Fluid Volume Research Articles

Associations of resuscitation fluid load, colloid-to-crystalloid infusion ratio and clinical outcomes in children with dengue shock syndrome.

Severe respiratory distress and acute kidney injury (AKI) are key factors leading to poor outcomes in patients with dengue shock syndrome (DSS). There is still limited data on how much resuscitated fluid and the specific ratios of intravenous fluid types contribute to the development of severe respiratory distress necessitating mechanical ventilation (MV) and AKI in children with DSS. This retrospective study was conducted at a tertiary pediatric hospital in Vietnam between 2013 and 2022. The primary outcomes were the need for MV and renal function within 48 h post-admission. A predictive model for MV was developed based on covariates from the first 24 h of PICU admission. Changes in renal function within 48 h were analyzed using a linear mixed-effects model. A total of 1,278 DSS children with complete clinical and fluid data were included. The predictive performance of MV based on the total intravenous fluid volume administered yielded an AUC of 0.871 (95% CI, 0.836-0.905), while the colloid-to-crystalloid ratio showed an AUC of 0.781 (95% CI, 0.743-0.819) (both P < 0.001). The optimal cut-off point of the cumulative fluid infusion was 181 mL/kg, whereas that of the colloid-to-crystalloid ratio was 1.6. Multivariable analysis identified female patients, severe bleeding, severe transaminitis, excessive fluid resuscitation, and a higher proportion of colloid solutions in the first 24 h as significant predictors of MV in DSS patients. The predictive model for MV demonstrated high accuracy, with a C-statistic of 89%, strong calibration, and low Brier score (0.04). Importantly, a more pronounced decline in glomerular filtration rate was observed in DSS patients who required MV than in those who did not. This study provides insights into optimizing fluid management protocols, highlighting the importance of monitoring fluid volume and the colloid-to-crystalloid ratio during early resuscitation to improve the clinical outcomes of DSS patients.

Faricimab efficacy in type 1 macular neovascularization: AI-assisted quantification of pigment epithelium detachment (PED) volume reduction over 12 months in Naïve and switch eyes

BackgroundThis study evaluates the efficacy of intravitreal Faricimab in reducing pigment epithelium detachment (PED) and fluid volumes in both treatment-naïve eyes and eyes unresponsive to anti-VEGF mono-therapies, all diagnosed with type 1 macular neovascularization (T1 MNV) over a period of 12-month.MethodsA retrospective, single-center cohort study was conducted at the Jules Gonin Eye Hospital, Lausanne, Switzerland. Clinical records of treatment-naïve and non-responder switch patients presenting T1 MNV secondary to neovascular age-related macular degeneration (nAMD) from September 2022 to March 2023 were reviewed. Patients received a loading dose of three monthly Faricimab injections followed by a treat-and-extend (T&E) regimen. Multimodal imaging, including structural OCT and AI-assisted analysis, was used to quantify PED volumes and related fluid biomarkers at baseline, 3-month, 6-month, and 12-month follow-up. Statistical analyses included linear mixed models to evaluate differences and trends in intraretinal (IRF), subretinal fluid (SRF) and PED volumes.Results65 eyes of 65 patients were enrolled (female: 70.7%; mean age = 80.7yrs, SD = 6.9yrs). 80% had received anti-VEGF treatment (Switch group) and 20% were treatment-Naïve at baseline. At 12 months, intravitreal treatments were more frequent in the Switch group (mean number = 8.3 vs. 6.0; p = 0.009). BCVA improved at the 12-month follow-up in Naïve eyes (+ 6.9 ETDRS letters from baseline, p = 0.053) and was maintained in Switch eyes. No cases of intraocular inflammation were observed. Significant reduction in SRF and IRF volumes were noted in both groups. A significant reduction in PED volume was observed over the follow-up period in both groups (mean slope = -206 nL, 95%CL = -273/-138; p-value < 0.001).ConclusionsIntravitreal Faricimab significantly reduced PED volumes in both treatment-Naïve and non-responder Switch patients over 12 months. The study highlights Faricimab’s potential as an effective treatment option for T1 MNV in nAMD, offering significant improvements in PED volume and related fluid biomarkers.

