Conversion to Veno-arteriovenous Extracorporeal Membrane Oxygenation for Differential Hypoxia
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- Journal of Chest Surgery
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- v.56 no.4
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- pp.274-281
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- 2023
Background: Patients who require initial venoarterial extracorporeal membrane oxygenation (VA ECMO) support may need to undergo veno-arteriovenous ECMO (VAV ECMO) conversion. However, there are no definitive criteria for conversion to VAV ECMO. We report 9 cases of VAV ECMO at Gyeongsang National University Changwon Hospital, Gyeongsang National University College of Medicine. Methods: Of 158 patients who received ECMO support between January 2017 and June 2019, 82 were supported by initial VA ECMO. We retrospectively reviewed the medical records of 9 patients (7 men and 2 women; age, 53.1±19.4 years) who had differential hypoxia and required VAV ECMO support. Percutaneous transaortic catheter venting was used to detect the differential hypoxia. Results: Among the 82 patients who received VA ECMO support, 9 (10.9%) had differential hypoxia and required conversion to VAV ECMO support. The mean time from VA ECMO support to VAV ECMO support and the mean duration of the VAV support were 2.1±2.2 days and 1.9±1.5 days, respectively. The average peak inspiratory pressure before and after VAV ECMO application was 23.89±3.95 cmH2O and 20.67±5.72 cmH2O, respectively, decreasing by an average of 3.2±3.5 cmH2O (p=0.040). The PaO2/FiO2 ratio was kept below 100 mm Hg in survivors and non-survivors for 116±65.4 and 250±124.9 minutes, respectively (p=0.016). Six patients underwent extracorporeal cardiopulmonary resuscitation, of whom 4 survived (67%). The overall survival rate of patients who underwent conversion from VA ECMO to VAV ECMO was approximately 56%. Conclusion: Rapid detection of differential hypoxia is required when VA ECMO is applied, and efficient conversion to VAV ECMO may be critical for patient survival.
Simple post-wash method by ion chromatography (IC) was established for the rapid and precise determination of fluoride ion in wastewater from mine in fluorite mineralized area. High sulfate in sample was retained in a pre-column and less strongly held fluoride ion was transferred to the principal separation system using modified conventional IC with switching technique. An analytical column with high capacity (AS 9 HC) was used as a pre-column to retain the amount of high sulfate. A guard column (AG 14) as a separation column was used to increase the response of fluoride and reduce the system pressure. According to the recovery of fluoride ion with one detector and the observation of sulfate peak with another conductivity detector, the optimum switching time of 10-port chromatographic injector was 4.3 min. The limit of detection (S/N = 3) of fluoride in synthetic solution containing
The Artificial Neural Network (ANN) model was suggested for predicting probability of precipitation (PoP) using RDAPS NWP model, observation at AWS and upper-air sounding station. The prediction work was implemented for flood season and the data period is the July, August of 2001 and June of 2002. Neural network input variables (predictors) were composed of geopotential height 500/750/1000 hPa, atmospheric thickness 500-1000 hPa, X & Y-component of wind at 500 hPa, X & Y-component of wind at 750 hPa, wind speed at surface, temperature at 500/750 hPa/surface, mean sea level pressure, 3-hr accumulated precipitation, occurrence of observed precipitation, precipitation accumulated in 6 & 12 hrs previous to RDAPS run, precipitation occurrence in 6 & 12 hrs previous to RDAPS run, relative humidity measured 0 & 12 hrs before RDAPS run, precipitable water measured 0 & 12 hrs before RDAPS run, precipitable water difference in 12 hrs previous to RDAPS run. The suggested ANN has a 3-layer perceptron (multi layer perceptron; MLP) and back-propagation learning algorithm. The result shows that there were 6.8% increase in Hit rate (H), especially 99.2% and 148.1% increase in Threat Score (TS) and Probability of Detection (POD). It illustrates that the suggested ANN model can be a useful tool for predicting rainfall event prediction. The Kuipers Skill Score (KSS) was increased 92.8%, which the ANN model improves the rainfall occurrence prediction over RDAPS.
