Total Fluid Volume Research Articles

Daily Fluid Intake Behaviors and Associated Health Effects Among Australian and United States Populations.

Minimal data exist exploring intercontinental differences in fluid intake (FI) beliefs and behaviors and the impact on fluid intake practices (i.e., fluid intake volume, beverage type, and timing of fluid intake). Therefore, this study explored the impact that FI beliefs and behaviors had on FI practices among emerging adults living in the United States (USA) and Australia (AUS). A total of 489 individuals (74.5% female; USA, 79.4%; age, 25 ± 6 years completed a 23-item survey between November 2020 and June 2021). Participants detailed their FI practices. FI beliefs were evaluated to determine their contribution to FI behaviors across the day. Multinomial and multiple linear regression analyses explored the association of daily FI beliefs and behaviors across multiple domains. Independent sample t-tests and chi-square analyses were conducted to compare FI practices, beliefs, and behaviors between individuals in the USA and AUS. FI behaviors were significantly different between countries, with the USA more likely to consume fluids to meet a total target volume (β = 1.150, p = 0.036) and consume fluid at the same time as structured daily activities (β = 0.773, p = 0.046) compared to FI alongside food intake. However, there were no differences in the types of beverage consumed (juice, sugar-sweetened beverages, tea, and coffee), total fluid volume, and physical activity (PA) between countries (p > 0.05). Beverage consumption was higher among USA than AUS residents for water, beer, and wine (p < 0.05). Total fluid consumption was greater among males (3,189 ± 2,407 ml) than females (2,215 ± 1,132 ml; β = 3.61, p < 0.001), individuals who regularly consumed fluid during the day to meet a targeted volume (β = 1,728.5, p < 0.001), and those who regularly consumed fluid as a habitual behavior (β = 3.97, p < 0.001) compared to those individuals who only consumed fluid alongside mealtimes (β = 1,041.7, p < 0.001). FI behaviors differed between the USA and AUS; however, total volume consumed, type of beverage consumed, and FI beliefs were similar. FI practices and behaviors appear to be individualized and context-specific among the studied populations.

Optimization of fracturing parameters for tight oil production based on genetic algorithm

It is difficult to determine the main controlling factors of tight oil production. In addition to the problem of uncontrollable prediction accuracy, the numerical prediction model established by the main controlling factors will also make the correctly predicted low production samples lose the value of development. Applying the optimization algorithm with fast convergence speed and global optimization to optimize the controllable parameters in the high-precision numerical prediction model can effectively improve the productivity of low production wells with timeliness, and bring greater economic value while saving development cost. Using PCA-GRA method, the sample weight and the weighted correlation ranking results of parameters affecting tight oil production were obtained. Thereupon then the main controlling factors of tight oil production were determined. Then we set up a BP neural network model with by taking the main controlling factors as input and tight oil production as output. The prediction effect of the network was good and can be put into use. The results of sensitivity analysis showed that the network was stable, and the total fracturing fluid volume had the greatest impact on the production of tight oil. Finally, by using genetic algorithm, we optimized the fracturing parameters of all low production well samples in the field data. Combined with the fracturing parameters of all high production well samples and the optimized fracturing parameters of low production wells, the optimal interval of fracturing parameters was given, which can provide guidance for the field fracturing operation.

1028-P: Acute Kidney Injury in Youth with Diabetes Admitted with Isolated Diabetic Ketoacidosis, Isolated Hyperglycemic Hyperosmolar State, and Hyperosmolar Diabetic Ketoacidosis: A Single Center Experience

