Background:Post-operative course after complex pediatric cardiac surgery is unpredictable. Although, change in arterial lactate levels has been used as a surrogate marker for many years, scientific evidence correlating the early perioperative lactate levels with outcome is still lacking.Objective:To evaluate the trends in lactate levels from intraoperative period to an extended post-operative period in pediatric intensive care unit (PICU) and to assess its usefulness as a prognostic marker.Design:Prospective observational study.Setting:Tertiary pediatric cardiac surgical unit.Patients:Thirty-five non-consecutive children aged 1-140 months who underwent surgery for congenital heart diseases (CHD) on cardiopulmonary bypass (CPB).Intervention:None.Materials and Methods:Arterial blood lactate levels were obtained at the following time points: After induction of anesthesia, 15 and 45 min after institution of CPB, at the start of rewarming, after sternotomy closure, then at 1, 6, 24, and 48 h in PICU. Other hemodynamic and clinical variables, CPB variables, blood gas values, and laboratory variables were also recorded.Results:Four patients died out of 35 patients (11.4%). Non-survivors showed significant persistent elevation in lactates (>4.0 mmol/l). Peak lactates correlate significantly with longer aortic cross clamp time, CPB duration, ventilation hours and PICU stay.Conclusion:Early point of care lactate can be a useful prognostic marker in post-cardiac surgery patients in adjunct with other parameters measured in PICU. This reiterates the importance of measuring lactates and timely recognition of at-risk patients, which on early intervention can help in reducing post-operative morbidity and mortality.
The dynamic characteristics of GaN--based Gunn diode are reported at D-band and the device properties are compared at the same operating conditions and frequency of operations with GaAs-based Gunn diode.The results indicate that GaN-based Gunn diode generates at least 100 times more power than corresponding GaAsbased Gunn diode at same operating conditions.
The ion implantation based impurity doping profile across a p-n junction can be represented accurately using Pearson's fourth moment approach. The high-frequency characteristics of the reverse biased p-n junction (IMPATT diodes) are computed using different ion implantation profiles. It has been observed that the microwave properties of IMPATT diodes are very sensitive to the change in doping profiles. The optimized ion implantation profiles are suggested for different frequency bands to fabricate the reverse biased p-n junction for application in high-frequency circuits.
The design for TSOP and TSON fault testability analysis and realizations of Domino VLSI CMOS Logic has been proposed. Domino VLSI CMOS circuits are fast dynamic CMOS circuits and hence suitable for fast and critical circuit applications. The proposed design beat the charge sharing difficulty with enhanced testability using faults TSOP and TSON. Furthermore, increase in number of transistors in the circuits, the proposed scheme shows uninterrupted power decrement in contrast to other schemes.
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