An approach to monitor the fraction of elemental carbon in the ultrafine aerosol

Attempts were made to measure the fraction of elemental carbon (EC) in ultrafine aerosol by modifying an Ambient Carbonaceous Particulate Monitor (ACPM, R&P 5400). The main modification consisted in placing a quartz filter in one of the sampling lines of this dual-channel instrument. With the filter all aerosol and EC contained in it is collected, while in the other line of the instrument the standard impactor samples only particles larger than 0.14 μm. The fraction of EC in particles smaller than 0.14 μm is derived from the difference in concentration as measured via the two sampling lines. Measurements with the modified instrument were made at a suburban site in Amsterdam, The Netherlands. An apparent adsorption artefact, which could not be eliminated by the use of denuders, precluded meaningful evaluation of the data for total carbon. Blanks in the measurements of EC were negligible and the EC data were hence further evaluated. We found that the concentration of EC obtained via the channel with the impactor was systematically lower than that in the filter-line. The average ratio of the concentrations was close to 0.6, which indicates that approximately 40% of the EC was in particles smaller than 0.14 μm. Alternative explanations for the difference in the concentration in the two sampling lines could be excluded, such as a difference in the extent of oxidation. This should be a function of loading, which is not the case. Another reason for the difference could be that less material is collected by the impactor due to rebound, but such bounce of aerosol is very unlikely in The Netherlands due to co-deposition of abundant deliquesced and thus viscous ammonium compounds. The conclusion is that a further modification to assess the true fraction of ultrafine EC, by installing an impactor with cut-off diameter at 0.1 μm, would be worth pursuing. © 2005 Elsevier Ltd. All rights reserved.

A prospective comparison of a noninvasive cardiac output monitor versus esophageal doppler monitor for goal-directed fluid therapy in colorectal surgery patients

Copyright © 2014 International Anesthesia Research Society.BACKGROUND: Goal-directed fluid therapy (GDFT) is associated with improved outcomes after surgery. The esophageal Doppler monitor (EDM) is widely used, but has several limitations. The NICOM, a completely noninvasive cardiac output monitor (Cheetah Medical), may be appropriate for guiding GDFT. No prospective studies have compared the NICOM and the EDM. We hypothesized that the NICOM is not significantly different from the EDM for monitoring during GDFT. METHODS: One hundred adult patients undergoing elective colorectal surgery participated in this study. Patients in phase I (n = 50) had intraoperative GDFT guided by the EDM while the NICOM was connected, and patients in phase II (n = 50) had intraoperative GDFT guided by the NICOM while the EDM was connected. Each patient's stroke volume was optimized using 250- mL colloid boluses. Agreement between the monitors was assessed, and patient outcomes (postoperative pain, nausea, and return of bowel function), complications (renal, pulmonary, infectious, and wound complications), and length of hospital stay (LOS) were compared. RESULTS: Using a 10% increase in stroke volume after fluid challenge, agreement between monitors was 60% at 5 minutes, 61% at 10 minutes, and 66% at 15 minutes, with no significant systematic disagreement (McNemar P > 0.05) at any time point. The EDM had significantly more missing data than the NICOM. No clinically significant differences were found in total LOS or other outcomes. The mean LOS was 6.56 ± 4.32 days in phase I and 6.07 ± 2.85 days in phase II, and 95% confidence limits for the difference were -0.96 to +1.95 days (P = 0.5016). CONCLUSIONS: The NICOM performs similarly to the EDM in guiding GDFT, with no clinically significant differences in outcomes, and offers increased ease of use as well as fewer missing data points. The NICOM may be a viable alternative monitor to guide GDFT.