Background: Diabetic ketoacidosis (DKA) and hyperglycemic hyperosmolar state (HHS) are hyperglycemic emergencies. The objective was to compare acute kidney injury (AKI) between youth with isolated DKA to those with hyperosmolarity and explore associations to risk of AKI. Methods: Charts were reviewed from 01/20through 12/2020 for youth admitted with DKA (serum bicarbonate ≤16 mEq/L) and/or HHS (blood glucose ≥600 mg/dL and osmolality ≥320 mOsm/kg) . Isolated HHS youth were combined with hyperosmolar DKA for analysis. AKI was defined as elevated creatinine level for age. The total amount of isotonic fluids administered was collected, both given as bolus or continuously within the first 12 hours after DKA and/or HHS confirmation. Identification of patients on an angiotensin-converting enzyme inhibitor (ACEI) was a marker for microalbuminuria. Results: A total of 369 admissions were included: 334 (90.5%) had isolated DKA, 32 (8.7%) had hyperosmolar DKA, and 3 (0.8%) had isolated HHS. Median age was 14 years (IQR=11.2,16.8) and 60% were female. Ninety-six percent had type 1 diabetes mellitus (DM) ; 4% had type 2 DM. New onset DM accounted for 31% of admissions. More hyperosmolar youth had AKI compared to isolated DKA (63% vs. 15%, p&amp;lt;0.001) . Both received similar total volume of fluids; median was 33.6 ml/kg (IQR=28.0,39.5) for isolated DKA and 38.5 ml/kg (IQR=29.1,45.4) for hyperosmolar (p=0.09) . For each unit increase in serum osmolality, the odds of having AKI increase by a factor of 1. (p&amp;lt;0.001) . The odds of AKI for new onset DM is 0.68 compared to known DM diagnosis (p=0.005) . Of the 17 patients (5%) taking an ACEI during admission, three had AKI. Conclusions: Higher serum osmolality or new onset DM are associated with increased odds of having AKI. Our findings will be useful to identify youth at risk for AKI and guide interventional studies for those with AKI and hyperosmolarity. Disclosure E.Zarse: None. M.Knoll: None. D.D.Williams: None. K.Halpin: None. G.Kallanagowdar: None. S.Tsai: Stock/Shareholder; Dexcom, Inc.

Drowning in antibiotics.

The National Confidential Enquiry into Perioperative Deaths (NCEPOD) report recommended that 'fluid prescribing be given the same value as drug prescribing', yet fluid prescription is commonly delegated to junior doctors despite being a notoriously challenging topic. When antibiotics are given as an infusion they are diluted in 100ml of fluid, which is often unaccounted for when thinking about a patient's fluid requirements. This closed-loop audit aimed to assess first, intravenous (IV) fluid therapy and second, electrolyte prescribing compliance with National Institute for Health and Care Excellence (NICE) guidelines, with and without the additional fluid given with antibiotic administration. Two retrospective audits were performed. Total fluid and electrolyte volume received with and without antibiotic fluids was correlated with recommendations in the NICE guidelines. Between cycles 1 and 2, potassium chloride with sodium chloride and glucose (PSG) was introduced as an alternative to IV maintenance fluid, and bolusing of antibiotics was mandatory. When analysing total fluid volume input per day, 10.4% and 7.45% of patients met their fluid requirement accurately in the first and second cycles, respectively. Within cycle 1, the mean total additional fluid that was given over 3 days with antibiotics was 1,572.73ml. In cycle 2, this decreased to 469.44ml when antibiotics were given as a bolus. In this closed-loop audit we noted that patients receiving IV fluids and IV antibiotics received too much additional fluid when the antibiotic dilution fluid was taken into account. Additional fluid was reduced alongside the proportion of electrolyte complications when bolusing of antibiotics was introduced. We recommend that that all nurses are trained to give antibiotics as a bolus because it can help to reduce fluid-related complications.

Acute results of a novel flexible tip radiofrequency catheter incorporating contact force sensing

Abstract Funding Acknowledgements Type of funding sources: Private company. Main funding source(s): Abbott Background Catheter ablation is an established therapy for paroxysmal atrial fibrillation (PAF). The TactiFlex Ablation Catheter, Sensor-Enabled (TactiFlex SE) is a next-generation radiofrequency ablation catheter incorporating highly accurate fiber optics-based contact force sensing technology with a flexible, laser-cut tip. This is the first report of results from the TactiFlex IDE clinical study. Purpose To demonstrate that ablation with TactiFlex SE is safe and effective for the treatment of drug refractory, symptomatic PAF. Methods The TactiFlex IDE (NCT04356040) is a prospective, non-randomized, multi-center clinical study which enrolled 305 subjects worldwide in the main study. Enrollment in the main study began on June 26, 2020 and completed on June 8, 2021. Subjects underwent de novo Pulmonary Vein Isolation (PVI) and, if indicated, a Cavotricuspid Isthmus ablation (CTI line) for CTI-dependent atrial flutter. Results Acute procedural success was achieved in 98.6% (274/278) of the main study cohort who underwent an ablation procedure using the TactiFlex SE. First pass success, defined as isolation of all pulmonary veins (PVs) confirmed after a minimum 20 min waiting period was achieved in 89.6% (249/278) of subjects. This was a significant improvement versus the TactiSense IDE trial (TactiCath Ablation Catheter, Sensor-Enabled). Significant decreases were also seen in total procedure time (123 min [101.0, 163.5]), total PV ablation time (55.5 min [35.0, 81.0]), total fluoroscopy time (6.0 min [0.0, 13.0]) and irrigation fluid volume (450.0 mL [346.0, 636.0]) (values given as Median [Q1, Q3]), see FIGURE. All subjects have completed at least 90 days of follow-up. Only 2.6% (7/271) of subjects required a repeat procedure during the 90-day blanking period. The primary safety and effectiveness endpoints will be evaluated at 12-months. At 90 days, 4.3% (12/281) subjects had experienced a primary safety endpoint event. Conclusions The acute data from the TactiFlex IDE clinical study demonstrate safety and effectiveness of the TactiFlex SE catheter in the treatment of PAF. Ablation procedures performed using the next-generation TactiFlex SE catheter were shorter and had improved acute clinical effectiveness outcomes versus the TactiSense IDE. It is anticipated these results will also be reflected in the 12-month safety and effectiveness endpoints.

