Results Of Gas Analysis Research Articles

Biochemical Approach of Acid-Base Disturbances: Diagnosis Algorithm

Context: The biochemical approach to acid-base balance classifies disturbances in two categories based on cellular mechanisms. The first one being cellular respiration (ATP), which presents high anion gap and changes in carbon dioxide levels, and the second one, cellular metabolism (ion transport through membrane channels), which evidences normal anion gap and changes in other cations and anions. Objective: To present a new diagnostic algorithm for acid-base disturbances, based on the biochemical approach. Method: Original research with systematic analysis and data organization, following biochemical processes that affect acid-base balance. Results: A simple, three-step algorithm which classifies information in a diagnostic table that connects blood gas analysis results (pH, anion gap or base excess, bicarbonate, carbon dioxide and unmeasured anions) with the biochemical cause and most probable clinical findings. Conclusions: The biochemical approach is considered the new model to understand, explain and diagnose acid-base balance and disturbances. All high anion gap disturbances occur in cellular respiration, while all normal anion gap disturbances occur in membrane channel function. The diagnosis algorithm simplifies and organizes the information to describe medical conditions with data from a blood gas analysis. This approach is the first model to establish a linear correlation between lab results, biochemical cause, and clinical findings of acid-base disturbances.

The Effect of Hypertonic Saline Nebulization on Arterial Blood Gas Parameters Among Patients on a Mechanical Ventilator.

Introduction Care of the airway is an essential part of the management of patients receiving mechanical ventilation. If the airway is not properly managed, an endotracheal airway can result in retained secretions, airway obstructions, and infections. These complications may prolong mechanical ventilation durationand length of hospital stayand may increase the cost of affordability. Hypertonic saline nebulized suctioning is a technique used to lessen the duration of mechanical air flow and enhance airway clearance, which helps patients on mechanical ventilation breathe easier. Aim The objective of the study isto assess the effectiveness of nebulization with hypertonic saline on arterial blood gas parameters among mechanically ventilated patients. Methods The quasi-experimental design adopted with thirty-five mechanically ventilated samples was chosen using a non-probability purposive sample technique. Following the pre-test in the endotracheal tube, nebulization was given with 2 ml of hypertonic saline over 15-20 mins, two times each day, to the mechanically ventilated patients. Post-test was carried out about 15-20 minutes after the procedureusing arterial blood gas analysis results were obtained and interpreted. Results The study reveals that the p values corresponding to the arterial blood gas parameters PCo2, pO2, and HCo3 are less than 0.01 and are significant at a 1% level, and arterial blood gas(ABG) pHis less than 0.05 and is significant at a 5% level; hence there is a high significant difference between the pre-test and post-test mean scores of arterial blood gas parameters PCo2, pO2, HCo3, and ABG pH. Hence, the study concluded that nebulization with hypertonic saline for patients with mechanical ventilators is more effective in improving arterial blood gas parameters.

Comparison of Blood Gas Analysis and Auto-Analyzer Results for Sodium and Potassium Levels in Elderly and Non-elderly Adult Emergency Department Patients.

Objectives This study aims to evaluate the concordance between blood gas and biochemical measurement methods for sodium and potassium levels in elderly and non-elderly patients within an emergency department (ED) setting. Methods A retrospective method comparison study was conducted at an ED from February 1, 2023, to March 1, 2023. The study included 414 patients, categorized into "elderly" (aged 65 and above; n = 138, 33.3%) and "non-elderly" (aged 18 to 64; n = 276, 66.7%) groups. Concordance was assessed using Bland-Altman, Passing-Bablok, and Lin's concordance correlation methods. Results In sodium measurements, the elderly group exhibited an average bias of -1.52 mEq/L (95% confidence interval [CI] -2.12 to -0.92), with lower and upper limits of agreement (LoA) at -8.46 and 5.42 mEq/L, respectively, indicating a broader variance than non-elderly patients, who showed an average bias of -0.82 mEq/L with limits of -4.97 to 3.32 mEq/L. For potassium, the elderly group's average bias was -0.46 mEq/L (95% CI -0.36 to -0.57), with limits of agreement from -1.68 to 0.75 mEq/L, compared to non-elderly patients with a bias of -0.29 mEq/L and limits of -0.71 to 0.13 mEq/L. Furthermore, concordance correlation coefficients revealed a reduced agreement in the elderly for both sodium (r ccc = 0.799) and potassium (r ccc = 0.529) compared to the non-elderly cohort (sodium r ccc = 0.821, potassium r ccc = 0.715). Conclusion The study identifies significant discrepancies in sodium and potassium levels between elderly and non-elderly patients, suggesting a need for diagnostic precision. It emphasizes the importance of customizing diagnostic approaches to better serve the elderly population in EDs.