Recently, advancements and commercialization in the field of maritime autonomous surface ships (MASS) has rapidly progressed. Concurrently, studies are also underway to develop methods for automatically surveying the condition of various on-board equipment remotely to ensure the navigational safety of MASS. One key issue that has gained prominence is the method to obtain values from analog gauges installed in various equipment through image processing. This approach has the advantage of enabling the non-contact detection of gauge values without modifying or changing already installed or planned equipment, eliminating the need for type approval changes from shipping classifications. The objective of this study was to identify a dynamically changing indicator needle within noisy images of analog gauges. The needle object must be identified because its position significantly affects the accurate reading of gauge values. An analog pressure gauge attached to an emergency fire pump model was used for image capture to identify the needle object. The acquired images were pre-processed through Gaussian filtering, thresholding, and morphological operations. The needle object was then identified through Hough Transform. The experimental results confirmed that the center and object of the indicator needle could be identified in images of noisy analog gauges. The findings suggest that the image processing method applied in this study can be utilized for shape identification in analog gauges installed on ships. This study is expected to be applicable as an image processing method for the automatic remote survey of MASS.
This study used gas chromatography combined with the microelectron capture detection method to determine the most effective washing and cooking methods for removing isoprothiolane from rice. The initial isoprothiolane concentrations in brown and polished rice, before washing, were 17.03 mg/kg and 1.67 mg/kg, respectively. Residual concentrations declined with more washing cycles (19.3-59.3% for brown rice; 43.1-66.5% for polished rice); and by increasing the temperature of the washing water from 5℃ to 40℃ (56.6-63.1% for brown rice; 67.1-74.9% for polished rice). Hand-washing samples using gentle stirring or harsh rubbing reduced pesticide concentrations by 63.1-71.6% for brown rice, versus 75.4-87.4% for polished rice. Reduction in isoprothiolane concentrations varied based on the rice cooker type and whether the rice was pre-soaked. Immediate cooking using an electric- or pressure-cooker showed 78.5% and 78.4% reduction in brown rice, compared with 94.0% and 94.0% for polished rice, respectively. Pre-cooking immersion for 30 min showed similar reductions of 83.4% and 83.4% in brown rice, versus 95.8% and 95.8% in polished rice. The results of this study suggest that the most effective method for removing residual isoprothiolane from both brown rice and polished rice was to wash six times (with vigorous rubbing during the 2nd and 3rd washing) in 7-fold water at 40℃, followed by immersion for 30 min before cooking. Regardless of the type of rice cooker, heating is sufficient to remove an average of 83.4% and 95.8% of isoprothiolane from brown rice and polished rice, respectively.
Indoor localization is a critical component for numerous applications, ranging from navigation in large buildings to emergency response. This paper presents an enhanced Pedestrian Dead Reckoning (PDR) scheme using smartphone sensors, integrating neural network-aided motion recognition, Kalman filter-based error correction, and multi-sensor data fusion. The proposed system leverages data from the accelerometer, magnetometer, gyroscope, and barometer to accurately estimate a user's position and orientation. A neural network processes sensor data to classify motion modes and provide real-time adjustments to stride length and heading calculations. The Kalman filter further refines these estimates, reducing cumulative errors and drift. Experimental results, collected using a smartphone across various floors of University, demonstrate the scheme's ability to accurately track vertical movements and changes in heading direction. Comparative analyses show that the proposed CNN-LSTM model outperforms conventional CNN and Deep CNN models in angle prediction. Additionally, the integration of barometric pressure data enables precise floor level detection, enhancing the system's robustness in multi-story environments. Proposed comprehensive approach significantly improves the accuracy and reliability of indoor localization, making it viable for real-world applications.