Utilising uniportal video-assisted thoracoscopic surgery for pericardial window: A 12-year single-centre experience in the diagnosis and treatment of pericardial effusion.

Uniportal video-assisted thoracoscopic surgery (Uni-VATS) is an effective minimally invasive technique for pericardial drainage, biopsy and window creation in cases of pericardial effusion (PE). This retrospective study evaluated 73 patients with PE who underwent pericardial window procedures between 2012 and 2024. Intraoperative and post-operative data related to Uni-VATS were assessed. The mean age of the patients was 53.79 ± 17.79 years (10-82 years), with 34 (46.6%) females and 39 (53.4%) males. The mean volume of pericardial fluid drained after window creation was 446.23 ± 199.81 cc (75-1100 cc). The mean operation time was 42.87 ± 12.79 min, and chest drain removal occurred after an average of 1.8 ± 1.2 days. The mean duration until discharge or referral to the follow-up clinic was 5.98 ± 2.14 days. In addition to the pericardial window procedure, pleural biopsy was performed in 12 patients, mediastinal mass biopsy in eight patients and wedge resection for parenchymal nodules in six patients. Microbiologic and virologic cultures of the fluids were negative in all cases. Among the 41 patients with benign cytology, pericardial biopsy results indicated tuberculosis in four patients (5.4%), amyloidosis in one patient (1.3%) and chronic or subacute nonspecific pericarditis in the remaining patients. Uni-VATS is a novel and safe technique that may be the preferred choice for pericardial window due to its diagnostic and therapeutic efficacy, ability to perform simultaneous procedures, favourable impact on operation duration/hospital stay, low complication rates and superiority compared to traditional methods.

Investigation of brain volume changes associated with aging: Results from the fourth research on osteoarthritis/osteoporosis against disability survey.

This study aims to investigate the impact of aging on brain volume among community residents in Japan, focusing on trends over time and specific brain structures. We analyzed data from the fourth survey (2015-2016) of the Research on Osteoarthritis/Osteoporosis Against Disability project, encompassing 2146 community residents from Japan's mountainous and coastal regions. A total of 1755 participants (81.8% of the baseline population) underwent extensive data collection including lifestyle and health questionnaires, anthropometric measurements and brain magnetic resonance imaging. The imaging data were processed to examine correlations between total brain volume, gray matter volume (GMV), white matter volume (WMV), cerebrospinal fluid volume and participant age. Analysis showed significant sex differences in total brain volume, with GMV demonstrating a strong negative correlation with age - more pronounced than the moderate negative correlation seen in WMV. Cerebrospinal fluid volume exhibited a strong positive correlation with age. Notably, specific brain regions such as the bilateral amygdala, hippocampus, thalamus and primary motor cortex showed significant age-related volume reductions. This study confirms that GMV and WMV are smaller in older individuals in the Japanese population, with more pronounced differences in GMV. The amygdala, hippocampus, thalamus and primary motor cortex were particularly affected. Geriatr Gerontol Int 2025; ••: ••-••.

Separation Time of Aluminothermic Reduction Products for Sustainable Silicon Production.

This work was carried out within the framework of the SisAl Pilot project, which is devoted to the environmentally friendly production of silicon. This new method relies on the aluminothermic reduction of quartz in slag, offering a more sustainable alternative to the traditional reduction of silica with carbon in submerged arc furnaces. The process takes place in a rotary kiln producing silicon (Si) and alumina slag (actually, a CaO - Al 2O 3 slag), which must be separated at the end to extract the silicon. This separation process is analyzed through mathematical modelling and numerical simulation, as it is of industrial interest to know how much time it takes for Si and CaO - Al 2O 3 slag to separate once the process has ended. Generally, a multiphase flow model is used to estimate the separation time of the two components once aluminothermic reduction has ended. Several scenarios are considered for the numerical simulation of the separation time, namely different initial configurations and material properties of both fluids are covered. Moreover, the separation times obtained with two distinct multiphase flow models -VOF (volume of fluid) and Eulerian- are compared. The separation times resulting from simulations using the multiphase Eulerian model are more realistic compared to those from the VOF model, which clearly tends to underestimate separation times. Furthermore, apart from the selected multiphase flow model, the density difference between silicon and alumina slag plays a critical role in determining the separation time.

