Continuous Renal Replacement Therapy with the Adsorbing Filter oXiris in Septic Patients: A Case Series.

Background: Extracorporeal treatment may be useful during sepsis, but definitive recommendations are lacking. Aim of this study is to review retrospectively the medical records of septic patients submitted to continuous renal replacement therapy (CRRT) with the adsorbing membrane oXiris and evaluate (1) the safety of the device, (2) the cardiorenal response, and (3) the immunological response. Materials and Methods: The medical records of 60 septic patients submitted to CRRT with the membrane oXiris from April 2011 to December 2018 have been reviewed. The adsorbing membrane oXiris® (Baxter, IL, USA) was used through a Prisma plataform (Prismaflex – Baxter, IL, USA). At basal time (T0), at 24 h (T1), and at the end of the treatment (T2) were analyzed the clinical data, the cytokines, and the time course of endotoxin. Results: Sixty patients were included in the study. In total, 85% of patients had acute kidney injury (AKI). Every CRRT treatment was of 72 ± 13 h, with the consumption of 3.2 ± 1 filters. No AE events were reported. The main cardiorenal and respiratory parameters improved with a decrease of the noradrenaline dosage. Cytokines, procalcitonin, and endotoxin activity assay decreased too. SOFA total improved from 12.4 ± 2 to 9 ± 2. Conclusion: In sepsis/septic shock patients with AKI, CRRT with the adsorbing membrane oXiris may be safe and improves the cardiorenal – function and the clinical condition. The effect on cytokines and endotoxin may explain in part these results. A RCT is warranted to confirm these data

Preoperative very short-term, high-dose erythropoietin administration diminishes blood transfusion rate in off-pump coronary artery bypass: A randomized blind controlled study

n/

An Analysis of English - Indonesian Translation Method Used by Ingrid Dwijani Nimpoeno in Translating Green’s The Fault in Our Stars. Ane Anggraeni 147010040

This research paper entitled “An Analysis of English - Indonesian Translation Me thod Used by Ingrid Dwijani Nimpoeno in Translating Green’s The Fault in Our Stars ” . The objectives of the research are to find out what the translation method mostly used in translating complex sentences and to analyze how the translation result of the most translation method used in translating complex sentences by Ingrid Dwijani Nimpo eno. The writer uses qualitative research method and applied descriptive analysis. The main sources are 63 data or text of complex sentences on the novel entitled The Fault in Our Stars. The result of data analysis showed that the translation mostly used w ere first is communicative translation 31 of 63 data (49,2%), the second is faithful translation 19 of 63 data (30,16%), the third is literal translation 9 of 63 data (14,23%), the fourth is semantic translation 3 of 63 data (4,77%), and the last is word b y word translation 1 of 63 data (1,6%). The conclusion is Ingrid Dwijani Nimpoeno produced the good translation in translating complex sentences, because her translation results are easy to understand, and the messages well delivered. In addition, altho ugh the method mostly used is communicative translation but she still maintained to the source language emphasis . In other side, her translation result is relevant with the classifications of good translation that purposed by some expert. However, the writ er attempted to correct several data which irrelevant, based on the theory. Keywords: Translation Method, Complex Sentenc

Biological solutions to aortic root replacement: valve-sparing versus bioprosthetic conduit‡

n/

Patient blood management in Europe

Preoperative anaemia is common in patients undergoing orthopaedic and other major surgery. Anaemia is associated with increased risks of postoperative mortality and morbidity, infectious complications, prolonged hospitalization, and a greater likelihood of allogeneic red blood cell (RBC) transfusion. Evidence of the clinical and economic disadvantages of RBC transfusion in treating perioperative anaemia has prompted recommendations for its restriction and a growing interest in approaches that rely on patients' own (rather than donor) blood. These approaches are collectively termed ‘patient blood management’ (PBM). PBM involves the use of multidisciplinary, multimodal, individualized strategies to minimize RBC transfusion with the ultimate goal of improving patient outcomes. PBM relies on approaches (pillars) that detect and treat perioperative anaemia and reduce surgical blood loss and perioperative coagulopathy to harness and optimize physiological tolerance of anaemia. After the recent resolution 63.12 of the World Health Assembly, the implementation of PBM is encouraged in all WHO member states. This new standard of care is now established in some centres in the USA and Austria, in Western Australia, and nationally in the Netherlands. However, there is a pressing need for European healthcare providers to integrate PBM strategies into routine care for patients undergoing orthopaedic and other types of surgery in order to reduce the use of unnecessary transfusions and improve the quality of care. After reviewing current PBM practices in Europe, this article offers recommendations supporting its wider implementation, focusing on anaemia management, the first of the three pillars of PBM

What's in a name:Are cultured red blood cells 'natural'?

The case of cultured red blood cells currently being grown in a laboratory for future use in human transfusion raises questions about the ontological status of such products of modern biotechnology. This paper presents results from a six-year ethnographic study involving interviews, focus groups and other forms of engagement with the scientific research team and other stakeholders, including public groups, which sought to understand respondents’ reactions to cultured red blood cells. These cells, derived from stem cell technology, have the potential to address the global shortage of donated blood. How these blood cells are situated within the spectrum of ‘natural’ to ‘synthetic’ will shape expectations and acceptance of this product, both within the scientific community and by wider publics: these blood cells are both novel and yet, at the same time, very familiar. Drawing on discussions related to classification and ‘anchoring’, we examine the contrasting discourses offered by our respondents on whether these blood cells are ‘natural’ or not and consider the impact that naming might have on both their future regulation and the eventual uptake of cultured red blood cells by society. [183 words]Output Status: Forthcoming/Available Onlin

Current trends in cannulation and neuroprotection during surgery of the aortic arch in Europe†‡

OBJECTIVES To conduct a survey across European cardiac centres to evaluate the methods used for cerebral protection during aortic surgery involving the aortic arch. METHODS All European centres were contacted and surgeons were requested to fill out a short, comprehensive questionnaire on an internet-based platform. One-third of more than 400 contacted centres completed the survey correctly. RESULTS The most preferred site for arterial cannulation is the subclavian-axillary, both in acute and chronic presentation. The femoral artery is still frequently used in the acute condition, while the ascending aorta is a frequent second choice in the case of chronic presentation. Bilateral antegrade brain perfusion is chosen by the majority of centres (2/3 of cases), while retrograde perfusion or circulatory arrest is very seldom used and almost exclusively in acute clinical presentation. The same pumping system of the cardio pulmonary bypass is most of the time used for selective cerebral perfusion, and the perfusate temperature is usually maintained between 22 and 26°C. One-third of the centres use lower temperatures. Perfusate flow and pressure are fairly consistent among centres in the range of 10-15 ml/kg and 60 mmHg, respectively. In 60% of cases, barbiturates are added for cerebral protection, while visceral perfusion still receives little attention. Regarding cerebral monitoring, there is a general tendency to use near-infrared spectroscopy associated with bilateral radial pressure measurement. CONCLUSIONS These data represent a snapshot of the strategies used for cerebral protection during major aortic surgery in current practice, and may serve as a reference for standardization and refinement of different approache