956 resultados para LOW-VOLUME VENTILATION


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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

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Pós-graduação em Engenharia Mecânica - FEG

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The volume-controlled mechanical ventilation and spontaneous ventilation, through haemogasometric, cardiovascular and spirometry variables were evaluated. Twenty-eight rabbits were distributed into two groups: GIVC (isoflurane and volume-controlled ventilation), GIVE (isoflurane and spontaneous ventilation), GSVC (sevoflurane and volume-controlled ventilation) and GSVE (sevoflurane and spontaneous ventilation). Induction was performed by mask with isoflurane (GIVE and GIVC) or sevoflurane (GSVE and GSVC) at 1.5 MAC in 100% oxygen. To maintain anesthesia, MAC was reset to 1. In GIVC and GSVC groups, rocuronium was administered at a dose of 0.6 mg/kg followed by its continuous infusion (0.6 mg/kg/h). In GSVE and GIVE, 0.9% NaCl was administered instead of rocuronium. Controlled ventilation was started by adjusting the capnometry in order to obtain values between 35 and 45 mmHg. Parameters were measured 60 minutes after induction of anesthesia (M0), 15 minutes after the bolus of rocuronium or 0.9% NaCl (M15) and every fifteen minutes (M30, M45 and M60). Hypercapnia and acidosis was evident in GIVC, GSVC and GSVE. We concluded that the volume-controlled mechanical ventilation was not able to maintain normocapnia in rabbits, producing acidosis in them, especially when using sevoflurane. The use of isoflurane showed greater stability than the sevoflurane anesthetic in the species studied.

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The chemical control of the causal agent of citrus black spot (CBS) has been highlighted for the excessive required number of sprayings, considerably increasing citrus production costs. Improvements in the spray efficiency and reductions in the quantity of phytosanitary products have already been searched, but the results of that practice are not consistent yet for its use at commercial scale. Thus, the aim of the present study was to evaluate the interference of reduced spray volumes in black spot control in citrus fruits. The experiment was carried out in commercial citrus orchard with 16-year-old plants of 'Valencia' variety, during 2007 agricultural season. Treatments consisted of three spray volumes: 3.5; 4.5 and 8.5 liters.plant-1, applied with Arbus 2000/Export airblast sprayer with special manifold of hydraulic nozzles, using fungicides and periods recommended for the disease control, totaling four sprayings plus a control treatment (without spray). The disease incidence and severity were evaluated by visual diagrammatic scale of notes in two different periods (preharvest and harvest), at three plant heights (low, middle and top) and three horizontal sections (entrance, frontal and exit) in two sides of the plant. The fallen fruits were counted every fifteen days, for previously selected plants, from the beginning of maturation to harvest, and the production was quantified (kg.plant-1). The disease incidence and severity were significantly lower when sprayings were done with 8.5 liters.plant-1 in the first evaluation period (pre-harvest), but in the harvest period there were not differences between the same parameters when 4.5 or 8.5 liters.plant-1 were sprayed. None of those treatments reduced the disease on the top section of plants, compared to control. The plant sections with fruits more exposed to sun rays, top and right side of the plant, demonstrated higher disease incidence and severity. The volume reduction from 8.5 to 4.5 liters.plant-1 can be adopted for citrus orchards without damaging the CBS control level.

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BackgroundRetinopathy of prematurity (ROP) is a complex condition of the developing retinal blood vessels and is one of the leading causes of preventable childhood blindness. Several risk factors for ROP have been studied over the past 50 years. Among them, general immaturity (low birth weight and low gestational age) and prolonged oxygen therapy have been consistently related to disease onset. However, it is understood that the progression of the disease is multifactorial and may be associated with others risk factors, such as multiple gestation, apnoea, intracranial haemorrhage, anaemia, sepsis, prolonged mechanical ventilation, multiple transfusions and light exposure. Furthermore, the precise role of these individual factors in the development of the disease has not yet been well established.ObjectivesTo determine whether the reduction of early environmental light exposure reduces the incidence of retinopathy of prematurity (ROP) or poor ROP outcomes among very low birth weight infants.Search methodsWe searched the following databases: the Cochrane Neonatal Group Specialised Register, CENTRAL (The Cochrane Library), MEDLINE, EMBASE, CINAHL, HealthSTAR, Science Citation Index Database, CANCERLIT, the Oxford Database of Perinatal Trials and www.clinicaltrials.gov. We also searched previous reviews including cross-references, abstracts, conference and symposia proceedings, and contacted expert informants. This search was updated in October 2012.Selection criteriaRandomised or quasi-randomised controlled trials that reduced light exposure to premature infants within the first seven days following birth were considered for this review. We also considered cluster-randomised controlled trials.Data collection and analysisData on clinical outcomes including any acute ROP and poor ROP outcome were extracted by both review authors independently and consensus reached. We conducted data analysis according to the standards of the Cochrane Neonatal Review Group.Main resultsData from four randomised trials with a total of 897 participants failed to show any reduction in acute ROP or poor ROP outcome with the reduction of ambient light to premature infants' retinas. The overall methodological quality of the included studies was about evenly split between those in which the classification was unclear and those in which the studies were categorised as low risk of bias. There was no report on the secondary outcomes considered in this review: quality of life measures; and time of exposure to oxygen.Authors' conclusionsThe evidence shows that bright light is not the cause of retinopathy of prematurity and that the reduction of exposure of the retinas of premature infants to light has no effect on the incidence of the disease.

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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

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Background: Late-onset sepsis (LOS) is an important cause of morbidity and mortality in very low birth weight (VLBW) infants.Aim: To determine the incidence, risk factors and etiology of LOS.Methods: LOS was investigated in a multicenter prospective cohort of infants at eight public university neonatal intensive care units (NICUs). Inclusion criteria included inborn, 23-33 weeks of gestational age, 400-1499 g birth weight, who survived >3 days.Results: Of 1507 infants, 357 (24%) had proven LOS and 345 (23%) had clinical LOS. Infants with LOS were more likely to die. The majority of infections (76%) were caused by Gram-positive organisms. Independent risk factors for proven LOS were use of central venous catheter and mechanical ventilation, age at the first feeding and number of days on parenteral nutrition and on mechanical ventilation.Conclusion: LOS incidence and mortality are high in Brazilian VLBW infants. Most risk factors are associated with routine practices at NICU.

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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)