Journal of clinical monitoring and computing
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J Clin Monit Comput · Jul 1999
Lithium dilution cardiac output measurements using a peripheral injection site comparison with central injection technique and thermodilution.
The lithium dilution technique for the measurement of cardiac output by the central injection of lithium chloride was introduced by Linton et al. in 1993. In the present report, we compare lithium dilution cardiac output measurement (LD) by the peripheral injection of lithium chloride (pLD) and by central venous injection (cLD), cardiac output determined by electromagnetic flowmetry (EM), and conventional thermodilution cardiac output measurement (TD) on ten swine. ⋯ The results of the present study indicate that pLD is a reliable technique.
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J Clin Monit Comput · Jul 1999
Predicted sevoflurane partial pressure in the brain with an uptake and distribution model comparison with the measured value in internal jugular vein blood.
In order to predict the partial pressure of volatile anesthetics in brain tissue, we developed a pharmacokinetic simulation model suitable for real time application. The accuracy of this model was examined by comparing the predicted values against measured values for blood sampled from the internal jugular vein, which was used as a measure of the partial pressure in the brain. ⋯ We conclude that our model is clinically useful for predicting sevoflurane partial pressure in the brain, assuming that Pj(S) reflects the sevoflurane partial pressure in the brain.
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J Clin Monit Comput · Jul 1999
Evaluation of a new fibre-optical monitor for respiratory rate monitoring.
To present further development of a fibre-optical respiratory rate monitor and evaluate the function in the final version. ⋯ The fibre-optical monitor has sufficient accuracy for clinical monitoring. It is easy to use and inexpensive. Combinations with pulse oximetry seem attractive, to use especially for application outside "high tech areas," for example when respiratory depressant drugs are used or in ambulances.
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The increasing focus on health care costs requires that all physicians evaluate practice behaviors. The primary emphasis in anesthesia has been limiting the use of expensive medications and interventions. Reducing waste is another approach, and volatile anesthetics are an appropriate target in that simple reduction of fresh gas-flow (FGF) rates is effective. A monitor that measures and displays the cost of wasted volatile anesthetic was developed and used to determine if real-time display of the cost would result in decreased FGF rates, which, in turn, would decrease wasted anesthetic. ⋯ Nine residents were initially enrolled, but due to scheduling difficulties only five residents completed the protocol. Data from cases using the WGM demonstrated a 50% decrease (3.58 +/- 1.34 l/min vs. 1.78 +/- 0.51 l/min (p = 0.009)) in the scavenger flow rates, which resulted in a 48% ($5.28 +/- 0.68 vs. $2.72 +/- 0.80 (p = 0.002)) decrease in hourly cost of wasted volatile anesthetic. There was no difference between the Baseline and Visible phases with regard to use of nitrous oxide or intravenous anesthetic agents. CONCLUSIONS. The WGM decreased wasted volatile anesthetic by encouraging decreased FGF rates.