Simulated large joint fluid model for evaluating intra-articular antibiotic delivery systems: initial evaluation using antibiotic-loaded calcium sulfate beads.

Introduction: Local antimicrobial delivery via calcium sulfate (CaSO) beads is used as an adjunctive treatment for periprosthetic joint infection. There is limited clinical information describing the performance of antimicrobial-loaded CaSO (ALCS) in large-scale applications. We developed a simulated large joint model to study properties of eluting ALCS. Methods: The in vitro testing platform was an adapted standardized model for tribological testing of prosthetic total hips and total knees (ASTM F732). The model was 70 mL total fluid volume, 25 % bovine serum, and 75 % phosphate-buffered saline, using ISO standard 14242-1 for human synovial fluid simulation. Four brands of CaSO were evaluated. Each 10 mL of CaSO was loaded with 1.2 grams (g) of tobramycin and 1 g of vancomycin powders. A 35 mL bead volume, equaling 175 beads, of each product was placed in incubated flasks. The test period was 6 weeks with scheduled interval fluid exchanges. Fluid samples were tested for antibiotic and calcium concentrations and pH. Results: Antibiotic elution showed an initial burst on Day 1, followed by a logarithmic reduction over 1 week. Tobramycin fully eluted within 2.5 weeks. Vancomycin showed sustained release over 6 weeks. Calcium ion concentrations were high, with gradual decrease after 3 weeks. All four CaSO products were inherently acidic. Fluid became more acidic with the addition of antibiotics primarily driven by vancomycin. Discussion: Clinicians should be cognizant of tobramycin elution burst with ALCS in large loads. The main driver of acidic pH levels was vancomycin. We propose that joint complications may result from lowered fluid acidity, and we suggest clinical study of synovial pH.

Effect of dietary protein and energy intake on embryonic survival and gene expression in the uterine endometrium of early pregnant gilts

Porcine embryonic loss during early gestation is a serious problem in swine production. Improving embryonic survival can be achieved by maternal manipulation. Protein and energy are two major components of the diet, which play decisive roles in embryonic survival. This study was performed to evaluate the effects of enhancing maternal protein or energy intake on embryonic survival during early gestation in gilts and to explore the underlying mechanism. From day (d) 0 to 30 of gestation, 40 gilts (Landrace × York) were randomly allocated to 5 diets according to daily intake of low (L, National Research Council (NRC) recommendation for gestation gilts), medium (M, 20% higher than NRC) or high (H, 40% higher than NRC) CP or metabolisable energy (ME) (LCPLME, MCPLME, HCPLME, LCPHME, HCPHME). Gilts were sacrificed on d 30 of gestation, and number of foetuses and corpora lutea, embryonic survival rate, uterine weight, and total volume of allantoic fluid were recorded or calculated. Gene expression was determined by Quantitative Real-time PCR (qPCR), western blot or immunohistochemistry. Results showed that increasing protein or ME intake significantly increased embryonic survival rate. Compared with diet LCPLME, plasma progesterone (P4) concentration in diet LCPHME increased at d 14 and d 30 of gestation. Progesterone receptor (PGR) was found not to be expressed in the epithelia but was strongly expressed in the stroma of the endometrium. Increasing protein or ME intake did not alter PGR expression in the endometrium. There was also no change in the amount of P4, hepatocyte growth factor, and fibroblast growth factor-7 in the endometrium. The mRNA abundance of cationic amino acid transporter 1 in the endometrium in diet LCPHME and HCPHME was significantly lower than in diet LCPLME. Diet HCPLME showed a tendency to increase neutral amino acid transporter 1 mRNA expression in the endometrium compared to diet LCPLME (P = 0.087). In conclusion, increasing maternal protein or ME intake had a positive effect on the embryonic survival. Increased protein intake by 20 or 40% did not alter plasma P4 level, but increasing ME intake by 40% improved plasma P4 concentration at d 14 and 30 of gestation. Increasing maternal protein or ME intake did not induce PGR expression in the endometrium. Maternal protein and energy intake likely mediate transportation of cationic and neutral amino acids from mother to foetus to affect embryonic survival and development.

