Snakes on an island: independent introductions have different potentials for invasion

Snakes introduced to islands can be devastating to naïve native fauna. However, introduced populations must establish before range expansion (invasion) can occur. The factors that can determine successful invasion are those associated with the introduction event (e.g., characteristics of the founding population), the location (e.g., suitable environment and prey availability) and the species (e.g. life history characteristics). Here, we collected morphometric, ecological and genetic data on the recently introduced California Kingsnake (Lampropeltis californiae) in Gran Canaria. We found that snakes occurring at two locations a few 10 s of km apart do not represent the same population. Genetic analyses confirmed significant genetic difference (FST = 0.184; Dest = 0.341), and that despite being inbred (Fis = 0.245–0.257) the populations had high levels of diversity (Ho = 0.485–0.490; allelic richness = 4.875–6.364). Snakes at the different Gran Canaria locations were significantly different in morphology (colouration, mass, length and age), fitness (egg production) and diet (rodents, skinks, lizards and geckos), supporting a hypothesis of separate founding groups in combination with local environmental heterogeneity leading to variation between these populations. We concluded that one population was more successful than the other in reproduction and recruitment, and may be having a greater impact on endemic reptiles. We recommend greater eradication effort for this population, as well as monitoring of local fauna at all locations to access the impact of predation

Weaning from mechanical ventilation in intensive care units across 50 countries (WEAN SAFE): a multicentre, prospective, observational cohort study

International audienceBackground: Current management practices and outcomes in weaning from invasive mechanical ventilation are poorly understood. We aimed to describe the epidemiology, management, timings, risk for failure, and outcomes of weaning in patients requiring at least 2 days of invasive mechanical ventilation. Methods: WEAN SAFE was an international, multicentre, prospective, observational cohort study done in 481 intensive care units in 50 countries. Eligible participants were older than 16 years, admitted to a participating intensive care unit, and receiving mechanical ventilation for 2 calendar days or longer. We defined weaning initiation as the first attempt to separate a patient from the ventilator, successful weaning as no reintubation or death within 7 days of extubation, and weaning eligibility criteria based on positive end-expiratory pressure, fractional concentration of oxygen in inspired air, and vasopressors. The primary outcome was the proportion of patients successfully weaned at 90 days. Key secondary outcomes included weaning duration, timing of weaning events, factors associated with weaning delay and weaning failure, and hospital outcomes. This study is registered with ClinicalTrials.gov, NCT03255109. Findings: Between Oct 4, 2017, and June 25, 2018, 10 232 patients were screened for eligibility, of whom 5869 were enrolled. 4523 (77·1%) patients underwent at least one separation attempt and 3817 (65·0%) patients were successfully weaned from ventilation at day 90. 237 (4·0%) patients were transferred before any separation attempt, 153 (2·6%) were transferred after at least one separation attempt and not successfully weaned, and 1662 (28·3%) died while invasively ventilated. The median time from fulfilling weaning eligibility criteria to first separation attempt was 1 day (IQR 0–4), and 1013 (22·4%) patients had a delay in initiating first separation of 5 or more days. Of the 4523 (77·1%) patients with separation attempts, 2927 (64·7%) had a short wean (≤1 day), 457 (10·1%) had intermediate weaning (2–6 days), 433 (9·6%) required prolonged weaning (≥7 days), and 706 (15·6%) had weaning failure. Higher sedation scores were independently associated with delayed initiation of weaning. Delayed initiation of weaning and higher sedation scores were independently associated with weaning failure. 1742 (31·8%) of 5479 patients died in the intensive care unit and 2095 (38·3%) of 5465 patients died in hospital. Interpretation: In critically ill patients receiving at least 2 days of invasive mechanical ventilation, only 65% were weaned at 90 days. A better understanding of factors that delay the weaning process, such as delays in weaning initiation or excessive sedation levels, might improve weaning success rates. Funding: European Society of Intensive Care Medicine, European Respiratory Society