Oxygen Tension Research Articles

Empiric gram-negative antibiotics usage among critically ill patients across 13 ICUs of Nepal: A retrospective cohort study

Background This study aims to investigate the associations between patient characteristics and the receipt of empiric broad-spectrum gram-negative antimicrobials among adult patients admitted to ICUs in Nepal. Methods A retrospective cohort study was conducted in 13 ICUs in Nepal between January 1st, 2020, and December 31st, 2022. Empiric antibiotic use was defined as receiving gram-negative antibiotics within the first two days of ICU admission without evidence of infection from culture. Patient characteristics between patients receiving narrow-spectrum antibiotics and broad-spectrum gram-negative antibiotics were compared. Continuous variables were compared using mean and standard deviation, with mean differences and 95% confidence intervals calculated. Categorical variables were compared using the chi-square test. A multi-level multivariable regression model assessed the relationship between selected variables and broad-spectrum antibiotic usage, treating admitting ICU as a random factor. Results Among 12,349 eligible patients, 8720 (70.6%) received Empiric gram-negative antibiotics. Of those, 3240 (37.15%) received empiric narrow-spectrum gram-negative antibiotics, and 5480 (62.8%) received Empiric broad-spectrum gram-negative antibiotics. Patients receiving broad-spectrum gram-negative antibiotics were older (57.4 vs 53.8 yrs); had higher mean heart rates (97.3 vs 89.5 bpm), respiratory rates (24 vs 21.9), a fraction of inspired oxygen ( 50% vs 40%), blood sugar levels (163.4 vs 153.9 mg/dl), total leucocyte counts (12,685 vs 10,647 cells/cu mm) and serum creatinine (2.06 vs 1.03 umol/l) compared to narrow spectrum antibiotics. Similarly, patients receiving broad-spectrum gram-negative antibiotics had lower systolic blood pressure (122.6 vs 126.5 mm Hg), partial pressure of oxygen (96.7 vs 105.3), and pH ( 7.33 vs 7.36) compared to narrow-spectrum antibiotics. On multivariable regression; patients with readmission, cardiac support, and mechanical ventilation were more likely to receive broad-spectrum antibiotics. Conclusion The rate of empiric broad-spectrum gram-negative antibiotics usage in intensive care units is significantly high and associated with features of increased severity of illness.

Colorimetric Oxygen Sensing by Analyzing Chromaticity Points for Polymer Cobalt Schiff Base in CIELAB

AbstractPolymer membranes of a copolymer ligand (L) coordinated to tetra‐coordinated N,N'‐ethylene bis(salicylideneiminato) cobalt(II) at the fifth coordinating site of the center cobalt(II), Co(II)S‐L, are prepared to measure colorimetrically the color changes in response to rapid reversible oxygen binding simultaneously with slow oxidation under moist conditions to yield Co(III)S‐L. The chromaticity point observed in CIELAB is the endpoint of the vector sum of the unit vectors for Co(II)S‐L, O2‐Co(II)S‐L, and Co(III)S‐L, scaled by their respective abundance ratios: (1 − m)(1 − n), m(1 − n), and n, where m is the ratio of O2‐Co(II)S‐L to the sum of Co(II)S‐L and O2‐Co(II)S‐L and n is the ratio of Co(III)S‐L to the total of the three cobalt complexes. The observed limited area in CIELAB as a stoichiometric Euclidean space is supported by the following two different reaction processes of the polymer membranes: an oxygen‐binding reaction under several different partial pressures of oxygen supplied to the membranes in a short period, during which oxidation of the cobalt(II) complexes is negligible, and an oxidation reaction over a long period at a constant partial pressure of oxygen. The chromaticity points in both processes progress linearly in three different two‐dimensional coordinates: a*b*, a*L*, and b*L*.

Effect of Temperature and Oxygen Concentration on Corrosion of J55 Steel in an O2/CO2 Environment

ABSTRACTThe corrosion product competition and transformation process of J55 under an O2/CO2 environment in the temperature range of 50–350°C and 0–1 MPa oxygen partial pressure range, respectively, were studied using electrochemical and surface analysis techniques as well as thermodynamic calculations to determine its corrosion rate change law and pitting corrosion phenomenon. This study demonstrates that the uniform corrosion rate of J55 with increasing temperature shows a trend of first increasing, then decreasing, and finally increasing. The transformation of its corrosion products, from FeCO3 into Fe3O4, is consistent with the altering corrosion rate law with increasing temperatures. J55 corrodes faster at 350°C as the O2 partial pressure increases. When the O2 partial pressure is low, the predominant kind of corrosion product that is obtained is FeCO3; when the O2 partial pressure exceeds 0.2 MPa, all corrosion products are transformed into iron oxides. As the oxygen partial pressure increases, J55's corrosion product film becomes increasingly less protective of the substrate, making the substance more vulnerable to corrosion reactions.

