RESUMO
Venoarterial extracorporeal membrane oxygenation (VA ECMO) is a form of temporary mechanical circulatory support and simultaneous extracorporeal gas exchange for acute cardiorespiratory failure, including refractory cardiogenic shock (CS) and cardiac arrest (CA). Few studies have assessed predictors of successful weaning (SW) from VA ECMO. This systematic review and meta-analysis aimed to identify a multiparameter strategy associated with SW from VA ECMO. PubMed and the Cochrane Library and the International Clinical Trials Registry Platform were searched. Studies reporting adult patients with CS or CA treated with VA ECMO published from the year 2000 onwards were included. Primary outcomes were hemodynamic, laboratory, and echocardiography parameters associated with a VA ECMO SW. A total of 11 studies (n=653) were included in this review. Pooled VA ECMO SW was 45% (95%CI: 39�%, I2 7%) and in?hospital mortality rate was 46.6% (95%CI: 33�%; I2 36%). In the SW group, pulse pressure [MD 12.7 (95%CI: 7.3�) I2 = 0%] and mean blood pressure [MD 20.15 (95%CI: 13.8�.4 I2 = 0) were higher. They also had lower values of creatinine [MD �59 (95%CI: �9 to �2) I2 = 7%], lactate [MD �1 (95%CI: �4 to �7) I2 = 89%], and creatine kinase [�79.5 (95%CI: �87 to �1) I2 = 38%]. And higher left and right ventricular ejection fraction, MD 17.9% (95%CI: �2�.2) I2 = 91%, and MD 15.9% (95%CI 11.9�) I2 = 0%, respectively. Different hemodynamic, laboratory, and echocardiographic parameters were associated with successful device removal. This systematic review demonstrated the relationship of multiparametric assessment on VA ECMO SW.
RESUMO
The essential oil and hydrosol extract of Nepeta nepetella subsp. amethystina, obtained by hydrodistillation and analysed by GC, GC–MS, 1H and 13C NMR, were evaluated for their antimicrobial activity using disks diffusion method and MICs against thirteen pathogenic microorganisms. The chemical analysis of essential oil and hydrosol extract allowed the identification of 34 and 12 constituents representing 96.77% and 80.07% of total oil and hydrosol extract, respectively. The two isomers 4a,7,7a-nepetalactone and 4a, 7, 7a-nepetalactone were found to be the major components in N. amethystina essential oil and hydrosol extract, , 7-nepetalactone and 4a,7a,7respectively. The two isomers 4a -nepetalactone were found to be the major components in N.7a amethystina essential oil and hydrosol extract. Candida albicans strains were the most sensitive microorganisms towards N. amethystina essential oil and hydrosol extract, which have the largest inhibition zones (˃30mm) and the lower MICs values (<1.25%). The anti-mold activity, carried out by the diffusion method, showed that N. amethystina essential oil has a very interesting activity against Aspergillus flavus and Cladosporium herbarium.
RESUMO
Staphylococcus aureus, one of the opportunistic species responsible for clinical and / or bacteriological infections may react with biotic and abiotic surfaces and produces biofilm. In this form the bacteria become somewhat vulnerable to various physical and / or chemical antimicrobial agents. The aim of this study was to investigate the antibacterial efficacy of PVI, alone and in combination with essential oils (EO) of three aromatic plants, Eucalyptus globulus, Thymus capitatus, and Rosmarinus officinalis, against biofilms of four clinical isolates of Staphylococcus aureus from intravenous catheter associated infections. These strains isolated at the university hospital of Tlemcen, were characterized and identified, in a previous study, as strongly adherent using the microtiter plate method. Minimum inhibitory (MIC) and minimum bactericidal (MBC) concentrations of different essential oils sole and in combination with PVI for studied strains grown in biofilm, were determined by microbroth dilution method. The antibacterial effect of EOs and PVI, alone and in combination, against biofilmforming staphylococci, was also demonstrated. EO of E. globulus was more effective, in comparaison with the two other EOs. In addition, the antibacterial effects of the three EOs studied in combination with PVI were deemed synergistic against the biofilm of all tested strains, with a fractional inhibitory concentration index (FICI) <0.5. Accordingly, we could suggest the use of PVI in combination with EOs, especially of E. globulus ; since this EO was proved to be more efficacious in enhancing the antibacterial efficacy of PVI against biofilm of S. aureus.