Fluid volume status detection model for patients with heart failure based on machine learning methods.

Fluid volume abnormalities are a major cause of exacerbations in heart failure patients. However, there is few efficient, rapid, or cost-effective clinical approach for determining volume status, resulting in inadequate or unsatisfactory treatment. The aim was to develop an early fluid volume detection model for heart failure patients utilizing a machine learning stratification. The training set data collected by Tianjin Chest Hospital on heart failure patients from December 2016 to December 2021, included 2056 samples and 97 medical characteristics. The minimum Redundancy Maximum Relevance(mRMR) feature selection method was utilized to filter features that were strongly related to the patient's fluid volume status. Four machine learning classification models were used to predict patients' fluid volume status, and their effectiveness was measured using the receiver operating characteristic (ROC) area under the curve (AUC), calibration curve, accuracy, precision, recall, F1 score, specificity, and sensitivity. Data from 186 heart failure patients collected between January 2022 and July 2022 were employed as an external validation set to investigate the effects of model training. SHapley Additive exPlanations (SHAP) were used to interpret the ML models. Thirty features were selected for model development, and the area under the ROC curve AUC (95% CI) for the four machine learning models in the testing set was 0.75 (0.73-0.77), 0.77 (0.74-0.79), 0.70 (0.67-0.73), and 0.76 (0.73-0.78), and the AUC (95% CI) in the external validation set was 0.74 (0.71-0.76), 0.70 (0.67-0.73), 0.64 (0.59-0.68), and 0.67 (0.63-0.71). Logistic regression models were globally interpreted using SHAP-based summary plots. Machine learning methods are effective in detecting fluid volume status in heart failure patients and can assist physicians with assisted diagnosis, thus helping clinicians to tailor precise management.

Simulation and experimental investigation on kinetic and thermodynamic characteristics of liquid nitrogen droplets impacting superheated wall

Liquid nitrogen droplets impacting superheated wall is an essential phenomenon in cryogenic phase-change spray cooling. In this study, the Volume of Fluid (VOF) method was used to develop a numerical model to investigate the kinetic and thermodynamic characteristics of liquid nitrogen droplets impacting superheated wall. The experiment for the impact of liquid nitrogen droplets was conducted to validate the simulation. The findings indicate that liquid nitrogen droplets impacting superheated wall exhibit three boiling regimes: contact boiling, transition boiling, and film boiling. During contact boiling, as We increases, droplets undergo three modes sequentially: spreading, forming fingering-like structures, and fragmentation. During transition boiling and film boiling, as We increases, droplets exhibit spreading, splashing, and fragmentation. Increasing the wall temperature leads to the formation of vapor pockets and vapor film, which results in deteriorated heat transfer at the solid–liquid contact area, and meanwhile reducing the extent of droplet spreading. Increasing We promotes droplet spreading, reducing vapor pockets and vapor film thickness, increasing wetting area, and postpones the onset of heat transfer deterioration. Increasing the wall temperature and We both lead to a higher decreasing rate of liquid volume of droplet which indicates an intensified vaporization rate. The larger the contact angle of the wall, the less the droplet spreads, and the lower the heat transfer between the droplets and the wall.

Pharmacological investigation of selected 1,2,4 triazole derivative against ethanol induced gastric ulcer.

The present study aims to assess the therapeutic potential of (2S,3S,4S,5S,6S-2-(acetoxymethyl)-6-(4-chlorophenyl)-3-(pyridine-4-yl)5-thioxo-4,5-dihydro-1,2,4-triazol-1-yl tetrahydro-2H-pyran 3,4,5tryltriacetate (JAK05) on gastric ulcer. The current study was designed to evaluate the anti-ulcer potential of JAK05 against ethanol-induced gastric ulcer by employing in silico, in vitro and in vivo techniques. In silico studies, JAK05 has a binding score ranging from -8.51 to -21.38 (kcal/mol). Molecular dynamics simulation at 100ns shows better structural stability, stable binding affinity and stable conformation when bonded to H+/K+-ATPase. In vitro study demonstrates that JAK05 inhibits Helicobactor pylori. In vivo study confirmed that JAK05 promotes ulcer healing in rats at a dose of 40mg/kg and demonstrated a protective effect on the gastric mucosa, comparable to omeprazole by modulating acid secretion and fluid volume. Glutathione, glutathione-s-transferase and catalase levels increased in rat stomach tissue while nitric oxide decreased with the administration of JAK05. Additionally, lipid peroxide levels were found to have significantly decreased. Pathological histopathology analysis shows improved tissue structure and reduced inflammatory markers. These findings were confirmed using immunohistochemistry and enzyme-linked immunosorbent assay. JAK05 exhibits a high affinity for selected targets. JAK05 shows anti-ulcer properties by targeting through multiple mechanisms inhibiting H. pylori, reducing oxidative stress, suppressing inflammation and blocking acid production.

