Failure of lactate clearance predicts the outcome of critically ill septic patients

Purpose: Early lactate clearance is an important parameter for prognosis assessment and therapy control in sepsis. Patients with a lactate clearance >0% might differ from patients with an inferior clearance in terms of intensive care management and outcomes. This study analyzes a large collective with regards to baseline risk distribution and outcomes. Methods: In total, 3299 patients were included in this analysis, consisting of 1528 (46%) ≤0% and 1771 (54%) >0% patients. The primary endpoint was intensive care unit (ICU) mortality. Multilevel logistic regression analyses were used to compare both groups: A baseline model (model 1) with lactate clearance as a fixed effect and ICU as a random effect was installed. For model 2, patient characteristics (model 2) were included. For model 3, intensive care treatment (mechanical ventilation and vasopressors) was added to the model. Models 1 and 2 were used to evaluate the primary and secondary outcomes, respectively. Model 3 was only used to evaluate the primary outcomes. Adjusted odds ratios (aORs) with respective 95% confidence intervals (CI) were calculated. Results: The cohorts had no relevant differences regarding the gender, BMI, age, heart rate, body temperature, and baseline lactate. Neither the primary infection focuses nor the ethnic background differed between both groups. In both groups, the most common infection sites were of pulmonary origin, the urinary tract, and the gastrointestinal tract. Patients with lactate clearance >0% evidenced lower sepsis-related organ failure assessment (SOFA) scores (7 ± 6 versus 9 ± 6; p < 0.001) and creatinine (1.53 ± 1.49 versus 1.80 ± 1.67; p < 0.001). The ICU mortality differed significantly (14% versus 32%), and remained this way after multivariable adjustment for patient characteristics and intensive care treatment (aOR 0.43 95% CI 0.36–0.53; p < 0.001). In the additional sensitivity analysis, the lack of lactate clearance was associated with a worse prognosis in each subgroup. Conclusion: In this large collective of septic patients, the 6 h lactate clearance is an independent method for outcome prediction

Efficiency of some cyanophytes as larval feed for silver carp (Hypophthalmichthys molitrix) and the culture of Spirulina platensis

Six-day old carp (Hypophthalmichthys molitix) fry (mean weight 3 mg) were stocked at 5/l in aquaria. These were fed with unialgal cultures of three species of blue-green algae, namely: Anabaena sp., Oscillatoria quadripunctulata and Spirulina platensis. Best increase in weight was obtained when feeding consisted of Spirulina followed by those fed with Oscillatoria. Poor results were obtained when fry were fed solely with Anabaena. Weight gain was highest during the first two weeks with Spirulina as feed. On the other hand, survival of fry was higher (68%) with Oscillatoria than with Spirulina (54%). Proximate analysis of fish and algae were conducted. Spirulina seemed to be the most promising live food organism for larval rearing of silver carp. Thus, laboratory culture of the cyanophyte at different pH (9, 10 and 11) and two types of media (hog manure and urea) were investigated. Algal biomass production in a semi-continuous, outdoor tank system was also determined

Algal production and utilization relevant to aquaculture in the Philippines

An outline is given of research conducted at the Aquaculture Department of SEAFDEC at Rizal, Philippines regarding algal culture and utilization. Culture methods for both brackishwater and freshwater algae are described and details given of applications of microalgae in the aquaculture industry, which include feed for fish and shrimp larvae

Ipil-ipil leaf meal as supplemental feed for T. nilotica in cages

Tilapia nolotica fingerlings were grown to marketable size in cages in Laguna Lake at a stocking density of 150/m super(2). Those given supplemental feed of ipil-ipil leaf meal at varying levels showed faster growth compared to the control given rice bran alone. Experiments in aquaria showed that T. nilotica) can tolerate high concentrations of ipil-ipil leaf meal in feeds without showing any symptom of toxicity. Costs and returns analysis was done

Supplemental feeding of Tilapia mossambica

T. mossambica were grown to marketable size in floating cages in Laguna de Bay at a stocking density of 75/m2. Those given supplemental feed 1 (rice bran:ipil-ipil:fish meal, 60:20:20) showed significantly faster growth than those fed with supplemental feed 2 (chopped snails:rice bran, 30:70). Controls, without supplemental feeding, showed slower growth rates as compared to the supplement-fed lots. A more efficient feed conversion ratio was obtained for feed 1 (4:1) as compared to feed 2 (6:1). Laboratory experiments in aquaria showed the feasibility of improving the growth of tilapia with ipil-ipil (Leucaena leucocephala) leaf meal alone. Varying levels of ipil-ipil, given at 3, 6, and 9% of the body weight, increased the body weight to 0.75 g, 1.68 g, and 2.94 g, respectively. Moreover, the crude protein content of tilapia increased proportionately with increasing levels of ipil-ipil leaf meal. The significance of the above results in the light of establishing a tilapia lake farming industry and its effect on the improved nutrition of the people were discussed

An assessment of algal growth in net cages in Laguna Lake

SEAFDEC Aquaculture Department No. 105.Quantitative determination of the algal population, in terms of cells/ml and biomass/ml, was conducted during the first month of growing P. monodon postlarvae in Laguna Lake. Algae were sampled from each side of net cages at depths of 15, 30 and 45 cm below the water surface. Accumulation of algae appeared to be influenced by the direction of water flow. Moreover, growth of algal species was inversely proportional to depth of water. After two weeks, algal biomass was estimated to reach 4.5 kg per cage (1 x 1 x 1 m). Diatoms (Chrysophyta) predominated throughout the experimental period followed by members of Cyanophyta and Chlorophyta

