Human CA 242

Few data are available regarding hypoxic hepatitis (HH) and acute liver failure (ALF) in patients resuscitated from cardiac arrest (CA). The aim of this study was to describe the occurrence of these complications and their association with outcome. All adult patients admitted to the Department of Intensive Care following CA were considered for inclusion in this retrospective study. Exclusion criteria were early death (<24 hours) or missing biological data. We retrieved data concerning CA characteristics and markers of liver function. ALF was defined as a bilirubin >1.2 mg/dL and an international normalized ratio >= 1.5. HH was defined as an aminotransferase level >1000 IU/L. Neurological outcome was assessed at 3 months and an unfavourable neurological outcome was defined as a Cerebral Performance Categories (CPC) score of 3-5. A total of 374 patients (age 62 [52-74] years; 242 male) were included. ALF developed in 208 patients (56%) and HH in 27 (7%); 24 patients developed both conditions. Patients with HH had higher mortality (89% vs. 51% vs. 45%, respectively) and greater rates of unfavourable neurological outcome (93% vs. 60% vs. 59%, respectively) compared to those with ALF without HH (n = 184) and those without ALF or HH (n = 163; p = 0.03). Unwitnessed arrest, non-shockable initial rhythm, lack of bystander cardiopulmonary resuscitation, high adrenaline doses and the development of acute kidney injury were independent predictors of unfavourable neurological outcome; HH (OR: 16.276 [95% Cls: 2.625-81.345; p = 0.003), but not ALF, was also a significant risk-factor for unfavourable outcome. Although ALF occurs frequently after CA, HH is a rare complication. Only HH is significantly associated with poor neurological outcome in this setting.

At "Debiensko" Desalination Plant salt crystallizer is supplied with untreated brine concentrated by RCC evaporation method that results in high energy consumption and huge amount of post-crystallization lye. Nanofiltration pre-treatment of coal-mine brine was then considered to improve plant outcome. Desal-5L (Osmonics) nanofiltration membrane was found to be suitable for the above purpose. The rejection coefficients were found as follows (%): Ca2+ - 68.8, Mg2+ -71.6, SO42- - 98.0, Cl- - 11.9, that lets us to estimate the composition of NF permeate at 85% recovery to be as follows (g/L)follows (g/L): Ca2+ - 0.242, Mg2+ -0.188, SO42-- 0.064, Cl- - 32.2. The performance of crystallization step was then estimated based on chemical composition of NF permeate and compared with operational data from "Debiensko" Desalination Plant. The energetic efficiency of the presently operated coal mine brine treatment system was compared with the one involving NF softening as the pretreatment for low energy VC thermal desalination in place of seeded VC (RCC presently applied). This comparison shows that unit energy consumption decreases from ca 970 kWh per 1 t of evaporated salt for untreated brine concentrated by RCC method to ca 450 kWh/t when low energy VC evaporation is applied. At the same time the amount of salt in post-crystallization lye decreases from approx. 110 kg per 1 t of evaporated salt produced to ca 50 kg.