Local structure maturation in high entropy oxide (Mg,Co,Ni,Cu,Zn)1‐x(Cr,Mn)xO thin films

AbstractHigh entropy oxides (HEOs) have garnered much interest due to their available high degree of tunability. Here, we study the local structure of (MgNiCuCoZn)0.167(MnCr)0.083O, a composition based on the parent HEO (MgNiCuCoZn)0.2O. We synthesized a series of thin films via pulsed laser deposition at incremental oxygen partial pressures. X‐ray diffraction shows lattice parameters to decrease with increased pO2 pressures until the onset of phase separation. X‐ray absorption fine structure shows that specific atomic species in the composition dictate the global structure of the material as Cr, Co, and Mn shift to energetically favorable coordination with increasing pressure. Transmission electron microscopy analysis on a lower‐pressure sample exhibits a rock salt structure, but the higher‐pressure sample reveals reflections reminiscent of the spinel structure. In all, these findings give a more complete picture of how (MgNiCuCoZn)0.167(MnCr)0.083O forms with varying initial conditions and advances fundamental knowledge of cation behavior in high entropy oxides.

Element behavior during autoclave oxidation of polymetallic sulfide flotation concentrate containing tungsten and molybdenum

In this paper, we investigate the behavior of associated elements (tungsten, molybdenum, and bismuth) contained in a sulfide gold-bearing concentrate during its autoclave oxidation. The process is studied using a sulfide flotation concentrate, crushed to a particle sieve mesh size of minus 0.045 mm and containing 22.1 g/t of gold, 133.2 g/t of silver, 2.7% of tungsten, 13% of molybdenum, and 0.7% of bismuth. The process was carried out in a 2 dm3 autoclave at a temperature of 220ºC and an oxygen partial pressure of 0.7 MPa. The concentrations of sulfuric acid and iron ions in the solution were determined by titrimetric analysis. Inductively coupled plasma atomic emission spectroscopy was used to determine the concentrations of bismuth, tungsten, molybdenum, copper, silver, and arsenic in the solution, as well as the content of bismuth, tungsten, molybdenum, copper, arsenic, lead, and iron and sulfur forms in the cake. The cake was also examined using diffraction analysis. Experiments on cyanidation of oxidized cake were carried out in the pH range of 10.0–10.5 and a NaCN concentration of 1 g/dm3 with a PuroliteS992 ion exchange resin for 24 h. Autoclave oxidation experiments showed the sulfide oxidation degree to be higher than 99%. Extraction of molybdenum into solution in the form of [MoO2(SO4)n]-(2n-2) and MoO 2+ amounted to 95%. The decrease in the solid mass led to an increase in the concentration of bismuth and tungsten in the cake, with their contents reaching 1.66% and 12.7%, respectively. The main phases in the cake were established to be scheelite, anhydrite, plumboyarosite, and bedantite. The extraction of precious metals at the subsequent cyanidation stage amounted to 97.5% of gold and 91.6% of silver. Therefore, autoclave cyanide processing of sulfide gold-containing concentrates leads to a molybdenum extraction in the autoclave oxidation solution at the level of 95%. During cyanidation, more than 90% of gold and silver are extracted. Due to the significant amount of tungsten (17%), bismuth (0.9%), lead (5.3%), and molybdenum (3.3%), the obtained cake cannot be considered a waste product.

Combined optical measurement of dissolved oxygen tension (DOT), pH value, biomass and viscosity in shake flasks

Shake flasks are widely spread in microbial process development. Characterization of the processes by manual offline sampling is time-consuming, highly laborious and a contamination risk. Online monitoring of key parameters would provide deeper insights, while saving time and effort. In this study, a device for optical online monitoring of dissolved oxygen tension (DOT), biomass, pH value and viscosity in shake flasks is presented. DOT measurement relies on fluorescent oxygen sensitive nanoparticles. The fluorescence intensity signal of the nanoparticles is used to trigger the DOT and scattered light measurements inside the rotating bulk liquid. The scattered light signal (610 – 630 nm) can be correlated to offline measured optical density OD600, even at elevated viscosity. The pH value is monitored online by using pH sensor spots, fixed inside the shake flasks. The shift of the angle of the bulk liquid Θ-Θ0 is correlated to the offline measured viscosity. Detection of the leading edge of the bulk liquid, necessary for viscosity measurement, can be performed either using the fluorescence intensity signal of the oxygen nanoparticles or the scattered light signal.

