115 research outputs found

    Postoperative Cryptococcus neoformans endocarditi

    Get PDF

    Pyrobitumen occurrence and formation in a Cambro–Ordovician sandstone reservoir, Fahud Salt Basin, North Oman

    No full text
    The Cambro–Ordovician Barik Sandstone reservoirs in the Fahud Salt Basin in Oman contain bitumen which may fill up to 40% of the porosity. In well Jaleel-1, this bitumen was isolated (according to kerogen procedure) and typed by NMR, elemental analysis and density measurements. The isolated bitumen is characterized by: (1) a highly aromatic character (NMR 75% CAro, H/C atomic ratio: 0.65), (2) a very high sulphur content (4.2%) and (3) a relatively high density (1.3–1.4 g/cm3). The insolubility and the reflectivity of the bitumen (1.2% Vr) qualify it as a low mature pyrobitumen. The combination of Rock-Eval and density data was used to calculate the actual volume of the pyrobitumen in the rock, as a percentage of porosity. It was found that the pyrobitumen volume shows a negative correlation with total porosity, indicating that small pores are more invaded by bitumen than larger ones. Finally, closed system pyrolysis experiments, performed on oils with different NSO contents, indicate that an in situ oil with a very high content of NSO compounds is required to generate such large amounts of pyrobitumen in the pore system. These observations suggest that the precursor oil of the current pyrobitumen was a very heavy oil tentatively assumed to be the result of a severe biodegradation. Basin modeling shows that the reservoir was charged already in Devonian times. A major uplift brought the oil accumulation near the surface during the Carboniferous and a rather regular burial to the present day position (4500 m, 140°C) (Loosveld et al., 1996). This scenario, involving a residence time at shallow depth, strengthens the biodegradation hypothesis. The numerical modeling, which involves the IFP kinetic model for secondary oil cracking, suggests that pyrobitumen formation is a very recent event. Inclusion of pyrobitumen particles within quartz overgrowth, containing fluid inclusions, provides an upper temperature limit for the beginning of pyrobitumen formation which comforts the result of kinetic modelling

    Fleury-sur-Orne – Carrière Saingt

    Get PDF
    La redécouverte par les archéologues en 2014 de l’une des nombreuses carrières-refuges utilisées par les civils pris sous les bombes lors de la Bataille de Caen (juin-juillet 1944), a offert l’opportunité de mettre en place une opération archéologique à caractère expérimental permettant de confronter différents types d’analyses, au croisement de l’archéologie, de l’histoire et de la sociologie. L’année 2015 a été consacrée à la mise en place du protocole d’étude et aux premiers tests dans plu..

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

    Get PDF
    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

    Extracorporeal Membrane Oxygenation for Severe Acute Respiratory Distress Syndrome associated with COVID-19: An Emulated Target Trial Analysis.

    Get PDF
    RATIONALE: Whether COVID patients may benefit from extracorporeal membrane oxygenation (ECMO) compared with conventional invasive mechanical ventilation (IMV) remains unknown. OBJECTIVES: To estimate the effect of ECMO on 90-Day mortality vs IMV only Methods: Among 4,244 critically ill adult patients with COVID-19 included in a multicenter cohort study, we emulated a target trial comparing the treatment strategies of initiating ECMO vs. no ECMO within 7 days of IMV in patients with severe acute respiratory distress syndrome (PaO2/FiO2 <80 or PaCO2 ≥60 mmHg). We controlled for confounding using a multivariable Cox model based on predefined variables. MAIN RESULTS: 1,235 patients met the full eligibility criteria for the emulated trial, among whom 164 patients initiated ECMO. The ECMO strategy had a higher survival probability at Day-7 from the onset of eligibility criteria (87% vs 83%, risk difference: 4%, 95% CI 0;9%) which decreased during follow-up (survival at Day-90: 63% vs 65%, risk difference: -2%, 95% CI -10;5%). However, ECMO was associated with higher survival when performed in high-volume ECMO centers or in regions where a specific ECMO network organization was set up to handle high demand, and when initiated within the first 4 days of MV and in profoundly hypoxemic patients. CONCLUSIONS: In an emulated trial based on a nationwide COVID-19 cohort, we found differential survival over time of an ECMO compared with a no-ECMO strategy. However, ECMO was consistently associated with better outcomes when performed in high-volume centers and in regions with ECMO capacities specifically organized to handle high demand. This article is open access and distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives License 4.0 (http://creativecommons.org/licenses/by-nc-nd/4.0/)
    corecore