Evaluation of the cellular and extracellular fluid of the body of calves using bio impedancemetry

Currently, non‐invasive animal research methods continue to develop, one of which is bioelectrical impedance analysis to determine the body's water, fat, fat‐free, and cell mass, which reflects the assessment of the body's liquids. The electrical and biological significance of impedance analysis lies in the fact that the measurement of the resistance (impedance) of the body's tissues or fluids changes during exposure to alternating currents of different frequencies and makes it possible to take into account the totality of resistance or the actual difference between two measurements taken in succession. The research object was newborn calves, healthy (G1) and with enteritis (G2), selected according to the principle of analogs, 15 animals in each group. The impedance measurements were studied using the “BICA” device (body impedance composition analyzer). Enteritis in calves is accompanied by a significant loss of electrolytes and free fluid, affecting normal metabolic processes. In this regard, the study of the liquids of the body of healthy and enteritis‐sick calves was the main goal of the research. The first signs of enteritis appeared more often on the second and third days of life. In G2: a decrease in motor activity, hunchback (calves do not lean well on the chest limbs, the head is lowered down) were shown, a decrease in the sucking reflex, retraction of the eyeballs into the orbits, low skin turgor, a red border on the gums under the arcade of the incisors. Feces in sick calves are unformed, watery, gray‐yellow in color, with a pungent, sour odor. On the tenth day of life in calves with enteritis, the total body fluid decreased, and this indicator was 1.5 times lower than in healthy calves (P &lt;0.01). The decrease in the total body fluid volume mainly occurred due to a decrease in the level of intracellular fluid, which in sick animals was 2.8 times lower than in healthy animals (p &lt;0.001). At the same time, the level of extracellular fluid in calves from the G1 and the G2 did not differ significantly and amounted to 7.9 ± 0.8% and 6.28 ± 1.0%, respectively. After the treatment (diet therapy and enroxil 5%, intramuscularly, at a dose of 1 ml per 20 kg of body weight once a day for 3 days) by the age of twenty days, the volume of total body fluid in calves with enteritis recovered and did not significantly differ from the level in healthy animals. There were no significant differences in the volume of extracellular fluid in the calves of both groups. However, as for the intracellular fluid volume, this indicator in recovered calves was still significantly lower (P &lt;0.05) than in healthy animals and amounted to 12.14 ± 1.0% and 15.48 ± 0, 7% respectively. Thus, from the data obtained, it can be seen that fluid loss occurs mainly due to the intracellular fluid with enteritis in calves. Complete recovery of the liquid sectors in calves was observed only by the age of one month.

Development of a Nonhuman Primate Model of Resistance to Punishment of Ethanol Choice