Exploring the Prevalence of Respiratory Failure in Adults Presenting With Acute Exacerbations of Chronic Obstructive Pulmonary Disease.

Chronic obstructive pulmonary disease (COPD) poses a significant global health burden and is a leading cause of morbidity and mortality. Acute exacerbations of COPD often lead to respiratory failure, necessitating a thorough understanding of its prevalence. This study aimed to investigate the prevalence of respiratory failure among adult patients experiencing acute exacerbations of COPD. A descriptive, cross-sectional study was conducted over a span of seven months at the internal medicine department of Hayatabad Medical Complex, Peshawar. A total of 255 adult patients with acute exacerbations of COPD were included, and their demographic data, as well as arterial blood gas (ABG) analysis results, were collected. The prevalence of respiratory failure was defined by specific arterial blood gas criteria. The study revealed a notable prevalence of respiratory failure (41.18%) among COPD patients presenting with acute exacerbations. Factors such as older age and male gender were identified as being associated with a heightened risk of respiratory failure. In conclusion, acute exacerbations of COPD predominantly affect middle-aged males (65.5%), with the 51-60 age group being the most impacted. Respiratory failure was present in over 41% of cases. ABG analysis indicated significant acid-base imbalances, hypoxemia, and hypercapnia, with compensatory chronic respiratory acidosis. These findings highlight the need for targeted interventions to manage and prevent COPD exacerbations, especially in middle-aged men.

Energy recovery from sewage sludge waste blends: Detailed characteristics of pyrolytic oil and gas

Using waste as an alternative energy source may partially replace fossil fuels. In this paper, energy recovery from waste blends (sewage sludge (SS), polyethylene (LDPE) and polypropylene (PP), paper rejects (PR), and waste tyres) was tested through laboratory-scale co-pyrolysis. For each co-pyrolysis test, 7 l of waste blend in different ratios were used. The results of pyrolytic oil and gas analyses show valuable compounds and chemical materials recovered. The detailed analyses show the effects of co-pyrolysis parameters, especially the ratios of waste blends with respect to the process temperature of 600°C, on the pyrolytic gas and oil. The highest volumes of gas (0.66 m3) and oil (699 ml) were obtained from sample 5_8 (PES:SS:PR). Waste blend 15_1 (LDPE:SS) had the highest gross calorific value (GCV) of 43.82 MJ/m3 in gas, and had the highest proportion of flammable components (46.31% of methane). Sample 5_8 had the highest calorific value in pyrolytic oil (45 MJ/kg) and sample 5_3 had the lowest (28.113 MJ/kg), which is comparable to coal. High-quality pyrolytic gas and oil were obtained with average GCV of 44 MJ/m3 and 40 MJ/kg respectively, where the average GCV of the most calorific fossil fuels is 43.6 MJ/kg in crude oil and 34 MJ/m3 in natural gas. We conclude that co-pyrolysis of sewage sludge and waste is a convenient and simple method of waste disposal under a synergetic effect of efficient waste management, energy production, and reduction of dependence on fossil fuels.

Effects of small-dose S-ketamine on anesthesia-induced atelectasis in patients undergoing general anesthesia accessed by lung ultrasound: study protocol for a randomized, double-blinded controlled trial.

