Aeration of the lungs must be monitored during general anesthesia. During mechanical ventilation, a variety of post-operative pulmonary complications can occur, including atelectasis, effusions, or pneumonia [1-3]. There are several methods to diagnose perioperative lung aeration [4,5]. Imaging studies, such as magnetic resonance imaging (MRI) and

Introduction: Iron deficiency anemia (IDA) is common among obstetric and gynecologic patients. This systematic review aimed to assess the comparative efficacy and safety of commonly used intravenous (IV) iron formulations, ferric carboxymaltose (FCM), and iron sucrose (IS) in the treatment of IDA in obstetric and gynecologic patients. Methods: We systematically searched PubMed, EMBASE, Cochrane CENTRAL, and Google Scholar for eligible randomized controlled trials (RCTs) comparing IV iron replacement using FCM and IS up to October 2019. The primary outcome was to compare the efficacy of FCM and IS, assessed by measuring serum hemoglobin (Hb) and ferritin levels before and after iron replacement. The secondary outcome was to compare the safety of FCM and IS, assessed by the incidence of adverse events during iron replacement. The meta-analysis was performed using RevMan 5.3. Results: We identified 9 RCTs with 910 patients (FCM group, n = 456; IS group, n = 454). Before iron replacement, FCM and IS group patients had similar baseline Hb (mean difference [MD], 0.04 g/dL; 95% confidence interval [CI], −0.07 to 015; I 2 = 0%; P = 0.48) and ferritin levels (MD, −0.42 ng/mL; 95% CI, −1.61 to 0.78; I 2 = 45%; P = 0.49). Following iron replacement, patients who received FCM had higher Hb (MD, 0.67; 95% CI, 0.25–1.08; I 2 = 92%; P = 0.002) and ferritin levels (MD, 24.41; 95% CI, 12.06–36.76; I 2 = 75%; P = 0.0001) than patients who received IS. FCM group showed a lower incidence of adverse events following iron replacement than IS group (risk ratio, 0.53; 95% CI, 0.35–0.80; I 2 = 0%; P = 0.003). Serious adverse events were not reported in any group. Conclusion: FCM group showed better efficacy in increasing Hb and ferritin levels and a favorable safety profile with fewer adverse events compared with IS group for IDA treatment among obstetric and gynecologic patients. However, this meta-analysis was limited by the small number of RCTs and high heterogeneity. Trial registration: The review was prospectively registered with the International Prospective Registry of Systematic Reviews ( https://www.crd.york.ac.uk/prospero/ , registration number CRD42019148905).

Background:External applied pneumatic pressure is usually used for rapid transfusion of red blood cells (RBCs). However, increased shear stress can cause increased hemolysis and decreased RBC elongation indices. Therefore, the purpose of this study was to measure the degree of hemolysis and the alteration of RBC elongation indices under varying external pressure in fresh and aged blood.Methods:Venous blood samples were obtained from 20 healthy human volunteers. Each blood bag was divided into 2 subgroups (5 or 35 days of storage), and 5 levels of pressure were applied: 0, 150, 200, 250, and 300 mmHg. After infusion, a laboratory study was conducted. The percentages of irreversibly changed cells were evaluated using Bessis classification. RBC elongation indices were measured using a microfluidic ektacytometer.Results:There were no significant differences in the percentage of irreversibly changed RBCs between the pressures of 0 and 300 mmHg. Moreover, there were no significant differences in laboratory test results or elongation indices among all levels of pressure. Irreversibly changed RBCs and hemolysis were increased depending on the storage period.Conclusion:Irreversible changes in RBCs did not occur as a result of external pressure. The hemolysis and elongation indices of fresh RBCs were not influenced by external pneumatic pressure up to 300 mmHg. Only the storage period affected the irreversible changes in RBCs and hemolysis. Therefore, the application of external pressure to RBCs in variously aged blood is likely to be a safe procedure.

BACKGROUND: Sepsis is a medical emergency during which early detection is closely associated with mortality. In sepsis, red blood cell (RBC) abnormalities have been reported. However, it is not known how early RBC abnormalities are expressed compared with various clinical manifestations used in sepsis-related organ failure assessment (SOFA). OBJECTIVE: Therefore, using a lipopolysaccharide (LPS)-induced sepsis model we investigated the clinical significance of RBC abnormalities as an early indicator in the detection of septic injury compared with clinical variables. METHODS: Sprague-Dawley rats received LPS (20 mg/kg) intraperitoneally. Aggregation indices (AIs) and aggregation half-time (T1/2), and elongation indices (EI max ) were measured. Clinical data-related SOFA and lactate were measured at 2 h, 4 h, 8 h and 12 h after LPS injection. RESULTS: AIs increased at 4 h, and T1/2 decreased at 2 h after LPS injection. Platelet counts decreased at 4 h, and lactate increased at 2 h after LPS injection. AIs showed strong correlations with T1/2 and platelets, EI max increased at 2 h after LPS injection, while EI max had a positive correlation with lactate. CONCLUSIONS: RBC aggregation appears to be an early indicator of clinical deterioration in sepsis and may represent a diagnostic indicator in sepsis.

Intravenous infusion flow regulators (IIFRs) are widely used devices but it is unknown how much the difference between the IIFR scale and the actual flow rate depends on the viscosity of the intravenous (IV) fluid. This study evaluated the effects of viscosity on the flow rate of five IV fluids (0.9% normal saline, Hartmann’s solution, plasma solution-A, 6% hetastarch, and 5% albumin) when using IIFRs. The viscosity of crystalloids was 1.07–1.12 mPa·s, and the viscosities of 6% hetastarch and 5% albumin were 2.59 times and 1.74 times that of normal saline, respectively. When the IIFR scales were preset to 20, 100, and 250 mL/hr, crystalloids were delivered at the preset flow rate within a difference of less than 10%, while 6% hetastarch was delivered at approximately 40% of the preset flow rates and 5% albumin was approximately 80% transmitted. When delivering colloids, IIFRs should be used with caution.