Gas Analysis Values Research Articles

Venous blood gas and lactate values in adult giraffe trained for voluntary jugular phlebotomy.

Blood gas analyses have previously been performed for giraffe under anesthesia and with physical restraint in a chute; however, reference values for giraffe that are trained to participate in venipuncture without chemical or physical restraint have not previously been described. Using a point-of-care blood gas and lactate analyzer and 20 giraffe trained for voluntary phlebotomy, values were determined for venous blood gasses and plasma lactate concentration. Ninety-five percent confidence in the mean values for venous pH (7.34-7.46), partial pressure of carbon dioxide (PCO2; 28.5-37.8 mmHg), partial pressure of oxygen (PO2; 56-102 mmHg), bicarbonate (HCO3 -; 18.9-21.0 mmol/L), base excess (BE; -6.0 to -3.6 mmol/L), total carbon dioxide (TCO2; 19.9-22.0 mmol/L), and lactate (0.32-0.56 mmol/L) were calculated. This is the first report on venous blood gas analysis values for giraffe without chemical or physical restraint. These data will provide a reference for clinical interpretation of venous blood gas and lactate values in giraffe and demonstrate some of the potential diagnostic benefits to training giraffe and other zoo species for voluntary medical procedures.

Is there any correlation between integrated pulmonary index and thoracic surgery patients’ follow-up data? a prospective, observational study

Purpose: In this study, we investigated the relationship between integrated pulmonary index and patients’ demographic data, surgical characteristics, postoperative complications, blood gas analysis, and hemodynamic values after thoracic surgery.
 Materials and Methods: A total of 97 patients scheduled for elective thoracic surgery were included in this study. After surgery, integrated pulmonary index monitoring was performed for all patients in the post-anesthetic care unit. Patients’ characteristics, postoperative hemodynamic values, arterial blood gas analysis, length of hospital stay, postoperative complications, duration of anesthesia, and duration of surgery were recorded. Their correlations with postoperative integrated pulmonary index scores at 30 minutes, 1 hour, and 2 hours were investigated. 
 Results: Patients’ demographic data and surgical characteristics did not affect integrated pulmonary index scores. No significant correlation was found between integrated pulmonary index scores and duration of anesthesia, duration of surgery, postoperative complications, or length of hospital stay. However, there was a correlation between postoperative hemodynamic values, arterial blood gas analysis and integrated pulmonary index score. 
 Conclusion: Integrated pulmonary index monitoring is a bedside and non-invasive method that displays multiple parameters on a single screen, corraletes with arterial blood gas analysis and hemodynamic values. Therefore, it may provide advantages in early follow-up of thoracic surgery patients. However, multicenter, randomized controlled studies with a larger number of patients are needed to investigate the efficacy of integrated pulmonary index in patients undergoing thoracic surgery.

Hematological, Biochemical and Blood Gas Findings in a Calf with Cerebral Theileriosis

This case report aims to present the clinical and laboratory findings of cerebral theileriosis in a 1-month-old female Holstein calf. In the clinical examination of the calf, blindness, ataxia, opistotonus, nystagmus and convulsions, anemia and petechial hemorrhage foci in the conjunctiva, upper palate, gingiva were observed, and asymmetrical enlargement of the left prescapular lymph node was detected. As a result of hematological examinations, it was determined that lymphocyte count, erythrocyte count, hemoglobin amount, mean erythrocyte diameter (MCV) and hematocrit values were lower than normal, but mean erythrocyte hemoglobin concentration (MCHC) and platelet values were lower than normal in the calf. higher than normal values. In terms of biochemical values, blood urea nitrogen (BUN), direct and indirect bilirubin, triglyceride and creatine kinase myocardial band (CK-MB) values were found to be higher than normal values. In blood gas analysis, blood pH and glucose values were lower than normal values, and lactate concentration was higher than reference values.The parameters in this case report are reported to be helpful in the differential diagnosis of similar cases that veterinarians in the field may encounter.

