Quo vadis, cold molecules? - Editorial review

We give a snapshot of the rapidly developing field of ultracold polar molecules abd walk the reader through the papers appearing in this topical issue

The clinical relevance of oliguria in the critically ill patient : Analysis of a large observational database

Funding Information: Marc Leone reports receiving consulting fees from Amomed and Aguettant; lecture fees from MSD, Pfizer, Octapharma, 3 M, Aspen, Orion; travel support from LFB; and grant support from PHRC IR and his institution. JLV is the Editor-in-Chief of Critical Care. The other authors declare that they have no relevant financial interests. Publisher Copyright: © 2020 The Author(s). Copyright: Copyright 2020 Elsevier B.V., All rights reserved.Background: Urine output is widely used as one of the criteria for the diagnosis and staging of acute renal failure, but few studies have specifically assessed the role of oliguria as a marker of acute renal failure or outcomes in general intensive care unit (ICU) patients. Using a large multinational database, we therefore evaluated the occurrence of oliguria (defined as a urine output 16 years) patients in the ICON audit who had a urine output measurement on the day of admission were included. To investigate the association between oliguria and mortality, we used a multilevel analysis. Results: Of the 8292 patients included, 2050 (24.7%) were oliguric during the first 24 h of admission. Patients with oliguria on admission who had at least one additional 24-h urine output recorded during their ICU stay (n = 1349) were divided into three groups: transient - oliguria resolved within 48 h after the admission day (n = 390 [28.9%]), prolonged - oliguria resolved > 48 h after the admission day (n = 141 [10.5%]), and permanent - oliguria persisting for the whole ICU stay or again present at the end of the ICU stay (n = 818 [60.6%]). ICU and hospital mortality rates were higher in patients with oliguria than in those without, except for patients with transient oliguria who had significantly lower mortality rates than non-oliguric patients. In multilevel analysis, the need for RRT was associated with a significantly higher risk of death (OR = 1.51 [95% CI 1.19-1.91], p = 0.001), but the presence of oliguria on admission was not (OR = 1.14 [95% CI 0.97-1.34], p = 0.103). Conclusions: Oliguria is common in ICU patients and may have a relatively benign nature if only transient. The duration of oliguria and need for RRT are associated with worse outcome.publishersversionPeer reviewe

Temporal changes in the epidemiology, management, and outcome from acute respiratory distress syndrome in European intensive care units: a comparison of two large cohorts

Background: Mortality rates for patients with ARDS remain high. We assessed temporal changes in the epidemiology and management of ARDS patients requiring invasive mechanical ventilation in European ICUs. We also investigated the association between ventilatory settings and outcome in these patients. Methods: This was a post hoc analysis of two cohorts of adult ICU patients admitted between May 1–15, 2002 (SOAP study, n = 3147), and May 8–18, 2012 (ICON audit, n = 4601 admitted to ICUs in the same 24 countries as the SOAP study). ARDS was defined retrospectively using the Berlin definitions. Values of tidal volume, PEEP, plateau pressure, and FiO2 corresponding to the most abnormal value of arterial PO2 were recorded prospectively every 24 h. In both studies, patients were followed for outcome until death, hospital discharge or for 60 days. Results: The frequency of ARDS requiring mechanical ventilation during the ICU stay was similar in SOAP and ICON (327[10.4%] vs. 494[10.7%], p = 0.793). The diagnosis of ARDS was established at a median of 3 (IQ: 1–7) days after admission in SOAP and 2 (1–6) days in ICON. Within 24 h of diagnosis, ARDS was mild in 244 (29.7%), moderate in 388 (47.3%), and severe in 189 (23.0%) patients. In patients with ARDS, tidal volumes were lower in the later (ICON) than in the earlier (SOAP) cohort. Plateau and driving pressures were also lower in ICON than in SOAP. ICU (134[41.1%] vs 179[36.9%]) and hospital (151[46.2%] vs 212[44.4%]) mortality rates in patients with ARDS were similar in SOAP and ICON. High plateau pressure (> 29 cmH2O) and driving pressure (> 14 cmH2O) on the first day of mechanical ventilation but not tidal volume (> 8 ml/kg predicted body weight [PBW]) were independently associated with a higher risk of in-hospital death. Conclusion: The frequency of and outcome from ARDS remained relatively stable between 2002 and 2012. Plateau pressure > 29 cmH2O and driving pressure > 14 cmH2O on the first day of mechanical ventilation but not tidal volume > 8 ml/kg PBW were independently associated with a higher risk of death. These data highlight the continued burden of ARDS and provide hypothesis-generating data for the design of future studies

