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

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

Geoeconomic variations in epidemiology, ventilation management, and outcomes in invasively ventilated intensive care unit patients without acute respiratory distress syndrome: a pooled analysis of four observational studies

Background: Geoeconomic variations in epidemiology, the practice of ventilation, and outcome in invasively ventilated intensive care unit (ICU) patients without acute respiratory distress syndrome (ARDS) remain unexplored. In this analysis we aim to address these gaps using individual patient data of four large observational studies. Methods: In this pooled analysis we harmonised individual patient data from the ERICC, LUNG SAFE, PRoVENT, and PRoVENT-iMiC prospective observational studies, which were conducted from June, 2011, to December, 2018, in 534 ICUs in 54 countries. We used the 2016 World Bank classification to define two geoeconomic regions: middle-income countries (MICs) and high-income countries (HICs). ARDS was defined according to the Berlin criteria. Descriptive statistics were used to compare patients in MICs versus HICs. The primary outcome was the use of low tidal volume ventilation (LTVV) for the first 3 days of mechanical ventilation. Secondary outcomes were key ventilation parameters (tidal volume size, positive end-expiratory pressure, fraction of inspired oxygen, peak pressure, plateau pressure, driving pressure, and respiratory rate), patient characteristics, the risk for and actual development of acute respiratory distress syndrome after the first day of ventilation, duration of ventilation, ICU length of stay, and ICU mortality. Findings: Of the 7608 patients included in the original studies, this analysis included 3852 patients without ARDS, of whom 2345 were from MICs and 1507 were from HICs. Patients in MICs were younger, shorter and with a slightly lower body-mass index, more often had diabetes and active cancer, but less often chronic obstructive pulmonary disease and heart failure than patients from HICs. Sequential organ failure assessment scores were similar in MICs and HICs. Use of LTVV in MICs and HICs was comparable (42\ub74% vs 44\ub72%; absolute difference \u20131\ub769 [\u20139\ub758 to 6\ub711] p=0\ub767; data available in 3174 [82%] of 3852 patients). The median applied positive end expiratory pressure was lower in MICs than in HICs (5 [IQR 5\u20138] vs 6 [5\u20138] cm H2O; p=0\ub70011). ICU mortality was higher in MICs than in HICs (30\ub75% vs 19\ub79%; p=0\ub70004; adjusted effect 16\ub741% [95% CI 9\ub752\u201323\ub752]; p&lt;0\ub70001) and was inversely associated with gross domestic product (adjusted odds ratio for a US$10 000 increase per capita 0\ub780 [95% CI 0\ub775\u20130\ub786]; p&lt;0\ub70001). Interpretation: Despite similar disease severity and ventilation management, ICU mortality in patients without ARDS is higher in MICs than in HICs, with a strong association with country-level economic status. Funding: No funding

Evaluation of anti-ulcer activity of Samanea saman (Jacq) merr bark on ethanol and stress induced gastric lesions in albino rats

Objective : To evaluate the antiulcer activity of Samanea saman (Jacq) Merr bark on ethanol and stress induced gastric lesions in albino rats. Materials and Methods : Gastric lesions were induced in rats by oral administration of absolute ethanol (5 ml/kg) and stress induced by water immersion. The antiulcer activity of methanolic extract of Samanea saman (Jacq) Merr bark (100 mg/kg, 200 mg/kg, 400 mg/kg) was compared with standard drugs. The parameters studied were ulcer index, gastric juice volume, pH, free acidity and total acidity. Result : Samanea saman (Jacq) Merr showed a dose dependent curative ratio compared to ulcer control groups. The extract at 400 mg/kg showed significant anti ulcer activity which is almost equal to that of the standard drug in both models. The volume of acid secretion, total and free acidity was decreased and pH of the gastric juice was increased compared to ulcer control group. Conclusions : The present study indicates that Samanea saman (Jacq) Merr bark extracts have potential anti ulcer activity

Gold nanoparticle immobilization on ZnO nanorods via bi-functional monolayers: A facile method to tune interface properties

10.1016/j.susc.2015.05.005Surface Science64123-2

Green tea polyphenols in cardiometabolic health: A critical appraisal on Phytogenomics towards personalized green tea

Cardiovascular disease is a chronic multifactorial health complication that is either directly or indirectly associated with pathophysiological mechanisms, including pro-oxidation, pro-inflammation, vascular and endothelial dysfunction, impaired platelet function, thrombosis, and others. The therapeutic options to circumvent cardiovascular complications include several phytomedicines, including green tea polyphenols. However, while many experimental and clinical studies report distinct mechanisms by which the polyphenols of green tea elicit a beneficial role in cardiometabolic health, the translation and applications of green tea polyphenols in clinics have yet to gain their optimal use on the broader population. This review critically appraises the various reported mechanisms of green tea polyphenols in modulating cardio-metabolic health and associated phyto-genomic challenges. Further, our review highlights the probability of gene polymorphic associated therapeutic variations in individuals using green tea for cardio-metabolic effects and the necessity to personalize green tea for clinical use, thereby improvising the risk-benefit ratio

High aspect ratio electrospun CuO nanofibers as anode material for lithium-ion batteries with superior cycleability

