Advanced Life Support Technology Research Articles

Ruthenium red alleviates post-resuscitation myocardial dysfunction by upregulating mitophagy through inhibition of USP33 in a cardiac arrest rat model

Cardiac arrest (CA) remains a leading cause of death, with suboptimal survival rates despite efforts involving cardiopulmonary resuscitation and advanced life-support technology. Post-resuscitation myocardial dysfunction (PRMD) is an important determinant of patient outcomes. Myocardial ischemia/reperfusion injury underlies this dysfunction. Previous reports have shown that ruthenium red (RR) has a protective effect against cardiac ischemia-reperfusion injury; however, its precise mechanism of action in PRMD remains unclear. This study investigated the effects of RR on PRMD and analyzed its underlying mechanisms. Ventricular fibrillation was induced in rats, which were then subjected to cardiopulmonary resuscitation to establish an experimental CA model. At the onset of return of spontaneous circulation, RR (2.5 mg/kg) was administered intraperitoneally. Our study showed that RR improved myocardial function and reduced the production of oxidative stress markers such as malondialdehyde (MDA), glutathione peroxidase (GSSG), and reactive oxygen species (ROS) production. RR also helped maintain mitochondrial structure and increased ATP and GTP levels. Additionally, RR effectively attenuated myocardial apoptosis. Furthermore, we observed downregulation of proteins closely related to mitophagy, including ubiquitin-specific protease 33 (USP33) and P62, whereas LC3B (microtubule-associated protein light chain 3B) was upregulated. The upregulation of mitophagy may play a critical role in reducing myocardial injury. These results demonstrate that RR may attenuate PRMD by promoting mitophagy through the inhibition of USP33. These effects are likely mediated through diverse mechanisms, including antioxidant activity, apoptosis suppression, and preservation of mitochondrial integrity and energy metabolism. Consequently, RR has emerged as a promising therapeutic approach for addressing post-resuscitation myocardial dysfunction.

Development of the on-orbit maintenance and manipulation workbench (MMW) for the Chinese space station

The logistic supply for Space Station is very expensive and difficult compared with any other human natural exploration activities due to launch costs and challenges, and the logistic problems of establishing bases on the Moon and Mars in the future will be more prominent. Especially for emergencies, the losses caused by ground support delay will be immeasurable. Considering the successful maintenance of the Hubble Telescope and operations on the ISS, one of the most effective methods to solve the logistic supply problem is to enhance the capability of self-maintenance and support of the facilities. Through the participation of astronauts and a series of tools and technical support, the capability of self-maintenance and support of the facilities can be effectively improved. For this purpose, the on-orbit Maintenance and Manipulation Workbench (MMW) has been developed and installed on the Mengtian Lab Module (MLM) of the Chinese Space Station (CSS) to provide an enclosed working area for on-orbit fault diagnosis, maintenance, and manual or mechanical operations for the payload. This paper introduces the development and functions of the MMW on the MLM. In the limited rack space and limited resources, the MMW provides a 380-L work volume, 1000-W DC power with a versatile supply interface (100, 28, and 12 Vdc), 800-W cooling capability, video and data recording and real-time downlink capabilities, ground commanding capability, wastes (waste gases and waste particles) treatment capabilities. With these capabilities, the MMW is an ideal platform to support the operation and test verification of fine mechanical operations, structural and electronic assembly of scientific experiments and technical experiments in the cabin, and to support the development of space robots and telescience technology experiments. Areas of research that will benefit from investigations in the MMW include fluid physics, materials science, combustion science, on-orbit maintenance and manipulation, and advanced life support technologies. The mechanical, electrical and thermal control subsystems are discussed separately. Special tests for the treatment of wastes have been carried out to verify the capabilities. The development of the MMW will surely enhance the space research in the forthcoming long-term activities of CSS.

