHODS We assessed concentrations of orange“drug”in a 0.2 mL/h low flow clinical model with blue dyed carrier fluid at 5 mL/h,using 3-,10-,or 60-mL syringes.A graduated volumetric pipette was used to measure total flow.Mean time to target concentration was 30,21,and 46 min in 3-,10-,and 60-mL syringes,respectively(P=0.42).After achieving target concentration,more dilute drug was delivered by 60-mL(P<0.001)and 10-mL syringes(P=0.04)compared to 3-mL syringes.Drug overdoses were observed during the initial 45 min of infusion in 10-and 60-mL syringes.Total volumes infused after target concentration were less in the 60-mL condition compared to 3-mL(P<0.01)and 10-mL(P<0.001)syringes.RESULTS Linear mixed effects models demonstrated lesser delivered drug concentrations in the initial 30 min by 3-mL compared to 10-and 60-mL syringes(P=0.005 and P<0.001,respectively)but greater drug concentrations and total infused drug in the subsequent 30-60 and 60-90 min intervals with the 3-and 10-mL compared to 60-mL syringes.CONCLUSION With carrier fluid,larger syringes were associated with significantly less drug delivery,less total volume delivered,and other flow problems in our low flow drug model.Carrier fluid should not be used to compensate for inappropriately large syringes in critical low flow drug infusions.
文摘BACKGROUND Knee and hip osteoarthritis affects millions of people around the world and is expected to rise even more in frequency as the population ages.Joint arthroplasty is the surgical management of choice in these articulations.Heterotopic ossi-fication and radiolucent lines formation are two frequent problems faced in hip and knee replacements respectively.Some studies show that the usage of pulsed lavage may prevent their formation.AIM To compare pulsed lavage to standard lavage in joint arthroplasty.METHODS PubMed,Cochrane,and Google Scholar(page 1-20)were searched till December 2023.Only comparative studies were included.The clinical outcomes evaluated were the heterotopic ossification formation in hip replacements,radiolucent lines formation,and functional knee scores in knee replacements.RESULTS Four studies met the inclusion criteria and were included in this meta-analysis.Pulsed lavage was shown to reduce the formation of radiolucent lines(P=0.001).However,no difference was seen in the remaining outcomes CONCLUSION Pulsed lavage reduced the formation of radiolucent lines in knee replacements.No difference was seen in the remaining outcomes.Furthermore,the clinical significance of these radiolucent lines is poorly understood.Better conducted randomized controlled studies and cost-effectivity studies are needed to reinforce these findings.