Atelectasis after anesthesia induction in most patients undergoing general anesthesia may lead to postoperative pulmonary complications (PPCs) and affect postoperative outcomes. However, there is still no existing effective method used for the prevention of perioperative atelectasis. S-ketamine may prevent atelectasis due to airway smooth muscle relaxation and anti-inflammatory effects. Lung ultrasound is a portable and reliable bedside imaging technology for diagnosing anesthesia-induced atelectasis. The primary objective of this study is to assess whether a small dose of S-ketamine can reduce the incidence of atelectasis after intubation, and further investigate the effects of preventing the early formation of perioperative atelectasis and PPCs. This is a single-institution, prospective, randomized controlled, parallel grouping, and double-blind study. From October 2020 to March 2022, 100 patients (18-60 years old) scheduled for elective surgery will be recruited from Beijing Tiantan Hospital, Capital Medical University, and randomly assigned to the S-ketamine group (group 1) and the normal saline group (group 2) at a ratio of 1:1. The label-masked agents will be administered 5 min before induction, and all patients will undergo a standardized general anesthesia protocol. Related data will be collected at three time points: after radial artery puncture (T1), 15 min after tracheal intubation (T2), and before extubation (T3). The primary outcome will be the total lung ultrasound scores (LUS) at T2. Secondary outcomes will include LUS in six chest regions at T2, total LUS at T3, arterial blood gas analysis results (PaCO2, PaO2) and PaO2/FiO2 at T2 and T3, and plateau pressure (Pplat) and dynamic lung compliance (Cdyn) at T2 and T3. The incidence of postoperative complications associated with S-ketamine and PPCs at 2 h and 24 h after surgery will be recorded. This trial aims to explore whether a simple and feasible application of S-ketamine before the induction of general anesthesia can prevent atelectasis. The results of this study may provide new ideas and direct clinical evidence for the prevention and treatment of perioperative pulmonary complications during anesthesia. ClinicalTrials.gov NCT04745286. Registered onFebruary 9, 2021.

Hemostatic effect of fibrinogen concentrate on traumatic massive hemorrhage: a propensity score matching study

BackgroundFibrinogen concentrate (FC) can be administered during massive transfusions to manage trauma-induced coagulopathy. However, its effectiveness in survival remains inconclusive due to scarce high-level evidence. This study aimed to investigate...

Long-term neurodevelopmental effects of exclusively high cord lactate levels in term newborn

Introduction Cord arterial blood gas analysis (ABGA) results are used as diagnostic criteria for hypoxic-ischemic encephalopathy in newborns with suspected perinatal asphyxia. This study evaluated the effect of cord ABGA lactate level on the long-term neurodevelopment of newborns without any clinical signs of perinatal asphyxia. Methods This clinical observation study was designed among term babies born between 2018 and 2019 in our unit. Cases with a 5-min Apgar score <7 and signs of fetal distress in their antenatal follow-up were excluded. The cases (n = 1438) were divided into two groups those with high cord lactate levels (above 5 mmol/L, n = 92) and those with low lactate levels (below 2 mmol/L, n = 255). An Ages and Stages Questionnaire, Third Edition (ASQ-3) developmental screening questionnaire was sent to all parents. Patients with a chronological age between 24 and 42 months and for whom the parents fulfilled the questionnaire (low lactate group, n = 29, and high lactate group, n = 45) were evaluated. Results No difference was observed between the two groups in terms of demographic characteristics such as age (p = .1669), male gender (p = .906), mother’s working situation (p = .948), mother’s education level (p = .828), father’s education level (p = .507), and family’s total income (p = .642). Mean ACQ-3 developmental screening test scores were significantly lower in the high lactate group compared to the low lactate group concerning; fine motor (40 vs. 60, p = .001), problem-solving (50 vs. 60, p = .002), and personal social development (45 vs. 60, p = .003). No difference was observed in terms of communication and gross motor total scores. Discussion In general practice, routine cord ABGA is not generally recommended for patients with normal Apgar scores and no suspected hypoxia. However, in this study, we observed that cases with a normal 5-min Apgar score, no suspected perinatal asphyxia, and a cord lactate value of ≥5 fell behind their peers when evaluated with the ACQ-3 developmental screening questionnaire.