Associations of arterial oxygen partial pressure with all‑cause mortality in critically ill ischemic stroke patients: a retrospective cohort study from MIMIC IV 2.2

BackgroundAs a supportive treatment, the effectiveness of oxygen therapy in ischemic stroke (IS) patients remains unclear. This study aimed to evaluate the relationships between arterial partial pressure of oxygen (PaO2) and both consciousness at discharge and all-cause mortality risk in ICU IS patients.MethodsBlood gas measurements for all patients diagnosed with IS were extracted from the MIMIC-IV database. Patients were classified into four groups based on their average PaO2 during the first ICU day: hypoxemia (PaO2 < 80 mmHg), normoxemia (PaO2 80–120 mmHg), mild hyperoxemia (PaO2 121–199 mmHg), and moderate/severe hyperoxemia (PaO2 ≥ 200 mmHg). The primary endpoint was 90-day all-cause mortality. Secondary outcomes included the level of consciousness at discharge, assessed by the Glasgow Coma Scale (GCS), and 30-day all-cause mortality. Multivariate Cox regression and Restricted cubic spline (RCS) analysis were used to investigate the relationship between mean PaO2 and mortality, and to assess the nonlinear association between exposure and outcomes.ResultsThis study included a total of 946 IS patients. The cumulative incidence of 30-day and 90-day all-cause mortality increased with decreasing PaO2 levels. RCS analysis revealed a nonlinear relationship between PaO2 and the risk of 30-day all-cause mortality (nonlinear P < 0.0001, overall P < 0.0001), as well as a nonlinear association between PaO2 and 90-day all-cause mortality (nonlinear P < 0.0001, overall P < 0.0001). The results remained consistent after excluding the small subset of patients who received reperfusion therapy. Sensitivity analysis indicated that the favorable impact on survival tends to increase with the extended duration of elevated PaO2.ConclusionsFor IS patients who do not receive reperfusion therapy or whose recanalization status is unknown, a lower PaO2 early during ICU admission is considered an independent risk factor for short-term and recent mortality. Adjusting respiratory parameters to maintain supraphysiological levels of PaO2 appears to be beneficial for survival, although this finding requires further validation through additional studies.Trial registrationNot applicable.

A compact machine perfusion device for whole blood perfusion in isolated rat liver.

We established a compact machine perfusion system for whole blood perfusion of rat liver by making use of oxygenation filters as an artificial lung. Livers removed from rats were divided into Krebs-Henseleit (control), 50% blood (hemoglobin: 7g/dL), and whole blood (hemoglobin: 14g/dL) groups, then perfused (total perfusate volume: 25ml) with a small oxygenation filter at 37°C for 120min. Blood or perfusate was collected over time, and blood gas and blood cell were measured. In addition, bile volume and portal venous pressure measurements were taken. In all groups, the partial pressure of oxygen was controlled to approximately 400mmHg. Flow rates were maintained at approximately about 20-30ml/min according to liver size. Portal venous pressure was normal in the 50% blood and whole blood groups, while lower than the reference value in the Krebs-Henseleit group. Twice as much bile was produced in the 50% blood and whole blood groups relative with the Krebs-Henseleit group. We observed no differences in hemoglobin and red blood cell levels. Lactate levels were normal in the 50% blood and whole blood groups, but were elevated in the Krebs-Henseleit group. Our compact perfusion system using oxygenation filters was able to maintain rat liver function by perfusing a small amount of extracorporeal blood. This system is simple and stable, and may contribute to the future development of machine perfusion systems.

Hemodynamic Disorders in Alcohol Withdrawal Syndrome

INTRODUCTION: The introduction of the study is determined by a high prevalence of alcoholism and a high incidence of complications from the cardiovascular system. AIM: To study the features of hemodynamics in patients with uncomplicated alcohol withdrawal syndrome (AWS) and in those with alcohol withdrawal delirium (delirium tremens). MATERIALS AND METHODS: The study enrolled 116 men, 58 of them with uncomplicated AWS, 78 with AWS and delirium. Basic hemodynamic parameters were studied: heart rate (HR), blood pressure (BP), and integral parameters — cardiac index (CI), total peripheral resistance (TPR), shock index (SI). Comparisons between the groups and correlation analysis were conducted to find relationships between hemodynamic parameters and clinical data. RESULTS: In patients with alcoholic delirium, hemodynamic parameters were statistically significantly higher than in patients with uncomplicated AWS: HR (р = 0.003), systolic BP (р = 0.02) and diastolic BP (р = 0.04), while no statistically significant differences in the integral parameters (CI, TPR, SI) were found between the groups. In patients of both groups, CI linearly decreased with age (p 0.0001). The same linearly CI decreased with increase in the duration of alcoholism (p = 0.02). With an increase in the amount of consumed alcohol during the binge period, a linear growth of CI was observed in withdrawal state (p = 0.001). The value of TPR increased with age (p = 0.005). Only in patients with delirium tremens, there was an inverse relationship between SI and partial tension of carbon dioxide in venous blood (r = -0.4; p = 0.014). Besides, only in patients with delirium tremens, by the 7th day of withdrawal, a direct relationship was established between the cardiac index and blood potassium level (r = 0.36; p = 0.03). CONCLUSIONS: There was no significant difference between hemodynamic parameters in uncomplicated AWS and in delirium tremens. CI in patients with uncomplicated AWS and in those with DT decreased with age and with increase in the alcohol load. The vessel tone was inversely proportional to CI throughout the entire period of observation. With the development of delirium, a correlation was noted between a decrease in the level of energy metabolism and the probability for decompensation of systemic circulation. At the stage of reduction of delirium tremens, a correlation was noted between CI and the blood potassium level that reflected the exhaustion of the cardiovascular system and reduction of its compensatory capacities.

