Oxygen Tension Research Articles

Clinical Characteristics of 427 Unvaccinated Chinese Adult Patients with Maintenance Hemodialysis Infected with the SARS-CoV-2 Omicron Variant: A Retrospective Study

Background: Maintenance hemodialysis (MHD) patients constitute a distinctive population characterized by unique traits, such as hemodialysis-related immune disturbances, and increased vulnerability to infections, heart failure, particularly severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Despite considerable research on MHD patients with coronavirus disease 2019 (COVID-19), there is limited information available on the clinical characteristics and outcomes of unvaccinated adult MHD patients infected with the SARS-CoV-2 Omicron variant. Methods: A retrospective investigation was conducted in a cohort of 427 unvaccinated MHD patients diagnosed with SARS-CoV-2 Omicron infection. The clinical symptoms, laboratory results, and treatment regimens were comprehensively examined. Multivariate regression identified independent risk factors for disease severity, and two-month follow-up assessments were conducted. Results: The cohort exhibited a spectrum of disease severity, with 37.5% classified as mild, 35.3% as common, 22.5% as severe, and 4.7% as critical. Serum C-reactive protein level, procalcitonin level, and bicarbonate concentration are related to the severity of the disease. Tailored treatment strategies—including nutritional support, hemodialysis management, anti-bacterial interventions, and more—were implemented. There was a 5.6% mortality rate, with a higher prevalence of deaths in the critical subtype. Independent risk factors for disease severity included fever, age, cycle threshold values (Ct values) of ORF1ab gene, and arterial oxygen partial pressure. Follow-up assessments revealed a median duration of 11 days for the negative nucleic acid of SARS-CoV-2. Twelve patients presented a second positive ORF1ab gene during follow-up but remained asymptomatic. Conclusion: These findings suggest the intricate clinical characteristics and outcomes of MHD patients with the SARS-CoV-2 Omicron infection. Tailored treatment strategies, continuous surveillance, and understanding prognostic factors are imperative for managing this high-risk population. Further research is warranted to validate these findings.

Association of Arterial Carbon Dioxide Tension Following In-Hospital Cardiac Arrest With Survival and Favorable Neurologic Outcome.

In-hospital cardiac arrest (IHCA) continues to be associated with high morbidity and mortality. The objective of this study was to study the association of arterial carbon dioxide tension (PaCO2) on survival to discharge and favorable neurologic outcomes in adults with IHCA. The study population included 353 adults who underwent resuscitation from 2011 to 2019 for IHCA at an academic tertiary care medical center with arterial blood gas testing done within 24 hours of arrest. Outcomes of interest included survival to discharge and favorable neurologic outcome, defined as Glasgow outcome score of 4-5. Of the 353 patients studied, PaCO2 classification included: hypocapnia (PaCO2 <35 mm Hg, n = 89), normocapnia (PaCO2 35-45 mm Hg, n = 151), and hypercapnia (PaCO2 >45 mm Hg, n = 113). Hypercapnic patients were further divided into mild (45 mm Hg < PaCO2 ≤55 mm Hg, n = 62) and moderate/severe hypercapnia (PaCO2 > 55 mm Hg, n = 51). Patients with normocapnia had the highest rates of survival to hospital discharge (52.3% vs. 32.6% vs. 30.1%, P < 0.001) and favorable neurologic outcome (35.8% vs. 25.8% vs. 17.9%, P = 0.005) compared those with hypocapnia and hypercapnia respectively. In multivariable analysis, compared to normocapnia, hypocapnia [odds ratio (OR), 2.06; 95% confidence interval (CI), 1.15-3.70] and hypercapnia (OR, 2.67; 95% CI, 1.53-4.66) were both found to be independently associated with higher rates of in-hospital mortality. Compared to normocapnia, while mild hypercapnia (OR, 2.53; 95% CI, 1.29-4.97) and moderate/severe hypercapnia (OR, 2.86; 95% CI, 1.35-6.06) were both independently associated with higher in-hospital mortality compared to normocapnia, moderate/severe hypercapnia was also independently associated with lower rates of favorable neurologic outcome (OR, 0.28; 95% CI, 0.11-0.73), while mild hypercapnia was not. In this prospective registry of adults with IHCA, hypercapnia noted within 24 hours after arrest was independently associated with lower rates of survival to discharge and favorable neurologic outcome.

Utility of Clinical Variables for Deciding Palliative Care in Paraquat Poisoning: A Retrospective Study.