Latent class analysis of imaging and clinical respiratory parameters from patients with COVID-19-related ARDS identifies recruitment subphenotypes

BackgroundPatients with COVID-19-related acute respiratory distress syndrome (ARDS) require respiratory support with invasive mechanical ventilation and show varying responses to recruitment manoeuvres. In patients with ARDS not related to COVID-19, two pulmonary subphenotypes that differed in recruitability were identified using latent class analysis (LCA) of imaging and clinical respiratory parameters. We aimed to evaluate if similar subphenotypes are present in patients with COVID-19-related ARDS.MethodsThis is the retrospective analysis of mechanically ventilated patients with COVID-19-related ARDS who underwent CT scans at positive end-expiratory pressure of 10 cmH2O and after a recruitment manoeuvre at 20 cmH2O. LCA was applied to quantitative CT-derived parameters, clinical respiratory parameters, blood gas analysis and routine laboratory values before recruitment to identify subphenotypes.Results99 patients were included. Using 12 variables, a two-class LCA model was identified as best fitting. Subphenotype 2 (recruitable) was characterized by a lower PaO2/FiO2, lower normally aerated lung volume and lower compliance as opposed to a higher non-aerated lung mass and higher mechanical power when compared to subphenotype 1 (non-recruitable). Patients with subphenotype 2 had more decrease in non-aerated lung mass in response to a standardized recruitment manoeuvre (p = 0.024) and were mechanically ventilated longer until successful extubation (adjusted SHR 0.46, 95% CI 0.23–0.91, p = 0.026), while no difference in survival was found (p = 0.814).ConclusionsA recruitable and non-recruitable subphenotype were identified in patients with COVID-19-related ARDS. These findings are in line with previous studies in non-COVID-19-related ARDS and suggest that a combination of imaging and clinical respiratory parameters could facilitate the identification of recruitable lungs before the manoeuvre.

The Correlation of Cord Arterial Blood Gas Analysis Results and Apgar Scores in Term Infants Without Fetal Distress.

Objective:This study aimed to evaluate the necessity of cord arterial blood gas analysis in cases without fetal distress and normal Apgar score.Materials and Methods:The cord arterial blood gas analysis and the 1- and 5-minute Apgar scores data of 1438 cases were evaluated. Newborns with fetal distress, neonates requiring cardiopulmonary resuscitation in the delivery room, congenital anomalies, severe and moderate acidemia (pH ≤7.1 at cord arterial blood gas analysis), and pre- and post-term newborns are excluded. Following cord arterial blood gas analysis, threshold values were accepted as abnormal pH <7.2, base excess ≥ −6 mmol/L, lactate ≥ 5 mmol/L, bicarbonate < 18 mmol/L, and partial pressure of carbon dioxide ≥ 50 mmHg. We evaluated the correlation between cord arterial blood gas analysis and 1- and 5-minute Apgar scores.Results:There was a significant correlation between both 1- and 5-minute Apgar scores and cord arterial blood gas analysis values such as pH, lactate, and partial pressure of carbon dioxide (P < .001). In addition, a significant correlation was found between the 5-minute Apgar score of <7 and some cord arterial blood gas analysis abnormal threshold values (pH, bicarbonate, base excess) (P < .001). We found that some patients with mild acidemia had 1- and 5-minute Apgar scores of ≥7 in 1.9% and 2% of cases, respectively.Conclusion:The 5-minute Apgar score of 7 or higher may not be sufficient to verify the well-being of a newborn. Relying only on the Apgar scores may create the risk of missing some newborns with mild metabolic acidosis. The necessity of routine cord arterial blood gas analysis should be considered in prospective studies even if there are no signs of fetal distress and Apgar score ≥7.

Prognostication of haemato-biochemical, electrolyte and blood gas parameters in canine parvoviral enteritis

Canine parvovirus (CPV) infection remains as a major threat to canine practitioners as well as pet owners as it requires intensive care for at least seven days and is associated with a high rate of fatality. This study conducted on 40 dogs with diarrhoea revealed a prevalence of 35 per cent (14/40) for CPV infection in Thissur, Kerala. Aetiology was confirmed by polymerase chain reaction (PCR) targeting the VP2 gene of CPV to get amplicon of approximately 583 bp length. Alterations in various blood parameters like blood gases, electrolytes, metabolites, haematological parameters and serum biochemical parameters are analysed and accessed as prognostic markers. Notable variations could be detected in the levels of pCO2, pO2, pSO2, HCO3-, base deficit, per cent of granulocytes, total erythrocyte count (TEC), haemoglobin (Hb), volume of packed red cells (VPRC), total protein, albumin, blood urea nitrogen (BUN) and alkaline phosphate (ALP). Mortality was associated with major decrease in the levels of HCO3- and a greater base deficit as evidenced from the blood gas analysis values. No correlation could be obtained for hypokalaemia and elevated levels of lactate in relation with mortality.