NUPR1 modulates pulmonary embolism progression via smooth muscle cells phenotypic transformation

ObjectiveThis study aimed to investigate the role of Nuclear Protein 1 (NUPR1) in pulmonary embolism (PE) and its impact on the phenotypic transformation of pulmonary artery smooth muscle cells (PASMCs). MethodsA PE model was established via autologous pulmonary emboli infusion into the jugular vein. Partial Pressure of Oxygen (PaO2), Oxygenation Index (OI), Brain Natriuretic Peptide (BNP), and Troponin I (TnI) were measured, and lung tissue was subjected to hematoxylin-eosin (HE) staining. NUPR1 expression was assessed through Immunofluorescence and Western blot analyses. To investigate role of NUPR1, PE rats were treated with lentiviral vectors for NUPR1 knockdown (si-NUPR1) or overexpression (ov-NUPR1), and the effects on lung pathology were examined. NUPR1 expression was evaluated in human PASMCs. Additionally, PASMCs from SD rats were cultured under normoxic and hypoxic conditions to evaluate NUPR1 expression. Transfection of NUPR1 expression vectors into PASMCs allowed monitoring of phenotypic transformation-associated protein changes and PASMCs activity. ResultsIncreased NURP1 was observed in human-derived PASMCs. In PE rats, histological examination revealed ruptured pulmonary alveoli, exudate accumulation, interstitial edema, and infiltration of inflammatory cells, concomitant with elevated NUPR1 expression levels. Knockdown of NUPR1 in PE rats significantly improved lung tissue structure, reducing alveolar rupture and interstitial edema. Conversely, NUPR1 overexpression exacerbated lung damage, leading to increased inflammatory infiltration. NUPR1 expression in rat PASMCs remained stable under normoxic conditions; however, under hypoxic conditions, NUPR1 protein expression increased progressively over time. Subsequent upregulation of NUPR1 expression led to a decrease in the levels of contractile phenotype markers α-SMA and SM22α in PASMCs, accompanied by increased expression of synthetic phenotype markers Vimentin and OPN. This phenotypic shift was associated with enhanced cellular proliferation, invasion, and migration. ConclusionsElevated NUPR1 expression in PE exacerbates abnormal PASMCs proliferation by promoting their phenotypic transformation, thereby fostering the pathological progression of PE.

The atomic-level structure and stability of interfaces of Pt nanoparticles in alumina: An experimental and computational evaluation

The atomic-level structure of interfaces between Pt and a transition form of Al2O3 were studied using a combination of electron microscopy and first principles calculations. A model system of Pt nanoprecipitates in Al2O3 were formed in sapphire wafers via high-energy ion implantation of Pt followed by thermal annealing at 1000 °C in air. The Pt nanoparticles took the form of tetrahedra and truncated tetrahedra primarily bound by {111}Pt facets. The high prevalence of these facets motivated the development of density functional theory (DFT) based models of (111)Pt interfaces with six different chemical terminations of (2¯01) θ-alumina. The atomic-level structure of the Pt/Al2O3 interfaces was characterized with aberration-corrected scanning transmission electron microscopy (STEM) and the experimental images were compared to STEM image simulations of the DFT models. The model interface with Pt bonded to oxygen-terminated θ-Al2O3, with the Pt located on top of the O and with an underlying layer of octahedral Al, provided the best match to the experimental images. This interfacial termination is also the most stable for the thermal annealing conditions used based on thermodynamic calculations of the interfacial energy as a function of temperature and oxygen partial pressure. This experimentally verified model provides a basis for improving models of Pt/γ-alumina interfaces.

Advanced maternal age affects their frozen-thawed embryo susceptibility to high oxygen environment

Preimplantation embryos can experience stress from laboratory interventions and a sub-optimal culture environment. Though research has demonstrated advanced maternal age impairs oocyte quality, the response of embryos derived from such oocytes to vitrification-thawing and culture in a high oxygen (O2) environment in the assisted reproductive technology laboratory is unknown. Therefore, in this study, embryos produced by in vitro fertilization (IVF) using oocytes from two- and eight-month-old Swiss albino mice were vitrified and thawed during their 6–8 cell stage. and cultured at low oxygen (5%) tension (LOT) and high oxygen (20%) tension (HOT). Embryo development, apoptosis, inner cell mass (ICM) outgrowth proliferation ability in vitro and pluripotency were assessed. Embryos from advanced maternal age cultured at HOT showed reduced fertilizing ability (p < 0.05), poor survival post-thawing (p < 0.05), and increased apoptosis (p < 0.01) in comparison to sibling embryos cultured at LOT. Importantly, the extended culture of vitrified-thawed embryos from advanced maternal age led to a significant (p < 0.001) reduction in complete ICM outgrowth formation at HOT in comparison to the LOT environment. The findings of this study suggest that HOT is detrimental to embryos from advanced maternal age, and importantly, vitrified-thawed embryos are more susceptible to stress, which could have negative implications, especially during the peri-implantation developmental period.