Several of the diagnostic criteria for alcohol use disorder (AUD) reflect the fact that some people continue to drink despite negative consequences. That is, vulnerable individuals are resistant to punishment. A better understanding of the behavioral and neurobiological factors that underlie this characteristic will lead to better preventive and treatment approaches to AUD. The objective of this study was to extend rodent studies by developing and validating a model of resistance to punishment of alcohol drinking in nonhuman primates. To increase translational relevance, the study was conducted in the context of an ethanol‐water choice procedure. Each day two 800‐ml bottles were hung on the monkey’s home cage for three hours, one containing a 4% ethanol solution and the other containing water. The primary dependent variable was ethanol choice (ml of ethanol consumed divided by total ml consumed x 100). When choice was stable (±10% of the 3‐day mean with no upward or downward trend), several manipulations were made. Experiment 1 characterized choice of several concentrations of ethanol (0%‐8%) versus water by substituting other ethanol concentrations for the 4% solution until choice again stabilized. The relationship between the available ethanol concentration and ethanol choice was characterized by an inverted U‐shaped function. In Experiment 2, the alternative (water) was manipulated to further validate the procedure as a model of choice. For monkeys in whom choice of the 4% ethanol solution was relatively low (&lt;30%), the bitter tastant quinine (0.01‐1.0 g/L) was added to the water solution. For monkeys with higher choice of 4% ethanol (&gt;70%), sucrose (1.0‐5.0%) was added to the water solution. These manipulations predictably increased and decreased, respectively, choice of the 4% ethanol solution. Finally, in Experiment 3, consumption of the 4% ethanol solution was punished by adding quinine (0.01‐5.6 g/L) to the ethanol solution. Increasing quinine concentrations decreased ethanol choice and ethanol intake in all monkeys without decreasing the total volume of fluid consumed. Individual differences were observed in the potency of quinine which can be interpreted as individual differences in sensitivity to punishment. These studies established and validated a novel nonhuman primate model of punishment of ethanol choice which can be used to characterize factors that underlie susceptibility versus resistance to punishing effects of adverse consequences of alcohol drinking.

Efficiency of isotonic drinks for rehydration of athletes of children and youth age

TThe most important factor limiting sports performance is insufficient fluid intake by athletes and dehydration of the body, while a significant decrease in performance and sports endurance begins with a dehydration level of 2 % and above.Objective: to study the effectiveness and safety of rehydration of the body of athletes­skiers of children and youth using isotonic drinks «Izonok» and «Izonok+».Materials and methods: the main group (n = 12, 16.2 ± 1.4 years) took isotonic drinks for 30 days to compensate for fluid losses, the comparison group (n = 8, 15.7 ± 1.1 years) — drinking water. Bioimpedance body composition analysis was carried out on a KM-AR-01-”Diamant” device (RF, St.Petersburg), and central hemodynamic analysis was carried out on a «SIMONA 111» (LLC “Okulyus 2000”, RF). The content of secretory immunoglobulin A (sIgA) and lysozyme in saliva samples of athletes was carried out by the enzyme immunoassay on an ANTHOS 2010 analyzer (Austria). Statistical data processing was carried out using the Statistica 6.0 software package from Stat Soft @ Ink USA.Results: The intake of an isotonic drink is accompanied by the stimulation of the production of secretory immunoglobulin (sIgA) and lysozyme compared to the consumption of drinking water. The total volume of fluid and the volume of extracellular fluid tended to increase; the volume of intracellular fluid remained practically unchanged; the amount of total water when taking isotonic increased.Conclusion: The investigated isotonic drinks “Izonok” and “Izonok+” are effective sports drinks for maintaining optimal water-salt balance and local immunity

Optimization of intravascular volume determination in patients with acute decompensated heart failure

Acute decompensated heart failure (ADHF) is based on multilevel pathological pathways, which include hemodynamic overload and venous stasis. Determination of the volemic status is one of the most important tasks in managing such patients. Despite the availability of modern diagnostic markers (physical examination, chest x-ray, and brain natriuretic peptide (BNP) assessment), they do not accurately assess the degree of fluid overload, and therefore there remains a need to find a new, accurate and simple technology for assessing pulmonary congestion. The urgency of this problem has led to the development of a novel non-invasive remote dielectric sensing (ReDS) technology, which is a quantitative method for measuring the total volume of lung fluid by determining the tissue dielectric properties. The use of this technology makes it possible to quickly, non-invasively and quantitatively measure the fluid content in the lungs, makes it possible to optimize the treatment regimen and reduces the number of readmissions. This article presents the results of studies on the efficacy, safety and prospects for using a ReDS technology for the quantitative measurement of total lung fluid in patients with ADHF.

Fluids affecting bladder urgency and lower urinary symptoms: results from a randomized controlled trial.

