| 1. |
- Dillenbeck, Emelie, et al.
(författare)
-
The design of the PRINCESS 2 trial: A randomized trial to study the impact of ultrafast hypothermia on complete neurologic recovery after out-of-hospital cardiac arrest with initial shockable
- 2024
-
Ingår i: American Heart Journal. - : MOSBY-ELSEVIER. - 0002-8703 .- 1097-6744. ; 271, s. 97-108
-
Tidskriftsartikel (refereegranskat)abstract
- Background Delayed hypothermia, initiated after hospital arrival, several hours after cardiac arrest with 8-10 hours to reach the target temperature, is likely to have limited impact on overall survival. However, the effect of ultrafast hypothermia, i.e., delivered intra-arrest or immediately after return of spontaneous circulation (ROSC), on functional neurologic outcome after out -of -hospital cardiac arrest (OHCA) is unclear. In two prior trials, prehospital trans -nasal evaporative intra-arrest cooling was safe, feasible and reduced time to target temperature compared to delayed cooling. Both studies showed trends towards improved neurologic recovery in patients with shockable rhythms. The aim of the PRINCESS2-study is to assess whether cooling, initiated either intra-arrest or immediately after ROSC, followed by in -hospital hypothermia, significantly increases survival with complete neurologic recovery as compared to standard normothermia care, in OHCA patients with shockable rhythms. Methods/design In this investigator -initiated, randomized, controlled trial, the emergency medical services (EMS) will randomize patients at the scene of cardiac arrest to either trans -nasal cooling within 20 minutes from EMS arrival with subsequent hypothermia at 33 degrees C for 24 hours after hospital admission (intervention), or to standard of care with no prehospital or in -hospital cooling (control). Fever ( > 37,7 degrees C) will be avoided for the first 72 hours in both groups. All patients will receive post resuscitation care and withdrawal of life support procedures according to current guidelines. Primary outcome is survival with complete neurologic recovery at 90 days, defined as modified Rankin scale (mRS) 0-1. Key secondary outcomes include survival to hospital discharge, survival at 90 days and mRS 0-3 at 90 days. In total, 1022 patients are required to detect an absolute difference of 9% (from 45 to 54%) in survival with neurologic recovery (80% power and one-sided alpha= 0,025, beta = 0,2) and assuming 2,5% lost to follow-up. Recruitment starts in Q1 2024 and we expect maximum enrolment to be achieved during Q4 2024 at 20-25 European and US sites. Discussion This trial will assess the impact of ultrafast hypothermia applied on the scene of cardiac arrest, as compared to normothermia, on 90 -day survival with complete neurologic recover y in OHCA patients with initial shockable rhythm. Trial registration NCT06025123. (Am Heart J 2024;271:97-108.)
|
|
| 2. |
- Frisk, Christopher, 1985-, et al.
(författare)
-
On the extraction of doping concentration from capacitance-voltage : A Cu2ZnSnS4 and ZnS sandwich structure
- 2017
-
Ingår i: IEEE Journal of Photovoltaics. - 2156-3381 .- 2156-3403. ; 7:5, s. 1421-1425
-
Tidskriftsartikel (refereegranskat)abstract
- The capacitance-voltage (C-V) method is frequently used to evaluate the net doping of thin-film solar cells, an important parameter for the function of solar cells. However, complex materials such as kesterites are challenging to characterize. To minimize ambiguity when determining the apparent doping concentration (N-A) of Cu2ZnSnS4 (CZTS), we fabricated and investigated different structures: CZTS/ZnS metal-insulator-semiconductor (MIS) device, stand-alone CZTS and ZnS metal-sandwich structures, and CZTS solar cells. Characterization was carried out by means of admittance spectroscopy (AS) and C-V measurements. ZnS exhibits excellent intrinsic properties, and with the high-quality MIS sample we managed to successfully isolate the capacitive response of the CZTS itself. N-A, as extracted from the MIS structure, is found to be more reliable and four times higher compared with the solar cell, impacting any estimated collection efficiency substantially. Data herein presented also show that CZTS has a substantial low-frequency dispersive capacitance and the extraction of N-A depends on the chosen measurement frequency, symptoms of presence of deep defects. Furthermore, the CZTS/ZnS MIS structure is strongly resilient to leakage currents at both forward and reverse voltage bias where contribution from deep defects is minimized and maximized, respectively.
|
|
| 3. |
- Lundin, Andreas, et al.
(författare)
-
Veno-arterial CO2 difference and respiratory quotient after cardiac arrest: An observational cohort study.
- 2021
-
Ingår i: Journal of critical care. - : Elsevier BV. - 1557-8615 .- 0883-9441. ; 62:April, s. 131-137
-
Tidskriftsartikel (refereegranskat)abstract
- To characterize venous-arterial CO2 difference (ΔpCO2) and the respiratory quotient (RQ) in post cardiac arrest patients and evaluate the association between these parameters and patient outcome.Data were obtained retrospectively from post cardiac arrest patients admitted between 2007 and 2016 to a medical intensive care unit. Comatose, adult patients in whom arterial and venous blood gas analyses were concomitantly performed in the first 24h were included. Patients were grouped according to the time-point of sampling; 0-6, 6-12 and 12-24h after admission.308 patients were included; 174 (56%) died before ICU discharge and 212 (69%) had an unfavorable neurologic outcome. RQ was associated with ICU mortality (OR:1.09 (95%CI: 1.04-1.14; p<0.01)), although not with neurological outcome. ΔpCO2 was negatively associated with both ICU mortality (OR: 0.92 (95%CI: 0.86-0.99; p=0.02)) and poor neurologic outcome (adjusted OR: 0.93 (95%CI: 0.87-0.99; p=0.02)). ΔpCO2 predicted an elevated RQ; a ΔpCO2 above 8.5mmHg identified a high RQ with reasonable sensitivity and specificity.RQ was associated with ICU mortality and ΔpCO2 identified elevated RQ in the early phase after cardiac arrest. However, ΔpCO2 were negatively associated with both ICU mortality and neurologic outcome.
|
|