A-342 Precision Evaluation of the pH, PO2 and PCO2 tests in the i-STAT® G3+ Cartridge using the i-STAT 1 System for Venous, Arterial and Capillary Whole Blood Specimens in Clinical Settings

Abstract Background Precise and accurate measurements of blood gases are important for the diagnosis, monitoring and treatment of respiratory, metabolic, and acid-base disturbances. This study demonstrates the precision of the pH, partial pressure of oxygen (PO2), and partial pressure of carbon dioxide (PCO2) tests in the i-STAT G3+ cartridge with the i-STAT 1 System in arterial, venous, and capillary whole blood specimens in point-of-care or clinical laboratory settings. Methods The precision of the i-STAT pH, PO2, and PCO2 tests in the i-STAT G3+ cartridge was assessed at external clinical sites by end-users using whole blood specimens across the measurement range for each test: pH (6.500 - 7.800 pH units), PO2 (5 - 700 mmHg), PCO2 (5.0 - 130.0 mmHg). The study included venous whole blood samples from ∼140 adult subjects (≥ 18 years) and arterial whole blood samples from ∼140 adult subjects at 3 clinical sites. Each whole blood sample was run in duplicate on the i-STAT G3+ cartridge. In addition, ∼140 specimens were collected in capillary tubes using two fingerstick draws from adult subjects and ∼20 capillary heel-stick specimens were collected into two capillary tubes from neonate subjects (birth - 28 days) at two clinical sites. Specimens used in this study were prospectively collected venous, arterial, or capillary specimens under an Institutional Review Board approved informed consent or were de-identified leftover venous or arterial specimens. For each specimen type, duplicates from each subject were grouped into subintervals based on their mean values. The subintervals included the medical decision levels of 7.300, 7.350 and 7.450 pH units for pH, 30, 45 and 60 mmHg for PO2 and 35, 45, 50 and 70 mmHg for PCO2. The estimates of the pooled standard deviation (SD) and pooled coefficient of variation (%CV), as well as their respective 95% confidence intervals were calculated for each subinterval. Results Across all specimen types (excluding outliers), the pooled SD for pH ranged from 0.00591 - 0.01747 pH units for subintervals 6.500 - 7.300, &amp;gt;7.300 - 7.450, &amp;gt;7.450 - 7.800 pH units. For PO2, the pooled SD ranged from 0.71 - 3.76 mmHg for subintervals 10 - 40 mmHg and &amp;gt;40 - 50 mmHg and the pooled %CV ranged from 1.63 - 8.76 %CV for subintervals &amp;gt;50 - 100 mmHg, &amp;gt;100 - 250 mmHg and &amp;gt;250 - 700 mmHg. For PCO2, the pooled SD ranged from 0.000 - 1.709 mmHg for subintervals 5.0 - 35.0 mmHg, &amp;gt;35.0 - 50.0 mmHg and &amp;gt;50.0 - 62.5 mmHg and the pooled %CV ranged from 1.10 - 3.62 %CV for subinterval &amp;gt;62.5 - 130.0 mmHg. Conclusions The precision study demonstrated that the pH, PO2 and PCO2 tests in the i-STAT G3+ cartridge when tested using the i-STAT 1 System deliver precise results within ∼2 minutes for venous, arterial, and capillary whole blood patient specimens when tested by end users in a point-of-care or clinical laboratory setting. These studies were funded by Abbott Laboratories.

A-329 Accuracy of the pH, PO2, and PCO2 Tests in the i-STAT® G3+ Cartridge Using the i-STAT 1 System for Venous, Arterial and Capillary Whole Blood Specimens in Clinical Settings