Patients with paraquat poisoning (PP) have a mortality rate comparable to that of advanced malignancies, yet palliative care is seldom considered in these patients. This audit aimed to identify triggers for early palliative care referral in critically ill patients with PP. Medical records of patients with PP were audited. Predictors of mortality within 48 hours of hospitalization and 24 hours of intensive care unit (ICU) admission were considered as triggers for palliative care referral. Among 108 patients, 84 complete records were analyzed, and 53 out of 84 (63.1%) expired. Within 48 hours after hospitalization, the lowest oxygen partial pressure in arterial blood to a fraction of inspired oxygen [the ratio of partial pressure of oxygen in arterial blood (PaO2) to the fraction of inspiratory oxygen concentration (FiO2) (PaO2/FiO2)] was the independent predictor of mortality, cut-off ≤ 197; the area under the curve (AUC), 0.924; sensitivity, 97%; specificity, 78%; p <0.001; and 95% confidence interval (CI): 0.878-0.978. Kaplan-Meier survival plot showed that the mean survival time of patients with the lowest PaO2/FiO2, ≤197, was 4.64 days vs 17.20 days with PaO2/FiO2 >197 (log-rank p < 0.001). Sequential organ failure assessment (SOFA) score within 24 hours of ICU admission had a cut-off ≥9; AUC, 0.980; p < 0.001; 95% CI: 0.955-1.000; 91% sensitivity; and 90% specificity for mortality prediction. Out of the total of 84 patients with PP analyzed, there were 11 patients admitted to the high dependency units (13.1%) and 73 patients admitted to the ICU (86.9%). Out of the total of 84 patients of PP in whom data was analyzed, 53 (63.1%) patients required ventilator support. All the 53 patients who required ventilator support due to worsening hypoxemia, eventually expired. The lowest PaO2/FiO2 ≤ 197 within 48 hours of hospitalization, SOFA score ≥9 within 24 hours of ICU admission or need for mechanical ventilation are predictors of mortality in PP patients, who might benefit from early palliative care. Rao S, Maddani SS, Chaudhuri S, Bhatt MT, Karanth S, Damani A, et al. Utility of Clinical Variables for Deciding Palliative Care in Paraquat Poisoning: A Retrospective Study. Indian J Crit Care Med 2024;28(5):453-460.

Unraveling the Correlation between the Interface Structures and Tunable Magnetic Properties of La1-xSrxCoO3-δ/La1-xSrxMnO3-δ Bilayers Using Deep Learning Models.

Perovskite oxides are gaining significant attention for use in next-generation magnetic and ferroelectric devices due to their exceptional charge transport properties and the opportunity to tune the charge, spin, lattice, and orbital degrees of freedom. Interfaces between perovskite oxides, exemplified by La1-xSrxCoO3-δ/La1-xSrxMnO3-δ (LSCO/LSMO) bilayers, exhibit unconventional magnetic exchange switching behavior, offering a pathway for innovative designs in perovskite oxide-based devices. However, the precise atomic-level stoichiometric compositions and chemophysical properties of these interfaces remain elusive, hindering the establishment of surrogate design principles. We leverage first-principles simulations, evolutionary algorithms, and neural network searches with on-the-fly uncertainty quantification to design deep learning model ensembles to investigate over 50,000 LSCO/LSMO bilayer structures as a function of oxygen deficiency (δ) and strontium concentration (x). Structural analysis of the low-energy interface structures reveals that preferential segregation of oxygen vacancies toward the interfacial La0.7Sr0.3CoO3-δ layers causes distortion of the CoOx polyhedra and the emergence of magnetically active Co2+ ions. At the same time, an increase in the Sr concentration and a decrease in oxygen vacancies in the La0.7Sr0.3MnO3-δ layers tend to retain MnO6 octahedra and promote the formation of Mn4+ ions. Electronic structure analysis reveals that the nonuniform distributions of Sr ions and oxygen vacancies on both sides of the interface can alter the local magnetization at the interface, showing a transition from ferromagnetic (FM) to local antiferromagnetic (AFM) or ferrimagnetic regions. Therefore, the exotic properties of La1-xSrxCoO3-δ/La1-xSrxMnO3-δ are strongly coupled to the presence of hard/soft magnetic layers, as well as the FM to AFM transition at the interface, and can be tuned by changing the Sr concentration and oxygen partial pressure during growth. These insights provide valuable guidance for the precise design of perovskite oxide multilayers, enabling tailoring of their functional properties to meet specific requirements for various device applications.

Crystallization of Y3Fe5O12 thin films on silicon photonic waveguides using CO2 laser annealing

We report the local crystallization of Y3Fe5O12 (YIG) thin films grown on Si substrates, and SOI waveguides by CO2 laser annealing (LA). The effect of laser power and oxygen pressure on the crystal structure of YIG films was systematically studied. Laser power dominated the YIG film crystallinity, while oxygen partial pressure during LA strongly influenced the crystal grain size and magnetic anisotropy. Fully crystallized YIG thin films with pure garnet phases were fabricated by LA. The refractive index n and extinction coefficient k were comparable to thin films fabricated by rapid thermal annealing (RTA). Propagation loss measured at 1550 nm wavelength on YIG/SOI waveguides and YIG/SiN ring resonators were comparable to RTA annealed films, promising device development for silicon photonics.