Impact of uterine cavity filling pressure levels on pain and procedure duration in diagnostic hysteroscopy: A retrospective cohort study.

This study investigates the impact of intracavitary pressure levels on pain, visualization quality, and procedure duration in office hysteroscopy, comparing standard pressures (60-100 mmHg) with high pressures (110-150 mmHg). We conducted a retrospective cohort study involving non-menopausal women undergoing diagnostic hysteroscopy at a tertiary clinic. Patients were categorized into two groups based on intracavitary pressure: the standard pressure group (60-100 mmHg; n = 72) and the high-pressure group (110-150 mmHg; n = 37). Outcomes measured included pain scores, procedure duration, and fluid volume used. Logistic regression was employed to identify risk factors for severe pain. The high-pressure group demonstrated significantly shorter procedure durations compared to the standard pressure group (96.56 ± 34.36 vs. 163.00 ± 61.78 s, p < 0.001). Pain scores were lower in the high-pressure group (VAS 3.00 [0.00-7.00] vs. 3.50 [0.00-9.00], p = 0.041). Additionally, high-pressure procedures used less fluid compared to standard pressure procedures, which helps to reduce the risk of fluid-related complications. Logistic regression analysis identified higher fluid volumes (odds ratio [OR] = 1.005, 95% confidence interval [CI] = 1.001-1.010) and the need for pressure increases (OR = 3.914, 95% CI = 1.157-13.238) as significant risk factors for severe pain. Higher intracavitary pressure levels (above 100 mmHg) in office hysteroscopy are associated with reduced pain, shorter procedure durations, and decreased fluid use, enhancing visualization and procedural efficiency while maintaining patient comfort.

Evaluation of gray-matter and white-matter microstructural abnormalities in children with growth hormone deficiency: a comprehensive assessment with synthetic magnetic resonance imaging.

Pediatric growth hormone deficiency (GHD) is a disease resulting from the impaired growth hormone-insulin-like growth factor-1 (GH-IGF-1) axis, but the effects of GHD on children's behavior and brain microstructural structure alterations have not yet been fully clarified. We aimed to investigate the quantitative profiles of gray matter and white matter in pediatric GHD using synthetic magnetic resonance imaging (MRI). The data of 50 children with GHD and 50 typically developing (TD) children were prospectively collected. Group differences in brain volumetric parameters, individual-level T1 and T2 relaxometry values, and myelin volume fraction (MVF) were assessed. Subsequently, magnetic resonance-based indices with significant differences between groups were correlated with clinical variables via partial correlation. Compared with TD children, children with GHD showed significantly decreased whole-brain gray-matter volume [P false discovery rate (PFDR) <0.001] and increased non-gray-matter/white-matter/cerebrospinal fluid (NoN) volume (PFDR<0.001). For gray-matter microstructural profiles, altered T1 and T2 relaxometry values in children with GHD were mainly distributed in the default mode (PFDR<0.001) and central executive networks (PFDR<0.001). For white-matter microstructural profiles, widespread increased regional MVF was mainly distributed in the corpus callosum, corticospinal tract, internal capsule, external capsule, and cingulum (all PFDR values <0.001). Meanwhile, the T2 relaxation values in the left cuneus (r=0.400; P=0.005) and MVF in the right corticospinal tract (r=0.313; P=0.032) had a positive relationship with IGF-1. Altered T1 and T2 relaxometry values and MVF in gray and white matter indicate the relevance of the default mode, central executive, somatosensory, visual, and cerebellar networks underlying pediatric GHD, which may imply the involvement of the GH-IGF-1 axis and myelin in the pathophysiological mechanism of GHD. Moreover, the brain microstructure alteration in cortico-striatal-limbic loop might be influenced by the GH-IGF-1 axis and play an important role in the behavioral impairments in children with GHD.

