RESUMEN
Continuing with previous research by our group in an ESF system, four types of enrichment treatments were assessed in gestating sows housed in Free Access Stalls: (1) Constant: constant provision of wood on chain; (2) Rotate: rotation of rope, straw and wood; (3) Stimulus: rotation of enrichments with an acoustic cue; and (4) Control: no enrichment. Treatments had a 12 day-duration. Four groups (28 ± 2 sows) were studied from weeks 6 to 14 of gestation. Groups received all treatments in random order. Three dominant and 3 subordinates per pen were selected using a feed competition test. Digital photos were collected at 10 min intervals for 8 h on days 1, 8, 10 and 12 to record interactions with enrichment. Skin lesions were assessed on days 1 and 12, and salivary cortisol was assessed in weeks 6, 10 and 14 of gestation. More enrichment use was observed in Rotate and Stimulus treatments compared to Constant, and more sows contacted enrichment when straw was provided in the Rotate and Stimulus treatments. There was no difference in the amount of enrichment use by dominants and subordinates, no cortisol concentration elevation in subordinate sows nor any difference in lesion scores. In conclusion, social status had little impact and feeding system is important to reduce stress and aggression.
RESUMEN
BACKGROUND: Arterial pressure lability is common during the process of replacing syringes used for norepinephrine infusions in critically ill patients. It is unclear if there is an optimal approach to minimise arterial pressure instability during this procedures. We investigated whether 'double pumping' changeover (DPC) or automated changeover (AC) reduced blood pressure lability in critically ill adults compared with quick syringe changeover (QC). METHODS: Patients requiring a norepinephrine infusion syringe change were randomised in a non-blinded trial undertaken in six ICUs. Randomisation was minimised by norepinephrine flow rate at inclusion and centre. The primary outcome was the frequency of increased/decreased mean arterial pressure (defined by 15 mm Hg from baseline measurements) within 15 min of switching the syringe compared with QC. RESULTS: Patients (mean age: 64 (range:18-88)) yr were randomly assigned to QC (n=95), DPC (n=95), or AC (n=96). Increased MAP was the commonest consequence of syringe changeovers. MAP variability was most frequent after DPC (89/224 changeovers; 39.7%) compared with 57/223 (25.6%) changeovers after quick syringe switch and 46/181 (25.4%) in patients randomised to receive automated changeover (P=0.001). Fewer events occurred with QC compared with DPC (P=0.002). Sensitivity analysis based on mixed models showed that performing several changeovers on a single patient had no impact. Both type of changeover and norepinephrine dose before syringe changeover were independently associated with MAP variations >15 mm Hg. CONCLUSIONS: Quick changeover of norepinephrine syringes was associated with less blood pressure lability compared with DPC. The prevalence of MAP variations was the same between AC and QC. CLINICAL TRIAL REGISTRATION: NCT02304939.
Asunto(s)
Presión Arterial/efectos de los fármacos , Cuidados Críticos , Norepinefrina/administración & dosificación , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Infusiones Intravenosas , Masculino , Persona de Mediana Edad , Evaluación de Resultado en la Atención de Salud , Jeringas , Adulto JovenRESUMEN
The goal of this study was to identify practical enrichments for sows in partially or fully slatted pen systems. Four treatments were applied: (1) Constant: constant provision of wood on chain; (2) Rotate: rotation of rope, straw and wood enrichments; (3) Stimulus: rotation of enrichments (as in Rotate) with an associative stimulus (bell or whistle); and (4) Control: no enrichment, with each treatment lasting 12 days. Six groups of 20 ± 2 sows were studied from weeks 6 to 14 of gestation in pens with one electronic sow feeder. Each group received all treatments in random order. Six focal animals (3 dominant and 3 subordinate) were selected per pen using a feed competition test. Digital photos were collected at 10 min intervals for 8 h (between 8 a.m. and 4 p.m.) on 4 days/treatment (d 1, 8, 10 and 12) to record interactions with enrichment. Skin lesions were assessed on days 1 and 12, and saliva cortisol samples collected in weeks 6, 10 and 14 of gestation on focal pigs. Sows spent more time in contact with enrichments in Rotate and Stimulus treatments than Constant. Enrichment treatments did not influence lesion scores. Subordinate sows spent more time standing and near enrichments than dominants. Subordinate sows also received more skin lesions and had higher salivary cortisol concentrations than dominants. These results indicate that access to enrichment is valued by sows but can result in greater aggression directed towards subordinates.
RESUMEN
BACKGROUND: The clinical interest of using bubble humidification of oxygen remains controversial. This study was designed to further explore whether delivering dry oxygen instead of bubble-moistened oxygen had an impact on discomfort of ICU patients. METHODS: This randomized multicenter non-inferiority open trial included patients admitted in intensive care unit and receiving oxygen. Any patient receiving non-humidified oxygen (between 0 and 15 L/min) for less than 2 h could participate in the study. Randomization was stratified based on the flow rate at inclusion (less or more than 4 L/min). Discomfort was assessed 6-8 and 24 h after inclusion using a dedicated 15-item scale (quoted from 0 to 150). RESULTS: Three hundred and fifty-four ICU patients receiving non-humidified oxygen were randomized either in the humidified (HO) (n = 172), using bubble humidifiers, or in the non-humidified (NHO) (n = 182) arms. In modified intention-to-treat analysis at H6-H8, the 15-item score was 26.6 ± 19.4 and 29.8 ± 23.4 in the HO and NHO groups, respectively. The absolute difference between scores in both groups was 3.2 [90% CI 0.0; + 6.5] for a non-inferiority margin of 5.3, meaning that the non-inferiority analysis was not conclusive. This was also true for the subgroups of patients receiving either less or more than 4 L/min of oxygen. At H24, using NHO was not inferior compared to HO in the general population and in the subgroup of patients receiving 4 L/min or less of oxygen. However, for patients receiving more than 4 L/min, a post hoc superiority analysis suggested that patients receiving dry oxygen were less comfortable. CONCLUSIONS: Oxygen therapy-related discomfort was low. Dry oxygen could not be demonstrated as non-inferior compared to bubble-moistened oxygen after 6-8 h of oxygen administration. At 24 h, dry oxygen was non-inferior compared to bubble-humidified oxygen for flows below 4 L/min.