Advanced arterial blood gas analysis in septic shock : a Singaporean nursing case review.

Introduction The admission to the Intensive Care Unit with a diagnosis of sepsis and/or septic shock is not uncommon. The aim of this article is to present a nursing case review of a patient admitted to the intensive care unit with a diagnosis of septic shock and the use of bedside acid–base formulae to inform clinical decision making. Method We chose to use a case review. This method is useful in reporting unusual or rare cases and is typically seen more in medicine than in nursing. Discussion The gentleman in question was a self-presentation with a short history of fever and worsening shortness of breath. His condition worsened where he required admission to the intensive care unit. The use of ‘advanced’ acid–base interpretation to guide his nursing care provided a platform from which to advance a deeper understanding of the intricacies the critically ill patient often presents. Conclusion The use of case review is enlightening in understanding the disease process and the decision-making that accompanies this. The lessons learnt are applicable to a wider nursing audience because understanding acid–base physiology is beneficial in supporting and advancing critical care nursing practice.

Insight into the thermal decomposition of kaolinite intercalated with potassium acetate : an evolved gas analysis

The thermal decomposition process of kaolinite–potassium acetate intercalation complex has been studied using simultaneous thermogravimetry coupled with Fourier-transform infrared spectroscopy and mass spectrometry (TG-FTIR-MS). The results showed that the thermal decomposition of the complex took place in four temperature ranges, namely 50–100, 260–320, 320–550, and 650–780 °C. The maximal mass losses rate for the thermal decomposition of the kaolinite–potassium acetate intercalation complex was observed at 81, 296, 378, 411, 486, and 733 °C, which was attributed to (a) loss of the adsorbed water, (b) thermal decomposition of surface-adsorbed potassium acetate (KAc), (c) the loss of the water coordinated to potassium acetate in the intercalated kaolinite, (d) the thermal decomposition of intercalated KAc in the interlayer of kaolinite and the removal of inner surface hydroxyls, (e) the loss of the inner hydroxyls, and (f) the thermal decomposition of carbonate derived from the decomposition of KAc. The thermal decomposition of intercalated potassium acetate started in the range 320–550 °C accompanied by the release of water, acetone, carbon dioxide, and acetic acid. The identification of pyrolysis fragment ions provided insight into the thermal decomposition mechanism. The results showed that the main decomposition fragment ions of the kaolinite–KAc intercalation complex were water, acetone, carbon dioxide, and acetic acid. TG-FTIR-MS was demonstrated to be a powerful tool for the investigation of kaolinite intercalation complexes. It delivers a detailed insight into the thermal decomposition processes of the kaolinite intercalation complexes characterized by mass loss and the evolved gases.

Evolved gas analysis of coal-derived pyrite/marcasite

The products evolved during the thermal decomposition of the coal-derived pyrite/marcasite were studied using simultaneous thermogravimetry coupled with Fourier-transform infrared spectroscopy and mass spectrometry (TG-FTIR–MS) technique. The main gases and volatile products released during the thermal decomposition of the coal-derived pyrite/marcasite are water (H2O), carbon dioxide (CO2), and sulfur dioxide (SO2). The results showed that the evolved products obtained were mainly divided into two processes: (1) the main evolved product H2O is mainly released at below 300 °C; (2) under the temperature of 450–650 °C, the main evolved products are SO2 and small amount of CO2. It is worth mentioning that SO3 was not observed as a product as no peak was observed in the m/z = 80 curve. The chemical substance SO2 is present as the main gaseous product in the thermal decomposition for the sample. The coal-derived pyrite/marcasite is different from mineral pyrite in thermal decomposition temperature. The mass spectrometric analysis results are in good agreement with the infrared spectroscopic analysis of the evolved gases. These results give the evidence on the thermal decomposition products and make all explanations have the sufficient evidence. Therefore, TG–MS–IR is a powerful tool for the investigation of gas evolution from the thermal decomposition of materials.

UEGO based measurement of EGR rate and residual gas fraction

A technique is presented for measuring the exhaust gas recirculation (EGR) and residual gas fraction (RGF) using a fast UEGO based O2 measurement of the manifold or in-cylinder gases, and of the exhaust gases. The technique has some advantages over the more common CO2-based method. In the case of an RGF measurement, fuel interference must be eliminated and special fuelling arrangements are is required. It is shown how a UEGO-based measurement, though sensitive to reactive species in the exhaust (such as H 2), as a system reports EGR/ RGF rates faithfully. Preliminary tests showed that EGR and RGF measurements using the O2 approach agreed well with CO2-based measurements. © 2011 SAE International.

Effects of ethanol on vehicle energy efficiency and implications on ethanol life-cycle greenhouse gas analysis.

Bioethanol is the world's largest-produced alternative to petroleum-derived transportation fuels due to its compatibility within existing spark-ignition engines and its relatively mature production technology. Despite its success, questions remain over the greenhouse gas (GHG) implications of fuel ethanol use with many studies showing significant impacts of differences in land use, feedstock, and refinery operation. While most efforts to quantify life-cycle GHG impacts have focused on the production stage, a few recent studies have acknowledged the effect of ethanol on engine performance and incorporated these effects into the fuel life cycle. These studies have broadly asserted that vehicle efficiency increases with ethanol use to justify reducing the GHG impact of ethanol. These results seem to conflict with the general notion that ethanol decreases the fuel efficiency (or increases the fuel consumption) of vehicles due to the lower volumetric energy content of ethanol when compared to gasoline. Here we argue that due to the increased emphasis on alternative fuels with drastically differing energy densities, vehicle efficiency should be evaluated based on energy rather than volume. When done so, we show that efficiency of existing vehicles can be affected by ethanol content, but these impacts can serve to have both positive and negative effects and are highly uncertain (ranging from -15% to +24%). As a result, uncertainties in the net GHG effect of ethanol, particularly when used in a low-level blend with gasoline, are considerably larger than previously estimated (standard deviations increase by >10% and >200% when used in high and low blends, respectively). Technical options exist to improve vehicle efficiency through smarter use of ethanol though changes to the vehicle fleets and fuel infrastructure would be required. Future biofuel policies should promote synergies between the vehicle and fuel industries in order to maximize the society-wise benefits or minimize the risks of adverse impacts of ethanol.

UEGO based measurement of EGR rate and residual gas fraction

A technique is presented for measuring the exhaust gas recirculation (EGR) and residual gas fraction (RGF) using a fast UEGO based O2 measurement of the manifold or in-cylinder gases, and of the exhaust gases. The technique has some advantages over the more common CO2-based method. In the case of an RGF measurement, fuel interference must be eliminated and special fuelling arrangements are is required. It is shown how a UEGO-based measurement, though sensitive to reactive species in the exhaust (such as H 2), as a system reports EGR/ RGF rates faithfully. Preliminary tests showed that EGR and RGF measurements using the O2 approach agreed well with CO2-based measurements. Copyright © 2011 SAE International.