TGR5 attenuates DOCA-salt hypertension through regulating histone H3K4 methylation of ENaC in the kidney.

Epithelial sodium channel (ENaC), located in the collecting duct principal cells of the kidney, is responsible for the reabsorption of sodium and plays a critical role in the regulation of extracellular fluid volume and consequently blood pressure. The G protein-coupled bile acid receptor (TGR5) is a membrane receptor mediating effects of bile acid and is implicated in kidney diseases. The current study aims to investigate whether TGR5 activation in the kidney regulated ENaC expression and potential mechanism. Lithocholic acid (LCA), a TGR5 agonist, markedly decreased systolic blood pressure induced by DOCA-salt in mice, which was associated with decreased ENaC expression in the kidney. DOCA-salt treatment increased renal expression of histone H3 lysine 4 trimethylation (H3K4me3) and decreased expression of lysine-specific demethylase 5A (KDM5A), a lysine demethylase, which was markedly reversed by LCA. TGR5 knockout caused further increased systolic blood pressure and ENaC expression in mice with DOCA-salt in association with increased H3K4me3 and decreased KDM5A. In immortalized mouse cortical collecting duct (mpkCCD) cells LCA markedly inhibited aldosterone-induced ENaC-mediated current. LCA treatment or TGR5 overexpression markedly inhibited ENaC and H3K4me3 protein expression in association with decreased KDM5A in mpkCCD cells treated with either aldosterone or angiotensin II. Inhibition or knockdown of KDM5A in mpkCCD cells prevented LCA-induced downregulation of ENaC expression by promoting H3K4me3 on the ENaC transcription start site. LCA upregulated KDM5A expression was likely through JNK/c-Jun signal pathway. In conclusion, LCA decreased blood pressure and ENaC protein expression in the kidney of mice with DOCA-salt, likely through activating TGR5 and upregulating KDM5A-induced H3K4me3 demethylation in ENaC promoter region.

Amniotic fluid stem cell extracellular vesicles promote lung development via TGF-beta modulation in a fetal rat model of oligohydramnios.

Oligohydramnios (decreased amniotic fluid volume for gestational age) is a severe condition associated with high morbidity and mortality mainly due to fetal pulmonary hypoplasia. Currently, there are limited treatment options to promote fetal lung development. Administration of stem cells and their derivates have shown promising regenerative properties for several fetal and neonatal diseases related to arrested lung development. Herein, we first characterized pulmonary hypoplasia secondary to oligohydramnios in a surgical rat model. Experimental induction of oligohydramnios led to impaired lung growth, branching morphogenesis (fewer airspaces with decreased Fgf10, Nrp1, Ctnnb1 expression), proximal/distal progenitor cell patterning (decreased Sox2 and Sox9 expression), and TGF-β signaling. We then tested antenatal administration of extracellular vesicles derived from amniotic fluid stem cells (AFSC-EVs). In oligohydramnios lungs, AFSC-EV administration improved lung branching morphogenesis and airway progenitor cell patterning at least in part through the release of miR-93-5p. Our experiments suggest that AFSC-EV miR-93-5p blocked SMAD 7, resulting in upregulation of pSMAD2/3 and restoration of TGF-β signaling. Conversely, oligohydramnios lungs treated with antagomir 93-5p transfected AFSC-EVs had decreased branching morphogenesis and TGF-β signaling. This is the first study reporting that antenatal administration of stem cell derivatives could be a potential therapy to rescue lung development in fetuses with oligohydramnios.

