Journal of clinical monitoring and computing
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Identification of humoral markers of acute lung injury may lead to insights into pathologic mechanisms. In addition, specific markers may be useful for predicting development of acute respiratory distress syndrome (ARDS) or for assessing prognosis. Ultimately, studies of lung injury markers may help define interventions that prevent or moderate ARDS. ⋯ Surfactant apoproteins may be important markers of injury or for prognosis. Levels of surfactant apoprotein A (SP-A) fall 50-75% in patients with severe lung injury compared to normal patients. Serum levels of SP-A in patients dying of acute respiratory distress syndrome are double serum levels of survivors.
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Pulmonary air embolism is a well-known consequence of surgery, trauma, diving, and aviation. This article reviews the physiological effects, means of detection and methods of prevention and treatment of pulmonary air embolism. The primary physiological effects are elevated pulmonary artery pressures, increased ventilation-perfusion inhomogeneity, and right ventricular failure. ⋯ Prevention measures include volume expansion, careful positioning, positive end-expiratory pressure, military anti-shock trousers, and jugular venous compression. Treatment of pulmonary air embolism includes flooding the surgical site with saline, controlling sites of air entry, repositioning the patient with the surgical site below the right atrium, aspiration of air from a central venous catheter, cessation of inhaled nitrous oxide, and resuscitation with oxygen, intravenous fluids, and inotropic agents. Some hypotheses on the effects of air in the pulmonary vasculature and investigational treatment options are discussed.
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J Clin Monit Comput · Jan 2000
Biography Historical Article Classical ArticleFoundations of anesthesiology. An account of some hydraulic and hydrostatical experiments made on the blood and blood-vessels of animals. 1710 [classical article].
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J Clin Monit Comput · Jan 2000
Clinical TrialAccuracy of capnography with a 30 foot nasal cannula for monitoring respiratory rate and end-tidal CO2 in children.
We tested the accuracy of a low flow (50 cc/min) sidestream capnography system equipped with an experimental 30-foot nasal cannula to monitor ventilatory status in children. End-tidal CO2 and respiratory rate, both at room air and in the presence of supplemental oxygen, were recorded simultaneously from the experimental 30-foot nasal cannula and the standard, FDA approved, 10-foot nasal cannula. The 30-foot nasal cannula was as accurate as the 10-foot nasal cannula in measuring respiratory rate and end-tidal CO2 in children. When supplemental oxygen was delivered by face-mask, there was no dilutional effect on the respiratory rate or end-tidal CO2 recorded with either the 10-foot or 30-foot nasal cannulas in place.
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J Clin Monit Comput · Jan 2000
Clinical TrialSonic vibrational analysis provides continuous measurement of arterial properties.
We describe a new technology for measuring artery mechanical properties, called Sonic Vibrational Analysis (SVA). We utilize SVA to study the changes in radial artery smooth muscle tone caused by intravenous infusion of vasoactive agents. ⋯ The current results are consistent with previous studies of the effects of vasoactive agents on the radial artery. SVA is non-invasive, continuous, localized to a well-defined section of artery, and suitable for the collection of large volumes of time-resolved data in a laboratory or clinical setting.