Objective: Neurologic complications in pediatric patients supported by extracorporeal membrane oxygenation (ECMO) are common and lead to morbidity and mortality; however, few modifiable factors are known. Design: Retrospective study of the Extracorporeal Life Support Organization registry (2010–2019). Setting: Multicenter international database Patients: Pediatric patients receiving ECMO (2010–2019) for all indications and any mode of support. Interventions: None. Measurements and Main Results: We investigated if early relative change in Paco 2 or mean arterial blood pressure (MAP) soon after starting ECMO was associated with neurologic complications. The primary outcome of neurologic complications was defined as a report of seizures, central nervous system infarction or hemorrhage, or brain death. All-cause mortality (including brain death) was used as a secondary outcome. Out of 7,270 patients, 15.6% had neurologic complications. Neurologic complications increased when the relative Paco 2 decreased by greater than 50% (18.4%) or 30–50% (16.5%) versus those who had a minimal change (13.9%, p < 0.01 and p = 0.046). When the relative MAP increased greater than 50%, the rate of neurologic complications was 16.9% versus 13.1% those with minimal change (p = 0.007). In a multivariable model adjusting for confounders, a relative decrease in Paco 2 greater than 30% was independently associated with greater odds of neurologic complication (odds ratio [OR], 1.25; 95% CI, 1.07–1.46; p = 0.005). Within this group, with a relative decrease in Paco 2 greater than 30%, the effects of increased relative MAP increased neurologic complications (0.05% per BP Percentile; 95% CI, 0.001–0.11; p = 0.05). Conclusions: In pediatric patients, a large decrease in Paco 2 and increase in MAP following ECMO initiation are both associated with neurologic complications. Future research focusing on managing these issues carefully soon after ECMO deployment can potentially help to reduce neurologic complications.
The Rhizobacterial isolate Bacillus licheniformis MML2501 effectively inhibited the mycelial growth of fungal pathogens viz., Macrophomina phaseolina, Fusarium udum, Fusarium oxysporum, Bipolaris oryzae, Pyricularia oryzae, Alternaria alternata and Curvularia lunata. Bacillus licheniformis MML2501 was tolerant to heavy metals such as zinc, cobalt and selenium. B. licheniformis MML2501 was tolerant to fungicides such as propiconazole and tridemorph and showed moderate tolerance to tricyclazole and it was showed resistant to antibiotics such as ampicillin, streptomycin, bacitracin, cephalotitin, erythromycin and oxytetracycline. Bacillus licheniformis MML2501 produced salicylic acid (SA), with a maximum yield of 18 µg/ml in optimized culture conditions such as pH 7.0, temperature 30°C, casaminoacids at a concentration of 0.4 % and at 200 rpm shaken condition. SA produced by Bacillus licheniformis MML2501 was further confirmed by TLC and HPLC analyses, in which the Rf value and retention time of 0.61 and 5.24 min, respectively were matching with that of authentic SA. Therefore the present study suggests that the rhizobacterial strain Bacillus licheniformis MML2501 has merits to be a beneficial bacteria for the crop protection through systemic resistance.
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