#1651 Urinary oxygen partial pressure: closely associated with hourly urine output induced by furosemide in patients with acute renal injury

Abstract Background and Aims Urine oxygen level, an indicator of kidney medullar oxygenation, is promising for predicting the onset of acute kidney injury (AKI). Furosemide, a commonly used diuretic in ICU, significantly increases urine output and is believed to change kidney medullar oxygenation. We monitored the longitudinal change of urinary oxygen partial pressure during bolus or pump administration of furosemide, aiming to describe the reaction pattern in an AKI-susceptible patient population. Method The prospective observational pilot study included seven adult patients in the ICU because of cardiac surgery or sepsis. We monitored the continuous urinary oxygen partial pressure for 8-24 hours through a device placed between the urinary catheter and collecting bag during furosemide administration, recorded hourly urine output simultaneously from a urine bag, and followed the patients in the hospital for the onset and development of AKI. Results We recruited three female patients and four male patients with an average age of 54 years and a medium of 5 days in ICU with an AKIN stage I of AKI during their hospital stay. None of them developed more severe stage AKI or required any kidney replacement therapy. We found a reverse correlation pattern between hourly urine output and urinary oxygen partial pressure. Specifically, the urine oxygen level dropped during urine volume increase caused by furosemide bolus administration and abolished by furosemide administration through a pump with more stable urine output. The paired t-test showed a significant increase in average urine oxygen level (mean difference = 21.2 mmHg, p = 0.044) recorded during the “high hourly urine output” period compared to the “low hourly urine period”. Conclusion We first found a drop in urinary oxygen partial pressure during the high urine output period elicited by bolus furosemide administration. It shed light on the confounding factors in AKI predicating during possible furosemide administration.

Superconductivity and Pronounced Electron‐Phonon Coupling in Rock‐Salt Al1−xO1−x and Ti1−xO1−x

AbstractThe highest ambient‐pressure Tc among binary compounds is 40 K (MgB2). Higher Tc is achieved in high‐pressure hydrides or multielement cuprates. Alternatively, are explored superconducting properties of binary, metastable sub‐oxides, that may emerge under extremely low oxygen partial pressure. The emphasis is on the rock‐salt structure, which is known to promote superconductivity, and exploring AlO, ScO, TiO, and NbO. Dynamic lattice stability is achieved by introducing metal and oxygen vacancies in the fashion of Nb1−xO1−x‐type structure (x = ¼). The electron‐phonon (e‐ph) coupling is remarkably large in Al1−xO1−x and Ti1−xO1−x (λ ≈ 2 at x = ¼), with Tc ≈ 35 K according to the Allen–Dynes equation. Significantly, the coupling strength is comparable to that in high‐pressure hydrides, yet, in contrast to hydrides and MgB2, the coupling is largely driven by low frequency phonons. Sc1−xO1−x and Nb1−xO1−x show significantly smaller λ and Tc. Further, hydrogen intercalation to boost λ and Tc is investigated. Only Ti1−x(O1−xHx) and Nb1−x(O1−xHx) are dynamically stable upon intercalation, where H, respectively, decreases and increases Tc. The effect of H doping on electronic structure and Tc is discussed. Altogether, the study suggests that metal sub‐oxides are promising compounds to achieve strong e‐ph coupling at ambient pressure.

#207 Early single session of hyperbaric oxygen therapy mitigates renal apoptosis in lipopolysaccharides-induced endotoxemia in rats