Knowledge Map Analysis of Basic Medical and Health Service Research Based on Web of Science

At present, the contradiction between people's growing demand for basic public health services and the unbalanced and insufficient development of basic public health services is becoming increasingly acute. Analyzing the research status and the latest progress in this field is of great significance to improve the level of basic medical public health services in various countries. This paper takes 5610 related studies of web of science from 2007 to 2020 as the research object, and uses CiteSpace, SPSS and other software to conduct co word analysis, literature cluster analysis and factor analysis. The results and conclusions are as follows: (1) There are great differences in the research and development level of basic medical public health services in the world, and the development efficiency is low. The country with the highest level of theory and technology development is the United States, followed by Canada and China; (2) In chronological order: the results of the frontier analysis of basic medical and health services in different periods have a strong inheritance relationship. The core evolution path is: Research on basic medical service level and medical quality in grass-roots communities → research on advanced life support theory and technology research on higher-level and higher-quality intelligent medical services; (3) The research on basic medical and health services has attracted a high degree of attention, mainly including cardiopulmonary resuscitation, medical services, emergency medical treatment and medical education.

Syphilis-associated septic cardiomyopathy: case report and review of the literature

BackgroundSeptic cardiomyopathy has been observed in association with influenza, indicating that not only bacteria but also other infective agents can cause this condition. There has been no systematic study as to whether Treponema pallidum infection induces septic cardiomyopathy, and we are the first to report this possibility.Case presentationWe report two cases of a 48-year-old man and a 57-year-old man who were diagnosed with syphilis-related septic cardiomyopathy. The diagnosis of cardiomyopathy was made based on elevation of cardiogenic markers and decrease in ejection fraction evaluated by echocardiography. Screen for infective pathogens was negative except for syphilis, which supported our diagnosis. The two patients recovered following effective anti-syphilis treatment and advanced life support technology. Syphilis serology became negative after treatment.ConclusionSyphilis has the potential to cause septic cardiomyopathy. Clinicians should consider Treponema pallidum in cases of septic cardiomyopathy with unknown pathogens. However, the specific pathophysiological mechanism of syphilis-associated septic cardiomyopathy has not been elucidated, and more specific studies are needed.

Common problems and counterplans of extracorporeal membrane oxygenation implementation in neonatal intensive care unit

Extracorporeal membrane oxygenation (ECMO) is by far one of the most advanced life support technology, which provides temporary cardiopulmonary support and earns precious time for patients waiting for the recovery of organ function.However, due to various factors and constraints, this technology is still at the initial stage of application in neonatal field in China.In the meantime, there are many problems to deal with.This article will mainly discuss about several aspects in ECMO management, including choice of patients, timing to start, choice of ECMO mode, management of running ECMO, complications and ethic issues. Key words: Extracorporeal membrane oxygenation; Infant, newborn; Treatment; Complication

Pediatric medication poisoning

The drug poisoning is the most common cause of children′s accident.The percentage is increasing every year.Analgesics, non-steroidal anti-inflammatory drugs and antihistamines are the most commonly ingested drugs in children.The principles of management of drug poisoning are: (1)resuscitation and initial stabilization; (2)diagnosis of type of poision.According to recent studies, gastric lavage should not routinely be used in all poisoning cases, instead the use of activated carbon is recommended.For severe or special cases advanced life support technologies such as mechanical ventilation, blood purification, extracorporeal membrane oxygenation should be considered. Key words: Drug poisoning; Children

Advanced Life Support Research and Technology Transfer at the University of Guelph

Abstract Research and technology developments surrounding Advanced Life-Support (ALS) began at the University of Guelph in 1992 as the Space and Advanced Life Support Agriculture (SALSA) program, which now represents Canada’s primary contribution to ALS research. The early focus was on recycling hydroponic nutrient solutions, atmospheric gas analysis and carbon balance, sensor research and development, inner/intra-canopy lighting and biological filtration of air in closed systems. With funding from federal, provincial and industry partners, a new generation of technology emerged to address the challenges of deploying biological systems as fundamental components of life-support infrastructure for long-duration human space exploration. Accompanying these advances were a wide range of technology transfer opportunities in the agri-food and health sectors, including air and water remediation, plant and environment sensors, disinfection technologies, recyclable growth substrates and advanced light emitting diode (LED) lighting systems. This report traces the evolution of the SALSA program and catalogues the benefits of ALS research for terrestrial and non-terrestrial applications.