Effect of intraoperative fluid volume on postoperative pulmonary complications in thoracic surgeries: A systematic review and meta-analysis

Background and Aims: There is a lack of clear recommendations on fluid strategies in patients undergoing thoracic surgeries. The primary objective of this study was to compare the amount of intraoperative intravenous fluid (IVF) infused between those who developed postoperative pulmonary complications (PPCs) and those who did not. Methods: All studies comparing PPCs in intraoperative restrictive versus liberal fluid therapies were included. Those studies where the average fluid infused was compared between PPC and the ‘no PPC’ groups were also included. The pooled mean difference in IVF between patients with and without PPC and the pooled risk ratio of PPC in restricted versus liberal fluid arms were calculated. Results: Articles from PubMed (n = 157), EMBASE (n = 724) and citation searching (n = 4) were included. After excluding duplicates, title–abstract screening for 759 articles and full-text screening for 24 articles were done. The mean fluid infused in the 11 included articles was significantly higher in those with PPC (mean difference: 1.51 ml/kg/h, P = 0.001). The pooled proportion of PPC in liberal fluid arms was higher than in restricted fluid arms [risk ratio = 0.58 (95% confidence interval: 0.33, 1.02), P = 0.06]. There was high heterogeneity in both the meta-analyses. Conclusion: The meta-analysis showed that increased intraoperative IVF is associated with higher PPCs, and a restricted fluid strategy might be safer to reduce PPCs. However, since most studies were observational with a high risk of bias and high heterogeneity, well-conducted randomised controlled trials are needed to derive recommendations.

A numerical study of two identical CO2 bubbles rising side by side in water coupled with mass transfer

ABSTRACT In contrast to the relatively straightforward rising dynamics of single bubbles, the behavior of multiple bubbles involves a more intricate interplay of flow field dynamics, trajectory patterns, morphological changes, and mass transfer phenomena. To reveal the coalescence characteristics and mass transfer effects of CO2 bubbles during the rising process, this study developed a coupled mass transfer numerical model for bubbles. The Volume of Fluid (VOF) method was used in combination with a mass transfer code for solving the model. The effects of bubble pair initial spacing and liquid viscosity on the coalescence and mass transfer were discussed. The numerical simulation results show that as the initial distance between the two bubbles decreases, the interaction force between the bubbles increases, and the possibility of bubble coalescence increases, the coalescence behavior reduces the contact area and thus decreases the amount of CO2 dissolved about 24.07%. When the initial viscosity of the liquid phase is low, there is an oscillation in the bubble velocity, and the two bubbles tend to merge. As the initial viscosity of the liquid phase increases, resistance increases, causing a decrease in bubble velocity. Consequently, the path of bubble ascent shifts from “approach-repulsion-approach” to “continuous repulsion.” The viscous resistance reduces the gas–liquid contact area, resulting in a corresponding decrease in the mass transfer rate, the dissolution amount of carbon dioxide decreased by approximately 24.42% in this case. The exploration of coupled fluid dynamics and mass transfer phenomena at the multi-bubble scale holds paramount importance in guiding the design and exploration of gas–liquid two-phase flow systems.

Does the Administration of Intravenous Fluid Matter in the Context of the Incidence of Postoperative Complications After Radical Cystectomy?

Introduction: Intravenous fluid management is integral to perioperative care, particularly under enhanced recovery after surgery (ERAS) protocols. In radical cystectomy (RC), which carries high risks of complications and mortality, optimizing fluid management poses a significant challenge due to the absence of definitive guidelines. Aim: the purpose of this study was to investigate the effects of intravenous fluid administration on postoperative complications in patients undergoing RC. Material and methods: This study involved 288 patients who underwent laparoscopic RC and urinary diversion from 2018 to 2022. ERAS protocols were implemented for all patients. Participants were divided into four groups based on the type of urinary diversion (ureterocutaneostomy vs. ileal conduit) and the intraoperative fluid volume input (less than 1000 mL vs. more than 1000 mL). Postoperative complications were evaluated at 30 and 90 days post-surgery using the Clavien-Dindo scale. The fluid management effectiveness was measured using the absolute Vascular Bed Filling Index (aVBFI) and the adjusted Vascular Bed Filling Index (adjVFBI). Results: The UCS is associated with a lower risk of increased severity of postoperative complications. The administration of more than 1000 mL of fluids was associated with a higher risk of complications (p = 0.035). However, after adjusting for the duration of the surgery and BMI, this association did not hold statistical significance, indicating that fluid volume alone is not a direct predictor of postoperative complications. At aVBFI values between zero and eight, urinary diversion using the UCS method is associated with a lower risk of complications compared to the IC. When aVBFI equals eight, the differences in the severity of complications between the UCS and the IC are minimal. However, when aVBFI exceeds eight, the IC is associated with fewer complications during the 30 days post-operation compared to the UCS. The correlation between the adjVFBI (B = -0.27; 95% CI: -0.45 to -0.08; p = 0.005) and the severity of complications up to 30 days postoperatively is similar to that seen with the aVBFI. Similarly, the correlation of the adjVFBI with the method of urinary diversion (B = 0.24; 95% CI: 0.06 to 0.43; p = 0.011) resembles that of the aVBFI. The volume of fluids administered and the indices aVBFI and adjVFBI did not influence the occurrence of complications 90 days postoperatively. Conclusions: The volume of fluids administered is not a factor directly affecting the occurrence of complications following RC when the ERAS protocol is used. The amount of intraoperative fluid administration should be adjusted according to the intraoperative blood loss. Our findings endorse the utility of aVBFI and adjVFBI as valuable tools in guiding fluid therapy within the framework of ERAS protocols. However, further multicenter randomized trials are needed to definitively determine the best fluid therapy regimen for patients undergoing RC.

