Valor nutricional de forraje de Pízamo (Erythrina glauca) ensilado con diferentes niveles de melaza y harina de arroz

This investigation evaluated the silage of Erythrina glauca forage in its nutritional quality, to be used later on in the animal feeding of in Colombia. The Erythrina glauca silage, was pack in silage bag was added to forage three levels of molasses (10%, 15% and 20%), besides, was added 3% of flour of rice by treatment, being the other half of the forage without flour, the silaje, was analyzed in four times of maturation: 0, 30, 60 y 90 days; with three repetitions each one. The trial was randomized completely to the chance with a factorial arrangement of 3x4x2, being respectively for treatments, and times of maduration and addition of flour of rice: It was used variance analysis and test of Tukey. The evaluated variables were: Dry matter, protein, raw fiber, fat, non-nitrogenaus extract, ash, the fiber in the neuter detergent (NFD), fiber in the acid detergent (AFD) and degradation in the rumen of the dry matter (DDM). The content of matter of the silage increased (P<0.05) when the levels of molasses were increased and flour of rice was added, while the time of maturation did not influence (P>0.05) on the DM content. The protein content decreased (P<0.05) as it increases the time of maturation, but it is increased (P<0.05) when flour of rice is added. The raw fiber, the NFD and the AFD decreased (P<0.05) as the time of maturation was increased. The opposite happened to the DDM at the 72 hours, which was increased (P<0.05) as it increased the time of maturation. The DDM in the different hours of degradation was minimum, being observed an alike result (P>0.05) in each one of the evaluated hours (6, 12, 24, 48 and 72) The DDM was quick in the first 6 hours, until 39%. The increment in the following hours was: 2%, 8%, 11% and 13,7%, respectively, that which indicated that the degradation was slow after the 6 hours until the 72 hours, the fat and ashy didn't affect any treatment. Was concluded that the raw fiber, the NFD, AFD were affected the fermentation of the microorganisms, since they break the cellular walls, causing a decrease, that which allows a bigger degradation in the rumen.El objetivo de esta de investigación fue evaluar el ensilaje de forraje de Pízamo (Erythrina glauca) en su calidad nutricional, para ser utilizado posteriormente en la alimentación animal de en el Piedemonte Llanero de Colombia. Se preparó ensilaje de forraje de Pízamo, en silo-bolsa con tres niveles de melaza: 10%, 15% y 20%, se tomó la mitad del material picado al cual se le había aplicado los diferentes niveles de melaza y se le adicionó un 3% de harina de arroz por tratamiento, quedando la otra mitad del material sin harina, conformando así las diferentes alternativas del ensilaje, para ser analizados en cuatro tiempos de maduración: inicial, treinta, sesenta y noventa días; con tres repeticiones cada uno; conformando un diseño experimental completamente al azar con un arreglo factorial de 3X4X2, siendo respectivamente para tratamientos, tiempos y adición de harina de arroz: Se utilizó análisis de varianza y prueba de Tukey. Las variables evaluadas fueron: Materia seca, proteína, fibra cruda, grasa, extracto no nitrógenado (ENN), cenizas, fibra detergente neutro (FDN), fibra detergente ácido (FDA) y degradabilidad ruminal de la materia seca (DMS). El contenido de materia del ensilaje se aumentó (P<0.05) cuando se incrementaron los niveles de melaza y se adicionó harina de arroz, mientras que el tiempo de maduración no influyó (P>0.05) en el contenido de MS. El contenido de proteína se disminuye (P<0.05) a medida que aumenta el tiempo de maduración, pero se incrementa (P<0.05) cuando se adiciona harina de arroz. La fibra cruda, la FDN y la FDA se disminuyeron (P<0.05) a medida que se incrementaba el tiempo de maduración. Lo contrario sucedió con la DMS a las 72 horas, la cual se fue incrementado (P<0.05) a medida que se aumentaba el tiempo de maduración. La DMS en las diferentes horas de degradación fue mínima, observándose un comportamiento similar (P>0.05) en cada una de las horas evaluadas (6, 12, 24, 48 y 72). La DMS fue rápida en las primeras 6 horas, llegando a un 39%, promedio de todos los tratamientos, el incremento en las siguientes horas fue: 2%, 8%, 11% y 13, 7%, respectivamente, lo cual indica que la degradación fue lenta después de las 6 horas hasta las 72 horas. El contenido de grasa y cenizas no se afectó con ningún tratamiento. Se puede concluir que la fibra cruda, la FDN, FDA se afectan con la fermentación de los microorganismos, puesto que rompen las paredes celulares, ocasionando una disminución, lo cual permite una mayor degradabilidad en el rumen