Abstract Background and Aims Sepsis-associated acute kidney injury (SA-AKI) is a prominent sepsis complication, often having adverse clinical outcomes. Hyperbaric oxygen therapy (HBOT), known for its anti-inflammatory characteristics, antioxidant effects, and ability to deliver high oxygen tension to hypo-perfused tissues, may offer potential benefits for SA-AKI. This study investigated whether HBOT improved renal injury in sepsis and elucidated its underlying mechanisms. Method An lipopolysaccharides (LPS)-induced endotoxemia model was established using eight-week-old C57BL/6 mice. Thirty minutes post-LPS administration, a subset of mice underwent HBOT at a 2.5 atmospheric pressure absolute with 100% oxygen for 60 minutes. After 24 hours, all mice were euthanized for measurements. Results Our results demonstrated that HBOT effectively mitigated renal tubular cell apoptosis, as evidenced by decreased apoptosis-associated proteins, including Bax/Bcl-2 and cleaved caspase 3/caspase 3 ratios. HBOT significantly reduced phosphorylated p53 proteins and cytochrome C levels, suggesting that HBOT may attenuate renal apoptosis through decreased p53 activation and cytochrome C release. Notably, HBOT preserved manganese-dependent levels of superoxide dismutase, an antioxidant enzyme, compared to the LPS group. Furthermore, transforming growth factor-β (TGF- β)/Smad4 and alpha-smooth muscle actin expressions were significantly reduced in the LPS+HBOT group. Conclusion An early single session of HBOT exhibited renoprotective effects in LPS-induced endotoxemia mice models by mitigating apoptosis by suppressing p53 activation and cytochrome C levels. The observed TGF-β decrease, downstream Smad expression reduction, and antioxidant capacity preservation following HBOT may contribute to these effects.

EXPLORATORY ANALYSIS OF URINE PO2 PERI-PROCEDURAL KINETICS AND CI-AKI PROGNOSTIC ABILITIES IN PATIENTS UNDERGOING PCI.

Novel contrast-induced acute kidney injury (CI-AKI) biomarkers are needed to detect earlier and with greater precision the pathophysiological changes in renal medulla associated with kidney damage. We prospectively assessed the kinetics of urine oxygen tension (PO2) in control healthy individuals, and its prognostic ability for CI-AKI in patients undergoing percutaneous coronary intervention (PCI). We enrolled 202 consecutive patients (78% men, mean age 66±10 years) treated with elective or urgent PCI. PO2 was measured using a point-of-care (POC) standard blood gas analyzer at 3 time points (baseline, post -within 3 hours- PCI and at 24 hours post PCI) in urine samples. CI-AKI was defined as an increase of ≥25% or ≥0.5 mg/dl in pre-PCI serum creatinine at 48 hours post PCI. Between baseline and post-PCI measurements, patients without CI-AKI showed a decrease of -37 (36) mmHg in PO2 urine levels whereas patients with CI-AKI showed a decrease of only -23 (38) mmHg. (P=0.014). Using ROC analysis, percentage change in urine PO2 immediately after PCI relative to baseline levels, significantly predicted CI-AKI (AUC 0.804 95%CI 0.717-0.892). A significant drop in urine oxygen tension appears as a normal response of the kidney medulla to an acute insult (contrast media) immediately post PCI with a recovery to baseline levels 24 hours later. Absence or attenuation of this drop in urine oxygen tension could predict CI-AKI earlier and more precisely.

ПРЕДПОЛАГАЕМЫЙ МЕХАНИЗМ ВЛИЯНИЯ КРАТКОВРЕМЕННОЙ ГИПОКСИИ НА ОБОНЯТЕЛЬНУЮ ЧУВСТВИТЕЛЬНОСТЬ

The article is focused on the effect of short-term hypoxia on the olfactory sensitivity. The effect of short-term hypoxia on the olfactory sensitivity in human and rats were studied by determination thresholds for n-butanol. We have shown that reduced oxygen partial pressure leads to reduction of olfactory sensitivity. As known, odorant detection thresholds characterize the functional state of receptor cells. It can be assumed that the weakening of their sensitivity may be caused by a lack of energy supply to the olfactory perception process in hypoxia. To test this hypothesis, we stimulated rat olfactory sensory neurons with n-butanol in rotenone model. The reaction of cellular respiration of olfactory sensory neurons was evaluated by changing the intensity of intrinsic fluorescence of reduced pyridine nucleotides (NADH) according to the B. Chance method. Analysis of the results showed that under normoxia, stimulation of olfactory neurons by odorant caused an increase in the intensity of NADH fluorescence, which indicates the accumulation of the reduced form of pyridine nucleotides in mitochondria, and, consequently, the activation of cellular respiration due to exposure to odorant. In hypoxia caused by rotenone, an increase in the induced change of fluorescence of NADH was either not registered or the amplitude of the reaction was halved. This means that the recovery of NADH due to the odorant either did not occur at all, or this reaction to the smell was significantly lower than with normoxia, which indicates a weakening of cellular respiration during hypoxia. This is the reason for the decrease in ATP synthesis, which affects the efficiency of the olfactory transduction process and the sensitivity of olfactory sensory neurons. Therefore, based on our results, it can be concluded that the weakening of olfactory sensitivity in rats and humans with hypoxia may be due to a weakening of cellular respiration in olfactory sensory neurons.

Normoxic Management during Cardiopulmonary Bypass Does Not Reduce Cerebral Mitochondrial Dysfunction in Neonatal Swine.