User Perceptions of Visual Blood: An International Mixed Methods Study on Novel Blood Gas Analysis Visualization.

Blood gas analysis plays a central role in modern medicine. Advances in technology have expanded the range of available parameters and increased the complexity of their interpretation. By applying user-centered design principles, it is possible to reduce the cognitive load associated with interpreting blood gas analysis. In this international, multicenter study, we explored anesthesiologists' perspectives on Visual Blood, a novel visualization technique for presenting blood gas analysis results. We conducted interviews with participants following two computer-based simulation studies, the first utilizing virtual reality (VR) (50 participants) and the second without VR (70 participants). Employing the template approach, we identified key themes in the interview responses and formulated six statements, which were rated using Likert scales from 1 (strongly disagree) to 5 (strongly agree) in an online questionnaire. The most frequently mentioned theme was the positive usability features of Visual Blood. The online survey revealed that participants found Visual Blood to be an intuitive method for interpreting blood gas analysis (median 4, interquartile range (IQR) 4-4, p < 0.001). Participants noted that minimal training was required to effectively learn how to interpret Visual Blood (median 4, IQR 4-4, p < 0.001). However, adjustments are necessary to reduce visual overload (median 4, IQR 2-4, p < 0.001). Overall, Visual Blood received a favorable response. The strengths and weaknesses derived from these data will help optimize future versions of Visual Blood to improve the presentation of blood gas analysis results.

Surface Geology Analysis on the Relationship between Fault Creep and Overpressure in Grobogan, Central Java, Indonesia

The Grobogan Regency is a significant location for oil and gas exploration due to its proximity to active oil and gas fields. Geologically, this area is intersected by the Kendeng thrust fault and exhibits several surface manifestations of mud volcanoes near the fault. However, there have been limited studies examining the activity of the Kendeng thrust fault and its relationship to overpressure and earthquakes, which could affect oil and gas exploration and natural disaster mitigation in the region. This paper focuses on utilizing surface geological mapping data and Interferometric Synthetic Aperture Radar (InSAR) data to analyze the relationship between fault creep and overpressure manifestations in Grobogan, Central Java. While continuous research on fault creep has been conducted since the 1960s on the San Andreas fault in the United States, there has been a lack of continuous research on onshore fault creep in the Northeast Java Basin or Kendeng Basin, particularly in the Grobogan area. This region, known for its abundance of active mud volcano manifestations, is predominantly characterized by marl and clay lithology. It represents a warm basin environment that is prone to overpressure and ideal for fault creep occurrences.To investigate further, fluid, gas, and mud samples were collected from the mud volcanoes, along with rock samples from the surrounding area, for comprehensive laboratory analysis. The integration of these sample analyses aimed to determine the correlation between the activity of the Kendeng thrust fault creep and the subsurface overpressure conditions. While this study observed several indications of creeping in the vicinity of InSAR anomalies, the exact location of the creeping fault plane could not be definitively determined. The Kendeng thrust fault exhibits the three main factors necessary for initiating fault creeping. The fault segment’s extremely slow creeping may be linked to the activity of the mud volcanoes, as indicated by the results of fluid, gas, and rock sample analysis. The findings of this research hold potential for informing the development of oil and gas fields, as well as enhancing the mitigation of natural disasters associated with oil and gas exploration and earthquakes in the region.

