Mixed venous oxygen saturation monitoring revisited : thoughts for critical care nursing practice

Background Less invasive methods of determining cardiac output are now readily available. Using indicator dilution technique, for example has made it easier to continuously measure cardiac output because it uses the existing intra-arterial line. Therefore gone is the need for a pulmonary artery floatation catheter and with it the ability to measure left atrial and left ventricular work indices as well the ability to monitor and measure a mixed venous saturation (SvO2). Purpose The aim of this paper is to put forward the notion that SvO2 provides valuable information about oxygen consumption and venous reserve; important measures in the critically ill to ensure oxygen supply meets cellular demand. In an attempt to portray this, a simplified example of the septic patient is offered to highlight the changing pathophysiological sequelae of the inflammatory process and its importance for monitoring SvO2. Relevance to clinical practice SvO2 monitoring, it could be argued, provides the gold standard for assessing arterial and venous oxygen indices in the critically ill. For the bedside ICU nurse the plethora of information inherent in SvO2 monitoring could provide them with important data that will assist in averting potential problems with oxygen delivery and consumption. However, it has been suggested that central venous saturation (ScvO2) might be an attractive alternative to SvO2 because of its less invasiveness and ease of obtaining a sample for analysis. There are problems with this approach and these are to do with where the catheter tip is sited and the nature of the venous admixture at this site. Studies have shown that ScvO2 is less accurate than SvO2 and should not be used as a sole guiding variable for decision-making. These studies have demonstrated that there is an unacceptably wide range in variance between ScvO2 and SvO2 and this is dependent on the presenting disease, in some cases SvO2 will be significantly lower than ScvO2. Conclusion Whilst newer technologies have been developed to continuously measure cardiac output, SvO2 monitoring is still an important adjunct to clinical decision-making in the ICU. Given the information that it provides, seeking alternatives such as ScvO2 or blood samples obtained from femorally placed central venous lines, can unnecessarily lead to inappropriate treatment being given or withheld. Instead when using ScvO2, trending of this variable should provide clinical determinates that are useable for the bedside ICU nurse, remembering that in most conditions SvO2 will be approximately 16% lower.

A novel route in bone tissue engineering : magnetic biomimetic scaffolds

In recent years, interest in tissue engineering and its solutions has increased considerably. In particular, scaffolds have become fundamental tools in bone graft substitution and are used in combination with a variety of bio-agents. However, a long-standing problem in the use of these conventional scaffolds lies in the impossibility of re-loading the scaffold with the bio-agents after implantation. This work introduces the magnetic scaffold as a conceptually new solution. The magnetic scaffold is able, via magnetic driving, to attract and take up in vivo growth factors, stem cells or other bio-agents bound to magnetic particles. The authors succeeded in developing a simple and inexpensive technique able to transform standard commercial scaffolds made of hydroxyapatite and collagen in magnetic scaffolds. This innovative process involves dip-coating of the scaffolds in aqueous ferrofluids containing iron oxide nanoparticles coated with various biopolymers. After dip-coating, the nanoparticles are integrated into the structure of the scaffolds, providing the latter with magnetization values as high as 15 emu g�1 at 10 kOe. These values are suitable for generating magnetic gradients, enabling magnetic guiding in the vicinity and inside the scaffold. The magnetic scaffolds do not suffer from any structural damage during the process, maintaining their specific porosity and shape. Moreover, they do not release magnetic particles under a constant flow of simulated body fluids over a period of 8 days. Finally, preliminary studies indicate the ability of the magnetic scaffolds to support adhesion and proliferation of human bone marrow stem cells in vitro. Hence, this new type of scaffold is a valuable candidate for tissue engineering applications, featuring a novel magnetic guiding option.

Simultaneous magnetic resonance imaging and consolidation measurement of articular cartilage

Magnetic resonance imaging (MRI) offers the opportunity to study biological tissues and processes in a non-disruptive manner. The technique shows promise for the study of the load-bearing performance (consolidation) of articular cartilage and changes in articular cartilage accompanying osteoarthritis. Consolidation of articular cartilage involves the recording of two transient characteristics: the change over time of strain and the hydrostatic excess pore pressure (HEPP). MRI study of cartilage consolidation under mechanical load is limited by difficulties in measuring the HEPP in the presence of the strong magnetic fields associated with the MRI technique. Here we describe the use of MRI to image and characterize bovine articular cartilage deforming under load in an MRI compatible consolidometer while monitoring pressure with a Fabry-Perot interferometer-based fiber-optic pressure transducer.

