Two different gel-type resins have been prepared by suspension polymerization using 2 wt % divinylbenzene (DVB) with either p-vinylbenzyl chloride (pVBC) or a mixture of VBC isomers (similar to 70% m-; similar to 30% p-). Significant difference in the chlorine content was observed, which was attributed to a more favored hydrolysis process when p-VBC was used. The presence of hydroxyl groups has been confirmed by elemental microanalytical data and solid-state C-13 cross-polarization/magic angle spinning (CP-MAS) nuclear magnetic resonance (NMR) spectra. Hypercrosslinked resins were prepared from both gel-type precursors by treatment with FeCl3, in 1,2-dichloroethane (DCE) at 80 degrees C. The resultant resins showed differences in specific surface area and degree of hydrophilicity. The performance of the hypercrosslinked resins was evaluated in solid-phase extraction (SPE) of polar compounds, and better results were obtained for the hypercrosslinked resin prepared from p-VBC that combines a relatively high specific surface area (908 m(2) g(-1)) and somewhat higher oxygen content (3.96 wt % O)
This Guidelines contains recommendations and suggestions based on the best evidence available for the management of sedation, analgesia and delirium of the critically ill patient, including a bundle of strategies that serves this purpose. We highlight the assessment of pain and agitation/sedation through validated scales, the use of opioids initially to apropiate analgesic control, associated with multimodal strategies in order to reduce opioide consumption; to promote the lowest level of sedation necessary avoiding over-sedation. Also, in case of the need of sedatives, choose the most appropiate for the patient needs, avoiding the use of benzodiazepines and identify risk factors for delirium, in order to prevent its occurrence, diagnose delirium and treat it with the most suitable pharmacological agent, whether it is haloperidol, atypical antipsychotics or dexmedetomidine, once again, avoiding the use of benzodiazepines and decreasing the use of opioids.
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