Investigating cold based summit glaciers through direct access to the glacier base: a case study constraining the maximum age of Chli Titlis glacier, Switzerland

Cold glaciers at the highest locations of the European Alps have been investigated by drilling ice cores to retrieve their stratigraphic climate records. Findings like the Oetztal ice man have demonstrated that small ice bodies at summit locations of comparatively lower altitudes may also contain old ice if locally frozen to the underlying bedrock. In this case, constraining the maximum age of their lowermost ice part may help to identify past periods with minimum ice extent in the Alps. However, with recent warming and consequent glacier mass loss, these sites may not preserve their unique climate information for much longer. Here we utilized an existing ice cave at Chli Titlis (3030 m), central Switzerland, to perform a case study for investigating the maximum age of cold-based summit glaciers in the Alps. The cave offers direct access to the glacier stratigraphy without the logistical effort required in ice core drilling. In addition, a pioneering exploration had already demonstrated stagnant cold ice conditions at Chli Titlis, albeit more than 25 years ago. Our englacial temperature measurements and the analysis of the isotopic and physical properties of ice blocks sampled at three locations within the ice cave show that cold ice still exists fairly unchanged today. State-of-the-art micro-radiocarbon analysis constrains the maximum age of the ice at Chli Titlis to about 5000 years before present. By this means, the approach presented here will contribute to a future systematic investigation of cold-based summit glaciers, also in the Eastern Alps

Unlocking annual firn layer water equivalents from ground-penetrating radar data on an Alpine glacier

The spatial representation of accumulation measurements is a major limitation for current glacier mass balance monitoring approaches. Here, we present a method for estimating annual accumulation rates on a temperate Alpine glacier based on the interpretation of internal reflection horizons (IRHs) in helicopter-borne ground-penetrating radar (GPR) data. For each individual GPR measurement, the signal travel time is combined with a simple model for firn densification and refreezing of meltwater. The model is calibrated at locations where GPR repeat measurements are available in two subsequent years and the densification can be tracked over time. Two 10.5 m long firn cores provide a reference for the density and chronology of firn layers. Thereby, IRHs correspond to density maxima, but not exclusively to former summer glacier surfaces. Along GPR profile sections from across the accumulation area we obtain the water equivalent (w.e.) of several annual firn layers. Because deeper IRHs could be tracked over shorter distances, the total length of analysed profile sections varies from 7.3 km for the uppermost accumulation layer (2011) to 0.1 km for the deepest (i.e. oldest) layer (2006). According to model results, refreezing accounts for 10% of the density increase over time and depth, and for 2% of the water equivalent. The strongest limitation to our method is the dependence on layer chronology assumptions. We show that GPR can be used not only to complement existing mass balance monitoring programmes on temperate glaciers but also to retrospectively extend newly initiated time series

Investigating cold based summit glaciers through direct access to the glacier base: A case study constraining the maximum age of Chli Titlis glacier, Switzerland

Cold glaciers at the highest locations of the European Alps have been investigated by drilling ice cores to retrieve their stratigraphic climate records. Findings like the Oetztal ice man have demonstrated that small ice bodies at summit locations of comparatively lower altitudes may also contain old ice if locally frozen to the underlying bedrock. In this case, constraining the maximum age of their lowermost ice part may help to identify past periods with minimum ice extent in the Alps. However, with recent warming and consequent glacier mass loss, these sites may not preserve their unique climate information for much longer. Here we utilized an existing ice cave at Chli Titlis (3030 m), central Switzerland, to perform a case study for investigating the maximum age of cold-based summit glaciers in the Alps. The cave offers direct access to the glacier stratigraphy without the logistical effort required in ice core drilling. In addition, a pioneering exploration had already demonstrated stagnant cold ice conditions at Chli Titlis, albeit more than 25 years ago. Our englacial temperature measurements and the analysis of the isotopic and physical properties of ice blocks sampled at three locations within the ice cave show that cold ice still exists fairly unchanged today. State-of-the-art micro-radiocarbon analysis constrains the maximum age of the ice at Chli Titlis to about 5000 years before present. By this means, the approach presented here will contribute to a future systematic investigation of cold-based summit glaciers, also in the Eastern Alps