RESUMO
BACKGROUND: Urine output (UO) is a vital sign for critically ill patients, but standards for monitoring and reporting vary widely between ICUs. Careful monitoring of UO could lead to earlier recognition of acute kidney injury (AKI) and better fluid management. We sought to determine if the intensity of UO monitoring is associated with outcomes in patients with and those without AKI. METHODS: This was a retrospective cohort study including 15,724 adults admitted to ICUs from 2000 to 2008. Intensive UO monitoring was defined as hourly recordings and no gaps > 3 hours for the first 48 hours after ICU admission. RESULTS: Intensive monitoring for UO was conducted in 4,049 patients (26%), and we found significantly higher rates of AKI (OR, 1.22; P < .001) in these patients. After adjustment for age and severity of illness, intensive UO monitoring was associated with improved survival but only among patients experiencing AKI. With or without AKI, patients with intensive monitoring also had less cumulative fluid volume (2.98 L vs 3.78 L; P < .001) and less fluid overload (2.49% vs 5.68%; P < .001) over the first 72 hours of ICU stay. CONCLUSIONS: In this large ICU population, intensive monitoring of UO was associated with improved detection of AKI and reduced 30-day mortality in patients experiencing AKI, as well as less fluid overload for all patients. Our results should help inform clinical decisions and ICU policy about frequency of monitoring of UO, especially for patients at high risk of AKI or fluid overload, or both.
Assuntos
Injúria Renal Aguda/diagnóstico , Unidades de Terapia Intensiva , Monitorização Fisiológica/métodos , Micção/fisiologia , Injúria Renal Aguda/fisiopatologia , Adulto , Idoso , Progressão da Doença , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Estudos Retrospectivos , Fatores de TempoRESUMO
Background: The effect of diverse oxygen transfer coefficient on the L-erythrulose production from meso-erythritol by a newly isolated strain, Gluconobacter kondonii CGMCC8391 was investigated. In order to elucidate the effects of volumetric mass transfer coefficient (K La) on the fermentations, baffled and unbaffled flask cultures, and fed-batch cultures were developed in present work. Results: With the increase of the K La value in the fed-batch culture, L-erythrulose concentration, productivity and yield were significantly improved, while cell growth was not the best in the high K La. Thus, a two-stage oxygen supply control strategy was proposed, aimed at achieving high concentration and high productivity of L-erythrulose. During the first 12 h, Klawas controlled at 40.28 h-1 to obtain high value for cell growth, subsequently K La was controlled at 86.31 h-1 to allow for high L-erythrulose accumulation. Conclusions: Under optimal conditions, the L-erythrulose concentration, productivity, yield and DCW reached 207.9 ± 7.78 g/L, 6.50 g/L/h, 0.94 g/g, 2.68 ± 0.17 g/L, respectively. At the end of fermentation, the L-erythrulose concentration and productivity were higher than those in the previous similar reports.
Assuntos
Gluconobacter/metabolismo , Oxigênio/metabolismo , Tetroses/biossíntese , Reatores Biológicos , Eritritol , Fermentação , CurtumeRESUMO
Abstract The principal objective of this study was to evaluate the kinetics of dihydroxyacetone production by Gluconobacter frateurii CGMCC 5397 under different oxygen volumetric mass transfer coefficient (kLa) conditions in submerged bioreactors using biodiesel-derived crude glycerol as the carbon source. kLa is a key fermentation parameter for the production of dihydroxyacetone. Cultivations were conducted in baffled- and unbaffled-flask cultures (the kLa values were 24.32 h−1 and 52.05 h−1, respectively) and fed-batch cultures (the kLa values were held at 18.21 h−1, 46.03 h−1, and 82.14 h−1) to achieve high dihydroxyacetone concentration and productivity. The results showed that a high kLa could dramatically increase dihydroxyacetone concentrations and productivities. The baffled-flask culture (with a kLa of 52.05 h−1) favored glycerol utilization and dihydroxyacetone production, and a dihydroxyacetone concentration as high as 131.16 g/L was achieved. When the kLa was set to 82.14 h−1 in the fed-batch culture, the dihydroxyacetone concentration, productivity and yield were 175.44 g/L, 7.96 g/L/h and 0.89 g/g, respectively, all of which were significantly higher than those in previous studies and will benefit dihydroxyacetone industrial production.
