Lung recruitment manoeuvres do not cause haemodynamic instability or oxidative stress but improve oxygenation and lung mechanics in a newborn animal model: an observational study.

BACKGROUND: Lung recruitment manoeuvres in neonates during anaesthesia are not performed routinely due to concerns about causing barotrauma, haemodynamic instability and oxidative stress. OBJECTIVE: To assess the influence of recruitment manoeuvres and positive end-expiratory pressure (PEEP) on haemodynamics, oxidative stress, oxygenation and lung mechanics. DESIGN: A prospective experimental study. SETTING: Experimental Unit, La Paz University Hospital, Madrid, Spain. ANIMALS: Eight newborn piglets (<48 h) with healthy lungs under general anaesthesia. INTERVENTIONS: The recruitment manoeuvres in pressure-controlled ventilation (PCV) were performed along with a constant driving pressure of 15 cmH2O. After the recruitment manoeuvres, PEEP was reduced in a stepwise fashion to find the maximal dynamic compliance step (maxCDyn-PEEP). Blood oxidative stress biomarkers (lipid peroxidation products, protein carbonyls, total glutathione, oxidised glutathione, reduced glutathione and activity of glutathione peroxidase) were analysed. MAIN OUTCOME MEASURES: Haemodynamic parameters, arterial partial pressure of oxygen (paO2), tidal volume (Vt), dynamic compliance (Cdyn) and oxidative stress biomarkers were measured. RESULTS: The recruitment manoeuvres did not induce barotrauma. Haemodynamic instability was not detected either in the maximum pressure step (overdistension step 5) or during the entire process. No substantial differences were observed in blood oxidative stress parameters analysed as compared with their baseline values (with 0 PEEP) or the values obtained 180 min after the onset of the recruitment manoeuvres (optimal PEEP). Significant maximal values were achieved in step 14 with an increase in paO2 (32.43 ±â€Š8.48 vs. 40.39 ±â€Š15.66 kPa; P = 0.037), Vt (47.75 ±â€Š13.59 vs. 73.87 ±â€Š13.56 ml; P = 0.006) and Cdyn (2.50 ±â€Š0.64 vs. 4.75 ±â€Š0.88 ml cmH2O; P < 0.001). Maximal dynamic compliance step (maxCdyn-PEEP) was 2 cmH2O. CONCLUSION: Recruitment manoeuvres in PCV with a constant driving pressure are a well tolerated open-lung strategy in a healthy-lung neonatal animal model under general anaesthesia. The recruitment manoeuvres improve oxygenation parameters and lung mechanics and do not cause barotrauma, haemodynamic instability or oxidative stress.

The High Testosterone Concentrations of the Bucks Used in the "Male Effect" Is Not a Prerequisite for Obtaining High Ovarian Activity in Goats from Mediterranean Latitudes.

Two experiments were carried out. Firstly, 54 anestrous females were placed in contact with photostimulated males (Photo; n = 27) or with no photostimulated males (Natural; n = 27). Moreover, a group of bucks treated with artificial photoperiod and a group of bucks subjected to natural photoperiod without contact with females was used (Photo Isolated and Natural Isolated, respectively). In the Natural groups, the testosterone concentrations were similar except for three days after the introduction of the bucks to the does (19.72 ± 4.11 vs. 2.05 ± 0.25 ng/mL for Natural and Natural isolated bucks, respectively, p < 0.05). However, no differences were observed in the Photo groups during the entire experiment. The percentage of females showing estrous was higher in the group of females in contact with photostimulated bucks (96 vs. 74%, respectively, p < 0.05). In the second experiment, a GnRH agonist, deslorelin, was used to regulate the testosterone concentrations of the bucks. Seventy anestrous females were divided into five groups depending on the treatment received by the bucks to which they were exposed: photostimulated bucks (Photo group, n = 14); photostimulated bucks but treated with the agonist at the onset of the photoperiod treatment (Photo-Ago Long group, n = 13); photostimulated bucks but treated with the agonist at the end of the photoperiod treatment (Photo-Ago Short group, n = 15); bucks receiving no photostimulation but treated with the agonist at the end of the photoperiod treatment period (Natural-Ago Short group, n = 13) and bucks receiving no photostimulation nor agonist (Natural group, n = 15). The agonist treatment increased testosterone concentrations after the injection, which remained high for the entire experiment (p < 0.05). Six days after the introduction of the bucks to the does, the testosterone concentrations increased only in the Natural group reaching similar concentrations to the other groups (12.17 ± 6.55, 16.69 ± 4.53, 8.70 ± 0.61, 11.03 ± 1.45 and 14.42 ± 3.64 ng/mL for Photo, Photo-Ago Long, Photo-Ago Short, Natural-Ago Short and Natural bucks, respectively, p > 0.05). No differences in reproductive parameters were observed (p > 0.05). These results demonstrate that, at Mediterranean latitudes, anestrous females can stimulate the testosterone concentrations of bucks after a period of isolation. The high testosterone concentrations are not a prerequisite for an adequate response to the male effect.

Twenty Years of Research in Seabass and Seabream Welfare during Slaughter.

The behavioural responses of fish to a stressful situation must be considered an adverse reaction caused by the perception of pain. Consequently, the handling prior to stunning and the immediacy of loss consciousness following stunning are the aspects to take into account during the slaughtering process. The most common commercial stunning method in seabream and seabass is based on hypothermia, but other methods such as electrical stunning, carbon dioxide narcosis or anaesthetic with clove oil, are discussed in relation to the time to reach the unconsciousness stage and some welfare indicators. Although seawater plus ice slurry is currently accepted in some guidelines of fish welfare well practices at slaughter, it cannot be considered completely adequate due to the deferred speed at which cause loss of consciousness. New methods of incorporating some kind of anaesthetic in the stunning tank could be a solution to minimize the impact on the welfare of seabass and seabream at slaughtering.

