IntroductionThe study was designed to assess the impact of fluid loading on lung aeration, oxygenation and hemodynamics in patients with septic shock and acute respiratory distress syndrome (ARDS).MethodsDuring a 1-year period, a prospective observational study was performed in 32 patients with septic shock and ARDS. Cardiorespiratory parameters were measured using Swan Ganz (n = 29) or PiCCO catheters (n = 3). Lung aeration and regional pulmonary blood flows were measured using bedside transthoracic ultrasound. Measurements were performed before (T0), at the end of volume expansion (T1) and 40 minutes later (T2), consisting of 1-L of saline over 30 minutes during the first 48 h following onset of septic shock and ARDS.ResultsLung ultrasound score increased by 23% at T2, from 13 at baseline to 16 (P < 0.001). Cardiac index and cardiac filling pressures increased significantly at T1 (P < 0.001) and returned to control values at T2. The increase in lung ultrasound score was statistically correlated with fluid loading-induced increase in cardiac index and was not associated with increase in pulmonary shunt or regional pulmonary blood flow. At T1, PaO2/FiO2 significantly increased (P < 0.005) from 144 (123 to 198) to 165 (128 to 226) and returned to control values at T2, whereas lung ultrasound score continued to increase.ConclusionsEarly fluid loading transitorily improves hemodynamics and oxygenation and worsens lung aeration. Aeration changes can be detected at the bedside by transthoracic lung ultrasound, which may serve as a safeguard against excessive fluid loading.

In the present study, we examined the potential role of paclobutrazol in delaying leaf senescence, in causing changes in the activities of antioxidants, and in the maintenance of photosynthetic activity during the senescence process, and, therefore, on the grain yield of maize under semiarid field conditions. Maize seeds were pretreated with 0 (CK), 200 (PS1), 300 (PS2), and 400 (PS3) mg paclobutrazol L−1. Our results indicated that elevated levels of reactive oxygen species (ROS) and higher accumulation of malondialdehyde (MDA) contents were positively associated with accelerated leaf senescence during the grain-filling periods. The leaf senescence resulted in the disintegration of the photosynthetic pigments and reduced the net photosynthetic rate after silking. However, the resultant ROS burst (O2− and H2O2) was lessened and the leaf senescence and chlorophyll degradation were evidently inhibited in leaves of paclobutrazol-treated maize plants, which was strongly linked with upregulated activities of antioxidant enzymes in treated plants. The enhanced chlorophyll contents and availability of a greater photosynthetic active green leaf area during the grain filling period facilitated the maintenance of higher photosynthetic rate, and light-harvesting efficiency of photosynthesis associated with photosystem II (PSII) resulted in higher kernel number ear−1 and thousand kernel weights, and thus increased the final grain yield. The average maize grain yield was increased by 18.8% to 55.6% in paclobutrazol treatments, compared to untreated control. Among the various paclobutrazol treatments, PS2 (300 mg L−1) treatment showed the most promising effects on enhancing the activities of antioxidative enzymes, delaying leaf senescence and improving the yield of maize. Thus, understanding this effect of paclobutrazol on delaying leaf senescence introduces new possibilities for facilitating yield improvement of maize under semiarid conditions.

No abstract