摘要 :
In pediatric fluid therapy it would be preferable to describe distribution and elimination a fluid bolus based on repetitive hemoglobin (Hb) according to kinetic principles. Pulse CO-Oximetry is a recent advancement in patient mon...
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In pediatric fluid therapy it would be preferable to describe distribution and elimination a fluid bolus based on repetitive hemoglobin (Hb) according to kinetic principles. Pulse CO-Oximetry is a recent advancement in patient monitoring that allows for the continuous noninvasive measurement of Hb (SpHb). The aim of this study was to describe the distribution and elimination of hydroxyethylstarch (HES) 130/0.4 in combination with crystalloids using a noninvasive Hb monitor in two cohorts of young children undergoing minor surgeries under general anesthesia. Two cohorts, 16 children aged 1-3 years and 12 aged 4-6 years, were investigated during anesthesia and minor surgical procedures. They were given a maintenance solution of lactated Ringer's and a fluid bolus of HES 130/0.4, 6 mL/kg over a period of 20 min. The whole procedure lasted 120 min, and SpHb values were measured every 10 min. The SpHb values were used to calculate plasma dilution, net volume, and mean residence time (MRT) of the infused fluid. A total of 377 measured SpHbs generated individual dilution plots that showed variability, particularly for the older cohort. Distribution and elimination rates of the infused fluid were calculated. Mean dilution plots were generated. There were no significant differences in dilution, net volume or MRT between groups. A non invasive Hb analyzer could be used to calculate fluid distribution. The variability in the data can probably be explained by reactions to anesthetic drugs, variability in measurement technique, variability in generating the complex capillary signals, and individual variability in baseline fluid status. The latter finding is important because this is a prerequisite for perioperative fluid planning for each individual.
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摘要 :
In pediatric fluid therapy it would be preferable to describe distribution and elimination a fluid bolus based on repetitive hemoglobin (Hb) according to kinetic principles. Pulse CO-Oximetry is a recent advancement in patient mon...
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In pediatric fluid therapy it would be preferable to describe distribution and elimination a fluid bolus based on repetitive hemoglobin (Hb) according to kinetic principles. Pulse CO-Oximetry is a recent advancement in patient monitoring that allows for the continuous noninvasive measurement of Hb (SpHb). The aim of this study was to describe the distribution and elimination of hydroxyethylstarch (HES) 130/0.4 in combination with crystalloids using a noninvasive Hb monitor in two cohorts of young children undergoing minor surgeries under general anesthesia. Two cohorts, 16 children aged 1–3 years and 12 aged 4–6 years, were investigated during anesthesia and minor surgical procedures. They were given a maintenance solution of lactated Ringer’s and a fluid bolus of HES 130/0.4, 6 mL/kg over a period of 20 min. The whole procedure lasted 120 min, and SpHb values were measured every 10 min. The SpHb values were used to calculate plasma dilution, net volume, and mean residence time (MRT) of the infused fluid. A total of 377 measured SpHbs generated individual dilution plots that showed variability, particularly for the older cohort. Distribution and elimination rates of the infused fluid were calculated. Mean dilution plots were generated. There were no significant differences in dilution, net volume or MRT between groups. A non invasive Hb analyzer could be used to calculate fluid distribution. The variability in the data can probably be explained by reactions to anesthetic drugs, variability in measurement technique, variability in generating the complex capillary signals, and individual variability in baseline fluid status. The latter finding is important because this is a prerequisite for perioperative fluid planning for each individual.
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The aim of this work is to analyze the role of shear evolution equation in the modeling of relativistic spheres in f(R) gravity. We assume that non-static diagonally symmetric geometry is coupled with dissipative anisotropic visco...