A922 Sequential measurement of 1 hour creatinine clearance (1-CRCL) in critically ill patients at risk of acute kidney injury (AKI)

Meeting abstrac

Ten golden rules for optimal antibiotic use in hospital settings: the WARNING call to action

Antibiotics are recognized widely for their benefits when used appropriately. However, they are often used inappropriately despite the importance of responsible use within good clinical practice. Effective antibiotic treatment is an essential component of universal healthcare, and it is a global responsibility to ensure appropriate use. Currently, pharmaceutical companies have little incentive to develop new antibiotics due to scientific, regulatory, and financial barriers, further emphasizing the importance of appropriate antibiotic use. To address this issue, the Global Alliance for Infections in Surgery established an international multidisciplinary task force of 295 experts from 115 countries with different backgrounds. The task force developed a position statement called WARNING (Worldwide Antimicrobial Resistance National/International Network Group) aimed at raising awareness of antimicrobial resistance and improving antibiotic prescribing practices worldwide. The statement outlined is 10 axioms, or “golden rules,” for the appropriate use of antibiotics that all healthcare workers should consistently adhere in clinical practice

Nutritional value of silage Erythrina glauca forage with different levels of molasses and rice flour

El objetivo de esta de investigación fue evaluar el ensilaje de forraje de Pízamo (Erythrina glauca) en su calidad nutricional, para ser utilizado posteriormente en la alimentación animal de en el Piedemonte Llanero de Colombia. Se preparó ensilaje de forraje de Pízamo, en silo-bolsa con tres niveles de melaza: 10%, 15% y 20%, se tomó la mitad del material picado al cual se le había aplicado los diferentes niveles de melaza y se le adicionó un 3% de harina de arroz por tratamiento, quedando la otra mitad del material sin harina, conformando así las diferentes alternativas del ensilaje, para ser analizados en cuatro tiempos de maduración: inicial, treinta, sesenta y noventa días; con tres repeticiones cada uno; conformando un diseño experimental completamente al azar con un arreglo factorial de 3X4X2, siendo respectivamente para tratamientos, tiempos y adición de harina de arroz: Se utilizó análisis de varianza y prueba de Tukey. Las variables evaluadas fueron: Materia seca, proteína, fibra cruda, grasa, extracto no nitrógenado (ENN), cenizas, fibra detergente neutro (FDN), fibra detergente ácido (FDA) y degradabilidad ruminal de la materia seca (DMS). El contenido de materia del ensilaje se aumentó (P<0.05) cuando se incrementaron los niveles de melaza y se adicionó harina de arroz, mientras que el tiempo de maduración no influyó (P>0.05) en el contenido de MS. El contenido de proteína se disminuye (P<0.05) a medida que aumenta el tiempo de maduración, pero se incrementa (P<0.05) cuando se adiciona harina de arroz. La fibra cruda, la FDN y la FDA se disminuyeron (P<0.05) a medida que se incrementaba el tiempo de maduración. Lo contrario sucedió con la DMS a las 72 horas, la cual se fue incrementado (P<0.05) a medida que se aumentaba el tiempo de maduración. La DMS en las diferentes horas de degradación fue mínima, observándose un comportamiento similar (P>0.05) en cada una de las horas evaluadas (6, 12, 24, 48 y 72). La DMS fue rápida en las primeras 6 horas, llegando a un 39%, promedio de todos los tratamientos, el incremento en las siguientes horas fue: 2%, 8%, 11% y 13, 7%, respectivamente, lo cual indica que la degradación fue lenta después de las 6 horas hasta las 72 horas. El contenido de grasa y cenizas no se afectó con ningún tratamiento. Se puede concluir que la fibra cruda, la FDN, FDA se afectan con la fermentación de los microorganismos, puesto que rompen las paredes celulares, ocasionando una disminución, lo cual permite una mayor degradabilidad en el rumen.This investigation evaluated the silage of Erythrina glauca forage in its nutritional quality, to be used later on in the animal feeding of in Colombia. The Erythrina glauca silage, was pack in silage bag was added to forage three levels of molasses (10%, 15% and 20%), besides, was added 3% of flour of rice by treatment, being the other half of the forage without flour, the silaje, was analyzed in four times of maturation: 0, 30, 60 y 90 days; with three repetitions each one. The trial was randomized completely to the chance with a factorial arrangement of 3x4x2, being respectively for treatments, and times of maduration and addition of flour of rice: It was used variance analysis and test of Tukey. The evaluated variables were: Dry matter, protein, raw fiber, fat, non-nitrogenaus extract, ash, the fiber in the neuter detergent (NFD), fiber in the acid detergent (AFD) and degradation in the rumen of the dry matter (DDM). The content of matter of the silage increased (P<0.05) when the levels of molasses were increased and flour of rice was added, while the time of maturation did not influence (P>0.05) on the DM content. The protein content decreased (P<0.05) as it increases the time of maturation, but it is increased (P<0.05) when flour of rice is added. The raw fiber, the NFD and the AFD decreased (P<0.05) as the time of maturation was increased. The opposite happened to the DDM at the 72 hours, which was increased (P<0.05) as it increased the time of maturation. The DDM in the different hours of degradation was minimum, being observed an alike result (P>0.05) in each one of the evaluated hours (6, 12, 24, 48 and 72) The DDM was quick in the first 6 hours, until 39%. The increment in the following hours was: 2%, 8%, 11% and 13,7%, respectively, that which indicated that the degradation was slow after the 6 hours until the 72 hours, the fat and ashy didn't affect any treatment. Was concluded that the raw fiber, the NFD, AFD were affected the fermentation of the microorganisms, since they break the cellular walls, causing a decrease, that which allows a bigger degradation in the rumen

