Anesthesia advanced circulatory life support

The constellation of advanced cardiac life support (ACLS) events, such as gas embolism, local anesthetic overdose, and spinal bradycardia, in the perioperative setting differs from events in the pre-hospital arena. As a result, modification of traditional ACLS protocols allows for more specific etiology-based resuscitation. Perioperative arrests are both uncommon and heterogeneous and have not been described or studied to the same extent as cardiac arrest in the community. These crises are usually witnessed, frequently anticipated, and involve a rescuer physician with knowledge of the patient's comorbidities and coexisting anesthetic or surgically related pathophysiology. When the health care provider identifies the probable cause of arrest, the practitioner has the ability to initiate medical management rapidly. Recommendations for management must be predicated on expert opinion and physiological understanding rather than on the standards currently being used in the generation of ACLS protocols in the community. Adapting ACLS algorithms and considering the differential diagnoses of these perioperative events may prevent cardiac arrest

A922 Sequential measurement of 1 hour creatinine clearance (1-CRCL) in critically ill patients at risk of acute kidney injury (AKI)

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Formal gas-phase polar [4+1(+)] cycloaddition of ionized methylene to alpha-dicarbonyl compounds: synthesis of 2-unsubstituted 1,3-dioxoles

Ion/molecule reactions of +CH2OCH2 with alpha-dicarbonyl compounds were performed via pentaquadrupole mass spectrometry. Besides the previously known [3(+) + 2] 1,3-cycloaddition reaction that forms cyclic 1,3-dioxonium ions, an unprecedented reaction proceeding formally by [4 + 1(+)] cycloaddition of ionized methylene (CH2+) to the alpha-dicarbonyl compounds occurs competitively, leading to the gas-phase synthesis of several ionized 2-unsubstituted 1,3-dioxoles. This novel cycloaddition reaction may therefore be added to the set of methods available for the synthesis of 1,3-dioxoles. Copyright (c) 2006 John Wiley & Sons, Ltd.41673574

R(Ar)O-N-2(+) vs. R(Ar)-N2O+: Are alkoxy-(aryloxy-)diazonium ions or alkyl-(aryl-)N-nitroso-onium ions formed in the gas-phase reactions of N2O with H+, Me+, Ph+, PhCH2+, Tr+ and PhCO+?

Gas-phase reactions of N2O with H+, Me+, Ph+, PhCH2+, Tr+ (the tropylium. ion) and PhCO+ were studied by pentaquadrupole mass spectrometry. Collision-induced dissociation (CID) of the product ions establishes that, in the diluted solvent and counterion-free MS environment, gaseous Me+ and Ph+ ions form preferentially Me(Ph)O-N-2(+) (electrophilic attack at oxygen), whereas PhCH2+ forms preferentially PhCH2-N2O+ (electrophilic attack at nitrogen). The nascent phenoxydiazonium. ion PhO-N-2(+) dissociates promptly by N-2 loss to form PhO+ as the observable addition product. The PhCO+ and Tr+ ions are unreactive towards addition to N2O. The CID and ion/molecule chemistry of [N2O + H](+) are in conclusive with regard to connectivity, because the ion is rather resistant towards dissociation and reacts essentially as a proton donor species. Gaseous MeO-N-2(+) is not only efficient as a methylating agent towards ethers, heteroaromatics and nitriles, but also displays a rich chemistry that includes polar [4+2(+)] stepwise cycloadditions with representative dienes and polar transacetalization with cyclic acetals. Relative energies and geometries of various RO-N-2(+)/R-N2O+ isomeric pairs were evaluated by MP2 and DFT calculations. ((c) Wiley-VCH Verlag GmbH & Co. KGaA, 69451 Weinheim, Germany, 2007).1707

Characterization of vegetable oils by electrospray ionization mass spectrometry fingerprinting: Classification, quality, adulteration, and aging

An improved approach for the direct infusion electrospray ionization mass spectrometry (ESI-MS) analysis of vegetable oils is described. The more polar components of the oils, including the fatty acids, are simply extracted with methanol/water (1:1) solution and analyzed by direct infusion ESI-MS in both the negative and positive ion modes. This fingerprinting analysis was applied to genuine samples of olive, soybean, corn, canola, sunflower, and cottonseed oil, to admixtures of these oils, and samples of aged soybean oil. ESI-MS fingerprints in the positive ion mode of the extracts divide the oils into well-defined groups, as confirmed by principal component analysis, whereas ESI-MS fingerprints in the negative ion mode clearly differentiate olive oil from the five other refined oils. The method is also shown to detect aging and adulteration of vegetable oils.77227429743

ESICM LIVES 2016: part two : Milan, Italy. 1-5 October 2016.

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