Severe Oleander Poisoning Presenting with Hyperkalaemia and Unusual Electrocardiographic Changes.

BackgroundHyperkalaemia in oleander (Nerium oleander) poisoning has been associated with a poor prognosis. Different electrocardiographic (ECG) presentations are possible because of vagotonia and hyperkalaemia.Methods/ResultsWe report a series of three cases of oleander poisoning in which ECG showed unusual hyperkalaemia features, such as bradyarrhythmia, sinoatrial block, atrioventricular block and junctional rhythm.ConclusionsIf arterial blood gas analysis or laboratory values indicate hyperkalaemia in oleander poisoning, the hyperkalaemia should be treated immediately, even if the ECG does not show typical hyperkalaemia features.LEARNING POINTSHyperkalaemia in oleander poisoning is associated with a poor prognosis.Hyperkalaemia should be treated aggressively in oleander poisoning even if the ECG does not show typical features, as mimics other conditions on ECG.

Prognostic value of lactate to hematocrit ratio score in patients with severe thoracoabdominal trauma.

Significant portion of trauma-related deaths occur in the 1st h; therefore, rapid diagnosis and adequate resuscita-tion in trauma patients are essential preventing mortality. In this study, we aimed to evaluate the role of lactate-to-hematocrite ratio (LHR) score for predicting mortality in patients with severe thoracoabdominal trauma. In this retrospective, cross-sectional study, we evaluated patients who applied to the emergency room between January 1, 2016, and December 31, 2019, due to multiple trauma. We measured the blood gas analysis values and LHR score of patients with severe thoracoabdominal trauma included in the study and investigated the effectiveness of the LHR score in predicting mortality. 106 patients with severe thoracoabdominal trauma were included in the study. The 30-day mortality rate of the patients was 42.5% (n=45). Considering the 30-day mortality rates, the initial hematocrit, lactate, base deficit, and LHR score were statistically different between patients who died and survived. When the cutoff value for the LHR score was taken as 0.187 on the ROC curve to distinguish mortality, the sensitivity was found to be 77.8%, specificity to be 90.2%. LHR score is an effective parameter with high sensitivity and specificity in predicting mortality in patients with severe thoracoabdominal trauma.

Prone and Lateral Positioning in Spontaneously Breathing Patients With COVID-19 Pneumonia Undergoing Noninvasive Helmet CPAP Treatment

Prone and Lateral Positioning in Spontaneously Breathing Patients With COVID-19 Pneumonia Undergoing Noninvasive Helmet CPAP Treatment

Validity And Reliability Of A Portable Metabolic Analyzer For Assessing Oxygen Consumption And Ventilation

Metabolic analyzers are standard tools in research-based, exercise physiology laboratories in university settings. Portable, low-cost metabolic analyzers have the capacity to extend the value of metabolic gas analysis beyond the traditional laboratory setting. PURPOSE: This study’s purpose was to assess validity and reliability of a portable, low-cost metabolic analyzer (VPRO) for assessment of oxygen consumption (VO2) and minute ventilation (VE) during progressive cycling testing. METHODS: In Protocol 1, eight male participants (height: 171.9 ± 5.8 cm, weight: 79.6 ± 8.3 kg, age: 41.0 ± 12.3 years) with previous competitive cycling experience ranging from 2-40 years completed an hour-long stationary cycling protocol twice, progressing from 100-300 Watts every 10-12 minutes while wearing the VPRO and a criterion measure (PMED) for five minutes each, at each stage. In Protocol 2, 16 recreationally active male participants (height: 168.2 ± 8.4 cm, weight: 76.5 ± 13.3 kg, age: 23.0 ± 9.4 years) completed three incremental, maximal stationary cycling tests wearing one of three analyzers for each test (VPRO version 1.1.1, VPRO version 1.2.1, PMED). Mean absolute percent differences (MAPD) ≤10% were deemed acceptable validity/reliability. RESULTS: For Protocol 1 and convergent validity, the VPRO had mean absolute differences from the PMED of <0.3 L/min for absolute VO2 and <5 L/min for VE overall and at each exercise stage. MAPD for VO2 and VE were <9% overall and <12% at each exercise stage. Test-retest reliability of VO2 and VE of the VPRO (MAPD: 8.9-11.0%) was lower than the PMED (MAPD: 4.7-7.6%). For Protocol 2, validity was similar for both VPRO versions (MAPD ~12% overall) compared to the PMED for VO2 and VE. CONCLUSIONS: The VPRO had an acceptable validity and test-retest reliability for most variables and intensities tested and may be an appealing option for VO2 and VE analysis.

