Journal of clinical monitoring and computing
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J Clin Monit Comput · Jan 2000
Discriminating between the effect of shunt and reduced VA/Q on arterial oxygen saturation is particularly useful in clinical practice.
There is an extensive literature on methods for discriminating between an increased shunt and a reduced ratio of ventilation to perfusion. In this review we prefer the terms "VA/Q" and "reduced or low VA/Q" rather than "V/Q inequality" to refer to the effects on arterial oxygenation of reducing V/Q below 0.8 to about 0.1. ⋯ However this review shows that, while an increased shunt and a decreased VA/Q both reduce arterial oxygen saturation (SaO2) at a particular inspired oxygen concentration (PIO2), the effect of shunt and reduced VA/Q have important clinical differences on the relationship between PIO2 and SaO2. The review also outlines a simple non-invasive method for measuring shunt and reduced VA/Q which illustrates the value of discriminating between them in clinical practice.
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We sought to improve the realism of our patient simulation environment by developing a simulation of the arterial-line monitoring system. Properties of the system we wished to depict were: electro-mechanical delay between ECG and radial artery pressure, beat to beat amplitude variability and respiratory variation, realistic looking pulse pressure in hypertensive and hypotensive states, a functional link to the stopcock and transducer flush, and filtering characteristics of the measurement system. ⋯ The realism of scenarios using the patient simulator is enhanced by having the arterial-line monitoring system more accurately simulated.