The Relationship between Blood Gas Analysis Profile and the Outcome of Severe COVID-19 Patients

Coronaviruses commonly infect the respiratory tract, leading to severe pneumonia. Respiratory problems cause numerous acid-base disorders in 2019 Coronavirus Disease (COVID-19) patients. Several studies have explored laboratory biomarkers used in the management and prognosis of COVID-19 patients during this pandemic; however, only a few focused on blood gas analysis. Determine the blood gas analysis pattern and its association with the outcome of severe COVID-19 patients treated in the Intensive Care Unit (ICU). This retrospective cohort study used secondary data from patients with severe COVID-19 treated in the ICU of Hasanuddin University Hospital between January and December 2021. There was a higher number of male (58.8%) compared to female patients (41.5%), with a mean age of 62 years. Respiratory alkalosis was the most prevalent blood gas disorder (24.4%). Metabolic alkalosis was a blood gas disorder with the highest number of recovery/improvement outcomes (8 patients). There was no significant relationship between blood gas analysis results and the outcome of severe COVID-19. In addition, no specific pattern was found in the results of blood gas analysis. Respiratory alkalosis was the most frequent blood gas disorder detected in these patients.

Prognostic role of intermountain risk score (IMRS) in intensive care unit patients with a diagnosis of COVID-19.

In this study, we aimed to assess the predictive value of Intermountain Risk Score (IMRS) in intensive care unit (ICU) patients with COVID-19. Our retrospective study included the data of 194 patients who were admitted to the COVID-19 ICU of a tertiary care center. COVID-19 diagnoses were made by a positive result from a real-time reverse-transcriptase (RT) polymerase chain reaction (PCR) assay of nasal and pharyngeal swab specimens. Patients who had negative RT-PCR results or who were not admitted to ICU and patients under 18 years old were excluded from the study. Complete blood count, biochemistry panel, and blood gas analysis results were gathered and compiled. 194 ICU patients with COVID-19 (PCR positive) were included in the study. The patients were divided into two groups according to IMRS (if IMRS was <15 in women and <17 in men, patients were included in the non-high-risk group, while patients with IMRS ≥15 in women and ≥17 in men were defined as a high-risk group). Multivariate regression analysis was performed to predict in-hospital mortality. The IMRS [OR: 1.17 (1.08-1.27) p<0.001)] was found to predict in-hospital mortality. In this study, we showed that the IMRS score at admission can predict in-hospital mortality in intensive care unit patients with a diagnosis of COVID-19.

Improving Clinical Decision-Making: A Focus on Early Warning Systems and Scoring Methods

Dear Editor, Examinations, laboratory tests, radiology, and clinical experience are required to make the most appropriate clinical decisions. There is no single universal clinical decision-making method advocated in routine medical literature. Often, this process is driven by experience, exploration, and clinical gestalt. Clinician management serves as a subjective decision tool in disease management. It has been extensively studied in the literature, particularly in entities such as pulmonary embolism, difficult airway prediction, and severe COVID-19 (1). By combining parameters such as laboratory-vital parameters and combined hematological parameters, clinical decision-making tools have been developed (2-3). Early warning systems (EWS) help predict which patients will require critical care by evaluating physiological parameters in busy and crowded workspaces. These scores, which can be measured through vital parameters and a simple physical examination, ensure the effective use of resources (4). In intensive care units (ICUs), complex systems are used to predict mortality. APACHE II is the most well-known score used in intensive care, consisting of many parameters that are computationally difficult. Vital parameters, biochemical tests, and blood gas analysis results are used when calculating APACHE II (5). On the other hand, important features of scores used in the emergency department are their quick and easy calculation, requiring no professional knowledge. The VitalPAC Early Warning Score (ViEWS), developed by Prytherch et al. in 2010, is an EWS that includes six physiological parameters. This score records the pulse rate, systolic blood pressure, respiratory minute rate, body temperature, level of consciousness (assessed by AVPU), and peripheral oxygen saturation (SpO2) parameters. ViEWS is created based on the degree of deviation of these six parameters from their normal ranges. Additional points are given if the patient receives oxygen support. The total ViEWS value, calculated by considering each parameter, provides information about the patient's prognosis (6). By adding the rapid lactate level to ViEWS (ViEWS-L), a score that better predicts outcomes in the geriatric population was developed (7). The Modified Early Warning Score (MEWS) is one of the triage scoring methods used to identify patients in need of intensive and critical care, and to expedite their transfer to the intensive care unit. It evaluates systolic blood pressure, heart rate, respiratory rate, body temperature, and neurological status. MEWS is included in routine nursing care procedures in some countries and is routinely assessed by nurses. ICU admission rates and mortality rates increase for those who score 5 or more on this scale, although this threshold may vary in different populations or clinical situations. In a Korean study analyzing sepsis patients, combining lactate with the MEWS score improved the prediction of the need for intensive care (8). The National Early Warning Score (NEWS) is another scoring system used to determine clinical deterioration and follow-up level for all hospitalized patients, as well as to predict clinically high-risk patients. It is calculated by evaluating respiratory rate, oxygen saturation, oxygen support status, blood pressure, body temperature, and neurological status. The NEWS-L score, obtained by combining NEWS with lactate, has been reported to be superior to NEWS alone in geriatric critically ill patients (9). However, contrary to the geriatric patient study, Özkan's study reported that NEWS-L was not superior to NEWS and that they exhibited similar predictive abilities (10). As a result, researchers are actively working on new parameters and scoring systems to optimize resource utilization and predict critical illness. Researchers should be encouraged to investigate studies on EWS lactate combinations or other combinations.