Caffeinated, alcoholic, artificially sweetened, carbonated, and acidic beverages are pervasive and consumed in large quantities. Reputedly, these beverages are "irritating to the bladder" and result in heightened void frequency, but prior studies lack control for intake volume. We tested the null hypothesis that women recruited from the community who demonstrate overactive bladder symptoms will show no difference by groups in void frequency when one group is instructed to replace listed beverages by substituting non-irritants (emphasis on water or milk) and the other group is instructed in healthy eating. This was a parallel-group randomized controlled trial design with a three-period fixed sequence (baseline and 2 and 6weeks post-baseline). We recruited 105 community women with overactive bladder symptoms. >7 voids per day or 2 voids per night, daily intake of ≥16oz. (473 ml) of beverages containing the ingredients listed above, and ≥ 32oz. (946 ml) of total fluid intake. Stratified randomization was conducted. The primary outcome was average daily void frequency on a 3-day diary. Participants were 86% white, mean (SD) age was 46.6 (17.6) years, and baseline void frequency was 9.2 (2.9) voids per day. At 2 and 6weeks, estimated average (SD) difference in void frequency between group 1 and group 2 was -0.46 (0.57) and -0.31 (0.57) voids per day (p > 0.05); the null hypothesis was not rejected. Women who reduce potentially irritating beverages while maintaining total fluid volume intake is not predictive of void frequency. Further research on type and volume of beverage intake is recommended.

Goal-directed fluid therapy in gastrointestinal cancer surgery

Objective: To investigate the effects of perioperative goal-directed fluid therapy (GDFT) on intraoperative fluid balance, postoperative morbidity, and mortality. Methods: This is a prospective randomized study, and 90 patients who underwent elective open gastrointestinal cancer surgery between April 2017 and May 2018 were included. Patients were randomized into 2 groups that received liberal fluid therapy (the LFT group, n=45) and goal-directed fluid therapy (the GDFT group, n=45). Patients’ Colorectal Physiologic and Operative Severity Score for the enUmeration of Mortality and Morbidity (CR-POSSUM) physiological score, Charlson Comorbidity Index (CCI), perioperative vasopressor and inotrope use, postoperative AKIN classification, postoperative intensive care unit (ICU) hospitalization, hospital stay, and 30-day mortality were recorded. Results: The volume of crystalloid used perioperatively and the total volume of fluid were significantly lower in the GDFT group compared to the LFT group (P&lt;0.05). CR-POSSUM physiological score and CCI were significantly higher in the GDFT group (P&lt;0.05). Although perioperative vasopressor and inotrope use was significantly higher in the GDFT group (P&lt;0.05), postoperative acute kidney injury development was not affected. Postoperative mortality was determined to be similar in both groups (P&gt;0.05). Conclusion: Although GDFT was demonstrated to be a good alternative method to LFT in open gastrointestinal cancer surgery, and it can prevent perioperative fluid overload, and the postoperative results are comparable in the two groups.

MATERIALS REQUIREMENT FOR CEMENTING THE SEVEN-INCH CASING LINER IN THE WELL X-13 AT Y FIELD

Cementing is a process of mixing cement powder, water and additives (cement slurry) which will be pumped into the wellbore through casing into the annulus along the wellbore. Liner is a casing hung onto the casing which has been set before. Before the calculation of cementing materials needed, it is needed to collect X-13 well data, in the form of well profile which is consist of casing and tubing dimension. Furthermore, laboratory data for cement and additives is also used. Based on the calculation, the total volume of cement slurry needed for open end interval cementing is 199.7 bbl, with the amount of cement sack needed is 595.2 sacks. The total solid additives needed is 21426.1 lbs and total liquid additives needed is 1294.542 gallons. The total volume of fluid needed to push the cement slurry into the cementing zone is 251.05 bbl.

Total Brain Volumetric Measures and Schizophrenia Risk: A Two-Sample Mendelian Randomization Study.

Schizophrenia (SCZ) is an idiopathic psychiatric disorder with a heritable component and a substantial public health impact. Although abnormalities in total brain volumetric measures (TBVMs) have been found in patients with SCZ, it is still unknown whether these abnormalities have a causal effect on the risk of SCZ. Here, we performed a Mendelian randomization (MR) study to investigate the possible causal associations between each TBVM and SCZ risk. Specifically, genome-wide association study (GWAS) summary statistics of total gray matter volume, total white matter volume, total cerebrospinal fluid volume, and total brain volume were obtained from the United Kingdom Biobank database (33,224 individuals), and SCZ GWAS summary statistics were provided by the Psychiatric Genomics Consortium (150,064 individuals). The main MR analysis was conducted using the inverse variance weighted method, and other MR methods, including MR-Egger, weighted median, simple mode, and weighted mode methods, were performed to assess the robustness of our findings. For pleiotropy analysis, we employed three approaches: MR-Egger intercept, MR-PRESSO, and heterogeneity tests. No TBVM was causally associated with SCZ risk according to the MR results, and no significant pleiotropy or heterogeneity was found for instrumental variables. Taken together, this study suggested that alterations in TBVMs were not causally associated with the risk of SCZ.