Optimal oxygen management during pediatric cardiopulmonary bypass (CPB) is unknown. We previously demonstrated an increase in cortical mitochondrial reactive oxygen species and decreased mitochondrial function after CPB using hyperoxic oxygen management. This study investigates whether controlled oxygenation (normoxia) during CPB reduces cortical mitochondrial dysfunction and oxidative injury. Ten neonatal swine underwent three hours of continuous CPB at 34 °C (flow > 100 mL/kg/min) via cervical cannulation targeting a partial pressure of arterial oxygen (PaO2) goal < 150 mmHg (normoxia, n = 5) or >300 mmHg (hyperoxia, n = 5). The animals underwent continuous hemodynamic monitoring and serial arterial blood sampling. Cortical microdialysate was serially sampled to quantify the glycerol concentration (represents neuronal injury) and lactate-to-pyruvate ratio (represents bioenergetic dysfunction). The cortical tissue was analyzed via high-resolution respirometry to quantify mitochondrial oxygen consumption and reactive oxygen species generation, and cortical oxidized protein carbonyl concentrations were quantified to assess for oxidative damage. Serum PaO2 was higher in hyperoxia animals throughout CPB (p < 0.001). There were no differences in cortical glycerol concentration between groups (p > 0.2). The cortical lactate-to-pyruvate ratio was modestly elevated in hyperoxia animals (p < 0.03) but the values were not clinically significant (<30). There were no differences in cortical mitochondrial respiration (p = 0.48), protein carbonyls (p = 0.74), or reactive oxygen species generation (p = 0.93) between groups. Controlled oxygenation during CPB does not significantly affect cortical mitochondrial function or oxidative injury in the acute setting. Further evaluation of the short and long-term effects of oxygen level titration during pediatric CPB on cortical tissue and other at-risk brain regions are needed, especially in the presence of cyanosis.

Changes in the indicators of hemodynamics and oxygen transport in patients with idiopathic pulmonary arterial hypertension depending on their survival

Background. Idiopathic pulmonary arterial hypertension (IPAH) is a severe disease that affects the vessels of the pulmonary circulation and leads to right ventricular failure and death of patients. Indicators of hemodynamics and oxygen transport play central role in the progression and development of the disease. Objective: to evaluate indicators of hemodynamics, oxygen transport. Materials and methods. The study included 124 patients with IPAH. They were divided into two groups: alive patients (group 1) and those who died (group 2). All of them underwent general clinical examinations, a 6-minute walk test, transthoracic and speckle tracking echocardiography, right heart catheterization, blood gas analysis and calculation of hemodynamic parameters. Results. We calculated and compared the right (RVSWI) (19.93 ± 7.84 vs. 16.47 ± 4.67 g·m·m–2, p = 0.009) and left ventricular stroke work index (LVSWI) (39.47 ± 10.53 vs. 35.92 ± 11.19 g·m·m–2, p = 0.036) and their ratio (RVSWI/LVSWI) (0.59 ± 0.16 vs. 0.46 ± ± 0.13, p = 0.008), right (RVPC) (97.00 ± 2.16 vs. 1.82 ± 1.04 g·m, p = 0.001) and left ventricular pump coefficient (LVPC) (5.36 ± 4.84 vs. 4.41 ± 2.15 g·m, p = 0.04) and their ratio (RVPC/LVPC) (0.54 ± 0.19 vs. 0.44 ± 0.11, p = 0.05) in both groups of patients. Also, we found differences in partial pressure of carbon dioxide (PaCO2) of venous blood (34.5 ± 5.1 vs. 40.2 ± 6.9 mm Hg, p = 0.02), partial pressure of oxygen (PaO2) of arterial blood (90.2 ± 15.1 vs. 78.9 ± 11.2 mm Hg; p = 0.01), arteriovenous oxygen difference (A-vO2) (4.5 ± 1.2 vs. 5.0 ± 0.8 ml/dL, p = 0.02) between both groups. Conclusions. RVSWI, LVSWI, RVSWI/LVSWI, RVPC, LVPC, RVPC/LVPC were significantly different between the groups. The use of the above hemodynamic parameters can help in a deeper understanding of the prognosis in IPAH patients. Performance of oxygen transport indicators (PaCO2, PaO2) and A-vO2 in IPAH patients provides a broader understanding of the status and prognosis of this disease.

