Browsing by Subject "OXYGENATION"

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  • Lehtoranta, Jouni; Bendtsen, Jorgen; Lannergren, Christer; Saarijarvi, Erkki; Lindström, Magnus; Pitkanen, Heikki (2022)
    We studied the effects of pumping surface water down through the pycnocline (i.e. artificial ventilation) on hydrodynamics, oxygen concentrations, hydrogen sulfide, and nutrients in two anoxic coastal basins (Lannerstasundet and Sandofjarden). In addition, in a corresponding laboratory aquarium experiment, pumping of less saline surface water entrained dense bottom water with a mixing ratio of 6.8 and illustrated dispersal below the pycnocline. Oxygen saturation increased from 0 to 20%; oxygen penetrated poorly into the sediment of the aquarium. In the salinity-stratified Lannerstasundet basin, ventilation also oxidized the anoxic bottom water. The ventilation removed hydrogen sulfide and decreased the sub-pycnocline water pools of phosphorus and ammonium, which was not observed in a neighboring reference basin. The summertime ventilation warmed and made the sub-pycnocline water less saline. In the autumn, the inflows of cooled water from the surroundings with equal or higher salinity promoted its sinking in the relatively warm ventilated basin. The inflows maintained oxygen concentrations between 4 and 8 mg L-1 for months after the ventilation ended. In contrast to Lannerstasundet, ventilation did not prevent formation of anoxia and release of nutrients in the temperature stratified Sandofjarden. Here, the ventilation capacity was less than that in Lannerstasundet and ventilation expanded the sub-thermocline bottom area, warmed the bottom sediments, and probably displaced oxic water from the experimental area. The ventilation did not promote density conditions for inflows and no marked inflow-induced oxidation was observed after midsummer. We conclude that a significant amount of anoxic water was entrained into the ascending plume which reduced the oxygen content below the pycnocline ventilation in aquarium experiment. Additionally, summertime ventilation may improve the status of the salinity-stratified basins for further oxidation. The improvement occurs due to autumn cooling and favorable basin topography, which promote inflows of oxic water with larger density and thereby, renewal of bottom water in the pumped basin. The semi-enclosed and temperature-stratified basin cannot form such favorable density conditions for inflows and thus ventilation is less efficient.
  • Bhide, Amarnath; Räsänen, Juha; Huhta, Heikki; Junno, Juulia; Erkinaro, Tiina; Ohtonen, Pasi; Haapsamo, Mervi; Acharya, Ganesh (2017)
    We hypothesized that in near-term sheep fetuses, hypoxemia changes myocardial function as reflected in altered ventricular deformation on speckle-tracking echocardiography. Fetuses in 21 pregnant sheep were instrumented. After 4 d of recovery, fetal cardiac function was assessed by echocardiography at baseline, after 30 and 120 min of induced fetal hypoxemia and after its reversal. Left (LV) and right (RV) ventricular cardiac output and myocardial strain were measured. Baseline mean (standard deviation [ SD]) LV and RV global longitudinal strains were -18.7% (3.8) and -14.3% (5.3). Baseline RV global longitudinal and circumferential deformations were less compared with those of the left ventricle (p = 0.016 and p <0.005). LV, but not RV, global longitudinal strain was decreased (p = 0.003) compared with baseline with hypoxemia. Circumferential and radial strains did not exhibit significant changes. In the near-term sheep fetus, LV global longitudinal and circumferential strains are more negative than RV strains. Acute hypoxemia leads to LV rather than RV dysfunction as reflected by decreased deformation. (C) 2017 World Federation for Ultrasound in Medicine & Biology.
  • Niemistö, Juha; Silvonen, Soila; Horppila, Jukka (2020)
    Effects of hypolimnetic aeration (pumping of epilimnetic water into the hypolimnion) on the quantity of settling material in eutrophied Lake Vesijarvi, Finland were studied by comparing spatially comprehensive gross sedimentation rates as dry and organic matter prior to aeration activity and during two aerated years. Possible changes in the organic matter (as loss on ignition, LOI), carbon (C) and nitrogen (N) contents and changes in the C/N ratio of the settling material and surface sediment were quantified. Thermal stratification broke up earlier due to aeration and was followed by sedimentation peaks. The absolute amount of dry and organic matter as well as C and N settling to the lake bottom were significantly higher in the aerated years. Increased sedimentation rates were especially pronounced in the deep zones indicating enhanced sediment focusing. Increased sedimentation of C and N reflected higher primary production during the aerated years, which most likely was associated with increased temperature and turbulence and the subsequent regeneration and recycling of nutrients in the water body. Aeration seemed to slightly enhance degradation, but contrary to its ultimate aim, it failed to decrease the phosphorus content of the water column and deposits of organic material in the deep zones of the lake.