Use of Advanced Life Support Technology in Patients with Life Threatening Degenerative Conditions (SA515)

•List at least three advanced life support modalities commonly considered by patients with irreversible organ failure of 1) lung, 2) heart, and 3) neuromuscular system. Modalities discussed will include ventilator, tracheostomy, VADs, long-term IV vasoactive medications, and novel cellular-based therapies, and organ transplantation is not an option.•Explore family views of the use of advanced technologies in supporting patients who have life-threatening progressive loss of vital function. THE PRO ARGUMENT FOR ADVANCED TECHNOLOGY SUPPORT: The attendee will be able to articulate two or three common goals or justifications that families have in using artificial, life prolonging therapies for their children whose natural disease is incurable and would be imminently fatal, and in whom organ transplantation is not an option. THE CON ARGUMENT FOR ADVANCED TECHNOLOGY SUPPORT: The attendee will be able to articulate two or three reasons why some families have chosen not to use artificial life prolonging therapies for their children whose natural disease is incurable and imminently fatal. Parents and children who live with chronic and degenerative medical conditions are frequently called upon to make difficult choices regarding the artificial prolongation of life. By their natures, most of these conditions are fatal. Yet, as technical medicine advances, some patients and parents may feel compelled to sustain life at any cost, while others may choose to avoid such therapies in the face of worsening quality of life. As palliative providers, it is important to have an appreciation of how families have approached such decisions, and how, in retrospect, they view the impact of their choices on fundamental issues such as family relationships and the child’s quality of life. This session will provide an opportunity for palliative providers to understand how medical communication affected such choices and how our role in such conversations might be improved. Risks and benefits of life-prolonging modalities will be discussed, including the known morbidities and the known and unknown potential to provide more time for a patient. Families will participate in this session. A central aim of this session is to highlight the active pursuit of meaning for one’s life and that of one’s family, and how the value of artificial life-prolonging therapies differs among families of children with progressive illness.

ELECTRICAL STORM AS THE INITIAL MANIFESTATION OF AN ELDERLY PATIENT WITH ACUTE MYOCARDIAL INFARCTION (ONE CASE REPORT)

ObjectivesTo investigate the characteristics and therapeutic method of electrical storm (ES) associated with acute coronary syndrome (ACS).MethodsThe clinical data of one elderly patient with ES induced by ACS were collected...

Canadian advanced life support capacities and future directions

Canada began research on space-relevant biological life support systems in the early 1990s. Since that time Canadian capabilities have grown tremendously, placing Canada among the emerging leaders in biological life support systems. The rapid growth of Canadian expertise has been the result of several factors including a large and technically sophisticated greenhouse sector which successfully operates under challenging climatic conditions, well planned technology transfer strategies between the academic and industrial sectors, and a strong emphasis on international research collaborations. Recent activities such as Canada’s contribution of the Higher Plant Compartment of the European Space Agency’s MELiSSA Pilot Plant and the remote operation of the Arthur Clarke Mars Greenhouse in the Canadian High Arctic continue to demonstrate Canadian capabilities with direct applicability to advanced life support systems. There is also a significant latent potential within Canadian institutions and organizations with respect to directly applicable advanced life support technologies. These directly applicable research interests include such areas as horticultural management strategies (for candidate crops), growth media, food processing, water management, atmosphere management, energy management, waste management, imaging, environment sensors, thermal control, lighting systems, robotics, command and data handling, communications systems, structures, in-situ resource utilization, space analogues and mission operations. With this background and in collaboration with the Canadian aerospace industry sector, a roadmap for future life support contributions is presented here. This roadmap targets an objective of at least 50% food closure by 2050 (providing greater closure in oxygen, water recycling and carbon dioxide uptake). The Canadian advanced life support community has chosen to focus on lunar surface infrastructure and not low Earth orbit or transit systems (i.e. microgravity applications). To advance the technical readiness for the proposed lunar missions, including a lunar plant growth lander, lunar “salad machine” (i.e. small scale plant production unit) and a full scale lunar plant production system, a suite of terrestrial developments and analogue systems are proposed. As has been successfully demonstrated by past Canadian advanced life support activities, terrestrial technology transfer and the development of highly qualified personnel will serve as key outputs for Canadian advanced life support system research programs. This approach is designed to serve the Canadian greenhouse industry by developing compliance measures for mitigating environmental impact, reducing labour and energy costs as well as improving Canadian food security, safety and benefit northern/remote communities.