Abstract Background Precise and accurate measurements of blood gases are important for the diagnosis, monitoring and treatment of respiratory, metabolic, and acid-base disturbances. This study demonstrates the accuracy of the pH, partial pressure of oxygen (PO2), and partial pressure of carbon dioxide (PCO2) tests in the i-STAT G3+ cartridge with the i-STAT 1 System in arterial, venous, and capillary whole blood specimens in point of care or clinical laboratory settings. Methods The accuracy of the PO2, and PCO2 tests in the i-STAT G3+ cartridge was assessed at external clinical sites in a method comparison study using whole blood specimens across the measurement range for each test: pH 6.5-7.8, PO2 5-700 mmHg, PCO2 5.0-130.0 mmHg. Specimens used in this study were venous, arterial, and capillary specimens prospectively collected under Institutional Review Board-approved informed consent or were leftover de-identified venous or arterial specimens. The study included venous and arterial whole blood samples from ∼140 adult subjects (≥ 18 years) at 3 clinical sites, and capillary whole blood samples from ∼180 adult subject at 3 clinicals sites and ∼25 neonate subjects (birth to 28 days) at 2 clinical sites. The RapidPoint System was used as comparator. For venous and arterial whole blood, samples were collected and tested in duplicate on the i-STAT G3+ cartridge and in singlicate on the RapidPoint System. For capillary whole blood samples, adult fingerstick samples and neonate heel-stick samples were collected in capillary tubes and tested in singlicate on the i-STAT G3+ cartridge and on the RapidPoint System. Passing-Bablok regression was performed for venous and arterial whole blood samples combined, using the first replicate from the i-STAT G3+ cartridge versus the singlicate result from the comparator, and for capillary whole blood samples (adult and neonate combined) using the singlicate result from the i-STAT G3+ cartridge versus the singlicate result from the comparator. Results Passing-Bablok regression of i-STAT G3+ cartridge results versus the comparator was used to calculate slope and correlation coefficient (r). For adult venous and arterial whole blood results, pH had slope = 0.96 and r = 0.99, PO2 had slope = 1.05 and r = 1.00, and PCO2 had slope = 1.04 and r = 0.98. For adult and neonate capillary whole blood results, pH had slope = 1.02 and r = 0.98, PO2 had slope = 1.09 and r = 0.99, and PCO2 had slope = 1.07 and r = 0.96. Conclusions These results demonstrate that the i-STAT 1 System delivers accurate pH, PO2, and PCO2 test results with ∼2 minutes using the i-STAT G3+ cartridge for venous, arterial and capillary whole blood samples for adult and neonate subjects when tested by end-users in a point of care or clinical laboratory setting. This study was funded by Abbott Laboratories.

A-349 Evaluation of i-STAT® Point of Care Blood Gas Cartridges and Competitor Blood Gas Devices Against Reference Standard for PCO2 and PO2

Abstract Background The i-STAT System provides laboratory quality results in minutes at the patient’s bedside. Accurate and rapid test results are critical for clinical decision making in the presence of blood gas disorders, including oxygenation and acid-base status, where the partial pressure oxygen (PO2) and partial pressure carbon dioxide (PCO2) are needed. The purpose of this study was to compare the analytical performance of the PO2 and PCO2 tests in the i-STAT G3+ and i-STAT CG8+ cartridges to the theoretical PO2 and PCO2 in prepared reference standards. Two other blood gas instruments, a benchtop device and a laboratory device were also compared to the reference PO2 and PCO2. Methods Venous whole blood samples were contrived using saturation tonometry with U.S. NIST (National Institute of Science and Technology) traceable gas tanks to prepare the reference standards, which were value assigned to theoretical PO2 or PCO2 levels based on the molar composition of the gas mixture used. Eleven levels spanning the reportable range of each PO2 (5 mmHg - 800 mmHg) and PCO2 (5 mmHg - 130 mmHg) were prepared and tested in duplicate on the i-STAT G3+ and i-STAT CG8+ cartridges, benchtop device, and the laboratory device. Passing-Bablok linear regression analysis was performed to evaluate the slope and correlation coefficient, comparing each blood gas device against the reference PO2 and PCO2 values. Study designs followed CLSI (Clinical and Laboratory Standards Institute) EP09C-ED3:2018, Measurement Procedure Comparison and Bias Estimation using Patient Samples, 3rd Edition. Passing-Bablok regression analysis was also performed for the i-STAT cartridges and benchtop device against the laboratory device. Results The regression analysis was performed against the reference standards. For PO2, slopes for the i-STAT cartridges ranged from 0.93 - 0.97, the slope for the benchtop device was 0.99, and the slope for the laboratory device was 0.97. Correlation coefficients for all devices were 1.00. For PCO2, slopes for the i-STAT cartridges ranged from 0.98 - 1.02, the slope for the benchtop device was 0.85, and the slope for the laboratory device was 1.01. Correlation coefficients were 1.00 for the i-STAT cartridges and laboratory device, and 0.99 for the benchtop device. The regression analysis was also performed against the laboratory device. For PO2, slopes for the i-STAT cartridges ranged from 0.96 - 1.00, and the slope for the benchtop device was 1.02. Correlation coefficients for all devices were 1.00. For PCO2, slopes for the i-STAT cartridges ranged from 0.97 - 1.01, and the slope for the benchtop device was 0.85. Correlation coefficients were 1.00 for the i-STAT cartridges and 0.99 for the benchtop device. Conclusions The study demonstrated that the i-STAT G3+ and i-STAT CG8+ cartridges used with the i-STAT System were shown to provide laboratory quality results within 2 minutes, showing good agreement to both reference standards and laboratory quality devices. For PCO2, the i-STAT System was shown to have better agreement to both theoretical reference standards and the laboratory device than the benchtop device. These studies were funded by Abbott Laboratories.

