52 research outputs found

    CMS physics technical design report : Addendum on high density QCD with heavy ions

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    Predictors of using extracorporeal membrane oxygenation in lung transplantation

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    Rationale. Lung transplantation is the only definitive treatment in end-stage pulmonary disease. Extracorporeal membrane oxygenation (ECMO) has been used during surgery in recent years as a replacement for respiratory function; ECMO, however, has some drawbacks: the presence of an extracorporeal circuit, the need for heparinization, potential thrombogenicity that underlies the risks of developing specific complications that worsen the transplantation prognosis. In this regard, it is relevant to study the factors that make it possible to predict the need in intraoperative ECMO in order to avoid its unjustified use.Purpose. To identify predictors for intraoperative use of ECMO in lung transplantation.Material and methods. The medical records of patients who underwent lung transplantation in the Sklifosovsky Research Institute for Emergency Medicine from May 2011 to July 2017 were retrospectively reviewed. Forty nine bilateral lung transplantations were made where 15 patients (30.6%) had lung transplantation performed without ECMO, and 34 (69.4%) underwent lung transplantation and ECMO. A central veno-arterial connection was used in all patients. The study analyzed various factors of patient condition at baseline and identified the most significant of them that enabled to predict the need of ECMO use at surgery with a high degree of probability, avoiding episodes of gas exchange and hemodynamic impairments, the prolongation of surgery, and, therefore, the graft ischemia time.Results. As assessed in this study, pulmonary hypertension was the only predictor of an increased likelihood of using ECMO. The probability of connection to ECMO statistically significantly increased in the patients with systolic pulmonary artery pressure higher 50 mm Hg (p<0.05).Conclusion. The presence of pulmonary hypertension > 50 mm Hg determines the preventive use of ECMO during lung transplantation, which should reduce the number of uncontrolled emergencies during the main stages of surgical intervention; in all other cases, ECMO should be connected basing either on the pulmonary artery compression test results or when indicated

    Ecological Aspects of the Formation of Regraded Solonchak in the Terek-Kuma Lowland of the Caspian

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    Aim. To reveal the basic patterns and principles of formation on the surface of crusty solonchak of an aeolian-accumulative horizon and its positive transformation at the taxonomic level.Material and Methods. On the surface of crusty solonchak there is formed a layer of silt-sand fractions with seeds of wild phytocenoses which move/перемещаюихся over the surface of the soil under the influence of atmospheric processes with the utilization of woody material protruding above the soil surface to 0.2 m. Analyses, surveys and observations were carried out of the key parts (for investigation - under the aeolian layer) of the crusty solonchak transformed through the dynamics of humidity, lowering of soil moisture (SC), granulometric composition, chemistry and level of soil salinity, as well as determination of the species composition of the phytocenoses and the accumulation of phytomass by plants.Results. The possibility was revealed of a positive transformation within eight years of a layer of silt-sand fractions with seeds of wild phytocenoses in the Wael humus horizon with a capacity of 5 cm ± 0.8 cm and containing 1.26% of humus. The type of salinization remains sulphate-chloride but the level of salinization decreases from very strong in the 0-5 layer to weak one in the 6-15 cm layer - on average. The profile of the crusty solonchak Скк [AJk - AJ,s - BCA,s - Cca,s] is changed to that of regraded solonchak Ckw [Wael - AJ,s - BCA,s - Cca,s]. The granulometric composition of the soil is improved and a productive phytocenosis is formed.Conclusion. The positive transformation of crusty solonchak to regraded contributes to the reduction of soil deflation and of aerial contamination by dust particle fractions, the lowering of carbon emissions from the soil and of the natural greenhouse effect, the increase of the utilization coefficient of photosynthetically active radiation (PAR) and the prevention of excessive overheating of the soil and atmosphere
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