Babies Breathing

ONE OF THE PILLARS of pediatric nursing is the care of critically ill neonates, nearly universally in acute care settings equipped with advanced life support technologies and staffed with armies of nurses, physicians, therapists, physiologists, social workers, psychologists, and assistive personnel. Parents and families participate in care giving and learn to negotiate the labyrinths of health-care systems and community resources. The costs of care, both emotionally and financially, are staggering and are not likely to be diminished, probably ever. Many nurses in these specialty areas bond to their patients and form strong attachments, at times clouding their goals for family involvement.

CPR in terminally ill patients?

While limiting and forgoing therapy at the end of life is now accepted on medical, ethical, moral and legal grounds, many Americans continue to die with heroic measures being taken to prevent their death. When the patient does eventually die, attempts are frequently made to revive the patient by performing cardiopulmonary resuscitation (CPR). While CPR may result in the establishment of a perfusing pressure, in almost all instances, the patient succumbs despite advanced life support technology. The widespread adoption of do-not-resuscitate (DNR) protocols has not prevented CPR from being performed on patients, who are unlikely to survive. We present two cases, which highlight the modern American way of dying. We submit that poor end-of-life care may result from physicians discomfort with death, their poor communication skills and their failure to fully comprehend the benefits and limitations of advanced life support technology. Furthermore, we maintain that CPR should only be performed on patients, who are likely to derive benefit from this intervention.

Application of NASA's advanced life support technologies in polar regions

NASA's advanced life support technologies are being combined with Arctic science and engineering knowledge in the Advanced Life Systems for Extreme Environments (ALSEE) project. This project addresses treatment and reduction of waste, purification and recycling of water, and production of food in remote communities of Alaska. The project focus is a major issue in the state of Alaska and other areas of the Circumpolar North; the health and welfare of people, their lives and the subsistence lifestyle in remote communities, care for the environment, and economic opportunity through technology transfer. The challenge is to implement the technologies in a manner compatible with the social and economic structures of native communities, the state, and the commercial sector. NASA goals are technology selection, system design and methods development of regenerative life support systems for planetary and Lunar bases and other space exploration missions. The ALSEE project will provide similar advanced technologies to address the multiple problems facing the remote communities of Alaska and provide an extreme environment testbed for future space applications. These technologies have never been assembled for this purpose. They offer an integrated approach to solving pressing problems in remote communities.

The space exploration initiative: A challenge to advanced life support technologies: Keynote presentation

President Bush has enunciated an unparalleled, open-ended commitment to human exploration of space called the Space Exploration Initiative (SEI). At the heart of the SEI is permanent human presence beyond Earth orbit, which implies a new emphasis on life science research and life support system technology. Proposed bioregenerative systems for planetary surface bases will require carefully designed waste processing elements whose development will lead to streamlined and efficient systems for applications on Earth.

The Space Exploration Initiative: a challenge to advanced life support technologies: keynote presentation.

President Bush has enunciated an unparalleled, open-ended commitment to human exploration of space called the Space Exploration Initiative (SEI). At the heart of the SEI is permanent human presence beyond Earth orbit, which implies a new emphasis on life science research and life support system technology. Proposed bioregenerative systems for planetary surface bases will require carefully designed waste processing elements whose development will lead to streamlined and efficient and efficient systems for applications on Earth.