Magnitude and precision of absolute blood volume estimated during hemodialysis

Background: Management of body fluid volumes and adequate prescription of ultrafiltration (UF) remain key issues in the treatment of chronic kidney disease patients.Objective: This study aims to estimate the magnitude as well as the precision of absolute blood volume ( V b ) modeled during regular hemodialysis (HD) using standard data available with modern dialysis machines.Methods: The estimation utilizes a two-compartment fluid model and a mathematical optimization technique to predict UF-induced changes in hematocrit measured by available on-line techniques. The method does not rely on a specific hematocrit sensor or a specific UF or volume infusion protocol and uses modeling and prediction tools to quantify the error in V b estimation.Results: The method was applied to 21 treatments (pre-UF body mass: 65.57 ± 13.44 kg, UF-volume: 3.99 ± 1.14 L) obtained in ten patients (4 female). Pre-HD V b was 5.4 ± 0.53 L with an average coefficient of variation of 9.8% (range 1 to 22%). A significant moderate correlation was obtained when V b was compared to a different method applied to the same data set (r = 0.5). Specific blood volumes remained above the critical level of 65 mL/kg in 17 treatments (80.9%).Conclusion: The method offers the opportunity to detect critical blood volumes during HD and to judge the quality and reliability of that information based on the precision of the V b estimate.

Role of tranexamic acid via intravenous and irrigation fluid route in controlling TURP-associated bleeding

BackgroundThis study aims to evaluate the efficacy and safety of tranexamic acid (TXA) administered via the I/V (Intravenous) route and irrigation fluid route during TURP to directly target the bleeding site.MethodsA total of 105 cases undergoing bipolar–TURP with gland size 40–100 g were randomized into three groups—control/placebo group (n = 35), I/V group (n = 35) (received 1gm TXA 20 min before the procedure) and irrigation group (n = 35) (received 500 mg TXA in every 3000 ml irrigation fluid up to a maximum of 2 g). Blood loss was estimated by recording haemoglobin and hematocrit at 4 h after the procedure and on first postoperative day. Other parameters such as resection time, intraoperative endoscopic vision, irrigation fluid volume and complications were noted.ResultsWhen measured at 4 h postoperatively, the drop in haemoglobin and haematocrit, respectively, was maximum in the control group (ΔHb = 0.78 g/dl, ΔHCT = 1.23%) followed by the irrigation group (ΔHb = 0.51 g/dl, ΔHCT = 0.72%) and was least in the I/V group (0.27 g/dl, 0.62%). The intergroup analysis showed significant difference only between the control vs I/V group (ΔHb p = 0.0163, ΔHCT p = 0.0253).On postoperative day 1, the drop in haemoglobin and haematocrit, respectively, was maximum in the control group (1.10 g/dl, 1.63%) followed by the irrigation group (0.828 g/dl, 0.911%) and was least in the I/V group (0.811 g/dl, 0.948%). The intergroup analysis showed significant difference between the control vs irrigation group (ΔHb p = 0.026, ΔHCT p = 0.0001) and control vs I/V group (ΔHb p = 0.016, ΔHCT p = 0.0003).Total resection time, average volume of irrigation fluid and average postoperative stay were comparable. No significant complications were observed.ConclusionsTXA, given either via I/V or irrigation fluid route, reduces postoperative blood loss associated with TURP. Both routes are superior to placebo, but neither is superior to the other. TXA via the intravenous route also reduces intraoperative blood loss, but the same advantage is not observed with administration through irrigation fluid. TXA via either route has no impact on endoscopic vision. Both routes of administration are safe with no reported side effects.