Influence of Zr-doping on the structure and transport properties of rare earth high-entropy oxides

Fluorite-type ceria-based ceramics are well established as oxygen ion conductors due to their high conductivity, superseding state-of-the-art electrolytes such as yttria-stabilized zirconia. However, at a specific temperature and oxygen partial pressure they occasionally exhibit electronic conduction attributed to polaron hopping via multivalent cations (e.g. Pr and Ce). (Ce, La, Pr, Sm, Y)O2−δ is a high-entropy oxide with a fluorite-type structure, featuring low concentrations of multivalent cations that could potentially mitigate polaron hopping. However, (Ce, La, Pr, Sm, Y)O2−δ undergoes a structural transition to the bixbyite-type structure above 1000 °C. In this study, we introduce Zr doping into (Ce, La, Pr, Sm, Y)O2−δ to hinder the structural transition at elevated temperatures. Indeed, the fluorite structure at elevated temperatures is stabilized at approximately 10 at.% Zr doping. The total conductivity initially increases with doping, peaking at 5 at.% Zr doping, and subsequently decreases with further doping. Interestingly, electronic conductivity in (Ce, La, Pr, Sm, Y)1−x Zr x O2−δ under oxidizing atmospheres is not significant and is lowest at 8 at.% Zr. These results suggest that ceria-based high-entropy oxides can serve as oxygen ion conductors with a significantly reduced electronic contribution. This work paves the way for new compositionally complex electrolytes as well as protective coatings for solid oxide fuel cells.

How quickly does FLASH need to be delivered? A theoretical study of radiolytic oxygen depletion kinetics in tissues

Purpose. Radiation delivered over ultra-short timescales (‘FLASH’ radiotherapy) leads to a reduction in normal tissue toxicities for a range of tissues in the preclinical setting. Experiments have shown this reduction occurs for total delivery times less than a ‘critical’ time that varies by two orders of magnitude between brain (∼0.3 s) and skin (⪆10 s), and three orders of magnitude across different bowel experiments, from ∼0.01 to ⪆(1–10) s. Understanding the factors responsible for this broad variation may be important for translation of FLASH into the clinic and understanding the mechanisms behind FLASH. Methods. Assuming radiolytic oxygen depletion (ROD) to be the primary driver of FLASH effects, oxygen diffusion, consumption, and ROD were evaluated numerically for simulated tissues with pseudorandom vasculatures for a range of radiation delivery times, capillary densities, and oxygen consumption rates (OCR’s). The resulting time-dependent oxygen partial pressure distribution histograms were used to estimate cell survival in these tissues using the linear quadratic model, modified to incorporate oxygen-enhancement ratio effects. Results. Independent of the capillary density, there was a substantial increase in predicted cell survival when the total delivery time was less than the capillary oxygen tension (mmHg) divided by the OCR (expressed in units of mmHg/s), setting the critical delivery time for FLASH in simulated tissues. Using literature OCR values for different normal tissues, the predicted range of critical delivery times agreed well with experimental values for skin and brain and, modifying our model to allow for fluctuating perfusion, bowel. Conclusions. The broad three-orders-of-magnitude variation in critical irradiation delivery times observed in in vivo preclinical experiments can be accounted for by the ROD hypothesis and differences in the OCR amongst simulated normal tissues. Characterization of these may help guide future experiments and open the door to optimized tissue-specific clinical protocols.

Brain tissue oxygen partial pressure monitoring and prognosis of patients with traumatic brain injury: a meta-analysis.

To assess whether monitoring brain tissue oxygen partial pressure (PbtO2) or employing intracranial pressure (ICP)/cerebral perfusion pressure (CCP)-guided management improves patient outcomes, including mortality, hospital length of stay (LOS), mean daily ICP and mean daily CCP during the intensive care unit(ICU)stay. We searched the Web of Science, EMBASE, PubMed, Cochrane Library, and MEDLINE databases until December 12, 2023. Prospective randomized controlled and cohort studies were included. A meta-analysis was performed for the primary outcome measure, mortality, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Eleven studies with a total of 37,492 patients were included. The mortality in the group with PbtO2 was 29.0% (odds ratio: 0.73;95% confidence interval [CI]:0.56-0.96; P = 0.03; I = 55%), demonstrating a significant benefit. The overall hospital LOS was longer in the PbtO2 group than that in the ICP/CPP group (mean difference:2.03; 95% CI:1.03-3.02; P<0.0001; I = 39%). The mean daily ICP in the PbtO2 monitoring group was lower than that in the ICP/CPP group (mean difference:-1.93; 95% CI: -3.61 to -0.24; P = 0.03; I = 41%). Moreover, PbtO2 monitoring did not improve the mean daily CPP (mean difference:2.43; 95%CI: -1.39 to 6.25;P = 0.21; I = 56%).Compared with ICP/CPP monitoring, PbtO2 monitoring reduced the mortality and the mean daily ICP in patients with severe traumatic brain injury; however, no significant effect was noted on the mean daily CPP. In contrast, ICP/CPP monitoring alone was associated with a short hospital stay.