Effects of Dietary Phenylalanine and Tyrosine Supplements on the Chronic Stress Response in the Seabream (Sparus aurata).

The increase of aquaculture production is associated with a growing interest in improving physiological status and welfare in fish. For this reason, the search for strategies for mitigating stress has been intensified, with one of these strategies being food supplementation with different amino acids (AA). The objective of this study was to evaluate the effects of dietary phenylalanine (Phe) and tyrosine (Tyr) supplements on the endocrine and physiological state of seabreams (Sparus aurata) subjected to chronic stress. The fish were stocked at 30 fish/tank in a recirculation aquatic system, fed one control diet and two diets supplemented with 5% Phe or Tyr for 90 days. Blood was drawn from 10 fish per tank every 30 days, and the weight and length were measured every 15 days. At the end of the experiment, length/weight of the fish were measured, and they were sacrificed for the extraction of blood, head kidney, liver, and brain. Classic plasma stress markers (glucose, lactate, proteins, and cortisol), as well as hormones derived from Phe and Tyr (adrenaline, norepinephrine, and dopamine) and the accumulation of AA were analyzed. Fish fed with diets supplemented with Phe or Tyr showed a reduction in various stress markers and physiological parameters. In addition, the stress condition favored a mobilization of AA toward the tissues, especially in supplemented diets, so this excess of AA could be used as an energy substrate to cope with stress.

Phenylalanine and Tyrosine as Feed Additives for Reducing Stress and Enhancing Welfare in Gilthead Seabream and Meagre.

Increased aquaculture production is associated with a growing interest in improving fish welfare. For this reason, the search for strategies to mitigate stress has intensified, one of these strategies being food supplementation with amino acids. The objective of this study was to evaluate the effects of dietary phenylalanine (Phe) and Tyrosine (Tyr) on the stress response and metabolism of juvenile gilthead seabreams (Sparus aurata) and meagres (Argyrosomus regius). Fish batches were fed a control diet and two diets supplemented with 5% Phe or Tyr for seven days. At the end of the experiment fish were stressed by air exposure for 3 min and then sacrificed for the extraction of blood and brain. Classical plasma stress markers were analyzed (glucose, lactate, proteins, cortisol), as well as hormones derived from those amino acids (adrenaline, noradrenaline and dopamine). Despite interspecific differences, fish fed the diets supplemented with Phe or Tyr showed a reduction on several stress markers. However, interspecific differences were detected for many indicators. Concretely, hormonal stress markers were significantly attenuated in meagres fed the enriched diets. Moreover, the stress condition favored a mobilization of amino acids towards the brain, especially in supplemented diets, hence this amino acid excess could be used as an energy substrate to cope with stress.

Cardiac Biomarkers of Low Cardiac Output Syndrome in the Postoperative Period After Congenital Heart Disease Surgery in Children.

INTRODUCTION AND OBJECTIVES: To assess the predictive value of atrial natriuretic peptide, ß-type natriuretic peptide, copeptin, mid-regional pro-adrenomedullin (MR-proADM) and cardiac troponin I (cTn-I) as indicators of low cardiac output syndrome in children with congenital heart disease undergoing cardiopulmonary bypass (CPB). METHODS: After corrective surgery for congenital heart disease under CPB, 117 children (aged 10 days to 180 months) were enrolled in a prospective observational pilot study during a 2-year period. The patients were classified according to whether they developed low cardiac output syndrome. Biomarker levels were measured at 2, 12, 24, and 48 hours post-CPB. The clinical data and outcome variables were analyzed by a multiple logistic regression model. RESULTS: Thirty-three (29%) patients developed low cardiac output syndrome (group 1) and the remaining 84 (71%) patients were included in group 2. cTn-I levels >14 ng/mL at 2hours after CPB (OR, 4.05; 95%CI, 1.29-12.64; P=.016) and MR-proADM levels>1.5 nmol/L at 24hours following CPB (OR, 15.54; 95%CI, 4.41-54.71; P<.001) were independent predictors of low cardiac output syndrome. CONCLUSIONS: Our results suggest that cTn-I at 2hours post-CPB is, by itself, an evident independent early predictor of low cardiac output syndrome. This predictive capacity is, moreover, reinforced when cTn-I is combined with MR-proADM levels at 24hours following CPB. These 2 cardiac biomarkers would aid in therapeutic decision-making in clinical practice and would also enable clinicians to modify the type of support to be used in the pediatric intensive care unit.

Descending necrotizing mediastinitis in early childhood: favorable outcome after aggressive treatment.

OBJECTIVE: To report a case of descending necrotizing mediastinitis (DNM), an unusual illness in childhood that develops as a complication of oropharyngeal infection. DESIGN: Descriptive case report. SETTING: Pediatric intensive care unit. PATIENT: A 19-month-old boy with a DNM that resulted from a pharyngeal abscess. INTERVENTIONS: Aggressive surgical debridement; intravenous therapy with broad-spectrum antibiotics. MEASUREMENTS AND MAIN RESULTS: Simple chest radiograph and computed tomographic scan, and routine culture were used to assess the patient. Administration of broad-spectrum antibiotics and surgical drainage resulted in clinical resolution of symptoms. CONCLUSIONS: An aggressive approach (broad-spectrum antibiotics and surgical debridement) can improve the prognosis of DNM in children.