Analysis of the Efficacy of Humidified High-Flow Nasal Oxygen Therapy Combined with Alveolar Lavage in the Treatment of Patients with Severe Pneumonia Complicated with Respiratory Failure

Objective: To analyze the curative effect of humidified high-flow nasal oxygen therapy combined with alveolar lavage in patients with severe pneumonia and respiratory failure. Methods: 120 patients with severe pneumonia complicated with respiratory failure admitted to the Third People’s Hospital of Xining from July 2021 to December 2022 were randomly divided into two groups: group A and group B. The patients in group A were given humidified high-flow nasal oxygen therapy combined with alveolar lavage, whereas those in group B were given humidified high-flow nasal oxygen therapy. The treatment efficacy, blood gas analysis results, and differences in inflammatory mediators were compared between the two groups. Results: The curative effect in group A (96.67%) was significantly higher than that in group B (81.67%), P &lt; 0.05; the partial pressure of carbon dioxide (PaCO2), partial pressure of oxygen (PaO2 ), oxygen saturation (SpO2 ), and Horowitz index (P/F) of group A were significantly better than group B, P &lt; 0.05; the interleukin 6 (IL-6), tumor necrosis factor alpha (TNF-α), and C-reactive protein (CRP) levels, white blood cell (WBC) count, serum procalcitonin (PCT), and neutrophil (N) percentage of group A were significantly lower than those of group B, P &lt; 0.05. Conclusion: For patients with severe pneumonia complicated with respiratory failure, alveolar lavage, on the basis of humidified high-flow oxygen therapy, can inhibit local inflammation, improve blood gas analysis results, promote disease recovery, and improve the clinical treatment effect.

Study on the inhibition performance of double network physicochemical nanocomposite gel inhibitor on coal spontaneous combustion

To strengthen the inhibition effect of an inhibitor on spontaneous coal combustion throughout the process, this study used solution polymerization to synthesize hyaluronic acid and polyethylene glycol into a double network gel. The double network gel was grafted with a chemical inhibitor, epigallocatechin gallate, and polymerized with nanomaterial attapulgite to prepare a double network gel composite inhibitor with a whole-process inhibition effect. From the results of the scanning electron microscopy test, we found that the folds and pores on the surface of the inhibitor considerably increased with composite treatment. From the results of thermogravimetric analysis, it was proved that the average increase in each characteristic temperature point of the coal sample was 28.15%. According to the results of differential scanning calorimetry, it was found that the heat release interval of the inhibited sample was narrowed, and the total heat release was reduced by 2408.08 J/g. From the results of gas analysis, it was concluded that the production of CO, CO2, and CH4 by the inhibited sample markedly reduced, which verified the environmental friendliness of the inhibitor. Through a diffuse reflection infrared spectrum test, it was found that the inhibition treatment could deactivate the active groups in coal and increase the content of the ether bonds of the stable functional groups, which proved that the composite inhibitor is an excellent fire prevention material.