Weaning from mechanical ventilation in intensive care units across 50 countries (WEAN SAFE): a multicentre, prospective, observational cohort study

International audienceBackground: Current management practices and outcomes in weaning from invasive mechanical ventilation are poorly understood. We aimed to describe the epidemiology, management, timings, risk for failure, and outcomes of weaning in patients requiring at least 2 days of invasive mechanical ventilation. Methods: WEAN SAFE was an international, multicentre, prospective, observational cohort study done in 481 intensive care units in 50 countries. Eligible participants were older than 16 years, admitted to a participating intensive care unit, and receiving mechanical ventilation for 2 calendar days or longer. We defined weaning initiation as the first attempt to separate a patient from the ventilator, successful weaning as no reintubation or death within 7 days of extubation, and weaning eligibility criteria based on positive end-expiratory pressure, fractional concentration of oxygen in inspired air, and vasopressors. The primary outcome was the proportion of patients successfully weaned at 90 days. Key secondary outcomes included weaning duration, timing of weaning events, factors associated with weaning delay and weaning failure, and hospital outcomes. This study is registered with ClinicalTrials.gov, NCT03255109. Findings: Between Oct 4, 2017, and June 25, 2018, 10 232 patients were screened for eligibility, of whom 5869 were enrolled. 4523 (77·1%) patients underwent at least one separation attempt and 3817 (65·0%) patients were successfully weaned from ventilation at day 90. 237 (4·0%) patients were transferred before any separation attempt, 153 (2·6%) were transferred after at least one separation attempt and not successfully weaned, and 1662 (28·3%) died while invasively ventilated. The median time from fulfilling weaning eligibility criteria to first separation attempt was 1 day (IQR 0–4), and 1013 (22·4%) patients had a delay in initiating first separation of 5 or more days. Of the 4523 (77·1%) patients with separation attempts, 2927 (64·7%) had a short wean (≤1 day), 457 (10·1%) had intermediate weaning (2–6 days), 433 (9·6%) required prolonged weaning (≥7 days), and 706 (15·6%) had weaning failure. Higher sedation scores were independently associated with delayed initiation of weaning. Delayed initiation of weaning and higher sedation scores were independently associated with weaning failure. 1742 (31·8%) of 5479 patients died in the intensive care unit and 2095 (38·3%) of 5465 patients died in hospital. Interpretation: In critically ill patients receiving at least 2 days of invasive mechanical ventilation, only 65% were weaned at 90 days. A better understanding of factors that delay the weaning process, such as delays in weaning initiation or excessive sedation levels, might improve weaning success rates. Funding: European Society of Intensive Care Medicine, European Respiratory Society