Machine Learning Quantification of Fluid Volume in Eyes With Retinal Vein Occlusion Treated With Aflibercept: The REVOLT Study.

Purpose: To evaluate the combined relationship between ischemia, retinal fluid, and layer thickness measurements with visual acuity (VA) outcomes in patients with retinal vein occlusion (RVO). Methods: Swept-source optical coherence tomography (OCT) data were used to assess retinal layer thickness and quantify intraretinal fluid (IRF) and subretinal fluid (SRF) using a deep learning-based, macular fluid segmentation algorithm for treatment-naïve eyes diagnosed with visual impairment resulting from central RVO (CRVO) or branch RVO (BRVO). Patients received 3 loading doses of 2 mg intravitreal aflibercept injections and were then put on a treat-and-extend regimen. Image analysis was performed at baseline and postoperatively at 3 months and 6 months. The baseline OCT morphologic features and fluid measurements were correlated with the changes in best-corrected VA (BCVA) using the Pearson correlation coefficient (r). Results: The study comprised 49 eyes. A combined model incorporating thickness in the outer plexiform layer (OPL), retinal nerve fiber layer (RNFL), and presence of IRF had the strongest overall correlation for CRVO (r = 0.865; P < .05). For BRVO, the addition of IRF to the OPL-inner nasal model had a strong correlation (r = 0.803; P < .05). The baseline ischemic index in the deep capillary complex showed a notable correlation with the 6-month change in BCVA for CRVO (r = 0.9101; P < .001) and BRVO (r = 0.9200; P < .001). Conclusions: A combined model of IRF volume, OPL, and RNFL layer thicknesses, along with ischemic indices, provides the best correlation to BCVA changes. Combined fluid and layer segmentation of OCT images provides clinically useful biomarkers for RVO patients. These results give insight into the pathology of RVOs and describe the relationship between deep capillary complex ischemia and OPL/RNFL thickness in BCVA outcomes.

Nursing Care According to NANDA-I Diagnoses, NIC Interventions, and NOC Outcomes in a Patient with Autoimmune Encephalitis: A Case Report

Encephalitis, defined as inflammation of the brain tissue, is an uncommon yet serious condition that can lead to severe brain damage. Nursing care is critical in increasing the effectiveness of treatment in patients with encephalitis. In the case presented here, care was planned and implemented based on nursing diagnoses by field in the NANDA-I classification, NIC interventions, and NOC outputs. The patients’ nursing diagnoses were identified as ineffective health management, imbalanced nutrition: less than body requirements, fluid volume deficit, constipation, impaired physical mobility, impaired verbal communication, hopelessness, impaired social interaction, ineffective sexuality, risk for impaired psychological health, risk for ineffective activity planning, risk for impaired independent decision making, hyperthermia, chronic pain, and risk for delayed development. The care plan for four of these diagnoses is presented.

Optimization of a monochromatic clapper-yule spectral prediction model based on the single ink drop spreading behavior in inkjet printing

In recent years, inkjet digital printing technology has become a popular research area. This paper focuses on the spreading behavior of single ink drops on coated paper in digital inkjet printing. It explores the impact of ink drop spreading on monochromatic spectral reflectance, providing new insights for the theoretical development of spectral prediction models. The study involves constructing a spreading behavior model through theoretical modeling. Numerical simulations were conducted using the Volume of Fluid (VOF) method in Fluent software to assess the feasibility of the theoretical model. Finally, experimental fitting was used to validate the accuracy of the theoretical model. Considering the feathering effect in practical printing, a comprehensive monochromatic extended Clapper-Yule spectral prediction model was developed based on the spreading behavior of single ink drops. The prediction results of this model showed significant accuracy improvements in monochromatic spectral prediction compared to the traditional segmented Clapper-Yule model. This research offers new perspectives for spectral prediction and provides theoretical guidance for enhancing print image quality.