The use of TCS devices in children as a bridge to transplant has risen rapidly in recent years, led by the growth of magnetically levitated centrifugal flow pumps. Compared with conventional ECMO, TCS durations are longer, and more importantly, patient survival is superior.
A measurement-based closed-loop control system using in-process ATR-FTIR spectroscopy coupled with a multivariate chemometric PLS calibration model is developed, validated, and applied to the monitoring and control of supersaturation in a 250- L industrial pilot-plant crystalliser. Supersaturation control experiments are carried out on seeded batch cooling crystallisation of β-l-glutamic acid from aqueous solutions using two methods of seeding involving addition of seeds to the solution and generation of seeds within the solution. The generic applicability of the approach is demonstrated through this challenging system reflecting this molecule’s weak chromophore for infrared and relatively low solubility compared with previous solute−solvent systems. Based on the laboratory experiments, the system was fully tested and optimised prior to a series of trials carried out in an industrial pilot plant at Syngenta, Münchwillen, Switzerland. Good control of the supersaturation is achieved at three levels, 1.1, 1.2, and 1.3, within a prescribed range of ±0.025. The average product crystal size is found to decrease with increasing supersaturation. Comparison between product crystals produced at the 20- and 250-L scales indicates that secondary nucleation is more prevalent at the smaller-scale size. For the same level of supersaturation, the rate of depletion of solute is faster at the 20-L scale size than at 250-L scale, and hence a higher cooling rate is required to maintain the desired supersaturation. However, for a given crystalliser scale size, as expected, the mean cooling rate required to maintain a constant supersaturation is found to increase with increasing supersaturation level.
The protocols and policies followed in this study were approved by the Stanford University Institutional Review Board (IRB 38337). Because of the retrospective nature and minimal risk of our study, individual participant consent was waived. Our study used a validated 'before and after' group level study design to examine the effect of introducing Del Nido cardioplegia as the only variable that was changed in our CABG protocol. All patients who underwent isolated CABG performed by an experienced specialist in coronary revascularization surgery at our institution during a 2-year period from October 2014 to October 2016 were assessed for inclusion. In July 2015, our institution's perfusion protocol for CABG surgery was changed from using BC to solely using DN. Overall, 27 consecutive BC patients (October 2014 to July 2015) and 54 consecutive DN patients (August 2015 to August 2016) were identified. Re-operative procedures and minimally invasive direct coronary artery bypass surgeries, which
The aim of this study is to evaluate the effect of temperature on cerebral oxygen metabolism at total body flow bypass and antegrade cerebral perfusion (ACP). Neonatal piglets were put on cardiopulmonary bypass (CPB) with the initial flow rate of 200mL/kg/min. After cooling to 18°C (n=6) or 25°C (n=7), flow was reduced to 100mL/kg/min (half-flow, HF) for 15min and ACP was initiated at 40mL/kg/min for 45min. Following rewarming, animals were weaned from bypass and survived for 4h. At baseline, HF, ACP, and 4 h post-CPB, cerebral blood flow (CBF) was measured using fluorescent microspheres. Cerebral oxygen extraction (CEO(2) ) and cerebral metabolic rate of oxygen (CMRO(2) ) were monitored. Regional cranial oxygen saturation (rSO(2) ) was continuously recorded throughout the procedure using near-infrared spectroscopy. At 18°C, CBF trended lower at HF and ACP and matched baseline after CPB. CEO(2) trended lower at HF and ACP, and trended higher after CPB compared with baseline. CMRO(2) at ACP matched that at HF. Cranial rSO(2) was significantly greater at HF and ACP (P<0.001, P<0.001) and matched baseline after CPB. At 25°C, CBF trended lower at HF, rebounded and trended higher at ACP, and matched baseline after CPB. CEO(2) was equal at HF and ACP and trended higher after CPB compared with baseline. CMRO(2) at ACP was greater than that at HF (P=0.001). Cranial rSO(2) was significantly greater at HF (P=0.01), equal at ACP, and lower after CPB (P=0.03). Lactate was significantly higher at all time points (P=0.036, P<0.001, and P<0.001). ACP provided sufficient oxygen to the brain at a total body flow rate of 100mL/kg/min at deep hypothermia. Although ACP provided minimum oxygenation to the brain which met the oxygen requirement, oxygen metabolism was altered during ACP at moderate hypothermia. ACP strategy at moderate hypothermia needs further investigation.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.