Risk factors for progression from severe maternal morbidity to death: a national cohort study.

Women continue to die unnecessarily during or after pregnancy in the developed world. The aim of this analysis was to compare women with severe maternal morbidities who survived with those who died, to quantify the risk associated with identified factors to inform policy and practice to improve survival

The role for high flow nasal cannula as a respiratory support strategy in adults: a clinical practice guideline

Purpose: High flow nasal cannula (HFNC) is a relatively recent respiratory support technique which delivers high flow, heated and humidified controlled concentration of oxygen via the nasal route. Recently, its use has increased for a variety of clinical indications. To guide clinical practice, we developed evidence-based recommendations regarding use of HFNC in various clinical settings. Methods: We formed a guideline panel composed of clinicians, methodologists and experts in respiratory medicine. Using GRADE, the panel developed recommendations for four actionable questions. Results: The guideline panel made a strong recommendation for HFNC in hypoxemic respiratory failure compared to conventional oxygen therapy (COT) (moderate certainty), a conditional recommendation for HFNC following extubation (moderate certainty), no recommendation regarding HFNC in the peri-intubation period (moderate certainty), and a conditional recommendation for postoperative HFNC in high risk and/or obese patients following cardiac or thoracic surgery (moderate certainty). Conclusions: This clinical practice guideline synthesizes current best-evidence into four recommendations for HFNC use in patients with hypoxemic respiratory failure, following extubation, in the peri-intubation period, and postoperatively for bedside clinicians

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

Meeting abstrac

Exploration of the superconducting properties of Y3Ba 5Cu8O18 with and without Ca doping by magnetic measurements

The superconducting Y3Ba5Cu8O18 (Y-358) and Y3Ba5Ca2Cu8O 18 (YCa-358) compounds have been synthesized by using the sol-gel method. Hence, the influence of doping of Ca into the compound Y-358 has been studied by comparing the resistivities, DC magnetizations both M(H) and M(T),flux pinning properties, AC susceptibilities and critical current densities of the undoped and doped compounds, at low temperatures. The AC susceptibility and resistivity measurements showed that the superconducting transition temperature, Tc, is suppressed (about 6 K) with the addition of Ca into the main compound. The hysteresis loops of YCa-358 show peak like projecting parts at temperatures below 45 K and around zero applied field that may be due to the local modulation of the composition in YCa-358. Such a behavior has been observed for the first time. The critical current densities, Jc, determined from the hysteresis measurements decrease with the addition of Ca into Y-358. At 15 K, the maximum values of Jc, for the compounds Y-358 and YCa-358 are found to be 8 × 104 A/cm 2 and 4.5 × 104 A/cm2, respectively. The flux pinning force, Fp, calculated from the field dependence of the Jc values shows that the irreversibility line shifts to lower magnetic fields with the doping of Ca into Y-358. Furthermore, the measurements of the inphase and out off components of the ACsusceptibilities clearly demonstrate that the superconducting volume fraction of Y-358 decreases with the addition of Ca. © 2011 Elsevier Masson SAS. All rights reserved.AMYO2009BAP1, FEF2009BAP10, FEF2009YL30This work was supported by Cukurova University under FEF2009BAP10, AMYO2009BAP1, and FEF2009YL30 project numbers. We wish to thank to Mr. Aydin Eraydin for graphical design

Prognostic significance of central venous-to-arterial carbon dioxide difference during the first 24 hours of septic shock in patients with and without impaired cardiac function

IF 6.238International audienceObjective: To investigate the prognostic significance of central venous-to-arterial carbon dioxide difference (cv-art CO2 gap) during septic shock in patients with and without impaired cardiac function.Methods: We performed a prospective cohort study in 10 French intensive care units. Patients suffering from septic shock were assigned to the impaired cardiac function group (‘cardiac group’, n=123) if they had atrial fibrillation (AF) and/or left ventricular ejection fraction (LVEF) 0.9 kPa at 12 h had a higher risk of day 28 mortality (hazard ratio=3.18; P=0.0049). Among the 59 patients in the cardiac group with mean arterial pressure (MAP) ≥65 mm Hg, central venous pressure (CVP) ≥8 mm Hg and central venous oxygen saturation (ScvO2) ≥70% at 12 h, those with a high cv-art CO2 gap (>0.9 kPa; n=19) had a higher day 28 mortality (37% vs. 13%; P=0.042). In the non-cardiac group, a high cv-art CO2 gap was not linked to a higher risk of day 28 death, whatever the threshold value of the cv-art CO2 gap.Conclusion: Patients with septic shock and with AF and/or low LVEF were more prone to a persistent high cv-art CO2 gap, even when initial resuscitation succeeded in normalizing MAP, CVP, and ScvO2. In these patients, a persistent high cv-art CO2 gap at 12 h was significantly associated with higher day 28 mortality