RESUMEN
Background: For cesarean delivery (CD), the 90% effective dosage (ED90) of oxytocin for a first bolus has been established. It is not yet known how much oxytocin to inject into obese women undergoing elective discectomy to keep their uterine tone (UT) appropriate. We hypothesized that patients who are overweight need a greater dose of oxytocin infusion; thus, we aimed to determine how the dose-response curve for oxytocin infusion changes following an initial 1 international unit (IU) bolus in obese women undergoing elective CD. Methods: One hundred parturients with a body mass index (BMI) greater than 30 kg/m2 were randomly assigned to receive an infusion rate of 14, 18, 22, or 26 IU/h of oxytocin. When the uterine palpation is as hard as touching the forehead or tip of the nose, it is considered sufficient UT according to the criteria used by obstetricians. The median effective dose (ED50) and ED90 values were determined using probit analysis. Results: We found the ED50 and ED90 values for the infusion dose of oxytocin were around 11.0 IU/h and 19.1 IU/h, respectively. Each group had a different number of parturients who needed rescued oxytocin: 14 IU/h for six, 18 IU/h for three, one for 22 IU/h, and none for 26 IU/h. The correlation between the frequency of rescued oxytocin administration and the amount of oxytocin infusion needed to avoid uterine atony was statistically significant (p = 0.02). Conclusion: The present research showed that the most effective dosage of oxytocin infusion for obese parturients undergoing elective CD is 19.1 IU/h, following an initial loading dose of 1 IU. Patients with obesity should receive a greater dosage of prophylactic oxytocin, and further studies comparing patients with and without obesity (with higher BMI) are required. Clinical Trial Registration: https://www.chictr.org.cn/showproj.html?proj=159951, identifier ChiCTR2200059582.
RESUMEN
Based on cluster analysis of species vertical stratification, the variations in concentration, allocation and seasonal dynamics of non-structural carbohydrates were investigated in a monsoon broad-leaved evergreen forest in Pu'er, Yunnan Province. The results showed that the concentrations of soluble sugar (3.9%) and nonstructural carbohydrates (NSC, 13.3%) were the highest in the sub-canopy. In contrast, the sugar/starch (0.76) of understory was the lowest. There was no significant difference in starch content among three forest layers. For all forest stories, the soluble sugar was mainly allocated to leaves and the roots had more starch and NSC. The soluble sugar contents in leaves and trunks of sub-canopy species were higher than canopy and understory species. There were no significant differences in soluble sugar content of twigs and roots among three different forest layers. The starch content of leaves increased with decreasing height of forest layers. In contrast, the lowest starch content (10.7%) of roots was in understory. There was no significant difference in starch content of twigs and trunks among three different forest layers. The NSC content of leaves was lower in canopy (10.7%) than that in sub-canopy (12.3%) and understory (12.0%). The lowest NSC content of roots was in understory (14.2%). The lowest sugar/starch of leaves, twigs, and trunks presented in understory, while the lowest sugar/starch of roots presented in canopy (0.79). There were dramatic seasonal variations in concentrations and components of NSC. The concentration of soluble sugar and the sugar/starch were higher in the rainy season than that in the dry season. However, the concentration of starch and NSC were higher in the dry season than in the rainy season. The variations in concentration of NSC and its components among forest layers indicated that species with different heights varied in their utilization strategies of carbon, which partly explained species coexistence.