In Vitro Evaluation of an Active Heat-and-Moisture Exchanger: The Hygrovent Gold

BACKGROUND: To improve the heat and humidification that can be achieved with aheat-and-moisture exchanger (HME),a hybrid active (ie,adds heat and water) HME,the Hygrovent Gold,was developed. We evaluated in vitro the performance of theHygrovent Gold. METHODS: We tested the Hygrovent Gold (with and without its supplemental heat andmoisture options activated),the Hygrobac,and the Hygrovent S. We measured theabsolute humidity,using a test lung ventilated at minute volumes of 5,10,and15 L/min,in normothermic (expired temperature 34 degrees C) and hypothermic(expired temperature 28 degrees C) conditions. We also measured the HMEs' flowresistance and weight after 24 h and 48 h. RESULTS: In its active mode the Hygrovent Gold provided the highest absolutehumidity,independent of minute volume,in both normothermia and hypothermia. Therespective normothermia and hypothermia absolute humidity values at 10 L/min were36.3 + 1.3 mg/L and 27.1 + 1.0 mg/L with the active Hygrovent Gold,33.9 + 0.5mg/L and 24.2 + 0.8 mg/L with the passive Hygrovent Gold,33.8 + 0.56 mg/L and24.4 + 0.4 mg/L with the Hygrobac,and 33.9 + 0.8 mg/L and 24.6 + 0.6 mg/L withthe Hygrovent S. The efficiency of the tested HMEs did not change over time. At24 h and 48 h the increase in weight and flow resistance was highest in theactive Hygrovent Gold. CONCLUSIONS: The passive Hygrovent Gold provided adequate heat and moisture innormothermia,but the active Hygrovent Gold provided the highest humidity,inboth normothermia and hypothermia

Preliminary evaluation of the performance of a new highly sensitive commercial immunoassay for serum ferritin determination

We evaluated the analytical performance of a new, commercial, fully automated immunoturbidimetric assay for the determination of ferritin [FERLatex(X2)CN SEIKEN, Denka Seiken, Japan] in serum on the Olympus AU2700 analyzer. The new assay is a latex-enhanced turbidimetric immunoassay with an analysis time of 10 min. The linearity of the assay was confirmed up to 2505 pmol/L (R-2 =0.999). The detection limit and the functional sensitivity were both 4.5 pmol/L. The intra- and inter-assay imprecision (CV) at 67, 506, 2186 pmol/L was < 1.8% and < 2.5%, respectively. Verification of the traceability to a WHO standard (80/578) showed a recovery of 102.6% (target value 449 pmol/L). No hook effect was observed in samples containing up to 33,705 pmol/L. The assay showed good correlation with the Beckman Immage nephelometric system (r=0.999). Hemoglobin <= 9.8 g/L), total bilirubin (<= 113 [Lmol/L), conjugated bilirubin (<= 109 mu mol/L) and rheumatoid factor (<= 5.2 x 10(5) IU/L) did not interfere with the assay. The reference interval (2.5-97.5 percentile) was 72-521 pmol/L for men and 27-267 pmol/L for women. The reference interval in patients with anemia, malignant tumors and hemochromatosis was 5.6-52, 130-2436 and 1465-2903 pmol/L, respectively. On the basis, of the receiver operating characteristic curve, the 90% sensitivity cut-off value to distinguish between patients with and without iron deficiency was 40 pmol/L. The new latex turbidimetric procedure for ferritin assay is an attractive alternative that avoids the need for dedicated instrumentation

Protective Mechanical Ventilation during General Anesthesia for Open Abdominal Surgery Improves Postoperative Pulmonary Function

BACKGROUND:: The impact of intraoperative ventilation on postoperative pulmonary complications is not defined. The authors aimed at determining the effectiveness of protective mechanical ventilation during open abdominal surgery on a modified Clinical Pulmonary Infection Score as primary outcome and postoperative pulmonary function. METHODS:: Prospective randomized, open-label, clinical trial performed in 56 patients scheduled to undergo elective open abdominal surgery lasting more than 2 h. Patients were assigned by envelopes to mechanical ventilation with tidal volume of 9 ml/kg ideal body weight and zero-positive end-expiratory pressure (standard ventilation strategy) or tidal volumes of 7 ml/kg ideal body weight, 10 cm H2O positive end-expiratory pressure, and recruitment maneuvers (protective ventilation strategy). Modified Clinical Pulmonary Infection Score, gas exchange, and pulmonary functional tests were measured preoperatively, as well as at days 1, 3, and 5 after surgery. RESULTS:: Patients ventilated protectively showed better pulmonary functional tests up to day 5, fewer alterations on chest x-ray up to day 3 and higher arterial oxygenation in air at days 1, 3, and 5 (mmHg; mean \ub1 SD): 77.1 \ub1 13.0 versus 64.9 \ub1 11.3 (P = 0.0006), 80.5 \ub1 10.1 versus 69.7 \ub1 9.3 (P = 0.0002), and 82.1 \ub1 10.7 versus 78.5 \ub1 21.7 (P = 0.44) respectively. The modified Clinical Pulmonary Infection Score was lower in the protective ventilation strategy at days 1 and 3. The percentage of patients in hospital at day 28 after surgery was not different between groups (7 vs. 15% respectively, P = 0.42). CONCLUSION:: A protective ventilation strategy during abdominal surgery lasting more than 2 h improved respiratory function and reduced the modified Clinical Pulmonary Infection Score without affecting length of hospital stay

Two-Neutron Halo is Unveiled in ^{29}F

We report the measurement of reaction cross sections (σ_{R}^{ex}) of ^{27,29}F with a carbon target at RIKEN. The unexpectedly large σ_{R}^{ex} and derived matter radius identify ^{29}F as the heaviest two-neutron Borromean halo to date. The halo is attributed to neutrons occupying the 2p_{3/2} orbital, thereby vanishing the shell closure associated with the neutron number N=20. The results are explained by state-of-the-art shell model calculations. Coupled-cluster computations based on effective field theories of the strong nuclear force describe the matter radius of ^{27}F but are challenged for ^{29}F

Referee ECM

Referee per Educazione Continua in Medicin