Effect of dexmedetomidine on pulmonary function in obese patients undergoing laparoscopic surgery

ObjectiveThis research aimed to ascertain the effect of dexmedetomidine on pulmonary function in obese patients undergoing laparoscopic surgery.MethodsObese patients undergoing laparoscopic surgery under general anesthesia were separated into the control group (group C) and the dexmedetomidine group (group D) (n = 30). Patients in group D were infused with dexmedetomidine (1 μg/kg) intravenously for 10 min and then at a rate of 0.5 mg/kg h until 30 min before the end of the surgery, and those in group C were infused with an equal volume of saline. The surgery time points were divided into: before anesthesia induction (T0), 5 min after intubation (T1), 30 min after pneumoperitoneum (T2), 10 min after pneumoperitoneum release (T3), at the time of extubation (T4), 3 min after extubation (T5), and 24 h after surgery (T6). Arterial blood was collected for blood gas analysis to record arterial partial pressure of oxygen (PaO2) and arterial partial pressure of carbon dioxide (PaCO2). Dynamic lung compliance (Cdyn), oxygenation index (OI), alveolar-arterial oxygen partial pressure difference (A-aDO2), and respiratory index (RI) were calculated. The time of surgery, anesthesia, CO2 pneumoperitoneum, eye-opening, and time from the end of surgery to extubation were recorded. Plasma IL-8 and IL-10 levels were measured from T0 to T6.ResultsThe time of surgery, anesthesia, CO2 pneumoperitoneum, eye-opening, and time from the end of surgery to extubation in group D were not statistically significant when compared with those in group C. Versus at the T1 time point, A-aDO2 and RI were higher and Cdyn and OI were lower in both groups at T2 and T3 time points. Versus group C, group D had higher Cdyn and OI and lower A-aDO2 and RI at T2 and T3 time points. Versus at the T0 time point, at each time point from T1 to T6, IL-8 and IL-10 levels were higher in both groups. Versus group C, group D had lower IL-8 and higher IL-10 levels at each time point from T1 to T6.ConclusionIn obese patients undergoing laparoscopic surgery under general anesthesia, the use of dexmedetomidine can improve the lung compliance and OI of the patients, inhibit the inflammatory response of the lungs of the patients and thus have a certain protective effect on the lung function.

Exposure to hyperbaric O2 levels leads to blood-brain barrier breakdown in rodents

IntroductionHyperbaric oxygen has been used as a medical treatment tool in hyperbaric chambers and is an integral part of professional and combat divers’ activity. In extreme cases, exposure to hyperbaric oxygen can develop central nervous system oxygen toxicity (CNS-OT), which leads to seizures and eventually death. CNS-OT is caused by neuronal hyperactivity due to high oxygen levels, potentially damaging brain cells including the blood-brain barrier (BBB). However, the effect of hyperbaric oxygen levels on the healthy BBB has not been characterized directly yet.MethodsSix or three different groups of ~ eight rats or mice, respectively, were exposed to increasing levels of partial pressure of oxygen (0.21 to 5 ATA) in a hyperbaric chamber, followed by MRI scanning with gadolinium. Statistical significance (adjusted p-value ≤ 0.05) was assessed using linear regression and ordinary one-way (rats) or two-way (mice) ANOVA with correction of multiple comparison tests. In rats, the effect of 100% oxygen at 5 ATA was independently validated using FITC-Dextran (5 kDa). Statistical significance (p-value ≤ 0.05) was assessed using Welch’s t-test and effect size was calculated by Cohen’s D.ResultsIn rats, analyzed MRI scans showed a significant trend of increase in the % gadolinium in brain tissues as a result of hyperbaric oxygen pressures (p-value = 0.0079). The most significant increase was measured at 4 ATA compared to air (adjusted p-value = 0.0461). Significant increased FITC-Dextran levels were measured in the rats’ brains under 100% oxygen at 5 ATA versus air (p-value = 0.0327; Effect size = 2.0). In mice, a significant increase in gadolinium penetration into the hippocampus and frontal cortex was measured over time (adjusted p-value < 0.05) under 100% oxygen at 3 and 5 ATA versus air, and between the treatments (adjusted p-value < 0.0001).ConclusionsThe BBB is increasingly disrupted due to higher levels of hyperbaric oxygen in rodents, indicating a direct relation between hyperbaric oxygen and BBB dysregulation for the first time. We suggest considering this risk in different diving activities, and protocols using a hyperbaric chamber. On the other hand, this study highlights the potential therapeutic usage of hyperbaric oxygen for controlled drug delivery through the BBB into brain tissues in different brain-related diseases.

The Role of the Tissue Perfusion Index in Predicting Disease Severity and Prognosis in Patients with Severe and Critical COVID-19.

