ABSTRACT
OBJECTIVES: The treatment of choice for congenital heart disease (CHD) with pulmonary arterial hypertension (PAH) is still controversial. We assessed the efficacy and safety of perioperative inhaled iloprost therapy in CHD with PAH. METHODS: Among 45 patients with a ventricular septal defect and/or an atrial septal defect with PAH, 28 patients were treated with inhaled iloprost before and after surgery. Perioperative clinical parameters and plasma B-type natriuretic peptide (BNP) were evaluated. RESULTS: No statistical difference in the estimated right ventricular systolic pressure (e-RVP), the e-RVP-to-systemic pressure ratio, and preoperative BNP levels between the iloprost group and the control group were found. Among the iloprost group, oxygen saturation was increased significantly after iloprost inhalation therapy (p = 0.0052). The iloprost group was also significantly correlated with less use of inhaled nitric oxide in the immediate postoperative period compared to the control group (p = 0.021). The durations of mechanical ventilation (p = 0.018), ICU stay (p = 0.005), and chest tube use (p = 0.039) were significantly shorter in the iloprost group compared to the control group. The plasma BNP, checked on 7th day of postoperatively, was lower in the iloprost group than in the control group (p = 0.008). CONCLUSION: Perioperative inhaled iloprost therapy showed the benefit of cardiac functional improvement and early weaning of postoperative supportive care in the management of CHD with PAH.
Subject(s)
Heart Septal Defects, Atrial/complications , Heart Septal Defects, Ventricular/complications , Hypertension, Pulmonary/drug therapy , Iloprost/administration & dosage , Vasodilator Agents/administration & dosage , Administration, Inhalation , Adolescent , Adult , Child , Child, Preschool , Heart Septal Defects, Atrial/surgery , Heart Septal Defects, Ventricular/surgery , Humans , Hypertension, Pulmonary/etiology , Infant , Perioperative Care , Retrospective Studies , Young AdultABSTRACT
Fabrication of high-conductivity ion exchange membranes (IEMs) is crucial to improve the performance of non-aqueous vanadium redox flow batteries (NAVRFBs). In the present work, anion exchange membranes with high-conductivity were fabricated by aligning ion channels of the polymer electrolyte impregnated in porous polytetrafluoroethylene (PTFE) under electric fields. It was observed that the ion channels of the polymer electrolyte were uniformly orientated in the atomic-force microscopy image. Its morphological change could minimize detouring of the transport of BF4 - ions. The results showed through-plane conductivity was improved from 12.7 to 33.1 mS cm-1. The dimensional properties of the fabricated membranes were also enhanced compared with its cast membrane owing to the reinforcing effect of the substrate. Especially, the NAVRFB assembled with the optimized membrane showed increased capacities, with a 97% coulombic efficiency and 70% energy efficiency at 80 mA cm-2. Furthermore, the optimized membrane made it possible to operate the NAVRFB at 120 mA cm-2. Its operating current density was 120 times higher than that of a frequently used AHA membrane for RFBs.