Characterization of A-site doped PrBaCo2O5+δ perovskites as cathode materials for IT-SOFCs

Creating highly efficient and durable cathodes persists as a formidable task in the realm of intermediate temperature solid oxide fuel cells (IT-SOFCs). Hence, we present a double perovskite oxide, Pr0.6Sr0.4BaCo2O5+δ (PS0.4BC), and its electrocatalytic activity is thoroughly investigated. The XRD test is carried out and a notable transformation in the phase structure is observed upon the introduction of Sr2+ ions into the PBC matrix. That is, the phase structure of the material changes from double perovskite structure to single perovskite structure. Through the TG and TEC test that the introduction of Sr2+ ions into the lattice can create additional sites for oxygen vacancy formation and reduce TEC values. Further verify that Sr doping can enhance the concentration of oxygen vacancies of the material. The PS0.4BC cathode material exhibits remarkably low polarization resistance, achieving an impressive value of 0.027 Ω cm2 at an operating temperature of 800 °C. Oxygen partial pressure test shows that as the oxygen partial pressure decreases, there is a notable increase in impedance, particularly evident in the low frequency region of the Nyquist plots. This indicates that the oxygen content has obvious effects on the low-frequency processes. When the oxygen partial pressure exceeds 0.05 atm, the oxygen adsorption-dissociation and diffusion process is the rate-limiting step in the ORR. However, when the oxygen partial pressure is less than 0.05 atm, the formation of lattice oxygen through the combination of oxygen ions and oxygen vacancies processes is the rate-limiting step. Compared PBC cathode material, the more pronounced changes in the high frequency arc of the PS0.4BC cathode at the same oxygen content. It shows that Sr doping significantly changes the high frequency process. After doping, the oxygen vacancy concentration increases, which facilitates the occurrence of the charge transfer process at high frequency.

Analysis of the electrical conductivity and activation energies of bismuth titanate (Bi4Ti3O12)

In this study, bismuth titanate (Bi4Ti3O12) was synthesized from pure solid compounds and structurally characterized by X-ray diffraction (XRD), scanning electron microscopy (SEM), and X-ray photoelectron spectroscopy (XPS). The electrical properties were evaluated by measuring the electrical conductivity of Bi4Ti3O12 at various oxygen partial pressures (pO2 = 10−5 and 10−8 atm) and temperatures (450 °C-750 °C). The electrical conductivity behavior was assessed during the heating and cooling processes. The material activation energies were determined based on the heating curve, which displayed Arrhenius-type behavior and activation energy slope changes, which could be attributed to point defects. When the temperature was increased from 450 °C to 750 °C at oxygen partial pressures pO2 = 10−5 atm, the electrical conductivity increased by about 62.9 %, whereas when the temperature decreased from 750 °C to 450 °C, the electrical conductivity was reduced by 35.95 %. The electrical behavior of Bi4Ti3O12 was analyzed by establishing its electrical conductivity and chemical activity under different oxygen partial pressures and heating-cooling conditions can allow the synthesis of materials with attractive characteristics for electronic applications.

Pulmonary Events in ICU patients with hyperoxia: is it possible to relate arterial partial pressure of oxygen to coded diseases? A retrospective analysis

ObjectiveOxygen has been used liberally in ICUs for a long time to prevent hypoxia in ICU- patients. Current evidence suggests that paO2 >300 mmHg should be avoided, it remains uncertain whether an “optimal level” exists. We investigated how “mild” hyperoxia influences diseases and in-hospital mortality. DesignThis is a retrospective study. Setting112 mechanically ventilated ICU-patients were enrolled. Patients or participants112 ventilated patients were included and categorized into two groups based on the median paO2 values measured in initial 24 h of mechanical ventilation: normoxia group (paO2 ≤ 100 mmHg, n = 43) and hyperoxia group patients (paO2 > 100 mmHg, n = 69). InterventionsNo interventions were performed. Main variables of interestThe primary outcome was the incidence of pulmonary events, the secondary outcomes included the incidence of other new organ dysfunctions and in-hospital mortality. ResultsThe baseline characteristics, such as age, body mass index, lactate levels, and severity of disease scores, were similar in both groups. There were no statistically significant differences in the incidence of pulmonary events, infections, and new organ dysfunctions between the groups. 27 out of 69 patients (39.1%) in the “mild” hyperoxia group and 12 out of 43 patients (27.9%) in the normoxia group died during their ICU or hospital stay (p = 0.54). The mean APACHE Score was 29.4 (SD 7.9) in the normoxia group and 30.0 (SD 6.7) in the hyperoxia group (p = 0.62). ConclusionsWe found no differences in pulmonary events, other coded diseases, and in-hospital mortality between both groups. It remains still unclear what the "best oxygen regime" is for intensive care patients.