Isolation and cultivation of Anabaena sp. from organic media after sterilization

A species of Anabaena was isolated from the fronds of Azolla pinnata by combining the chopped fronds of the Azolla extract with either lake water or an organic medium (duck manure alone or combined with banana stalk) and sterilizing at 121°C and 15 psi for 20 min. Growth of Anabaena sp. was observed within 33 to 37 days and compared with the morphology of A. azollae squeezed from the fronds of Azolla pinnata. Results were discussed regarding the high temperature tolerance of the recently isolated Anabaena sp. Anabaena sp. was incubated in synthetic sponge carriers and grown in different media. The total nitrogen contributions of Anabaena sp. in lake water and in nitrogen-free inorganic medium was 22.3 and 13.2 mg/l respectively after 60 days

Feed preference of milkfish (Chanos chanos Forsskal) fry given different algal species as natural feed

Portion of a paper presented at the Second International Milkfish Aquaculture Conference, Iloilo City, Philippines, 4–8 October, 1983. SEAFDEC, Aquaculture Department, contribution no. 179.Acclimated milkfish fry (mean wet weight, 6.0 mg) were fed with unialgal cultures of five species of freshwater algae: Oscillatoria quadripunctulata, Chroococcus dispersus, Navicula notha, Euglena elongata and Chlorella ellipsoidea. In the first experiment, the filamentous blue-green alga, Oscillatoria, appeared most acceptable to milkfish fry throughout the growing period, while feeding milkfish fry with the unicellular species, Chroococcus, resulted in lower weights and survival. In the second experiment, increases in weight of milkfish fry fed with Oscillatoria alone or in combination with Chroococcus were comparable. However, a significant increase in survival was obtained with the combination feeding. A third experiment showed that high density cultures of Oscillatoria resulted in significantly large weight increments in all growth stages. The other algae tested did not support growth of milkfish fry. 14C-Labeled algae of the same species were fed to milkfish fry. Significantly high assimilation retes were observed in almost all growth stages of milkfish fry with Oscillatoria alone or Chroococcus alone. Negligible amounts of Navicula, Chlorella and Euglena were assimilated

Acceptability of five species of freshwater algae to tilapia (Oreochromis niloticus) fry

Unialgal cultures of Oscillatoria quadripunctulata, Chroococcus dispersus, Navicula notha, Euglena elongata, and Chlorella ellipsoidea were fed to tilapia fry for 30 days. Mean weights and survival rates of the fry were highest when given Navicula (105.6 mg, 86%) and Chroococcus (89.1 mg, 90%). Oscillatoria, a filamentous cyanophyte, showed limited acceptability to tilapia fry, possibly because of its larger size in comparison with Chroococcus. Fry fed Chlorella and Euglena did not survive at all. C14-labeled algae of the above species were fed to tilapia fry of varying ages. Assimilation rates per fry after 24 hours of feeding with a suitable algal species increased with the age of the fry. Moreover, the same trend as in the growth and survival experiments was observed, i.e., the highest assimilation rates were obtained in 40-day old tilapia fry given Navicula and Chroococcus as natural feeds. On the other hand, negligible amounts of the other three algal species tested were assimilated by tilapia fry. The above results were explained in terms of the enzyme secretion of tilapias. There seemed to be no transition stage in the feeding habit of both fry and adult tilapia. The acceptability of plant matter in the diet of even the early larval stages was demonstrated

Machine learning predicts mortality in septic patients using only routinely available ABG variables: a multi-centre evaluation

open5siPurpose: To evaluate the application of machine learning methods, specifically Deep Neural Networks (DNN) models for intensive care (ICU) mortality prediction. The aim was to predict mortality within 96 hours after admission to mirror the clinical situation of patient evaluation after an ICU trial, which consists of 24-48 hours of ICU treatment and then “re-triage”. The input variables were deliberately restricted to ABG values to maximise real-world practicability. Methods: We retrospectively evaluated septic patients in the multi-centre eICU dataset as well as single centre MIMIC-III dataset. Included were all patients alive after 48 hours with available data on ABG (n = 3979 and n = 9655 ICU stays for the multi-centre and single centre respectively). The primary endpoint was 96 -h-mortality. Results: The model was developed using long short-term memory (LSTM), a type of DNN designed to learn temporal dependencies between variables. Input variables were all ABG values within the first 48 hours. The SOFA score (AUC of 0.72) was moderately predictive. Logistic regression showed good performance (AUC of 0.82). The best performance was achieved by the LSTM-based model with AUC of 0.88 in the multi-centre study and AUC of 0.85 in the single centre study. Conclusions: An LSTM-based model could help physicians with the “re-triage” and the decision to restrict treatment in patients with a poor prognosis.openWernly, Bernhard; Mamandipoor, Behrooz; Baldia, Philipp; Jung, Christian; Osmani, VenetWernly, Bernhard; Mamandipoor, Behrooz; Baldia, Philipp; Jung, Christian; Osmani, Vene