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Effects of positive end-expiratory pressure on intracranial pressure,cerebral perfusion pressure,and brain oxygenation in acute brain injury:Friend or foe?A scoping review

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Journal of Intensive Medicine 2024年第2期4卷 247-260页

作者： Greta Zunino Denise Battaglini daniel agustin godoy IRCCS Ospedale Policlinico San Martino GenovaItaly Dipartimento di Scienze Diagnostiche e Chirurgiche Integrate Universitàdegli Studi di GenovaGenovaItaly Neurointensive Care Unit Sanatorio PasteurCatamarcaArgentina

Background Patients with acute brain injury(ABI)are a peculiar population because ABI does not only affect the brain but also other organs such as the lungs,as theorized in brain–lung crosstalk *** patients often require mechanical ventilation(MV)to avoid the complications of impaired respiratory function that can follow ABI;MV should be settled with meticulousness owing to its effects on the intracranial compartment,especially regarding positive end-expiratory pressure(PEEP).This scoping review aimed to(1)describe the physiological basis and mechanisms related to the effects of PEEP in ABI;(2)examine how clinical research is conducted on this topic;(3)identify methods for setting PEEP in ABI;and(4)investigate the impact of the application of PEEP in ABI on the *** The five-stage paradigm devised by Peters et *** expanded by Arksey and O'Malley,Levac et al.,and the Joanna Briggs Institute was used for *** also adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses(PRISMA)extension *** criteria:we compiled all scientific data from peer-reviewed journals and studies that discussed the application of PEEP and its impact on intracranial pressure,cerebral perfusion pressure,and brain oxygenation in adult patients with *** criteria:studies that only examined a pediatric patient group(those under the age of 18),experiments conducted solely on animals;studies without intracranial pressure and/or cerebral perfusion pressure determinations,and studies with incomplete *** authors searched and screened for inclusion in papers published up to July 2023 using the PubMed-indexed online *** were presented in narrative and tubular *** The initial search yielded 330 references on the application of PEEP in ABI,of which 36 met our inclusion *** has recognized beneficial effects on gas exchange,but it produces hemodynamic changes that should be predicted to avoi

关键词： Acute brain injury Mechanical ventilation Positive end-expiratory pressure Intracranial pressure Brain-lung crosstalk Multimodal monitoring

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Steps to consider in the approach and management of critically ill patient with spontaneous intracerebral hemorrhage

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World Journal of Critical Care Medicine 2015年第3期4卷 213-229页

作者： daniel agustin godoy Gustavo Rene Pi?ero Patricia Koller Luca Masotti Mario Di Napoli Neurocritical Care Unit Intensive Care Unit San Juan Bautista Hospital Intensive Care Unit Leónidas Lucero Hospital Internal Medicine Santa Maria Nuova Hospital Neurological Service San Camillo de’ Lellis General Hospital Neurological Section SMDN-Center for Cardiovascular Medicine and Cerebrovascular Disease Prevention

Spontaneous intracerebral hemorrhage is a type of stroke associated with poor outcomes. Mortality is elevated, especially in the acute phase. From a pathophysiological point of view the bleeding must traverse different stages dominated by the possibility of re-bleeding, edema, intracranial hypertension, inflammation and neurotoxicity due to blood degradation products, mainly hemoglobin and thrombin. Neurological deterioration and death are common in early hours, so it is a true neurologicalneurosurgical emergency. Time is brain so that action should be taken fast and accurately. The most significant prognostic factors are level of consciousness, location, volume and ventricular extension of the bleeding. Nihilism and early withdrawal of active therapy undoubtedly influence the final result. Although there are no proven therapeutic measures, treatment should be individualized and guided preferably by pathophysiology. The multidisciplinary teamwork is essential. Results of recently completed studies have birth to promising new strategies. For correct management it's important to establish an orderly and systematic strategy based on clinical stabilization, evaluation and establishment of prognosis, avoiding secondary insults and adoption of specific individualized therapies, including hemostatic therapy and intensive control of elevated blood pressure. Uncertainty continues regarding the role of surgery.

