C3d Assay in Correlation With Single Antigen Bead Assay for Human Leukocyte Antigen Antibodies

Background

Single antigen bead assay (SAB) is a sensitive method for detecting HLA antibodies, but it does not specifically identify clinically relevant subsets. Recently, a new assay has been developed for detection of C3d bound to HLA antibody-antigen complex. We evaluated the C3d assay regarding its correlation with SAB in renal patients.

Why saying what you mean matters: An analysis of trauma team communication

Background

We hypothesized that team communication with unmatched grammatical form and communicative intent (mixed mode communication) would correlate with worse trauma teamwork.

Effect of prolonged inspiratory time on gas exchange during robot-assisted laparoscopic urologic surgery

Background

Gas exchange disturbance may develop during urologic robotic laparoscopic surgery with the patient in a steep Trendelenburg position. This study investigated whether prolonged inspiratory time could mitigate gas exchange disturbances including hypercapnia.

Methods

In this randomized cross-over trial, 32 patients scheduled for robot-assisted urologic surgery were randomized to receive an inspiratory to expiratory time ratio (I:E) of 1:1 for the first hour of pneumoperitoneum followed by 1:2 for last period of surgery (group A, n?=?17) or I:E of 1:2 followed by 1:1 (group B, n?=?15). Arterial blood gas analysis, airway pressure and hemodynamic variables were assessed at four time points (T1: 10?min after induction of general anesthesia, T2: 1?h after the initiation of pneumoperitoneum, T3: 1?h after T2 and T4: at skin closure). The carry over effect of initial I:E was also evaluated over the next hour through arterial blood gas analysis.

Results

There was a significant decrease in partial pressure of oxygen in arterial blood (PaO₂) for both groups at T2 and T3 compared to T1 but in group B the PaO₂ at T4 was not decreased from the baseline. Partial pressure of carbon dioxide in arterial blood (PaCO₂) increased with I:E of 1:2 but did not significantly increase with I:E of 1:1; however, there were no differences in PaO₂ and PaCO₂ between the groups.

Conclusion

Decreased oxygenation by pneumoperitoneum was improved and PaCO₂ did not increase after 1 h of I:E of 1:1; however, the effect of equal ratio ventilation longer than 1 h remains to be determined. There was no carryover effect of the two different I:E ratios.