The wall shear stress in the vicinity of end-to end anastomoses under steady flow conditions was measured using a flush-mounted hot-film anemometer(FMHFA) probe. The experimental measurements were in good agreement with numerical results except in flow with low Reynolds numbers. The wall shear stress increased proximal to the anastomosis in flow from the Penrose tubing (simulating an artery) to the PTFE: graft. In flow from the PTFE graft to the Penrose tubing, low wall shear stress was observed distal to the anastomosis. Abnormal distributions of wall shear stress in the vicinity of the anastomosis, resulting from the compliance mismatch between the graft and the host artery, might be an important factor of ANFH formation and the graft failure. The present study suggests a correlation between regions of the low wall shear stress and the development of anastomotic neointimal fibrous hyperplasia(ANPH) in end-to-end anastomoses. 30523 T00401030523 ^x Air pressure decay(APD) rate and ultrafiltration rate(UFR) tests were performed on new and saline rinsed dialyzers as well as those roused in patients several times. C-DAK 4000 (Cordis Dow) and CF IS-11 (Baxter Travenol) reused dialyzers obtained from the dialysis clinic were used in the present study. The new dialyzers exhibited a relatively flat APD, whereas saline rinsed and reused dialyzers showed considerable amount of decay. C-DAH dialyzers had a larger APD(11.70
The wall shear stress in the vicinity of end-to end anastomoses under steady flow conditions was measured using a flush-mounted hot-film anemometer(FMHFA) probe. The experimental measurements were in good agreement with numerical results except in flow with low Reynolds numbers. The wall shear stress increased proximal to the anastomosis in flow from the Penrose tubing (simulating an artery) to the PTFE: graft. In flow from the PTFE graft to the Penrose tubing, low wall shear stress was observed distal to the anastomosis. Abnormal distributions of wall shear stress in the vicinity of the anastomosis, resulting from the compliance mismatch between the graft and the host artery, might be an important factor of ANFH formation and the graft failure. The present study suggests a correlation between regions of the low wall shear stress and the development of anastomotic neointimal fibrous hyperplasia(ANPH) in end-to-end anastomoses. 30523 T00401030523 ^x Air pressure decay(APD) rate and ultrafiltration rate(UFR) tests were performed on new and saline rinsed dialyzers as well as those roused in patients several times. C-DAK 4000 (Cordis Dow) and CF IS-11 (Baxter Travenol) reused dialyzers obtained from the dialysis clinic were used in the present study. The new dialyzers exhibited a relatively flat APD, whereas saline rinsed and reused dialyzers showed considerable amount of decay. C-DAH dialyzers had a larger APD(11.70
Objectives: The purpose of this study is to provide data for the improvement of hypertension management of community health practitioner posts through the study on hypertension management in community health practitioner posts. Methods: A questionnaire was mailed to 700 community health practitioners and 205 of them responded during the period from March 13, 2003 to May 13. The survey results were analyzed using SPSS program, version 11. Results: The results are as follows; 1. There are two major activities in a hypertension prevention project for community: health education and early detection. About 57% of community health care practitioners perform a health education for community people four times a year. The 64.5% of them used the materials for health education provided from a community health center and 22.1% of them performed a post-evaluation. The main method of early detection of hypertension was measurement of blood pressure of person to visit, which was 96.1%. Other methods included home visiting(89.3%), a referral from community hospitals and other resources(49.1%), health promotion events(39.5%), and a review of medical records(35.7%). 2. For the registration and management of patients with hypertension, about 36% of community health centers used a special form and more than 50% of them have registered patients who were managed by other health care institutions in the community. A computerized program was used for the management of patients with hypertension in 68.5% of them. More than 60% of them responded that it was used for report, treatment, and follow-up of patients with hypertension.
The detection methods are required to monitor and diagnose the abnormality on the insulation condition inside a gas-insulated switchgear (GIS). Due to a good sensitivity to the products decomposed by partial discharges (PDs) in