Magnetic convection heat transfer in an open ended enclosure filled with paramagnetic fluids

Numerical simulations of thermomagnetic convection of paramagnetic fluids placed in a micro-gravity condition (g nearly 0) and under a uniform vertical gradient magnetic field in an open ended square enclosure with ramp heating temperature condition applied on a vertical wall is investigated in this study. In presence of the strong magnetic gradient field thermal convection of the paramagnetic fluid might take place even in a zero-gravity environment as a direct consequence of temperature differences occurring within the fluid. The thermal boundary layer develops adjacent to the hot wall as soon as the ramp temperature condition is applied on it. There are two scenario that can be observed based on the ramp heating time. The steady state of the thermal boundary layer can be reached before the ramp time is finished or vice versa. If the ramp time is larger than the quasi-steady time then the thermal boundary layer is in a quasi-steady mode with convection balancing conduction after the quasi-steady time. Further increase of the heat input simply accelerates the flow to maintain the proper thermal balance. Finally, the boundary layer becomes completely steady state when the ramp time is finished. Effects of magnetic Rayleigh number, Prandtl number and paramagnetic fluid parameter on the flow pattern and heat transfer are presented.

Defects induced ferromagnetism in plasma-enabled graphene nanopetals

Ferromagnetism in graphene is fascinating, but it is still a big challenge for practical applications due to the weak magnetization. In order to enhance the magnetization, here, we design plasma-enabled graphene nanopetals with ultra-long defective edges of up to 105 m/g, ultra-dense lattice vacancies, and hydrogen chemisorptions. The designed graphene nanopetals display robust ferromagnetism with large saturation magnetization of up to 2 emu/g at 5 K and 1.2 emu/g at room temperatures. This work identifies the plasma-enabled graphene nanopetals as a promising candidate for graphene-based magnetic devices.

Dense plasmas in magnetic traps : generation of focused ion beams with controlled ion-to-neutral flux ratios

Customized magnetic traps were developed to produce a domain of dense plasmas with a narrow ion beam directed to a particular area of the processed substrate. A planar magnetron coupled with an arc discharge source created the magnetic traps to confine the plasma electrons and generate the ion beam with the controlled ratio of ion-to-neutral fluxes. Images of the plasma jet patterns and numerical vizualizations help explaining the observed phenomena.

Control of ion density distribution by magnetic traps for plasma electrons

The effect of a magnetic field of two magnetic coils on the ion current density distribution in the setup for low-temperature plasma deposition is investigated. The substrate of 400 mm diameter is placed at a distance of 325 mm from the plasma duct exit, with the two magnetic coils mounted symmetrically under the substrate at a distance of 140 mm relative to the substrate centre. A planar probe is used to measure the ion current density distribution along the plasma flux cross-sections at distances of 150, 230, and 325 mm from the plasma duct exit. It is shown that the magnetic field strongly affects the ion current density distribution. Transparent plastic films are used to investigate qualitatively the ion density distribution profiles and the effect of the magnetic field. A theoretical model is developed to describe the interaction of the ion fluxes with the negative space charge regions associated with the magnetic trapping of the plasmaelectrons. Theoretical results are compared with the experimental measurements, and a reasonable agreement is demonstrated.

Magnetic control of breakdown : toward energy-efficient hollow-cathode magnetron discharges

Characteristics of electrical breakdown of a planar magnetron enhanced with an electromagnet and a hollow-cathode structure, are studied experimentally and numerically. At lower pressures the breakdown voltage shows a dependence on the applied magnetic field, and the voltage necessary to achieve the self-sustained discharge regime can be significantly reduced. At higher pressures, the dependence is less sensitive to the magnetic field magnitude and shows a tendency of increased breakdown voltage at the stronger magnetic fields. A model of the magnetron discharge breakdown is developed with the background gas pressure and the magnetic field used as parameters. The model describes the motion of electrons, which gain energy by passing the electric field across the magnetic field and undergo collisions with neutrals, thus generating new bulk electrons. The electrons are in turn accelerated in the electric field and effectively ionize a sufficient amount of neutrals to enable the discharge self-sustainment regime. The model is based on the assumption about the combined classical and near-wall mechanisms of electron conductivity across the magnetic field, and is consistent with the experimental results. The obtained results represent a significant advance toward energy-efficient multipurpose magnetron discharges.

Plasma/ion-controlled metal catalyst saturation : enabling simultaneous growth of carbon nanotube/nanocone arrays

It is shown that the simultaneous saturation of Ni nanoparticles used as catalyst for vertically aligned carbon nanotube and nanocone arrays can be improved in low-temperature plasma- or ion-assisted processes compared with neutral gas-based routes. The results of hybrid multiscale numerical simulations of the catalyst nanoarrays (particle sizes of 2 and 10 nm) saturation with carbon show the possibility of reducing the difference in catalyst incubation times for smallest and largest catalyst particles by up to a factor of 2. This approach is generic and provides process conditions for simultaneous nucleation and growth of uniform arrays of vertically aligned nanostructures. © 2008 American Institute of Physics.

Single-step synthesis and magnetic separation of graphene and carbon nanotubes in arc discharge plasmas

The unique properties of graphene and carbon nanotubes made them the most promising nanomaterials attracting enormous attention, due to the prospects for applications in various nanodevices, from nanoelectronics to sensors and energy conversion devices. Here we report on a novel deterministic, single-step approach to simultaneous production and magnetic separation of graphene flakes and carbon nanotubes in an arc discharge by splitting the high-temperature growth and low-temperature separation zones using a non-uniform magnetic field and tailor-designed catalyst alloy, and depositing nanotubes and graphene in different areas. Our results are very relevant to the development of commercially-viable, single-step production of bulk amounts of high-quality graphene.

