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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. |
- Rajatheva, Nandana, et al.
(författare)
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White Paper on Broadband Connectivity in 6G
- 2020
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- This white paper explores the road to implementing broadband connectivity in future 6G wireless systems. Different categories of use cases are considered, from extreme capacity with peak data rates up to 1 Tbps, to raising the typical data rates by orders-of-magnitude, to support broadband connectivity at railway speeds up to 1000 km/h. To achieve these goals, not only the terrestrial networks will be evolved but they will also be integrated with satellite networks, all facilitating autonomous systems and various interconnected structures.We believe that several categories of enablers at the infrastructure, spectrum, and protocol/ algorithmic levels are required to realize the intended broadband connectivity goals in 6G. At the infrastructure level, we consider ultra-massive MIMO technology (possibly implemented using holographic radio), intelligent reflecting surfaces, user-centric and scalable cell-free networking, integrated access and backhaul, and integrated space and terrestrial networks. At the spectrum level, the network must seamlessly utilize sub-6 GHz bands for coverage and spatial multiplexing of many devices, while higher bands will be used for pushing the peak rates of point-to-point links. The latter path will lead to THz communications complemented by visible light communications in specific scenarios. At the protocol/algorithmic level, the enablers include improved coding, modulation, and waveforms to achieve lower latencies, higher reliability, and reduced complexity. Different options will be needed to optimally support different use cases. The resource efficiency can be further improved by using various combinations of full-duplex radios, interference management based on rate-splitting, machine-learning-based optimization, coded caching, and broadcasting.
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