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Sodium variability is associated with increased mortality in severe burn injury

Burns & Trauma 2017年第4期5卷 243-248页

作者： Soman Sen Nam Tran Brian Chan Tina L. Palmieri David G. Greenhalgh kiho cho Department of Surgery Division of Burn Surgery University of California Davis 2425 Stockton Blvd. Suite 718 Sacramento CA 95817 USA

Background:Dysnatremias are associated with increased mortality in critically ill patients. Hypernatremia in burn patients is also associated with poor survival. Based on these findings, we hypothesized that high plasma sodium variability is a marker for increased mortality in severely burn-injured patients. Methods:We performed a retrospective review of adult burn patients with a burn injury of 15%total body surface area (TBSA) or greater from 2010 to 2014. All patients included in the study had at least three serum sodium levels checked during admission. We used multivariate logistic regression analysis to determine if hypernatremia, hyponatremia, or sodium variability independently increased the odds ratio (OR) for death. Results:Two hundred twelve patients met entry criteria. Mean age and%TBSA for the study was 45 ± 18 years and 32 ± 19%. Twenty-nine patients died for a mortality rate of 14%. Serum sodium was measured 10,310 times overall. The median number of serum sodium measurements per patient was 22. Non-survivors were older (59 ± 19 vs. 42 ± 16 years) and suffered from a more severe burn injury (50 ± 25%vs. 29 ± 16%TBSA). While mean sodium was significantly higher for non-survivors (138 ± 3 milliequivalents/liter (meq/l)) than for survivors (135 ± 2 meq/l), mean sodium levels remained within the laboratory reference range (135 to 145 meq/l) for both groups. Non-survivors had a significantly higher median number of hypernatremic (>145 meq/l) measurements (2 vs. 0). Coefficient of variation (CV) was significantly higher in non-survivors (2.85 ± 1.1) than survivors (2.0 ± 0.7). Adjusting for TBSA, age, ventilator days, and intensive care unit (ICU) stay, a higher CV of sodium measurements was associated with mortality (OR 5.8 (95%confidence interval (CI) 1.5 to 22)). Additionally, large variation in sodium ranges in the first 10 days of admission may be associated with increased mortality (OR 1.35 (95%CI 1.06 to1.7)). Conclusions:Increased variability in plasma sodium may be associated with death in severe

关键词： Sodium Burns Critical illness Ions Hypernatremia Hyponatremia

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Bulk-Si photonics technology for DRAM interface[Invited]

引用

Photonics Research 2014年第3期2卷 S0025-S0033页

作者： Hyunil Byun Jinkwon Bok Kwansik cho Keunyeong cho Hanmei choi Jinyong choi Sanghun choi Sangdeuk Han Seokyong Hong Seokhun Hyun TJJeong Ho-Chul Ji In-Sung Joe Beomseok Kim Donghyun Kim Junghye Kim Jeong-Kyoum Kim kiho Kim Seong-Gu Kim Duanhua Kong Bongjin Kuh Hyuckjoon Kwon Beomsuk Lee Hocheol Lee Kwanghyun Lee Shinyoung Lee Kyoungwon Na Jeongsik Nam Amir Nejadmalayeri Yongsang Park Sunil Parmar Junghyung Pyo Dongjae Shin Joonghan Shin Yong-hwack Shin Sung-Dong Suh Honggoo Yoon Yoondong Park Junghwan choi Kyoung-Ho Ha Gitae Jeong Samsung Electronics 1 SamsungjeonjaroHwasungshiGyoung-gido445-330South Korea

We present photonics technology based on a bulk-Si substrate for cost-sensitive dynamic random-access memory(DRAM)optical interface application.We summarize the progress on passive and active photonic devices using a local-crystallized Si waveguide fabricated by solid phase epitaxy or laser-induced epitaxial growth on bulk-Si substrate.The process of integration of a photonic integrated circuit(IC)with an electronic IC is demonstrated using a 65 nm DRAM periphery process on 300 mm wafers to prove the possibility of seamless integration with various complementary metal-oxide-semiconductor devices.Using the bulk-Si photonic devices,we show the feasibility of high-speed multidrop interface:the Mach–Zehnder interferometer modulators and commercial photodetectors are used to demonstrate four-drop link operation at 10 Gb∕s,and the transceiver chips with photonic die and electronic die work for the DDR3 DRAM interface at 1.6 Gb∕s under a 1∶4 multidrop configuration.

关键词： interferometer waveguide interface

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