Cerebral structural alterations in the patients undergoing postherpetic neuralgia: A VBM-MRI study.

This study aimed to investigate the changes in gray matter (GM) volume and density in patients with postherpetic neuralgia (PHN). Using voxel-based morphometry (VBM), the differences in cerebral GM volume and concentration between 25 PHN patients and 25 healthy controls with similar gender ratios, ages, and education were compared. Meanwhile, correlation analysis was performed between the value of GM volume/concentration in the brain areas with discrepancy and the visual analog scale (VAS) score/lesion duration. The global GM volume in PHN patients was lower than that of healthy controls, while the total volume of cerebrospinal fluid in PHN patients was higher than that of healthy controls. In PHN patients, the GM volume decreased in the striatum, cerebellum, precentral gyrus, middle frontal gyrus, parahippocampal gyrus, postcentral gyrus, and so forth; the GM concentration decreased in the striatum, insula, middle and posterior cingulate, and superior temporal gyrus. There was a negative correlation between GM concentration in the right parahippocampal gyrus and the VAS in patients with PHN. In PHN patients, GM volume and density in the brain regions involved in nociceptive sensation, pain perception, and integration decreased significantly. The interaction between chronic pain of PHN and alteration of the cerebral structure may contribute to the occurrence and development of PHN.

513 Fluid Over-Resuscitation in Burn Patients After Initial 24-Hours of Care is Associated with Increased Mortality

IntroductionFluid resuscitation is a cornerstone of modern burn care. Despite the use of well-established formulae to determine the appropriate amount of fluid resuscitation for the first 24 hours of care, there is increasing recognition that patients receive fluids in excess of predicted volumes, a phenomenon termed fluid creep. Underscoring the significance of this phenomenon is the association between large volumes of fluid resuscitation and adverse outcomes. Although research in non-burn ICU patients reveals a clear association between overall fluid intake and increased morbidity, minimal burn-related literature exists regarding fluid patterns after the initial 24-hour period and their impact on outcomes. We hypothesized that increased fluid administration after the standard initial resuscitation period is associated with increased morbidity and mortality.MethodsA retrospective chart review was performed for 113 patients with ≥20% TBSA burns admitted to an American Burn Association-verified burn center between 2010 and 2020. Patients admitted with Stevens-Johnson Syndrome and/or Toxic Epidermal Necrolysis, with length of stay ≤ 72 hours, who required renal replacement therapy (RRT) within 72 hours of admission, and those with withdrawal of care ≤ 7 days of admission were excluded. Univariate and multivariate logistic regression was used to determine the association between the primary outcome of in-hospital mortality and secondary outcomes of increased ventilator days, acute kidney injury, need for RRT, and hospital length of stay, with increasing total and net fluid volumes from days 2 through 7 of treatment. Additionally, the association between first OR day and total fluid volumes in the first week were assessed.ResultsMedian age was 41 years (IQR 23-55) and TBSA was 31% (IQR 24-43). 21 patients (18.6%) died during hospitalization. Increase in net fluid balance from days 2-7 were associated with increased mortality (OR 1.016, 95% CI 1.00 – 1.03, p = 0.013). Increasing total fluid volumes were significantly associated with increased ventilator days (OR 1.027, 95% CI 1.008-1.047, p = 0.006) and acute kidney injury (OR 1.003, 95% CI 1.000-1.006, p = 0.017). Early first OR day was associated with decreased net fluid balance between hospital days 2-7 (OR 0.993, 95% CI 0.989-0.997, p = 0.001).ConclusionsSimilar to studies on other ICU populations, increasing total fluid volumes and net fluid balance is associated with adverse outcomes in critically ill burn patients. Additionally, earlier initial OR is associated with less total fluid volumes and lower net fluid balance in the first week of hospitalization. Further investigation is needed to elucidate optimal markers of resuscitation in burn patients in an effort to decrease adverse fluid administration.

Intermittent boluses of balanced salt solution for post-operative intravenous hydration following elective major abdominal and thoracic surgery in children.

