Hyperoxemia and excess oxygen use in early acute respiratory distress syndrome : Insights from the LUNG SAFE study

Publisher Copyright: © 2020 The Author(s). Copyright: Copyright 2020 Elsevier B.V., All rights reserved.Background: Concerns exist regarding the prevalence and impact of unnecessary oxygen use in patients with acute respiratory distress syndrome (ARDS). We examined this issue in patients with ARDS enrolled in the Large observational study to UNderstand the Global impact of Severe Acute respiratory FailurE (LUNG SAFE) study. Methods: In this secondary analysis of the LUNG SAFE study, we wished to determine the prevalence and the outcomes associated with hyperoxemia on day 1, sustained hyperoxemia, and excessive oxygen use in patients with early ARDS. Patients who fulfilled criteria of ARDS on day 1 and day 2 of acute hypoxemic respiratory failure were categorized based on the presence of hyperoxemia (PaO2 > 100 mmHg) on day 1, sustained (i.e., present on day 1 and day 2) hyperoxemia, or excessive oxygen use (FIO2 ≥ 0.60 during hyperoxemia). Results: Of 2005 patients that met the inclusion criteria, 131 (6.5%) were hypoxemic (PaO2 < 55 mmHg), 607 (30%) had hyperoxemia on day 1, and 250 (12%) had sustained hyperoxemia. Excess FIO2 use occurred in 400 (66%) out of 607 patients with hyperoxemia. Excess FIO2 use decreased from day 1 to day 2 of ARDS, with most hyperoxemic patients on day 2 receiving relatively low FIO2. Multivariate analyses found no independent relationship between day 1 hyperoxemia, sustained hyperoxemia, or excess FIO2 use and adverse clinical outcomes. Mortality was 42% in patients with excess FIO2 use, compared to 39% in a propensity-matched sample of normoxemic (PaO2 55-100 mmHg) patients (P = 0.47). Conclusions: Hyperoxemia and excess oxygen use are both prevalent in early ARDS but are most often non-sustained. No relationship was found between hyperoxemia or excessive oxygen use and patient outcome in this cohort. Trial registration: LUNG-SAFE is registered with ClinicalTrials.gov, NCT02010073publishersversionPeer reviewe

Plan de negocio para la implementaci?n de una empresa de Asesor?a Virtual R?pida - ?Dr. Matem?tico al Rescate?

?Dr. Matem?tico al Rescate? es una alternativa innovadora pensada en los padres de familia y sus hijos, orientada a la resoluci?n de problemas espec?ficos a trav?s de una conexi?n s?ncrona, donde el asesorado puede interactuar con el asesor hasta lograr el entendimiento de lo explicado. Ofrecemos una soluci?n inmediata apoyada en el uso de la tecnolog?a, este servicio abarcar? a las familias con hijos en educaci?n secundaria de Lima Metropolitana que pertenecen a los NSE A, B y C

nBu2Sn(SnBu)2 and nBu3SnEnBu (E = S or Se) - effective single source precursors for the CVD of SnS and SnSe thermoelectric thin films

The use of single source precursors offers a convenient option for the chemical vapour deposition of thin film semiconductor materials with good stoichiometric control and precursor efficiency. Here we show that reaction of nBu3SnCl with NaSnBu or LiSenBu, or nBu2SnCl2 with 2 mol equiv. of NaSnBu, gives the molecular alkyltin chalcogenolate precursors, nBu3SnEnBu (E = S (1), Se (3)) and nBu2Sn(SnBu)2 (2), respectively, in good yield as colourless (S) or yellow/orange (Se) oils. These were characterised by 1H, 13C{1H}, 77Se{1H} and 119Sn{1H} NMR spectroscopy, microanalysis and thermogravimetric analysis. Low pressure CVD experiments using these precursors showed that (1) gave S-deficient SnS thin films, whereas using (2) and implementing short deposition times and low precursor loadings, gave stoichiometric SnS films. Stoichiometric SnSe films were also obtained using (3) and confirmed by grazing incidence XRD analysis, which revealed the films adopt the orthorhombic Pnma structure. SEM and EDX analysis, together with Raman spectroscopic data, were also used to identify the films deposited and to correlate with the deposition conditions employed. Variable temperature Seebeck and Hall effect characterisation confirm that the stoichiometric SnS and SnSe films are semiconducting and highly resistive, giving large positive Seebeck coefficients, with the overall power factor ranging from 0.017 at 300 K to 0.049 μW cm−1 K−2 at 450 K for SnS and increasing from 0.06 at 300 K to 0.4 μW cm−1 K−2 at 425 K for SnSe

The value of open-source clinical science in pandemic response: lessons from ISARIC

International audienc

Measurements of the Total and Differential Higgs Boson Production Cross Sections Combining the H??????? and H???ZZ*???4??? Decay Channels at s\sqrt{s}=8??????TeV with the ATLAS Detector

Measurements of the total and differential cross sections of Higgs boson production are performed using 20.3~fb$^{-1}$ of $pp$ collisions produced by the Large Hadron Collider at a center-of-mass energy of $\sqrt{s} = 8$ TeV and recorded by the ATLAS detector. Cross sections are obtained from measured $H \rightarrow \gamma \gamma$ and $H \rightarrow ZZ ^{*}\rightarrow 4\ell$ event yields, which are combined accounting for detector efficiencies, fiducial acceptances and branching fractions. Differential cross sections are reported as a function of Higgs boson transverse momentum, Higgs boson rapidity, number of jets in the event, and transverse momentum of the leading jet. The total production cross section is determined to be $\sigma_{pp \to H} = 33.0 \pm 5.3 \, ({\rm stat}) \pm 1.6 \, ({\rm sys}) \mathrm{pb}$. The measurements are compared to state-of-the-art predictions.Measurements of the total and differential cross sections of Higgs boson production are performed using 20.3  fb-1 of pp collisions produced by the Large Hadron Collider at a center-of-mass energy of s=8  TeV and recorded by the ATLAS detector. Cross sections are obtained from measured H→γγ and H→ZZ*→4ℓ event yields, which are combined accounting for detector efficiencies, fiducial acceptances, and branching fractions. Differential cross sections are reported as a function of Higgs boson transverse momentum, Higgs boson rapidity, number of jets in the event, and transverse momentum of the leading jet. The total production cross section is determined to be σpp→H=33.0±5.3 (stat)±1.6 (syst)  pb. The measurements are compared to state-of-the-art predictions.Measurements of the total and differential cross sections of Higgs boson production are performed using 20.3 fb$^{-1}$ of $pp$ collisions produced by the Large Hadron Collider at a center-of-mass energy of $\sqrt{s} = 8$ TeV and recorded by the ATLAS detector. Cross sections are obtained from measured $H \rightarrow \gamma \gamma$ and $H \rightarrow ZZ ^{*}\rightarrow 4\ell$ event yields, which are combined accounting for detector efficiencies, fiducial acceptances and branching fractions. Differential cross sections are reported as a function of Higgs boson transverse momentum, Higgs boson rapidity, number of jets in the event, and transverse momentum of the leading jet. The total production cross section is determined to be $\sigma_{pp \to H} = 33.0 \pm 5.3 \, ({\rm stat}) \pm 1.6 \, ({\rm sys}) \mathrm{pb}$. The measurements are compared to state-of-the-art predictions