Changes in pH and electrolytes during therapeutic plasma exchange in patients with liver diseases and factors predictive of these changes.

Therapeutic plasma exchange (TPE) disturbs the pH and electrolyte status. This study aimed to analyze the changes in pH, ionized calcium (iCa), sodium (Na), potassium (K), and bicarbonate (HCO3 ) of patients undergoing TPE and factors affecting these changes. The study included patients (age > 16 years) undergoing TPE from July 2016 to August 2017. Data on patient demographics, TPE procedures, pre-, and immediate post-TPE blood gas analysis values and adverse events during TPE were collected. A statistical analysis of the data was done to determine changes in pH and electrolytes and the factors affecting them. The changes in iCa, Na, and K due to the procedure were found to be statistically significant (P < .001). The changes in systolic (P = .010) and diastolic (P = .001) blood pressure during the procedure were significant. The predictors for the change in iCa were pre-procedure iCa (P < .001), age of the patient (P < .001), and the pre-procedure pH (P = .002). Complications related to hypocalcemia occurred in 12% of the TPE procedures. Hypocalcemic manifestations did not show any significant association with pre-procedure iCa levels, change in iCa levels during the procedure and age or gender of the patient. TPE induces marked changes in electrolytes but these changes are transient and do not warrant any intervention. The correction of iCa levels pre-TPE and continuous infusion of calcium during the procedure helps prevent marked fluctuations in iCa levels. This does not eliminate risks of hypocalcemia. Vigilance and preparedness to deal with complications related to hypocalcemia is the best strategy.

Effectiveness of home-based preoperative pulmonary rehabilitation in COPD patients undergoing lung cancer resection.

To investigate the effectiveness of a home-based preoperative rehabilitation program for improving preoperative lung function and surgical outcome of patients with chronic obstructive pulmonary disease (COPD) undergoing lobectomy for cancer. This was a prospective, observational, single-center study including 59 patients with mild COPD who underwent lobectomy for lung cancer. All patients attended a home-based preoperative rehabilitation program including a minimum of 3 sessions each week for 4 weeks. Each session included aerobic and anaerobic exercises. Participants recorded the frequency and the duration of exercise performed in a diary. The primary end point was to evaluate changes in lung function including predicted postoperative (PPO) forced expiratory volume in 1 second (FEV1), 6-minute walking distance test (6MWD), PPO diffusing capacity for carbon monoxide (DLCO) %, and blood gas analysis values before and after the rehabilitation program. Postoperative pulmonary complications were recorded and multivariable analysis was used to identify independent prognostic factors (secondary end point). All patients completed the 4-week rehabilitation program. Thirteen of 59 (22%) patients (Group A) performed <3 sessions per week (mean sessions per week: 2.3±1.3); 46 of 59 (78%) patients (Group B) performed ⩾3 sessions per week (mean sessions per week: 3.5±1.6). The comparison of PPO FEV1% and 6MWD before and after rehabilitation showed a significant improvement only in Group B. No significant changes in PPO DLCO% or in blood gas analysis values were seen. Nine patients presented postoperative pulmonary complications, including atelectasis (n = 6), pneumonia (n = 1), respiratory failure (n = 1), and pulmonary embolism (n = 1). Group A presented higher number of postoperative pulmonary complications than Group B (6 vs 3; p = 0.0005). Multivariate analysis showed that the number of weekly rehabilitation sessions was the only independent predictive factor (p = 0.001). Our simple and low-cost rehabilitation program could improve preoperative clinical function in patients with mild to moderate COPD undergoing lobectomy and reduce postoperative pulmonary complications. All patients should be motivated to complete at least 3 rehabilitation sessions per week in order to obtain significant clinical benefits. Our preliminary results should be confirmed by larger prospective studies.

Reduction in respiratory exacerbation rate in patients with severe bilateral cerebral palsy following daily PEP-mask therapy: a retrospective study.