  • Stewart, J. A.; Särkelä, M. O. K.; Salmi, T.; Wennervirta, J.; Vakkuri, A. P.; Vainikka, T. L. S.; Suojaranta, R.; Mäki, Kaisa; Ilkka, V. H.; Viertiö-Oja, H.; Salminen, U-S (2020)
    Background and Aims: Circulatory arrest carries a high risk of neurological damage, but modern monitoring methods lack reliability, and is susceptible to the generalized effects of both anesthesia and hypothermia. The objective of this prospective, explorative study was to research promising, reliable, and noninvasive methods of neuromonitoring, capable of predicting neurological outcome after hypothermic circulatory arrest. Materials and Methods: Thirty patients undergoing hypothermic circulatory arrest during surgery of the thoracic aorta were recruited in a single center and over the course of 4 years. Neuromonitoring was performed with a four-channel electroencephalogram montage and a near-infrared spectroscopy monitor. All data were tested off-line against primary neurological outcome, which was poor if the patient suffered a significant neurological complication (stroke, operative death). Results: A poor primary neurological outcome seen in 10 (33%) patients. A majority (63%) of the cases were emergency surgery, and thus, no neurological baseline evaluation was possible. The frontal hemispheric asymmetry of electroencephalogram, as measured by the brain symmetry index, predicted primary neurological outcome with a sensitivity of 79 (interquartile range; 62%-88%) and specificity of 71 (interquartile range; 61%-84%) during the first 6 h after end of circulatory arrest. Conclusion: The hemispheric asymmetry of frontal electroencephalogram is inherently resistant to generalized dampening effects and is predictive of primary neurological outcome. The brain symmetry index provides an easy-to-use, noninvasive neuromonitoring method for surgery of the thoracic aorta and postoperative intensive care.
  • Skrifvars, Markus B.; Ameloot, Koen; Grand, Johannes; Reinikainen, Matti; Hästbacka, Johanna; Niemelä, Ville; Hassager, Christian; Kjaergaard, Jesper; Åneman, Anders; Tiainen, Marjaana; Nielsen, Niklas; Ullen, Susann; Dankiewicz, Josef; Olsen, Markus Harboe; Jorgensen, Caroline Kamp; Saxena, Manoj; Jakobsen, Janus C. (2022)
    Background Hypotension is common after cardiac arrest (CA), and current guidelines recommend using vasopressors to target mean arterial blood pressure (MAP) higher than 65 mmHg. Pilot trials have compared higher and lower MAP targets. We will review the evidence on whether higher MAP improves outcome after cardiac arrest. Methods This systematic review and meta-analysis will be conducted based on a systematic search of relevant major medical databases from their inception onwards, including MEDLINE, Embase and the Cochrane Central Register of Controlled Trials (CENTRAL), as well as clinical trial registries. We will identify randomised controlled trials published in the English language that compare targeting a MAP higher than 65-70 mmHg in CA patients using vasopressors, inotropes and intravenous fluids. The data extraction will be performed separately by two authors (a third author will be involved in case of disagreement), followed by a bias assessment with the Cochrane Risk of Bias tool using an eight-step procedure for assessing if thresholds for clinical significance are crossed. The outcomes will be all-cause mortality, functional long-term outcomes and serious adverse events. We will contact the authors of the identified trials to request individual anonymised patient data to enable individual patient data meta-analysis, aggregate data meta-analyses, trial sequential analyses and multivariable regression, controlling for baseline characteristics. The certainty of the evidence will be assessed by the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system. We will register this systematic review with Prospero and aim to redo it when larger trials are published in the near future. Conclusions This protocol defines the performance of a systematic review on whether a higher MAP after cardiac arrest improves patient outcome. Repeating this systematic review including more data likely will allow for more certainty regarding the effect of the intervention and possible sub-groups differences.