Experimental investigation on soot formation and characteristics of ethylene flames: Scale effects

Understanding the mechanism of scale effect was of great significance for both fundamental theory and actual combustion regulation. Using five combustors of different diameters (4, 6, 7, 8, and 10 mm), this study experimentally investigated the impact of scale effect on soot formation and combustion characteristics using optical and sampling diagnostic methods. For the optical results of two-color pyrometry, the scale effect exerted a non-monotonic effect on flame temperature. The flame temperature increased firstly with the enlargement of the combustor diameter from 4 to 7 mm, but it decreased rapidly when the combustor diameter continued to increase from 7 to 10 mm. However, the soot concentration increased at first and then remained constant approximately with the enlargement of combustor diameter, which exhibited a different tendency from flame temperature. For the sampling results of TEM and TGA, fringe tortuosity and oxidation rate of soot decreased with the combustor diameter enlargement, indicating the higher soot carbonization degree from the larger scale. Furthermore, for the result of exhaust gas analysis, the C2H4 concentration decreased first and then increased with the enlargement of combustor diameter, which also proved that the scale effect exerted a non-monotonic effect on the combustion process.

DIAGNOSIS OF POWER TRANSFORMERS INSTALLED IN THE ABIDJAN SOUTH AREA IN COTE DIVOIRE USING DATABASES CONSISTING OF GAS ANALYSIS RESULTS DISSOLVED IN INSULATING OILThe transformer is the most important piece of equipment in the electric power system used to transmit and distribute electricity. The oil/paper mixed insulation system is one of the essential parts due to the various defects that

DIAGNOSIS OF POWER TRANSFORMERS INSTALLED IN THE ABIDJAN SOUTH AREA IN COTE DIVOIRE USING DATABASES CONSISTING OF GAS ANALYSIS RESULTS DISSOLVED IN INSULATING OILThe transformer is the most important piece of equipment in the electric power system used to transmit and distribute electricity. The oil/paper mixed insulation system is one of the essential parts due to the various defects that

Exploration of the Role of Cluster Nursing in RICU AECOPD Patients With RF

Objective: To observe the clinical benefit of cluster nursing mode in RICU patients with acute exacerbation of Chronic Obstructive Pulmonary Disease (COPD) complicated with RF. Methods: From December 2020 to March 2022, 73 cases of patients with acute COPD and RF admitted to RICU Department of Respiratory Department were selected. According to the order before and after admission to RICU department of respiratory department, patients with inability to communicate due to disease were excluded and divided into two groups. Control group: Adoption of traditional nursing mode; Observation group: Cluster nursing mode was adopted. After nursing, blood gas analysis results and patients' satisfaction scores on nursing work were compared and observed between the two groups. Results: The blood gas analysis results of the observation group were significantly better than the control group, and their evaluation of nursing work was also higher than the control group. Conclusion: In the clinical operation of our department RICU, this cluster nursing mode alleviates the distress perception of patients with COPD acute attack combined with RF, which also alleviates the patients' mood, improves the patients' understanding and satisfaction of nursing work, and thus playing a promoting role in improving the nursery-patient relationship and nursery-patient harmony.

Regularities of change in physical-mechanical and corrosion properties of heat-strengthened reinforcing 20GS2 steel

The effect of the regularities in changes of the physical-mechanical and corrosion properties of 20GS2 reinforcing steel subjected to heat treatment is considered. It is found that steel has the highest sensitivity to cracking, regardless of the type of tempering (from electric heating or furnace), in the temperature range of 400...450 °С, and with a subsequent increase in tempering temperature, cracking resistance increases. The electron microscopic studies made it possible to establish that at 450 °С the martensitic orientation of cementite plates completely disappears, coherence is lost, block boundaries disintegrate, sizes and shapes of cementite plates change, and precipitation of carbides along grain boundaries begins. Such an unstable structure has an increased ability to absorb hydrogen (results of gas analysis), which leads to an acceleration of the process of hydrogen cracking. Therefore, electric heating of 20GS2 steel after high-temperature thermomechanical treatment is required to be carried out to temperatures of 500...550 °С.

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.