Respiratory complications caused by the inability to protect the upper airways and ineffective cough represent a major cause of morbidity and mortality in patients with cerebral palsy (CP). Even though the application of positive end-expiratory pressure (PEP) through a face mask has gained large popularity as a technique to prevent bronchial mucous encumbrance, its long-term effects on clinical course and respiratory function in individuals with CP have not been investigated. The aim of this study is to investigate whether regular application of PEP through a face mask can improve clinical status and respiratory function in patients with severe CP. Observational, retrospective cohort study. The outpatient rehabilitation unit of the IRCCS E. Medea Rehabilitation Hospital in Conegliano, Italy. CP outpatients admitted to the unit between January 1st, 2006 and December 31st, 2018. All the medical records of the enrolled patients were collected and reviewed. All patients underwent multidisciplinary respiratory evaluation at T0 (immediately before the beginning of PEP-use) and T1 (12 months after). The evaluation assessed respiratory infections history (number of exacerbations per year), blood gas analysis, measurement of airway resistance through the interrupter technique. Twenty-one patients affected with CP (mean age 9.19±5.56 years, range 3-23 years, 8 females) were included. All patients had more than 3 infections per year (mean 4.81±1.17) in the year prior to treatment (T0). At T1 mean number of infections was 1.57±0.81); 17 patients (80%) reported less than three infections; two patients (10%) reported zero infections, two patients (10%) reported three infections. Blood gas analysis and airway resistance values did not show a significant difference at T0 and T1. Daily PEP-mask therapy reduces frequency of respiratory exacerbations in patients with severe bilateral CP. PEP-mask is a valuable rehabilitative tool in severe CP patients with frequent respiratory exacerbations.

An Algorithmic Approach for and Special Characteristics of Veno-Venous Extracorporeal Life Support in Patients With Severe Asthma Attack: A Case Report and Review of the Literature

Little is known about the indicators and special characteristics of veno-venous extracorporeal life support (VV-ECLS) in patients with a severe asthma attack. We included a new case with near-fatal asthma (NFA) in a medical intensive care unit (MICU). Cases with severe asthma attack requiring VV-ECLS from 1980 to 2018 from the literature were added. The general information, laboratory examinations, treatments and outcomes were summarized. There were seventeen cases with severe asthma attack supported with VV-ELCS from the literature, including our case; six of them received extracorporeal CO2 removal (ECCO2R). The average age of the patients was 37 (±18) years, and only three had an underlying disease. Among the seventeen patients, most had a history of prior exacerbations and improper therapies before the current exacerbation, for which there were eleven (64.7%) and nine (52.9%) patients, respectively. As high as fourteen patients (82.4%) had a combination of complications related to asthma pre-ECLS. The most common complication was severe and refractory acidosis. Arterial blood gas analysis values and respiratory mechanics improved significantly post-ECLS. The average blood flow and gas flow of the patients receiving VV-ECLS were 2.3 (±1.2) L/min and 4.0 (±2.6) L/min, respectively. The mean duration of ECLS was 48 (35-96) hours. Complications related to ECLS occurred in 35.3% of the patients, among which hemorrhage was the high prevalence (23.5%). An algorithmic approach to VV-ECLS was described for a patient with a history of prior exacerbations and improper therapies that should be actively supported by ECLS once he becomes unresponsive to maximal therapies or presents with a combination of severe complications. Considering the short duration and the high risk of haemorrhage, anticoagulation without heparin might be a choice.

Comparison of ventilation parameters and blood gas analysis in mechanically-ventilated children who received chest physiotherapy and suctioning vs. suctioning alone

