The use of protective mechanical ventilation during extracorporeal membrane oxygenation for the treatment of acute respiratory failure.

Acute respiratory failure (ARF) strikes an estimated two million people in the United States each year, with care exceeding US$50 billion. The hallmark of ARF is a heterogeneous injury, with normal tissue intermingled with a large volume of low compliance and collapsed tissue. Mechanical ventilation is necessary to oxygenate and ventilate patients with ARF, but if set inappropriately, it can cause an unintended ventilator-induced lung injury (VILI). The mechanism of VILI is believed to be overdistension of the remaining normal tissue known as the 'baby' lung, causing volutrauma, repetitive collapse and reopening of lung tissue with each breath, causing atelectrauma, and inflammation secondary to this mechanical damage, causing biotrauma. To avoid VILI, extracorporeal membrane oxygenation (ECMO) can temporally replace the pulmonary function of gas exchange without requiring high tidal volumes (VT) or airway pressures. In theory, the lower VT and airway pressure will minimize all three VILI mechanisms, allowing the lung to 'rest' and heal in the collapsed state. The optimal method of mechanical ventilation for the patient on ECMO is unknown. The ARDSNetwork Acute Respiratory Management Approach (ARMA) is a Rest Lung Approach (RLA) that attempts to reduce the excessive stress and strain on the remaining normal lung tissue and buys time for the lung to heal in the collapsed state. Theoretically, excessive tissue stress and strain can also be avoided if the lung is fully open, as long as the alveolar re-collapse is prevented during expiration, an approach known as the Open Lung Approach (OLA). A third lung-protective strategy is the Stabilize Lung Approach (SLA), in which the lung is initially stabilized and gradually reopened over time. This review will analyze the physiologic efficacy and pathophysiologic potential of the above lung-protective approaches.

Ultrafast single-photon detection at high repetition rates based on optical Kerr gates under focusing: erratum.

Two typos are corrected, and the linear refractive index n is removed from the expressions of the phase shift in Opt. Lett.46, 560 (2021)OPLEDP0146-959210.1364/OL.414895. The removal of n reduces the gate efficiency, but it does not affect the general findings. Here, we present the corrected equations and the corresponding new numerical results, showing that increasing the pulse energy from 1.8 nJ to 4 nJ leads to nearly the same results of Opt. Lett.46, 560 (2021)OPLEDP0146-959210.1364/OL.414895.

Ultrafast single-photon detection at high repetition rates based on optical Kerr gates under focusing.

The ultrafast detection of single photons is currently restricted by the limited time resolution (a few picoseconds) of the available single-photon detectors. Optical gates offer a faster time resolution, but so far they have been applied mostly to ensembles of emitters. Here, we demonstrate through a semi-analytical model that the ultrafast time-resolved detection of single quantum emitters can be possible using an optical Kerr shutter at gigahertz rates under focused illumination. This technique provides sub-picosecond time resolution, while keeping a gate efficiency at around 85%. These findings lay the ground for future experimental investigations on the ultrafast dynamics of single quantum emitters, with implications for quantum nanophotonics and molecular physics.