13CO2 recovery fraction in expired air of septic patients under mechanical ventilation

The continuous intravenous administration of isotopic bicarbonate (NaH13CO2) has been used for the determination of the retention of the 13CO2 fraction or the 13CO2 recovered in expired air. This determination is important for the calculation of substrate oxidation. The aim of the present study was to evaluate, in critically ill patients with sepsis under mechanical ventilation, the 13CO2 recovery fraction in expired air after continuous intravenous infusion of NaH13CO2 (3.8 µmol/kg diluted in 0.9% saline in ddH2O). A prospective study was conducted on 10 patients with septic shock between the second and fifth day of sepsis evolution (APACHE II, 25.9 ± 7.4). Initially, baseline CO2 was collected and indirect calorimetry was also performed. A primer of 5 mL NaH13CO2 was administered followed by continuous infusion of 5 mL/h for 6 h. Six CO2 production (VCO2) measurements (30 min each) were made with a portable metabolic cart connected to a respirator and hourly samples of expired air were obtained using a 750-mL gas collecting bag attached to the outlet of the respirator. 13CO2 enrichment in expired air was determined with a mass spectrometer. The patients presented a mean value of VCO2 of 182 ± 52 mL/min during the steady-state phase. The mean recovery fraction was 0.68 ± 0.06%, which is less than that reported in the literature (0.82 ± 0.03%). This suggests that the 13CO2 recovery fraction in septic patients following enteral feeding is incomplete, indicating retention of 13CO2 in the organism. The severity of septic shock in terms of the prognostic index APACHE II and the sepsis score was not associated with the 13CO2 recovery fraction in expired air.Pró-Reitoria de Pesquisa da Universidade de São Paulo (USP)(FAEPA) Fundação de Amparo ao Ensino, Pesquisa e AssistênciaFAPES

Ecological and reproductive aspects of Neoechinorhynchus pimelodi Brasil-Sato & Pavanelli (Eoacanthocephala, Neoechinorhynchidae) of Pimelodus maculatus Lacépède (Siluroidei, Pimelodidae) of the São Francisco River, Brazil

Ecological and reproductive aspects of Neoechinorhynchus pimelodi Brasil-Sato & Pavanelli, 1998, in Pimelodus maculatus Lacépède, 1803 collected in the São Francisco river during periods of drought (July 1995 and 1996) and floodings (January 1996 and 1997) of this river basin are provided. In tropical regions where the amount of rainfall alters the hydrological regimen of limnological systems water temperature has not had an important role in infections of N. pimelodi in P. maculatus. Prevalence was somewhat higher during drought periods. Intensity of infection varied slightly between collecting periods. Mature male and female acanthocephalans were present in all periods. Females were predominant. Mature females were present in higher numbers during flooding periods with a corresponding decrease in juvenile acanthocephalans. Recruitment and constant losses of N. pimelodi seem to be controlled by transmission mechanisms independently of density. Mechanisms may consist of infected prey availability (potential intermediate hosts) and changes of preferred alimentary items in the diets of juvenile and mature P. maculatus