Background Chest physiotherapy and suctioning are routine methods for airway clearance in mechanically-ventilated children. However, chest physiotherapy has not been confirmed to affect ventilation parameters, such as tidal volume (TV), peak inflation pressure (PIP), peak inspiratory flow (PIF), and peak expiratory flow (PEF), as well as blood gas analysis (BGA) values in pediatric intensive care unit (PICU) patients.Objective To determine the efficacy of chest physiotherapy and suctioning vs. suctioning alone for improving the mechanical ventilation parameters and BGA.Methods This randomized, single-blind, clinical trial was conducted from November 2012 to June 2013 in the PICU at Haji Adam Malik Hospital, Medan. A total of 40 mechanically-ventilated pediatric patients were enrolled and divided into either the chest physiotherapy and suctioning group (24 subjects) or the suctioning alone group (16 subjects). Subjects underwent treatment, followed by monitoring of their ventilation parameters and blood gas analyses. Data were analyzed by independent t-test and Mann-Whitney test.Results Subjects comprised of 23 boys and 17 girls, with an age range of 1–204 months. After the respective treatments (chest physiotherapy and suctioning vs. suctioning alone), the ventilation parameters were as follows: median TV (60.0 vs. 56.5 mL, respectively; P=0.838), median PEF (10.4 vs. 10.8 I/s, respectively; P=0.838), median PIF (7.4 vs. 8.2 I/s, respectively; P=0.469), and mean PIP (17.3 vs. 15.6 cmH2O, respectively; P=0.23). The BGA values were: median pH (7.4 vs. 7.3, respectively; P=0.838), median pCO2 (38.4 vs. 36.2 mmHg, respectively; P=1.000), mean pO2 (136.6 vs. 139.2 mmHg, respectively; P=0.834), median HCO3 (20.4 vs. 22.7 mmol/L, respectively; P=0.594), median TCO2 (22.0 vs. 23.7 mmol/L, respectively; P=0.672), mean BE (-4.3 vs. -3.1 mmol/L, respectively; P=0.629), and median O2 saturation (98.5 vs. 98.3 %, respectively; P=0.967).Conclusion In mechanically-ventilated children in the PICU, ventilation parameters and BGA values are not significantly different between subjects who received both chest physiotherapy and suctioning and those who received suctioning alone.

Treatment of neonates with respiratory distress syndrome by proportional assist ventilation plus synchronized intermittent mandatory ventilation: a comparison study.

The proportion assisted ventilation (PAV) can improve patient-ventilator interaction, reducing the incidence of end-expiratory asynchrony and increasing the time of synchrony. PAV could compensate for the leaks by elastic and resistive unloading and thus is ideal for neonates with uncuffed airways. The aim of this study was to compare the relevant clinical parameters of neonates with respiratory distress syndrome (RDS) who are supported by PAV plus synchronized intermittent mandatory ventilation (SIMV) and SIMV. Forty-six neonates diagnosed as RDS who required mechanical ventilation were randomly divided into observer group (support by PAV+SIMV mode, N.=23) and control group (support by SIMV mode, N.=23). The X-ray grading situation, the number of asynchrony-delayed trigger, mean arterial blood pressure (MABP), spontaneous respiratory rate (RR), heart rate (HR), blood gas analysis values and circulation and respiratory parameters at each timepoint after 30 minutes, 12, 24, 48 and 72 hours of mechanical ventilation were observed. The forty-four neonates in two groups have been cured, the other 2 neonates (one in each group) gave up treatment and automatically discharged. There were no statistically significant differences in male, gestational age, body weight, duration of mechanical ventilation, oxygen dependence and hospital stay between the two groups (all P>0.05). There were no statistically significant differences in MABP, HR and ratio of arterial-to-alveolar partial pressure of oxygen (a/APO<inf>2</inf>) at each time point after mechanical ventilation between the two groups(all P>0.05). The number of asynchrony-delayed trigger in observer group was lower than that in control group, the difference was statistically significant (P<0.05). The number of spontaneous RR in observer group was higher than that in control group. The difference was statistically significant (P<0.05). The PAV plus SIMV shows a good clinical effect in treatment of neonates with RDS. It could be better to use neonatal spontaneous breathing and might cause less damage to the lung than SIMV mode.

Efficacy and safety of a novel ultrafiltration device for treating patients with refractory heart failure

To evaluate the efficacy and safety of a new ultrafiltration device for treating refractory heart failure patients. A total of 52 patients (37 male, age 29-85(33±44)years) with refractory heart failure were treated using a new ultrafiltration device (FQ-16). Body weight, dyspnea score, oxygen saturation (SatO2), left ventricular ejection fraction(LVEF), BUN, creatinine, electrolytes and blood gas analysis were assessed before and after the treatment. Hypotension event and other main adverse events were recorded. Ultrafiltration duration ranged between 8-22 hours. Total ultrafiltration volume was (4 489±1 548) ml. Compared with baseline, patients' body weight decreased from (75.3±8.74) kg to (69.8±8.39) kg (P<0.01), dyspnea score improved from 2.47±1.55 to 12.87±3.61 (P<0.01) and SatO2 increased from 91.0±6.01 to 96.4±2.52 (P<0.01) and LVEF increased from (30.0±4.1)% to (36.0±4.3)% (P<0.01) after ultrafiltration. Blood creatinine, BUN, electrolytes and blood gas analysis values were similar at baseline and post ultrafiltration. No hypotension event and other main adverse events occurred during the ultrafiltration treatment. The novel ultrafiltration device adequately relieved hypervolemia and dyspnea in patients with refractory heart failure and the treatment process is safe in this patient cohort.

