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Introduction: One lung ventilation (OLV) is a technique used during lung resection surgery to facilitate optimal surgical conditions. However, this may result in severe hypoxemia due to the right-to-left shunt created in the collapsed lung. Several techniques are used to overcome hypoxemia, one of which is continuous positive airway pressure (CPAP) to the non-dependent lung. Another technique is ventilating the non-dependent lung with a minimal volume, thus creating differential lung ventilation (DLV) or split lung ventilation (SLV). In this study, we compared the efficacy of CPAP to DLV during video-assisted thoracoscopic (VATS) lung resection., Materials and Methods: In this single-center randomized controlled, cross-over study, each patient acted as his control as well as the study. Patients crossed over from SLV to CPAP (or vice versa) with an interval period during which only OLV was used (control period). The primary objective of the study was to observe the changes in oxygenation, ventilation, and the surgeons' perception of the surgical field using CPAP or SLV to the non-ventilated lung during the period of OLV in patients undergoing thoracic surgery., Results: The study revealed that oxygenation was significantly better when using SLV to the non-ventilated lung during the period of OLV (P = 0.03). However, the surgeon found a significantly better surgical field when applying CPAP to the surgical field., Conclusions: The study showed that using SLV to the non-ventilated lung during the period of OLV was superior in terms of oxygenation, although it interfered more with the surgical field., (Copyright © 2024 Copyright: © 2024 Annals of Cardiac Anaesthesia.)

Background: Patients with chronic kidney disease (CKD) who undergo hemodialysis are predisposed to interstitial cerebral edema. Robotic-assisted laparoscopic surgery can increase optic nerve sheath diameter (ONSD) and intracranial pressure. The impact of robotic-assisted kidney transplant (RAKT) on ONSD is complicated by the presence of CKD, the administration of furosemide and mannitol, and the manipulation of hemodynamics. We examined ONSD variations in patients undergoing RAKT over a 1-year period at our institution. Furthermore, we attempted to identify any perioperative hemodynamic factors influencing these changes., Methods: This prospective study included 20 patients undergoing RAKT. ONSD, heart rate, central venous pressure, systolic blood pressure, diastolic blood pressure (DBP), and mean arterial pressure (MAP) were measured following intubation (T1), after assuming the steep Trendelenburg position (T2), 1 hour after docking (T3), upon reperfusion (T4), after transition to the supine position (T5), and 3 hours postextubation (T6). Repeated measures analysis of variance with post hoc Bonferroni correction was employed to compare variables at each time point. Pearson correlation analysis was utilized to assess relationships between variables. P-values ≤0.05 were considered to indicate statistical significance., Results: ONSD (in mm) increased from T1 (3.60±0.44) to T3 (4.06±0.45, P=0.002) and T4 (3.99±0.62, P=0.046), before falling to its lowest value at T6 (3.42±0.64, P=0.002). Pearson correlation analysis revealed significant correlations (P<0.05) between changes in ONSD at T3 and both DBP (r=0.637) and MAP (r=0.522)., Conclusions: During RAKT with open ureteric anastomosis, ONSD initially increased, then decreased following reperfusion. DBP and MAP displayed positive correlations with ONSD changes at T3.

Groundwater quality in Wadi Fatimah is evaluated and demarcated for agriculture utilities using comprehensive approaches namely, international standards, agricultural water quality (AWQ) indices, irrigation water quality index (IWQI), and trace metals. Groundwater samples were collected (n = 59) and analysed for EC, pH, major and minor ions and trace metals. According to FAO recommendations, 42% of samples (EC > 3000 µS/cm) are inappropriate for agricultural uses. AWQ indices including salinity hazard, Kelly's ratio and Na% show that 50%, 19% and 37% of samples, respectively, are unsuitable for agricultural uses. USSL classification reveals that groundwater is preferable only for high-permeability soils and salt-tolerant crops. IWQI suggests that 88% of samples are moderately usable for agriculture. The interrelationship between water salinity and crop yield justified that 73%, 59%, 51% and 25% of samples are desirable to yield 90% in date palm trees, sorghum, rice and citrus fruits, respectively. Groundwater is appropriate for date palm trees except in downstream regions. Boron concentration suggests that 52%, 81% and 92% of samples are suitable for sensitive, semi-tolerant and tolerant crops, respectively. Groundwater in the central part (suitable for sensitive crops), central and upstream regions (semi-tolerant crops) and all regions except downstream (tolerant crops) are suitable for cultivation. Trace metals contents illustrate that 36%, 34%, 22%, 8%, 5% and 100% of samples are inappropriate for agriculture due to high concentrations of Cr, Cu, Ni, V, Mn and Mo, respectively in the groundwater. Further, AWQ indices, IWQI, USSL classifications and trace metals ensure that groundwater in the downstream, and a few pockets in the upstream are unfit for agricultural uses. This study recommends that groundwater in this basin is more suitable for tolerant crops (ie. date palm, sorghum) followed by semi-tolerant and sensitive crops., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)