Maintenance fluids following major operations in children are typically administered with a continuous rate. We hypothesized that administering fluids as intermittent boluses is more physiologic and could limit post-operative fluid volume, thereby avoiding harmful effects of excess fluid. We retrospectively reviewed children aged 1-21 admitted after an elective major abdominal or thoracic operation from 2015 to 2021. We excluded non-elective operations and patients receiving peri-operative enteral or parenteral nutrition. We analyzed total fluid volume at 0-24, 24-48, 48-72, and 72-96h, time to regular diet and discharge, and end-organ complications. We identified 363 patients, of which 108 received intermittent boluses and 255 continuous fluids. Bolus group patients received significantly less fluid up to 72h post-operatively with average rates of 0.49mL/kg/h vs 0.86mL/kg/h at 0-24h (p << 0.01), 0.57mL/kg/h vs 1.46mL/kg/h at 24-48h (p << 0.01), and 0.50 vs 0.92mL/kg/h at 48-72h (p << 0.01). Additionally, the bolus group maintained adequate urine output, tolerated a regular diet sooner (2.08days vs 2.51days; p = 0.0023) and averaged a shorter hospital stay (3.12 vs 4.14days; p = 0.004). There was no difference in adverse effects between the two groups. Utilizing intermittent boluses reduces the volume of maintenance fluids administered and may lead to a faster time to regular diet and discharge. IV. Retrospective review.

CALCULATION OF CEMENTING MATERIAL WITH PLUG BALANCE METHOD AT PLUG CEMENT PROGRAM OF WELL X FIELD Y

A cement plug is a method to place a plug to a specific depth using cement to close the well, preventing lost circulation, sidetracking at the beginning of directional drilling, and to provides a place for an open hole test. The cement plug method used in this research is the balanced plug method. This research was conducted by collecting data on Well X, in the form of well profile data covering casing and tubing dimensions. Furthermore, laboratory data for cement and additives are used. Results of the research showed that the total volume of cement slurry needed is equal to 29.455 bbl, the number of sacks of cement for cementing the open end interval of 81.4 meters is as much as 155 sacks of cement, and the total volume of fluid required to push the cement slurry into a cementing zone is equal 64.15 bbl.

Effect of post-operative goal-directed fluid therapy (GDFT) on organ function after orthotopic liver transplantation: Secondary outcome analysis of the COLT randomised control trial

BackgroundGoal-directed fluid therapy (GDFT) has been shown to reduce the complications following a variety of major surgical procedures, possibly mediated by improved organ perfusion and function. We have shown that it is feasible to randomise patients to GDFT or standard fluid management following liver transplant in the cardiac-output optimisation following liver transplantation (COLT) trial. The current study compares end organ function in patients from the COLT trial who received GDFT in comparison to those receiving standard care (SC) following liver transplant. MethodsAdult patients with liver cirrhosis undergoing liver transplantation were randomised to GDFT or SC for the first 12 h following surgery as detailed in a published trial protocol. GDFT protocol was based on stroke volume (SV) optimisation using 250 ml crystalloid boluses. Total fluid administration and time to extubation were recorded. Hourly SV and cardiac output (CO) readings were recorded from the non-invasive cardiac output monitoring (NICOM) device in both groups. Pulmonary function was assessed by arterial blood gas (ABG) and ventilatory parameters. Lung injury was assessed using PaO2:FiO2 ratios and calculated pulmonary compliance. The KDIGO score was used for determining acute kidney injury. Renal and liver graft function were assessed during the post-operative period and at 3 months and 1-year. Results60 patients were randomised to GDFT (n = 30) or SC (n = 30). All patients completed the 12 h intervention period. GDFT group received a significantly higher total volume of fluid during the 12 h trial intervention period (GDFT 5317 (2335) vs. SC 3807 (1345) ml, p = 0.003); in particular crystalloids (GDFT 3968 (2073) vs. SC 2510 (1027) ml, p = 0.002). There was no evidence of significant difference between the groups in SV or CO during the assessment periods. Time to extubation, PaO2: FIO2 ratios, pulmonary compliance, ventilatory or blood gas measurements were similar in both groups. There was a significant rise in serum creatinine from baseline (77 μmol/L) compared to first (87 μmol/L, p = 0.039) and second (107 μmol/L, p = 0.001) post-operative days. There was no difference between GDFT and SC in the highest KDIGO scores for the first 7 days post-LT. At 1-year follow-up, there was no difference in need for renal replacement therapy or graft function. ConclusionsIn this randomised trial of fluid therapy post liver transplant, GDFT was associated with an increased volume of crystalloids administered but did not alter early post-operative pulmonary or renal function when compared with standard care.