Early mobilization after transcatheter aortic valve implantation: observational cohort study.

AIMS: Early mobilization is associated with improved outcomes in hospitalized older patients. We sought to determine the effect of a nurse-led protocol on mobilization 4 h after transfemoral transcatheter aortic valve implantation (TAVI) across different units of care. METHODS AND RESULTS: We conducted a prospective observational cohort single-centre study of consecutive patients. We implemented a standardized protocol for safe early recovery and progressive mobilization in the critical care and cardiac telemetry units. We measured the time to first mobilization and conducted descriptive statistics to identify patient and system barriers to timely ambulation. We recruited 139 patients (82.5 years, SD = 6.7; 46% women). At baseline, patients who were mobilized early (≤4 h) and late (>4 h) did not differ, except for higher rates of diabetes (25.5% vs. 43.9%, P = 0.032) and peripheral arterial disease (8.2% vs. 26.8%, P = 0.003) in the late mobilization group. The median time to mobilization was 4 h [inter-quartile range (IQR) 3.25, 4]; 98 patients (70.5%) were mobilized successfully after 4 h of bedrest; 118 (84.9%) were walking by the evening of the procedure (<8 h bedrest); and 21 (15.1%) were on bedrest overnight and mobilized the following day. Primary reasons for overnight bedrest were arrhythmia monitoring (n = 10, 7.2%) and haemodynamic and/or neurological instability (n = 6, 4.3%); six patients (4.3%) experienced delayed ambulation due to system issues. Procedure location in the hybrid operating room and transfer to critical care were associated with longer bedrest times. CONCLUSION: Standardized nurse-led mobilization 4 h after TF TAVI is feasible in the absence of clinical complications and system barriers.

Quantitative tracking of the growth of individual algal cells in microdroplet compartments.

In this paper we introduce a simple droplet-based microfluidic system consisting of two separate devices to encapsulate and culture microalgae, in contrast to cultivation in bulk liquid medium. This microdroplet technology has been used to monitor the growth of individual microalgal cells in a constant environment for extended periods of time. Single cells from three species of green microalgae, (two freshwater species Chlamydomonas reinhardtii and Chlorella vulgaris, and one saline species Dunaliella tertiolecta), were encapsulated and incubated in microdroplet compartments of diameter of ∼80 µm, and their growth analysed over 10 days. In all cases, the doubling time of microalgae grown in microdroplets was similar to growth in bulk. The growth of C. reinhardtii in microdroplets of varying diameters and with different initial cell numbers per droplet was investigated, as well as the effect of varying medium conditions such as pH and nitrogen concentration. This methodology offers the opportunity to study characteristics over time of individual cells and colonies, as well as to screen large numbers of them.