Ultrafast rogue wave patterns in fiber lasers

Fiber lasers are convenient for studying extreme and rare events, such as rogue waves, thanks to the lasers’ fast dynamics. Indeed, several types of rogue wave patterns were observed in fiber lasers at different time-scales: single peak, twin peak, and triple peak. We measured the statistics of these ultrafast rogue wave patterns with a time lens and developed a numerical model proving that the patterns of the ultrafast rogue waves were generated by the non-instantaneous relaxation of the saturable absorber together with the polarization mode dispersion of the cavity. Our results indicate that the dynamics of the saturable absorber is directly related to the dynamics of ultrafast extreme events in lasers

The picosecond structure of ultra-fast rogue waves

We investigated ultrafast rogue waves in fiber lasers and found three different patterns of rogue waves: single- peaks, twin-peaks, and triple-peaks. The statistics of the different patterns as a function of the pump power of the laser reveals that the probability for all rogue waves patterns increase close to the laser threshold. We developed a numerical model which prove that the ultrafast rogue waves patterns result from both the polarization mode dispersion in the fiber and the non-instantaneous nature of the saturable absorber. This discovery reveals that there are three different types of rogue waves in fiber lasers: slow, fast, and ultrafast, which relate to three different time-scales and are governed by three different sets of equations: the laser rate equations, the nonlinear Schrodinger equation, and the saturable absorber equations, accordingly. This discovery is highly important for analyzing rogue waves and other extreme events in fiber lasers and can lead to realizing types of rogue waves which were not possible so far such as triangular rogue waves

Case Report Use of Early Inhaled Nitric Oxide Therapy in Fat Embolism Syndrome to Prevent Right Heart Failure

Fat embolism syndrome (FES) is a life-threatening condition in which multiorgan dysfunction manifests 48-72 hours after long bone or pelvis fractures. Right ventricular (RV) failure, especially in the setting of pulmonary hypertension, is a frequent feature of FES. We report our experience treating 2 young, previously healthy trauma patients who developed severe hypoxemia in the setting of FES. Neither patient had evidence of RV dysfunction on echocardiogram. The patients were treated with inhaled nitric oxide (NO), and their oxygenation significantly improved over the subsequent few days. Neither patient developed any cardiovascular compromise. Patients with FES that have severe hypoxemia and evidence of adult respiratory distress syndrome (ARDS) are likely at risk for developing RV failure. We recommend that these patients with FES and severe refractory hypoxemia should be treated with inhaled NO therapy prior to the onset of RV dysfunction

Case Report Use of Early Inhaled Nitric Oxide Therapy in Fat Embolism Syndrome to Prevent Right Heart Failure

Copyright © 2014 Evgeni Brotfain et al.This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Fat embolism syndrome (FES) is a life-threatening condition in which multiorgan dysfunction manifests 48–72 hours after long bone or pelvis fractures. Right ventricular (RV) failure, especially in the setting of pulmonary hypertension, is a frequent feature of FES.We report our experience treating 2 young, previously healthy trauma patients who developed severe hypoxemia in the setting of FES. Neither patient had evidence of RV dysfunction on echocardiogram. The patients were treated with inhaled nitric oxide (NO), and their oxygenation significantly improved over the subsequent few days. Neither patient developed any cardiovascular compromise. Patients with FES that have severe hypoxemia and evidence of adult respiratory distress syndrome (ARDS) are likely at risk for developing RV failure. We recommend that these patients with FES and severe refractory hypoxemia should be treated with inhaled NO therapy prior to the onset of RV dysfunction. 1

Cardiac Arrhythmias in a Septic ICU Population: A Review

Progressive cardiovascular deterioration plays a central role in the pathogenesis of multiple organ failure (MOF) caused by sepsis. Evidence of various cardiac arrhythmias in septic patients has been reported in many published studies. In the critically ill septic patients, compared to non-septic patients, new onset atrial fibrillation episodes are associated with high mortality rates and poor outcomes, amongst others being new episodes of stroke, heart failure and long vasopressor usage. The potential mechanisms of the development of new cardiac arrhythmias in sepsis are complex and poorly understood. Cardiac arrhythmias in critically ill septic patients are most likely to be an indicator of the severity of pre-existing critical illness

Urine flow rate monitoring in hypovolemic multiple trauma patients

Abstract Background The urine output is an important clinical parameter of renal function and blood volume status, especially in critically ill multiple trauma patients. In the present study, the minute-to-minute urine flow rate and its variability were analyzed in hypotensive multiple trauma patients during the first 6 h of their ICU (intensive care unit) stay. These parameters have not been previously reported. Methods The study was retrospective and observational. Demographic and clinical data were extracted from the computerized Register Information Systems. A total of 59 patients were included in the study. The patients were divided into two study groups. Group 1 consisted of 29 multiple trauma patients whose systolic blood pressure was greater than 90 mmHg on admission to the ICU and who were consequently deemed to be hemodynamically compromised. Group 2 consisted of 30 patients whose systolic blood pressure was less than 90 mmHg on admission to the ICU and who were therefore regarded as hemodynamically uncompromised. Results The urine output and urine flow rate variability during the first 6 h of the patients’ ICU stay was significantly lower in group 2 than in group 1 (p < 0.001 and 0.006 respectively). Statistical analysis by the Pearson method demonstrated a strong direct correlation between decreased urine flow rate variability and decreased urine output per hour (R = 0.17; P = 0.009), decreased mean arterial blood pressure (R = 0.24; p = 0.001), and increased heart rate (R = 0.205; p = 0.001). Conclusion These findings suggest that minute-to-minute urine flow rate variability is a reliable incipient marker of hypovolemia and that it should therefore take its place among the parameters used to monitor the hemodynamic status of critically ill multiple trauma patients