关键词： Intracerebral hemorrhage Prognosis Hematoma expansion Inflammation Hemostatic therapy Oral anticoagulants

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Controlled Reduction of Iron Content in Zirconiun Ore:A Case Study in Polyphase Mineralization,Pocs de Caldas Alkaline Plateau

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Journal of Geological Resource and Engineering 2018年第6期6卷 229-238页

作者： Ana Olivia Barufi Franco-Magalhas daniel Francso de godoy Leticia dos Santos Pires Instituto de Ciecia e Tecnologia Universidade Federal de AlfenasCampus Pocs de CaldasPocs de Caldas 37715-400Brazil Departamento de Petrologia e Metalogenia Instituto de Geociências e Ciências ExatasUniversidade Estadual PaulistaCampus Rio ClaroRio Claro 13506-900Brazil

In PCAC(Po?os de Caldas Alkaline Complex),in southeastern Brazil,it is observed a polyphase mineralization related to Zr-,U-,Th-,Mo-,and REE-enrichment due to hydromethermal processes which affected alkaline primary *** Zr-minerals were leached and concentrated as“caldasite”,a rock composed mainly by zircon and baddeleyite in different *** techniques of mineralogical characterization were applied and results indicated zircon,baddeleyite,magnetite and iron-oxyhydroxides,*** separation by WHIMS(Wet High-Intensity Magnetic Separation)was performed in order to indicate the efficiency for Fe-concentration removal for potential application in refractory industry.

关键词： Zircon baddeleyite caldasite Pocos de Caldas alkaline massif Brazil

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Biocomposites Based on Thermoplastic Starch and Granite Sand Quarry Waste

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Journal of Renewable Materials 2019年第4期7卷 393-402页

作者： María G.Passaretti Mario D.Ninago Cecilia I.Paulo Horacio A.Petit Edgardo F.Irassarc daniel A.Vega Marcelo A.Villar Olivia V.López Planta Piloto de Ingeniería Química PLAPIQUI(UNS-CONICET)Camino"La Carrindanga"Km 7Bahía Blanca8000Buenos AiresArgentina Departamento de Ingeniería Química Universidad Nacional del Sur(UNS)Bahía Blanca8000Buenos AiresArgentina Facultad de Ciencias Aplicadas a la Industria(FCAI) Universidad Nacional de Cuyo(UNCuyo)Bernardo de Irigoyen 375San Rafael5600MendozaArgentina Consejo Nacional de Investigaciones Científicas y Técnicas(CONICET) Godoy Cruz 2290Ciudad Autónoma de Buenos AiresC1425FQBBuenos AiresArgentina Facultad de Ingeniería Universidad Nacional del Centro de la Provincia de Buenos Aires(UNCPBA).Centro de Investigaciones en Física e IngenieríaCIFICEN(UNCPBA-CICPBA-CONICET)7400OlavarríaArgentina Instituto de Física del Sur IFISUR(UNS-CONICET)Bahía Blanca8000Argentina

Granite stone is a by-product of the rock crushing *** industrial waste in powder form that causes health problems and environmental *** particles fraction can be used as a partial replacement of sand in concrete *** this work,an alternative exploitation of this waste fraction is *** sand(GS)with particles mean size of ~1μm was employed as thermoplastic starch(TPS)filler at different *** were obtained by melt-mixing and thermo-compression,achieving translucent and easy to handle films.A good GS dispersion within the matrix was evidenced by *** presence induced a shift of starch’s melting point to higher values and a better thermal *** UV absorption capacity was increased ~90% by GS *** increment in TPS Young’s modulus and maximum tensile stress of 5 and 3 times,respectively was observed by adding 5%w/w GS.

关键词： Thermoplastic starch granite sand melt processing final properties

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