Assuntos
Di-Hidroxiacetona/metabolismo , Gluconobacter/metabolismo , Glicerol/metabolismo , Oxigênio/metabolismo , Biotransformação , Reatores Biológicos/microbiologia , Carbono/metabolismoRESUMO
The principal objective of this study was to evaluate the kinetics of dihydroxyacetone production by Gluconobacter frateurii CGMCC 5397 under different oxygen volumetric mass transfer coefficient (kLa) conditions in submerged bioreactors using biodiesel-derived crude glycerol as the carbon source. kLa is a key fermentation parameter for the production of dihydroxyacetone. Cultivations were conducted in baffled- and unbaffled-flask cultures (the kLa values were 24.32h(-1) and 52.05h(-1), respectively) and fed-batch cultures (the kLa values were held at 18.21h(-1), 46.03h(-1), and 82.14h(-1)) to achieve high dihydroxyacetone concentration and productivity. The results showed that a high kLa could dramatically increase dihydroxyacetone concentrations and productivities. The baffled-flask culture (with a kLa of 52.05h(-1)) favored glycerol utilization and dihydroxyacetone production, and a dihydroxyacetone concentration as high as 131.16g/L was achieved. When the kLa was set to 82.14h(-1) in the fed-batch culture, the dihydroxyacetone concentration, productivity and yield were 175.44g/L, 7.96g/L/h and 0.89g/g, respectively, all of which were significantly higher than those in previous studies and will benefit dihydroxyacetone industrial production.
Assuntos
Di-Hidroxiacetona/metabolismo , Gluconobacter/metabolismo , Glicerol/metabolismo , Oxigênio/metabolismo , Reatores Biológicos/microbiologia , Biotransformação , Carbono/metabolismoRESUMO
The principal objective of this study was to evaluate the kinetics of dihydroxyacetone production by Gluconobacter frateurii CGMCC 5397 under different oxygen volumetric mass transfer coefficient (kLa) conditions in submerged bioreactors using biodiesel-derived crude glycerol as the carbon source. kLa is a key fermentation parameter for the production of dihydroxyacetone. Cultivations were conducted in baffled- and unbaffled-flask cultures (the kLa values were 24.32 h1 and 52.05 h1, respectively) and fed-batch cultures (the kLa values were held at 18.21 h1, 46.03 h1, and 82.14 h1) to achieve high dihydroxyacetone concentration and productivity. The results showed that a high kLa could dramatically increase dihydroxyacetone concentrations and productivities. The baffled-flask culture (with a kLa of 52.05 h1) favored glycerol utilization and dihydroxyacetone production, and a dihydroxyacetone concentration as high as 131.16 g/L was achieved. When the kLa was set to 82.14 h1 in the fed-batch culture, the dihydroxyacetone concentration, productivity and yield were 175.44 g/L, 7.96 g/L/h and 0.89 g/g, respectively, all of which were significantly higher than those in previous studies and will benefit dihydroxyacetone industrial production. (AU)
Assuntos
Transferência de Oxigênio , Di-Hidroxiacetona , Glicerol , Biocombustíveis , GluconobacterRESUMO
OBJECTIVE: To survey the prevalence of diabetes mellitus (DM) and pre-diabetes mellitus (PDM) in the Muslim population in northwest China, and discuss the risk factor. MATERIALS AND METHODS: According to the income and the population, we randomly selected 3 villages with stratified and cluster sampling. The subjects were residents ≥ 20 years of age, and were from families which have been local for > 3 generations. The questionnaire and oral glucose tolerance test (OGTT) were completed and analyzed for 660 subjects. RESULTS: The prevalence of DM and PDM between the Han and Muslim populations were different (P = 0.041). And the prevalence were also different with respect to age in the Han (P < 0.001) and Muslim population (P < 0.001) respectively. Except for the 20-year-old age group the prevalence of DM and PDM within the Muslim population was higher than the Han (P = 0.013), we did not find any significant difference for other age groups (P > 0.05). The intake of salt (P < 0.001) and edible oil (P < 0.001) in the Muslim population was higher than the Han, while cigarette smoking (P < 0.001) and alcohol consumption (P < 0.001) was lower. BMI (P < 0.001), age (P = 0.025), and smoking cigarettes (P = 0.011) were risk factors for DM and PDM, but alcohol consumption (P < 0.001) was a protective factor. CONCLUSIONS: In northwest China, the prevalence of DM was higher in the Muslim population, and it was special higher on the 20-year-old age compared to the Han. This might be explained by the potential genetic differences and poor dietary habits.
