Annals of biomedical engineering
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It is proposed that the maximum in cuff pressure oscillations during oscillometry is due to the buckling of the brachial artery under a cuff. This theory is investigated by means of a mathematical model of oscillatometry that includes the mechanics of the occlusive arm cuff, the arterial pressure pulse waveform, and the mechanics of the brachial artery. A numerical solution is provided for the oscillations in cuff pressure for one cycle of cuff inflation and deflation. ⋯ These findings support the case that the model is representative of oscillometry. Finally, the model predicted values for the systolic and diastolic detection ratios of 0.593 and 0.717, respectively, similar to those found empirically. These ratios alter with blood pressure, but the tightness of the cuff wrap did not change their value.
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Results from primate studies show a transient increase in intracranial pressure (ICP) after a nonimpact inertial loading condition. The measured ICP increase varies linearly with the peak tangential load of these experiments. These experiments point to possible alterations in cerebral blood flow. ⋯ The model combines the effects of cerebral venous constriction, arterial dilatation, and raised mean blood pressure to yield the characteristic immediate rise and exponential decay of ICP. The main contributor to the increase in intracranial pressure is believed to be vasodilation of cerebral arteries following venous constriction. Passive release of cerebrospinal fluid (CSF) is believed to mediate the long-term decay of intracranial pressure and possibly contribute to local hyperemia.
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Hoffmann half-frame external fixation device configurations often fail under minimal loads secondary to joint slippage. In these experiments improved universal joints that were developed in an earlier study were tested on Hoffmann half-frame assemblies. ⋯ No changes in overall rigidity were noted, but significant increases in yield loads and loads to frame failure were achieved. Such improvements will increase the reliability and usefulness of the Hoffmann device to the orthopaedic community.
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A totally self-contained instrument for the measurement of cardiac output is described. The microcomputer controlled instrument is based upon the principles of thermodilution and is capable of making cardiac output determinations on a minute by minute basis. ⋯ The accuracy and reproducibility of flow determinations made with the system compare favorably with those made with a conventional cardiac output monitor. This study demonstrates the feasibility of a stand-alone cardiac output computer that can provide virtually continuous measurements of blood flow without the intervention of a technician.
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Impedance cardiography has not achieved popularity in the Intensive Care Unit (ICU) to date probably because of the limitations in technique and interpretation associated with the altered physiology of critically ill patients, and also because of interference from other machinery in the ICU. The current climate of questioning the existing technology for bedside cardiovascular assessment however spurs the need to evaluate impedance cardiography as a noninvasive alternative. Validation in noncritically ill patients is good when compared to other technologies (e.g., thermodilution, Fick, dye dilution (r greater than 0.9)). ⋯ This is thought to be a measure of contractility that is independent of preload and afterload. The ultimate test in the ICU for impedance cardiography is whether clinical outcome of critically ill patients is altered by the use of this technology. Such outcome testing is essential before the true value of impedance cardiography in the management of critically ill patients can be determined.