The study investigated whether percutaneous partial pressure of oxygen (PtcO2), percutaneous partial pressure of carbon dioxide (PtcCO2), and the derived tissue perfusion index (TPI) can predict the severity and short-term outcomes of severe and critical COVID-19. Prospective observational study conducted from January 1, 2023 to February 10, 2023. A teaching hospital specializing in tertiary care in Nanjing City, Jiangsu Province, China. Adults (≥18 years) with severe and critical COVID-19. Not applicable. The general information and vital signs of the patients were collected. The PtcO2 and PtcCO2 were monitored in the left dorsal volar. The ratio of TPI was defined as the ratio of PtcO2/fraction of inspired oxygen (FiO2) to PtcCO2. Mortality at 28 was recorded. The ability of the TPI to assess disease severity and predict prognosis was determined. Severity of the disease on the enrollment and mortality at 28. A total of 71 patients with severe and critical COVID-19, including 40 severe and 31 critical cases, according to the COVID-19 treatment guidelines published by WHO, were recruited. Their median age was 70 years, with 56 (79%) males. The median SpO2/FiO2, PtcO2, PtcCO2, PtcO2/ FiO2, and TPI values were 237, 61, 42, 143, and 3.6 mm Hg, respectively. Compared with those for severe COVID-19, the TPI, PtcO2/ FiO2, SpO2/FiO2, and PtcO2 were significantly lower in critical COVID-19, while the PtcCO2 was significantly higher. After 28 days, 26 (37%) patients had died. TPI values < 3.5 were correlated with more severe disease status (AUC 0.914; 95% CI: 0.847-0.981, P < 0.001), and TPI < 3.3 was associated with poor outcomes (AUC 0.937; 95% CI 0.880-0.994, P < 0.001). The tissue perfusion index (TPI), PtcCO2, and PtcO2/ FiO2 can predict the severity and outcome of severe and critical COVID-19.

Effect of KCl on high‐temperature corrosion of low‐alloyed steel under low oxygen partial pressure

AbstractLow oxygen environments in biomass gasification and the presence of chlorine in feedstocks can influence the corrosion rate of steel by affecting the formation of protective oxide scales. The effect of KCl on the high‐temperature corrosion of low‐alloyed steel (13CrMo4‐5) under low oxygen partial pressure is investigated by KCl salt spray (0.1 mg·cm−2) and exposure to 3 vol% H2 + 30 vol% H2O + Ar (balance) at 500°C for up to 168 h. Specimens without KCl salt are exposed for reference. Specimens are characterized after exposure by mass change, SEM/EDS, and XRD. KCl‐deposited specimens exhibit about 30% lower mass gain after exposure compared to non‐sprayed specimens. Their scale shows a porous innermost layer and a denser layer on top. No Fe or Cr chlorides are identified. The specimens without salt exhibit a similar two‐layered scale, with a porous inner Fe‐Cr oxide, followed by a denser and thicker Fe‐oxide above. KCl could potentially protect the surface from further degradation by physically covering the specimen, altering the scale morphology, and forming a less permeable barrier, hindering the transport of species through the scale.

Chemical Potential Analysis as an Alternative to the van't Hoff Method: Hypothetical Limits of Solar Thermochemical Hydrogen.

The van't Hoff method is a standard approach for determining reaction enthalpies and entropies, e.g., in the thermochemical reduction of oxides, which is an important process for solar thermochemical fuels and numerous other applications. However, by analyzing the oxygen partial pressure pO2, e.g., as measured by thermogravimetric analysis (TGA), this method convolutes the properties of the probe gas with the solid-state properties of the examined oxides, which define their suitability for specific applications. The "chemical potential method" is here proposed as an alternative. Using the oxygen chemical potential ΔμO instead of pO2 for the analysis, this method does not only decouple gas-phase and solid-state contributions but also affords a simple and transparent approach to extracting the temperature dependence of the reduction enthalpy and entropy, which carries important information about the defect mechanism. For demonstration of the approach, this work considers three model systems; (1) a generic oxide with noninteracting, charge-neutral oxygen vacancy defects, (2) Sr0.86Ce0.14MnO3(1-δ) alloys with interacting vacancies, and (3) a model for charged vacancy formation in CeO2, which reproduces the extensive experimental TGA data available in the literature. The reduction behavior of these model systems obtained from the chemical potential method is correlated with simulated results for the thermochemical water splitting cycle, highlighting the exceptional behavior of CeO2, which originates from defect ionization. The theoretical performance limits for solar thermochemical hydrogen within the charged defect mechanism are assessed by considering hypothetical materials described by a variation of the CeO2 model parameters within a plausible range.