Assuntos
Glicemia/metabolismo , Diabetes Mellitus/epidemiologia , Comportamento Alimentar , Islamismo , Estado Pré-Diabético/epidemiologia , Adulto , Idoso , Povo Asiático/etnologia , Glicemia/análise , Índice de Massa Corporal , China/epidemiologia , China/etnologia , Análise por Conglomerados , Efeito de Coortes , Diabetes Mellitus/metabolismo , Feminino , Macrossomia Fetal/complicações , Teste de Tolerância a Glucose , Humanos , Masculino , Pessoa de Meia-Idade , Estado Pré-Diabético/metabolismo , Prevalência , Fatores de Risco , Cloreto de Sódio na Dieta , Inquéritos e Questionários , Adulto JovemRESUMO
Objective To survey the prevalence of diabetes mellitus (DM) and pre-diabetes mellitus (PDM) in the Muslim population in northwest China, and discuss the risk factor. Materials and methods According to the income and the population, we randomly selected 3 villages with stratified and cluster sampling. The subjects were residents ≥ 20 years of age, and were from families which have been local for > 3 generations. The questionnaire and oral glucose tolerance test (OGTT) were completed and analyzed for 660 subjects. Results The prevalence of DM and PDM between the Han and Muslim populations were different (P = 0.041). And the prevalence were also different with respect to age in the Han (P < 0.001) and Muslim population (P < 0.001) respectively. Except for the 20-year-old age group the prevalence of DM and PDM within the Muslim population was higher than the Han (P = 0.013), we did not find any significant difference for other age groups (P > 0.05). The intake of salt (P < 0.001) and edible oil (P < 0.001) in the Muslim population was higher than the Han, while cigarette smoking (P < 0.001) and alcohol consumption (P < 0.001) was lower. BMI (P < 0.001), age (P = 0.025), and smoking cigarettes (P = 0.011) were risk factors for DM and PDM, but alcohol consumption (P < 0.001) was a protective factor. Conclusions In northwest China, the prevalence of DM was higher in the Muslim population, and it was special higher on the 20-year-old age compared to the Han. This might be explained by the potential genetic differences and poor dietary habits. .
Objetivo Avaliar a prevalência de diabetes melito (DM) e pré-diabetes melito (PDM) na população muçulmana no noroeste da China e discutir os fatores de risco. Materiais e métodos Selecionamos três vilarejos de acordo com a renda e a população, usando uma amostra estratificada e por cluster. Os sujeitos eram residentes com ≥ 20 anos de idade e de famílias que estavam no local há mais de três gerações. Foram feitos e analisados um questionário e o teste de tolerância oral à glicose (TTOG) para 660 sujeitos. Resultados A prevalência do DM e PDM entre as populações Han e muçulmana foi diferente (P = 0,041), e as prevalências também foram diferentes com relação à idade na população Han (P < 0,001) e muçulmana (P < 0,001), respectivamente. Exceto pela faixa etária de 20 anos de idade, a prevalência do DM e PDM na população muçulmana foi maior do que na população Han (P = 0,013), não havendo diferenças significativas para as outras faixas etárias (P > 0,05). A ingestão de sal (P < 0,001) e óleos comestíveis (P < 0,001) na população muçulmana foi mais alta do que na população Han, enquanto o tabagismo (P < 0,001) e consumo de álcool (P < 0,001) foram mais baixos. O IMC (P < 0,001), a idade (P = 0,025) e o tabagismo (P = 0,011) foram fatores de risco para o DM e PDM, mas o consumo de álcool (P < 0,001) foi um fator protetor. Conclusões No noroeste da China, a prevalência de DM é maior na população muçulmana e é especialmente mais alta na faixa etária de 20 anos de idade, quando comparada com a população Han. Isso pode ser explicado por diferenças genéticas potenciais e hábitos alimentares ruins. .