Biomedizinische Technik. Biomedical engineering
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Comparative Study
The Narcotrend Index: classification algorithm, correlation with propofol effect-site concentrations, and comparison with spectral parameters.
A reliable assessment of the depth of hypnosis during sedation and general anaesthesia using the EEG is a subject of current interest. The Narcotrend Index implemented in the latest version 4.0 of the EEG monitor Narcotrend provides an automatic classification of the EEG on a scale ranging from 100 (awake) to 0 (very deep hypnosis, EEG suppression). The classification algorithms implemented in the EEG monitor Narcotrend are described. ⋯ The Narcotrend Index had the highest average correlation with the propofol effect-site concentration and the smallest variability of the individual correlation values. Moreover, the Narcotrend Index was the only parameter which showed a monophasic trend over the whole investigated time period. The Narcotrend monitor can make a significant contribution to the improvement of the quality of anaesthesia by adjusting the dosage of hypnotics to individual patient needs.
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Comparative Study
Comparative study of the thermal properties of mud and peat solutions applied in clinical practice.
Different peloids as e.g. mud and peat have been traditionally used for therapeutic purposes successfully, especially of there thermal actions. It was the aim of the experimental study to compare the thermal properties of two peloids, mud and peat, with a view to assessing their thermal effects when they are applied in clinical practice. ⋯ The comparative studies of the thermal properties of water and water solutions of peat and curative mud show that the thermal effect of the water bath is substantially smaller than that of the peat and mud applications. This difference is due to a greater extent to the high values of the dynamic viscosity, not allowing cooling by convection and protecting the surface of the skin upon applications of peloid solutions with a higher temperature.
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Whole-body cooling can be used in the treatment of various brain pathologies, for example, after hypoxic events. Potential complications include haemodynamic instability, coagulation disorders and infection. Selective brain cooling (SBC) would therefore appear to make good sense. ⋯ Under SBC the cortical temperature dropped from 38.4 degrees C to 27.7 degrees C while the core temperature remained stable. In an animal model SBC was successfully accomplished via the pharynx. Further studies should now be done to evaluate the effectiveness of this approach in larger animals with potentially different anatomical features.
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Comparative Study
[Bispectral analysis does not differentiate between anaesthesia EEG and a linear random process].
Bispectral analysis of the electroencephalogram (EEG) has been used to monitor depth of anaesthesia. In the majority of publications this has involved the use of the so called BIS-Index TM (Aspect Medical Systems, Inc.). The exact relationship of this index to such bispectral parameters as the bispectrum and bicoherence has not yet been reported. ⋯ The percentage of epochs (8.192 s, 1024 data points) with non-trivial bicoherence was: Lorenz data 95.4%, phase randomized Lorenz data 9.4%, synthetic Gaussian data 14.8%, original EEG 9.1%, phase randomized EEG 5.1%. The original EEG data were not found to contain a higher percentage of epochs with non-trivial bicoherence than the phase randomized data and the synthetic Gaussian data. We conclude that bispectral analysis does not substantially add to the information obtained with other methods of quantitative EEG analysis.
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Comparative Study
[Method for measuring respiration in sleep: capnography for determining ventilation].
Ventilation serves the exchange of gases between the organism and the environment. Oxygen uptake and CO2 elimination are controlled by feedback loops, that keep fluctuations in arterial CO2 pressure (PaCO2) within narrow limits Disorders in the central regulation of breathing, or impairment of the respiratory apparatus, may result in a mismatch between metabolic CO2 production and ventilatory CO2, elimination and thus in fluctuations in the PaCO2: inappropriately increased ventilation (hyperventilation) causes hypocapnia, and reduced ventilation (hypoventilation) causes hypercapnia. In order to detect such disorders during sleep, PCO2 measurement is of great importance, but direct and continuous measurement of the PaCO2 is invasive and thus unsuitable in the clinical setting. ⋯ Thus 46% of the variation in PETCO2 was explained by changes in PaCO2. Currently the literature contains few further data on capnography during sleep. It is concluded that, provided the limitations of the method are respected and comparison with the PETCO2 is made, capnography may be a useful, noninvasive and continuous measuring method for assessing ventilation during sleep in patients with suspected sleep related breathing disorders.