Awake prone positioning and ventilation distribution as assessed by electric impedance tomography in patients with non-COVID-19 acute respiratory failure: A prospective physiology study

BackgroundAwake prone positioning (APP) can reportedly reduce the need for intubation and help to improve the prognosis of patients with acute hypoxemic respiratory failure (AHRF) infected with COVID-19. However, its physiological mechanism remains unknown. In this study, we evaluated the effect of APP on lung ventilation in patients with moderate-to-severe AHRF in an attempt to better understand the effects on ventilation distribution and to prevent intubation in non-intubated patients. MethodsThe prospective study was performed in the Department of Critical Care Medicine at Shanghai General Hospital, China, from January 2021 to November 2022. The study included patients with AHRF (partial pressure of oxygen [PaO2]/inspired oxygen concentration [FiO2] <200 mmHg or oxygen saturation [SpO2]/FiO2 <235) treated with high-flow nasal oxygen. Electrical impedance tomography (EIT) measurements including center of ventilation (COV), global inhomogeneity (GI) index, and regional ventilation delay (RVD) index were performed in the supine position (T0), 30 min after the start of APP (T1), and at 30 min returning to supine position after the APP (T2). Clinical parameters like SpO2, respiratory rate (RR), FiO2, heart rate (HR), and ROX (the ratio of SpO2 as measured by pulse oximetry/FiO2 to RR) were also recorded simultaneously at T0, T1, and T2. To evaluate the effect of the time points on the variables, Mauchly's test was performed for sphericity and repeated measures analysis of variance was applied with Bonferroni's post hoc multiple comparisons. ResultsTen patients were enrolled. The PaO2/FiO2 ratio was (111.4±33.4) mmHg at the time of recruitment. ROX showed a significant increase after initiation of APP {median (interquartile range [IQR]): T0: 7.5 (6.0–10.1) vs. T1: 7.6 (6.4–9.3) vs. T2: 8.3 (7.2–11.0), P=0.043}. RR (P=0.409), HR (P=0.249), and SpO2/FiO2 (P=0.103) did not change significantly during prone positioning (PP). The COV moved from the ventral area to the dorsal area (T0: [48.8±6.2] % vs. T1: [54.8±6.8] % vs. T2: [50.3±6.1] %, P=0.03) after APP. The GI decreased significantly after APP (T0: median=42.7 %, [IQR: 38.3–47.5] % vs. T1: median=38.2 %, [IQR: 34.6–50.7] % vs. T2: median=37.4 %, [IQR: 34.2–41.4] %, P=0.049). RVD (P=0.794) did not change after APP. ConclusionsAPP can improve ventilation distribution and homogeneity of lung ventilation as assessed by EIT in non-intubated patients with AHRF.Trail Registration Chinese Clinical Trial Registry Identifier: ChiCTR2000035895.

Ultra-fast-track cardiac anesthesia in minimally invasive cardiac surgery: a retrospective observational study.

There is no uniformity on the safety profile of ultra-fast-track cardiac anesthesia (UFTCA), and there is a lack of research on the postoperative lung function status of patients with UFTCA. This retrospective study was to examine the benefits of UFTCA on the postoperative recovery and pulmonary function of patients undergoing minimally invasive cardiac surgery (MICS). This retrospective study was performed on patients who underwent MICS at Zhejiang Provincial People's Hospital between January 2022 and July 2023. Patients were retrospectively segregated into two groups: UFTCA group and conventional general anesthesia (CGA group). Primary endpoints encompassed differences in the duration of postoperative intensive care unit (ICU) stay and overall hospital stay. Secondary observations included in-hospital mortality rate, 3-month post-discharge survival rate, oxygenation indexes of preoperative (T0), immediately after extubation (T1), 6 hours after extubation (T2), and 12 hours after extubation (T3), use of high-flow nasal cannula oxygen therapy in the ICU, postoperative total chest drainage volume, and the rate of complications. Group comparisons were performed using grouped t-tests and repeated measures analysis of variance (ANOVA). The UFTCA group (n=327) demonstrated shorter ICU and hospital stays when compared with the CGA group (n=216) (P=0.001). At the immediately after extubation, the UFTCA group exhibited a decrease in oxygenation index [arterial oxygen partial pressure (PaO2)/fraction of inspired oxygen (FiO2)] accompanied by elevated alveolar-arterial oxygen tension difference [P(A-a)O2] and respiratory index [P(A-a)O2/PaO2] values compared to the CGA group (P=0.001). However, by 12 hours after extubation, the UFTCA group manifested an improved PaO2/FiO2 and diminished P(A-a)O2/PaO2 values compared to the CGA group. The UFTCA group required high-flow oxygen therapy after extubation with greater frequency than the CGA group (P=0.001). However, neither the UFTCA nor CGA group had patients who needed reintubation (P>0.05). No significant differences were observed in postoperative atelectasis and pulmonary edema rates between the groups (P>0.05), the UFTCA group recorded a diminished total chest drainage volume postoperatively (P=0.001). Incidence of postoperative nausea and vomiting (PONV) was heightened in the UFTCA group (P=0.01), while the incidence of delirium was less frequent when compared with the CGA group (P=0.001). UFTCA demonstrates potential benefits in minimizing ICU and postoperative hospital stay in patients undergoing MICS. This approach also contributes to a reduction in postoperative chest drainage volume and a decreased likelihood of postoperative delirium. Despite the initial decline in lung oxygenation immediately following early post-extubation, subsequent lung function proves to be superior, with no differences in postoperative atelectasis or pulmonary edema rates. However, the implementation of UFTCA requires additional strategies to prevent the occurrence of PONV.