Magnetic-field-enhanced synthesis of single-wall carbon nanotubes in arc discharge

The ability to control the properties of single-wall nanotubes (SWNTs) produced in the arc discharge is important for many practical applications. Our experiments suggest that the length of SWNTs significantly increases (up to 4000 nm), along with the purity of the carbon deposit, when the magnetic field is applied to arc discharge. Scanning electron microscopy and transmission electron microscopy analyses have demonstrated that the carbon deposit produced in the magnetic-field-enhanced arc mainly consists of the isolated and bunched SWNTs. A model of a carbon nanotube interaction and growth in the thermal plasma was developed, which considers several important effects such as anode ablation that supplies the carbon plasma in an anodic arc discharge technique, and the momentum, charge, and energy transfer processes between nanotube and plasma. It is shown that the nanotube charge with respect to the plasma as well as nanotube length depend on plasma density and electric field in the interelectrode gap. For instance, nanotube charge changes from negative to positive value with an electron density decrease. The numerical simulations based on the Monte Carlo technique were performed, which explain an increase in the nanotubes produced in the magnetic-field-enhanced arc discharge. © 2008 American Institute of Physics.

Plasma-controlled metal catalyst saturation and the initial stage of carbon nanostructure array growth

The kinetics of the nucleation and growth of carbon nanotube and nanocone arrays on Ni catalyst nanoparticles on a silicon surface exposed to a low-temperature plasma are investigated numerically, using a complex model that includes surface diffusion and ion motion equations. It is found that the degree of ionization of the carbon flux strongly affects the kinetics of nanotube and nanocone nucleation on partially saturated catalyst patterns. The use of highly ionized carbon flux allows formation of a nanotube array with a very narrow height distribution of half-width 7 nm. Similar results are obtained for carbon nanocone arrays, with an even narrower height distribution, using a highly ionized carbon flux. As the deposition time increases, nanostructure arrays develop without widening the height distribution when the flux ionization degree is high, in contrast to the fairly broad nanostructure height distributions obtained when the degree of ionization is low.

Electron transport across magnetic field in low-temperature plasmas : an alternative approach for obtaining evidence of Bohm mechanism

A comparative study involving both experimental and numerical investigations was made to resolve a long-standing problem of understanding electron conductivity mechanism across magnetic field in low-temperature plasmas. We have calculated the plasma parameters from experimentally obtained electric field distribution, and then made a 'back' comparison with the distributions of electron energy and plasma density obtained in the experiment. This approach significantly reduces an influence of the assumption about particular phenomenology of the electron conductivity in plasma. The results of the experiment and calculations made by this technique have showed that the classical conductivity is not capable of providing realistic total current and electron energy, whereas the phenomenological anomalous Bohm mobility has demonstrated a very good agreement with the experiment. These results provide an evidence in favor of the Bohm conductivity, thus making it possible to clarify this pressing long-living question about the main driving mechanism responsible for the electron transport in low-temperature plasmas.

Effective control of ion fluxes over large areas by magnetic fields : from narrow beams to highly uniform fluxes

An effective control of the ion current distribution over large-area (up to 103 cm2) substrates with the magnetic fields of a complex structure by using two additional magnetic coils installed under the substrate exposed to vacuum arc plasmas is demonstrated. When the magnetic field generated by the additional coils is aligned with the direction of the magnetic field generated by the guiding and focusing coils of the vacuum arc source, a narrow ion density distribution with the maximum current density 117 A m-2 is achieved. When one of the additional coils is set to generate the magnetic field of the opposite direction, an area almost uniform over the substrate of 103 cm2 ion current distribution with the mean value of 45 A m-2 is achieved. Our findings suggest that the system with the vacuum arc source and two additional magnetic coils can be effectively used for the effective, high throughput, and highly controllable plasma processing.

Carbon saturation of arrays of Ni catalyst nanoparticles of different size and pattern uniformity on a silicon substrate

The kinetics of saturation of Ni catalyst nanoparticle patterns of the three different degrees of order, used as a model for the growth of carbon nanotips on Si, is investigated numerically using a complex model that involves surface diffusion and ion motion equations. It is revealed that Ni catalyst patterns of different degrees of order, with Ni nanoparticle sizes up to 12.5 nm, exhibit different kinetics of saturation with carbon on the Si surface. It is shown that in the cases examined (surface coverage in the range of 1-50%, highly disordered Ni patterns) the relative pattern saturation factor calculated as the ratio of average incubation times for the processes conducted in the neutral and ionized gas environments reaches 14 and 3.4 for Ni nanoparticles of 2.5 and 12.5 nm, respectively. In the highly ordered Ni patterns, the relative pattern saturation factor reaches 3 for nanoparticles of 2.5 nm and 2.1 for nanoparticles of 12.5 nm. Thus, more simultaneous saturation of Ni catalyst nanoparticles of sizes in the range up to 12.5 nm, deposited on the Si substrate, can be achieved in the low-temperature plasma environment than with the neutral gas-based process.