Methods: Septic patient with hyperlactatemia and metabolic acidosis were randomized to receive either high SID fl uid or Hartmann's solution during initial fl uid resuscitation. The primary outcome measures the pH and bicarbonate levels difference pre- and post- resuscitation.
Results: One hundred and sixty-two patients underwent randomization, 81 were assigned each to receive high SID fluid or Hartmann's solution. Both groups had similar baseline characteristics. High SID group received 23.5 mL/kg and the Hartmann's group received 22.7 mL/kg (p = 0.360). High SID fluid increased the mean (± SD) pH by 0.107 (± 0.09) vs. Hartmann's solution by 0.014 (± 0.12), p ≤ 0.001. Mean bicarbonate level increased signifi cantly in high SID group compared to Hartmann's (4.30 ± 3.76 vs. 1.25 ± 3.33, p ≤ 0.001). High SID group had higher post resuscitation lactate clearance than Hartmann's group (25.4 ± 28.3% vs. 12.0 ± 34.1%, p = 0.009). Shorter hospital stay was observed in highSID group 8.04 ± 5.96 days vs. Hartmann's group 12.18 ± 12.41 days (p = 0.048). Both groups showed no difference in incidence of pulmonary oedema, acute kidney injury and mortality.
Conclusions: Initial resuscitation using high SID fluid in selected septic patient improves pH and bicarbonate levels. The high SID group had better post resuscitation lactate clearance and shorter hospital stay.
METHODS: the potential of developing natural disinfectant while using watermelon rinds (WR), pineapple (PP), orange peels (OP), palm kernel cake (PKC), and rice bran (RB), via lacto-fermentation was investigated. The obtained lactic acid bacteria (LAB) metabolites were then employed and the in vitro antifungal activity toward five spoilage fungi of mango was tested through liquid and solid systems. Besides, the effect of the produced disinfectant on the fungal growth inhibition and quality of mango was investigated.
RESULTS: the strains Lactobacillus plantarum ATCC8014 and Lactobacillus fermentum ATCC9338 growing in the substrates PKC and PP exhibited significantly higher in vitro antifungal activity against Colletotrichum gloeosporioides and Botryodiplodia theobromae as compared to other tested LAB strains and substrates. The in-situ results demonstrated that mango samples that were treated with the disinfectant produced from PKC fermented with L. plantarum and L. fermentum had the lowest disease incidence and disease severity index after 16 days shelf life, as well as the lowest conidial concentration. Furthermore, PKC that was fermented by L. fermentum highly maintained the quality of the mango.
CONCLUSIONS: lactic acid fermentation of PKC by L. fermentum demonstrated a high potential for use as a natural disinfectant to control C. gloeosporioides and B. theobromae on mango.