The First 10 Years of Aerobic Exercise Responses to Long-Duration ISS Flights.

Aerobic deconditioning may occur during International Space Station (ISS) flights. This paper documents findings from exercise testing conducted before, during, and after ISS expeditions. There were 30 male and 7 female astronauts on ISS missions (48 to 219 d, mean 163 d) who performed cycle exercise protocols consisting of 5-min stages eliciting 25%, 50%, and 75% peak oxygen uptake (Vo(2peak)). Tests were conducted 30 to 90 d before missions, on flight day 15 and every 30 flight days thereafter, and on recovery (R) days +5 and +30. During pre- and postflight tests, heart rate (HR) and metabolic gas exchange were measured. During flight, extrapolation of the HR and Vo2 relationship to preflight-measured peak HR provided an estimate of Vo(2peak), referred to as the aerobic capacity index (ACI). HR during each exercise stage was elevated (P < 0.05) and oxygen pulse was reduced (P < 0.05) on R+5 compared to preflight; however, no other metabolic gas analysis values significantly changed. Compared to preflight, the ACI declined (P < 0.001) on R+5, but recovered to levels greater than preflight by R+30 (P = 0.008). During flight, ACI decreased below preflight values, but increased with mission duration (P < 0.001). Aerobic deconditioning likely occurs initially during flight, but ACI recovers toward preflight levels as flight duration increases, presumably due to performance of exercise countermeasures. Elevated HR and lowered oxygen pulse on R+5 likely results from some combination of relative hypovolemia, lowered cardiac stroke volume, reduced cardiac distensibility, and anemia, but recovery occurs by R+30.

Influence of moisture content on the formaldehyde release of particle- and fibreboards bonded with tannin–formaldehyde resins

The main objective of this study was to evaluate the influence of moisture content on the formaldehyde release of particleboards and medium density fibreboards (MDF) bonded with tannin–formaldehyde (TF-) resins. The results revealed that increasing the moisture content in the TF-bonded boards elicited a decline in the content of extractable formaldehyde (perforator values according to EN 120). This is an opposing behaviour to the general state of knowledge related to the influence of moisture content on the formaldehyde content (EN 120) of particleboards and MDF bonded with urea–formaldehyde based resins. Moreover, the TF-bonded panels showed a decrease in the gas analysis values (EN 717-2), flask values (EN 717-3) as well as formaldehyde emission measured in the 1 m3-chamber (EN 717-1). EN 120 (now also pr EN ISO 12460–5, 2013) does not take into consideration that boards bonded with other binders rather than aminoplastic resins may behave differently at different moisture contents. Insofar, it leaves no leeway to consider different binders systems.

Effects of sevoflurane anesthesia on righting reflex and hemolymph gas analysis variables for Chilean rose tarantulas (Grammostola rosea).

To determine the safety, efficacy, and effects on hemolymph gas analysis variables of sevoflurane anesthesia in Chilean rose tarantulas (Grammostola rosea). 12 subadult Chilean rose tarantulas of unknown sex. Spiders were anesthetized in a custom chamber with sevoflurane (5% in oxygen [1.0 L/min]), then allowed to recover in 100% oxygen. Righting reflex was evaluated every 3 minutes during anesthesia to determine time to anesthetic induction and recovery. Hemolymph samples were collected from an intracardiac location prior to and after induction of anesthesia and evaluated to determine various gas analysis variables. Mean ± SD induction and recovery times were 16 ± 5.91 minutes and 29 ± 21.34 minutes, respectively. Significant differences were detected for Po2, base excess, and glucose and ionized magnesium concentrations between hemolymph samples obtained before anesthesia and those obtained after induction of anesthesia. CONCLUSIONS AND CLINICAL RELEVANCE-Results of this study suggested that the use of sevoflurane as an anesthetic agent for Chilean rose tarantulas was safe and effective. Various hemolymph sample gas analysis values changed during anesthesia.