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The aim of this work is to analyze the role of shear evolution equation in the modeling of relativistic spheres in f(R) gravity. We assume that non-static diagonally symmetric geometry is coupled with dissipative anisotropic viscous fluid distributions in the presence of f(R) dark source terms. A specific distribution of f(R) cosmic model has been assumed and the spherical mass function through generic formula introduced by Misner Sharp has been formulated. Some very important relations regarding Weyl scalar, matter variables and mass functions are being computed. After decomposing orthogonally the Riemann tensor, some scalar variables in the presence of f(R) extra degrees of freedom are calculated. The effects of the three parametric modified structure scalars in the modeling of Weyl, shear, expansion scalar differential equations are investigated. The energy density irregularity factor has been calculated for both anisotropic radiating viscous with varying Ricci scalar and dust cloud with present Ricci scalar corrections.
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This work is devoted to the study of some dynamical features of spherical relativistic locally anisotropic stellar geometry in f(R) gravity. In this paper, a specific configuration of tanh f(R) cosmic model has been taken into acc...
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This work is devoted to the study of some dynamical features of spherical relativistic locally anisotropic stellar geometry in f(R) gravity. In this paper, a specific configuration of tanh f(R) cosmic model has been taken into account. The mass function through technique introduced by Misner-Sharp has been formulated and with the help of it, various fruitful relations are derived. After orthogonal decomposition of the Riemann tensor, the tanh modified structure scalars are calculated. The role of these tanh modified structure scalars (MSS) has been discussed through shear, expansion as well as Weyl scalar deferential equations. The inhomogeneity factor has also been explored for the case of radiating viscous locally anisotropic spherical system and spherical dust cloud with and without constant Ricci scalar corrections.
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The work is devoted to analyzing the effects of dark source polynomial curvature corrections in the mathematical modeling of radiating stars. In this scenario, we have used a particular f(R, T) model and consider the spherically s...
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The work is devoted to analyzing the effects of dark source polynomial curvature corrections in the mathematical modeling of radiating stars. In this scenario, we have used a particular f(R, T) model and consider the spherically symmetric geometry of relativistic interior. We assumed that our geometry is coupled with anisotropic shearing matter distribution undergoing radiating epoch with free streaming and diffusion approximation. We have calculated spherically symmetric total matter content with the help of Misner-Sharp formalism. A particular relation among anisotropic pressure, shearing viscosity, radiating parameters, energy density, and tidal forces is obtained. We then expressed this equation with the help of f(R, T) structure scalar, the scalar obtained by orthogonal decomposition of the Riemann tensor. The role of the logarithmic Ricci and trace of stress-energy tensor terms are also observed through Weyl scalar, shear, expansion scalar differential equations.
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Background: Surgeons depend on fluid intake and output (I/O) measurements for assessment of resuscitation and fluid balance during the perioperative period. Frequently, these measurements are taken by Registered Nurses (RNs) and/o...
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Background: Surgeons depend on fluid intake and output (I/O) measurements for assessment of resuscitation and fluid balance during the perioperative period. Frequently, these measurements are taken by Registered Nurses (RNs) and/or Patient Care Technicians (PCTs). There is variability in the accuracy and consistency of these measurements across nursing units. The goal of this study is to establish what barriers exist in obtaining accurate fluid measurements and potential solutions.
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Background: Wide ranges of sodium concentrations for different body fluid losses have been noted with minimal substantiating data and variability among sources, leading to use of "cumulative fluid balance" regardless of compositio...
