Extracorporeal Life Support for Cardiac Arrest and Cardiogenic Shock

The rising incidence and recognition of cardiogenic shock has led to an increase in the use of veno-arterial extracorporeal membrane oxygenation (VA-ECMO). As clinical experience with this therapy has increased, there has also been a rapid growth in the body of observational and randomized data describing the clinical and logistical considerations required to institute a VA-ECMO program with successful clinical outcomes. The aim of this review is to summarize this contemporary data in the context of four key themes that pertain to VA-ECMO programs: the principles of patient selection; basic hemodynamic and technical principles underlying VA-ECMO; contraindications to VA-ECMO therapy; and common complications and intensive care considerations that are encountered in the setting of VA-ECMO therapy

The Keck Cosmic Web Imager: a capable new integral field spectrograph for the W. M. Keck Observatory

The Keck Cosmic Web Imager (KCWI) is a new facility instrument being developed for the W. M. Keck Observatory and funded for construction by the Telescope System Instrumentation Program (TSIP) of the National Science Foundation (NSF). KCWI is a bench-mounted spectrograph for the Keck II right Nasmyth focal station, providing integral field spectroscopy over a seeing-limited field up to 20"x33" in extent. Selectable Volume Phase Holographic (VPH) gratings provide high efficiency and spectral resolution in the range of 1000 to 20000. The dual-beam design of KCWI passed a Preliminary Design Review in summer 2011. The detailed design of the KCWI blue channel (350 to 700 nm) is now nearly complete, with the red channel (530 to 1050 nm) planned for a phased implementation contingent upon additional funding. KCWI builds on the experience of the Caltech team in implementing the Cosmic Web Imager (CWI), in operation since 2009 at Palomar Observatory. KCWI adds considerable flexibility to the CWI design, and will take full advantage of the excellent seeing and dark sky above Mauna Kea with a selectable nod-and-shuffle observing mode. In this paper, models of the expected KCWI sensitivity and background subtraction capability are presented, along with a detailed description of the instrument design. The KCWI team is lead by Caltech (project management, design and implementation) in partnership with the University of California at Santa Cruz (camera optical and mechanical design) and the W. M. Keck Observatory (program oversight and observatory interfaces)

A near-infrared tip-tilt sensor for the Keck I laser guide star adaptive optics system

The sky coverage and performance of laser guide star (LGS) adaptive optics (AO) systems is limited by the natural guide star (NGS) used for low order correction. This limitation can be dramatically reduced by measuring the tip and tilt of the NGS in the near-infrared where the NGS is partially corrected by the LGS AO system and where stars are generally several magnitudes brighter than at visible wavelengths. We present the design of a near-infrared tip-tilt sensor that has recently been integrated with the Keck I telescope’s LGS AO system along with some initial on-sky results. The implementation involved modifications to the AO bench, real-time control system, and higher level controls and operations software that will also be discussed. The tip-tilt sensor is a H2RG-based near-infrared camera with 0.05 arc second pixels. Low noise at high sample rates is achieved by only reading a small region of interest, from 2×2 to 16×16 pixels, centered on an NGS anywhere in the 100 arc second diameter field. The sensor operates at either Ks or H-band using light reflected by a choice of dichroic beamsplitters located in front of the OSIRIS integral field spectrograph

Keck Planet Imager and Characterizer: A dedicated single-mode fiber injection unit for high resolution exoplanet spectroscopy

The Keck Planet Imager and Characterizer (KPIC) is a purpose-built instrument to demonstrate new tech- nological and instrumental concepts initially developed for the exoplanet direct imaging field. Located downstream of the current Keck II adaptive optic system, KPIC contains a fiber injection unit (FIU) capable of combining the high-contrast imaging capability of the adaptive optic system with the high dispersion spectroscopy capability of the current Keck high resolution infrared spectrograph (NIRSPEC). Deployed at Keck in September 2018, this instrument has already been used to acquire high resolution spectra (R < 35, 000) of multiple targets of interest. In the near term, it will be used to spectrally characterize known directly imaged exoplanets and low-mass brown dwarf companions visible in the northern hemisphere with a spectral resolution high enough to enable spin and planetary radial velocity measurements as well as Doppler imaging of atmospheric weather phenomena. Here we present the design of the FIU, the unique calibration procedures needed to operate a single-mode fiber instrument and the system performance

Keck Planet Imager and Characterizer: demonstrating advanced exoplanet characterization techniques for future extremely large telescopes (Conference Presentation)

The Keck Planet Imager and Characterizer (KPIC) is an upgrade to the Keck II adaptive optics system enabling high contrast imaging and high-resolution spectroscopic characterization of giant exoplanets in the mid-infrared (2-5 microns). The KPIC instrument will be developed in phases. Phase I entails the installation of an infrared pyramid wavefront sensor (PyWFS) based on a fast, low-noise SAPHIRA IR-APD array. The ultra-sensitive infrared PyWFS will enable high contrast studies of infant exoplanets around cool, red, and/or obscured targets in star forming regions. In addition, the light downstream of the PyWFS will be coupled into an array of single-mode fibers with the aid of an active fiber injection unit (FIU). In turn, these fibers route light to Keck's high-resolution infrared spectrograph NIRSPEC, so that high dispersion coronagraphy (HDC) can be implemented for the first time. HDC optimally pairs high contrast imaging and high-resolution spectroscopy allowing detailed characterization of exoplanet atmospheres, including molecular composition, spin measurements, and Doppler imaging. We will provide an overview of the instrument, its science scope, and report on recent results from on-sky commissioning of Phase I. We will discuss plans for optimizing the instrument to seed designs for similar modes on extremely large telescopes

Atmospheric metallicity and C/O of HD 189733 b from high-resolution spectroscopy

We present high-resolution $K$-band emission spectra of the quintessential hot Jupiter HD 189733 b from the Keck Planet Imager and Characterizer (KPIC). Using a Bayesian retrieval framework, we fit the dayside pressure-temperature profile, orbital kinematics, mass-mixing ratios of H$_2$O, CO, CH$_4$, NH$_3$, HCN, and H$_2$S, and the $\rm ^{13}CO/^{12}CO$ ratio. We measure mass fractions of $\rm \log H_2O = -2.0^{+0.4}_{-0.4}$ and $\rm \log CO = -2.2^{+0.5}_{-0.5}$, and place upper limits on the remaining species. Notably, we find $\rm \log CH_4 < -4.5$ at 99\% confidence, despite its anticipated presence at the equilibrium temperature of HD 189733 b assuming local thermal equilibrium. We make a tentative ($\sim3\sigma$) detection of $\rm ^{13}CO$, and the retrieved posteriors suggest a $\rm ^{12}C/^{13}C$ ratio similar to or substantially less than the local interstellar value. The possible $\rm ^{13}C$ enrichment would be consistent with accretion of fractionated material in ices or in the protoplanetary disk midplane. The retrieved abundances correspond to a substantially sub-stellar atmospheric $\rm C/O = 0.3\pm0.1$, while the carbon and oxygen abundances are stellar to slightly super-stellar, consistent with core-accretion models which predict an inverse correlation between C/O and metallicity. The specific combination of low C/O and high metallicity suggests significant accretion of solid material may have occurred late in the formation process of HD 189733 b.Comment: 17 pages, 7 figures, 2 tables, accepted in A