A simple and efficient sol–gel/electrospinning technique is employed for the preparation of high aspect ratio CuO nanofibers. Characterizations studies including X-ray diffraction, scanning electron microscopy, High-resolution-transmission electron microscopy are employed to analyze the crystal structure, and morphology of electrospun CuO nanofibers. Electrochemical lithium storage properties are evaluated in half-cell configurations at room temperature between 0.005 and 3 V vs Li. Cyclic voltammetry is used to study the reaction mechanism during charge–discharge process. Electrospun CuO nanofibers delivered stable reversible capacity of 452 mAh g–1 at current density of 100 mA g–1 in half-cell configuration (Li/CuO nanofibers). The cell displayed the very stable cycling behavior up to 100 cycles at current density of 100 mA g–1. Rate capability studies of CuO nanofibers are conducted and presented. Our studies have shown that the enhanced cycleability of CuO electrospun nanofibers are due to the fibrous morphology formed by nanoscopic CuO particles which could not only increase the electrode/electrolyte contact area but also enables the facile partial reduction of Cu2O into metallic particles (Cu0)

Exceptional Performance of TiNb₂O₇ Anode in All One-Dimensional Architecture by Electrospinning

We report the extraordinary performance of an Li-ion battery (full-cell) constructed from one-dimensional nanostructured materials, i.e. nanofibers as cathode, anode, and separator-cum-electrolyte, by scalable electrospinning. Before constructing such a one-dimensional Li-ion battery, electrospun materials are individually characterized to ensure its performance and balancing the mass loading as well. The insertion type anode TiNb₂O₇ exhibits the reversible capacity of ∼271 mAh g^–1 at current density of 150 mA g^–1 with capacity retention of ∼82% after 100 cycles. Under the same current density, electrospun LiMn₂O₄ cathode delivered the discharge capacity of ∼118 mAh g^–1. Gelled electrospun polyvinylidene fluoride-<i>co</i>-hexafluoropropylene (PVdF-HFP) nanofibers membrane is used as the separator-cum-electrolyte in both half-cell and full-cell assembly which exhibit the liquid like conductivity of ∼2.9 mS cm^–1 at ambient conditions. Full-cell, LiMn₂O₄|gelled PVdF-HFP|TiNb₂O₇ is constructed by optimized mass loading of cathode with respect to anode and tested between 1.95 and 2.75 V at room temperature. The full-cell delivered the reversible capacity of ∼116 mAh g^–1 at current density of 150 mA g^–1 with operating potential and energy density of ∼2.4 V and ∼278 Wh kg^–1, respectively. Further, excellent cyclability is noted for such configuration irrespective of the applied current densities

Electrospun ZnO Nanowire Plantations in the Electron Transport Layer for High-Efficiency Inverted Organic Solar Cells

Inverted bulk heterojunction organic solar cells having device structure ITO/ZnO/poly­(3-hexylthiophene) (P3HT):[6,6]-phenyl C61 butyric acid methyl ester (PCBM) /MoO₃/Ag were fabricated with high photoelectric conversion efficiency and stability. Three types of devices were developed with varying electron transporting layer (ETL) ZnO architecture. The ETL in the first type was a sol–gel-derived particulate film of ZnO, which in the second and third type contained additional ZnO nanowires of varying concentrations. The length of the ZnO nanowires, which were developed by the electrospinning technique, extended up to the bulk of the photoactive layer in the device. The devices those employed a higher loading of ZnO nanowires showed 20% higher photoelectric conversion efficiency (PCE), which mainly resulted from an enhancement in its fill factor (FF). Charge transport characteristic of the device were studied by transient photovoltage decay and charge extraction by linearly increasing voltage techniques. Results show that higher PCE and FF in the devices employed ZnO nanowire plantations resulted from improved charge collection efficiency and reduced recombination rate

Effect of La-Doping on optical bandgap and photoelectrochemical performance of hematite nanostructures

© the Partner Organisations 2014.La-doped hematite nanotubes are fabricated by electrospinning of a sol-gel solution consisting of La(iii) acetylacetonate hydrate/polyvinylpyrrolidone(PVP)/ferric acetylacetonate, and subsequent sintering at 500 °C for 5 h in air. Further grinding of these nanotubes affords La-doped hematite nanoparticles. FESEM EDX indicates that the La content is 3.66 mol% in La-doped hematite. HRTEM and XRD reveal that La3+ cations are doped into the hematite crystal lattice. UV-Vis diffuse reflectance shows increased light absorption for La-doped hematite, with the bandgap reduced from 2.58 eV to 2.46 eV. EIS and four-probe characterization demonstrate that La-doping reduces charge transfer resistance and increases the electrical conductivity, thus leading to improved charge transportation. Photoelectrochemical (PEC) water splitting studies show that under 100 mW cm-2 simulated solar irradiation, La-doped hematite nanoparticles demonstrate a net photocurrent density up to 0.112 and 0.270 mA cm-2 at 1.23 and 1.60 V vs. RHE, which are 187% and 63% higher than pristine hematite nanoparticles, respectively. The effect of La-doping on improving electrical conductivity, light absorption, and PEC performance is mainly attributed to the intensification of crystal orientation along the (110) plane and the lattice expansion caused by the La3+ cations, which have much larger radii and are more electron-rich than Fe3+.Link_to_subscribed_fulltex