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Background: Wide ranges of sodium concentrations for different body fluid losses have been noted with minimal substantiating data and variability among sources, leading to use of "cumulative fluid balance" regardless of composition in hospitalized patients. Aims: To define the sodium concentrations of fluid losses from the body. Method: We performed a systematic search and literature review in adult humans using PubMed database. Results: Inclusion criteria were met for 107 full-text articles. Mean sodium concentrations were significantly lower for acidic (mean +/- SD: 44 +/- 12 mEq/L) than for alkaline (55 +/- 13 mEq/L) gastric fluid, higher for bile (185 +/- 24 mEq/L) or pancreatic fluid (156 +/- 3 mEq/L) than for all other body fluids, and similar for intact small bowel (119 +/- 14 mEq/L) and ileostomy outputs (116 +/- 25 mEq/L). Sodium concentrations were significantly greater for cholera-induced diarrhea (128 +/- 18 mEq/L) and lower for osmotic-induced diarrhea (28 +/- 16 mEq/L) than all other causes of diarrhea. For osmotic diarrheas, sorbitol-induced diarrhea sodium concentration was higher (63 +/- 17 mEq/L) than for carbohydrate malabsorption (43 +/- 20 mEq/L), lactulose (26 +/- 19 mEq/L), Idolax (16 +/- 13 mEq/L), or polyethylene glycol (13 +/- 7 mEq/L). For secretory diarrheas, sodium concentration for idiopathic causes (53 +/- 22 mEq/L) was lower than for neuroendocrine and villous tumors (75 +/- 13 mEq/L) or nonosmotic laxatives (88 +/- 33 mEq/L). For pleural, peritoneal, and edema fluid, sodium concentrations (137 +/- 13 mEq/L) were similar to plasma. No data were found for wound fluid. Sodium concentration for sweat was 44 +/- 17 mEq/L. Conclusions: This is the first in-depth review of verifiable sodium concentrations of body fluids most commonly lost in hospitalized patients. Sodium concentrations are fluid-specific and consistent. Sodium concentrations for diarrhea are associated with specific mechanisms/causes. These data should be useful to more accurately replace sodium and water content for specific body fluid losses.
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The possibilities, advantages, shortcomings, and prospects of using supercritical fluids for separating and extracting metal complexes with organic reagents are considered. The theoretical bases of supercritical fluid chromatograp...
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The possibilities, advantages, shortcomings, and prospects of using supercritical fluids for separating and extracting metal complexes with organic reagents are considered. The theoretical bases of supercritical fluid chromatography and factors influencing the separation of metal complexes (nature of the organic reagent, solubility of reagents and complexes in a supercritical fluid, type of column, motionless phase, addition of a modifier into the mobile phase, and the test solvent) are discussed. The processes occurring in complexes during chromatography are discussed. The bases of supercritical fluid extraction and factors influencing extraction of metals (nature and solubility in a supercritical fluid of an organic reagent and complexes; concentration and ways of introducing the reagent into the system; addition of the modifier, water, and surfactants; the collector; and the matrix) are considered. The possibilities of methods for determining metals in various objects are shown.
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Background Perioperative fluid therapy remains a highly debated topic. Its purpose is to maintain or restore effective circulating blood volume during the immediate perioperative period. Maintaining effective circulating blood vol...
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Background Perioperative fluid therapy remains a highly debated topic. Its purpose is to maintain or restore effective circulating blood volume during the immediate perioperative period. Maintaining effective circulating blood volume and pressure are key components of assuring adequate organ perfusion while avoiding the risks associated with either organ hypo- or hyperperfusion. Relative to perioperative fluid therapy, three inescapable conclusions exist: overhydration is bad, underhydration is bad, and what we assume about the fluid status of our patients may be incorrect. There is wide variability of practice, both between individuals and institutions. The aims of this paper are to clearly define the risks and benefits of fluid choices within the perioperative space, to describe current evidence-based methodologies for their administration, and ultimately to reduce the variability with which perioperative fluids are administered.
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The structural properties of fluids whose molecules interact via potentials with a hard core plus two piece-wise constant sections of different widths and heights are presented. These follow from the more general development previ...
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The structural properties of fluids whose molecules interact via potentials with a hard core plus two piece-wise constant sections of different widths and heights are presented. These follow from the more general development previously introduced for potentials with a hard core plus n piece-wise constant sections [A. Santos, S. B. Yuste, and M. Lopez de Haro, Condens. Matter Phys. 15, 23602 (2012)]10.5488/CMP.15.23602 in which use was made of a semi-analytic rational-function approximation method. The results of illustrative cases comprising eight different combinations of wells and shoulders are compared both with simulation data and with those that follow from the numerical solution of the Percus-Yevick and hypernetted-chain integral equations. It is found that the rational-function approximation generally predicts a more accurate radial distribution function than the Percus-Yevick theory and is comparable or even superior to the hypernetted-chain theory. This superiority over both integral equation theories is lost, however, at high densities, especially as the widths of the wells and/or the barriers increase.
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