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- Ferrando, Carlos, et al.
(författare)
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Effects of oxygen on post-surgical infections during an individualised perioperative open-lung ventilatory strategy : a randomised controlled trial
- 2020
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Ingår i: British Journal of Anaesthesia. - : ELSEVIER SCI LTD. - 0007-0912 .- 1471-6771. ; 124:1, s. 110-120
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Tidskriftsartikel (refereegranskat)abstract
- Background: We aimed to examine whether using a high fraction of inspired oxygen (FIO2) in the context of an individualised intra- and postoperative open-lung ventilation approach could decrease surgical site infection (SSI) in patients scheduled for abdominal surgery. Methods: We performed a multicentre, randomised controlled clinical trial in a network of 21 university hospitals from June 6, 2017 to July 19, 2018. Patients undergoing abdominal surgery were randomly assigned to receive a high (0.80) or conventional (0.3) FIO2 during the intraoperative period and during the first 3 postoperative hours. All patients were mechanically ventilated with an open-lung strategy, which included recruitment manoeuvres and individualised positive end-expiratory pressure for the best respiratory-system compliance, and individualised continuous postoperative airway pressure for adequate peripheral oxyhaemoglobin saturation. The primary outcome was the prevalence of SSI within the first 7 postoperative days. The secondary outcomes were composites of systemic complications, length of intensive care and hospital stay, and 6-month mortality. Results: We enrolled 740 subjects: 371 in the high FIO2 group and 369 in the low FIO2 group. Data from 717 subjects were available for final analysis. The rate of SSI during the first postoperative week did not differ between high (8.9%) and low (9.4%) FIO2 groups (relative risk [RR]: 0.94; 95% confidence interval [CI]: 0.59-1.50; P=0.90]). Secondary outcomes, such as atelectasis (7.7% vs 9.8%; RR: 0.77; 95% CI: 0.48-1.25; P=0.38) and myocardial ischaemia (0.6% [n=2] vs 0% [n=0]; P=0.47) did not differ between groups. Conclusions: An oxygenation strategy using high FIO2 compared with conventional FIO2 did not reduce postoperative SSIs in abdominal surgery. No differences in secondary outcomes or adverse events were found.
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| 2. |
- Godoy, Benigno, et al.
(författare)
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Boron isotope variations in a single monogenetic cone : La Poruña (21°53′S, 68°30′W), Central Andes, Chile
- 2023
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Ingår i: Lithos. - : Elsevier. - 0024-4937 .- 1872-6143. ; 440
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Tidskriftsartikel (refereegranskat)abstract
- La Poruña is a monogenetic volcano located within the Altiplano-Puna Volcanic Complex (21°-24°S) in the Central Andean subduction zone. Since crustal contamination of Andean magmas is ubiquitous, and because extensive geochemical data exist for La Poruña, we employ this volcano as a case study to examine the behavior of boron isotopes during crustal assimilation. We present whole-rock boron concentration and 11B/10B ratios (as δ11B values) for La Poruña lava samples that were prepared as nano-particulate pressed pellets. La Poruña B contents range from 14 to 20 μg/g and δ11B values range from −1.39 ± 0.54 ‰ (2σ) to +0.94 ± 0.30 ‰ (2σ), which overlap with the range of available whole-rock data for Central Andean lavas. Moreover, La Poruña δ11B values correlate negatively with 87Sr/86Sr ratios from the same samples. Since 87Sr/86Sr is a proxy for crustal contamination at La Poruña, the data lead us to suggest that La Poruña magmas assimilated a low-δ11B, high 87Sr/86Sr component such as Andean continental crust. Mixing models based on B and Sr isotopes support a broadly two-step magma evolution for La Poruña. In step 1, mantle-derived primary melts interacted with boron-rich slab-derived fluids with high δ11B values, which yielded subduction-modified parental magmas with ca. 3 μg/g B and relatively high δ11B values. In step 2, the high δ11B parental magmas ascended through the crust where they assimilated up to 20% crustal material, which further modified their δ11B values and 87Sr/86Sr ratios. In comparison to available regional values for B and δ11B, it appears that La Poruña and nearby volcanic centers shared a similar source and magmatic history, whereas volcanoes south of 23°S differ. We stress, however, that deconvolving the roles of various subduction and crustal inputs in the Central Andes would require further studies on individual volcanoes along the arc.
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