Journal of clinical monitoring and computing
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J Clin Monit Comput · Apr 2009
Evaluation of a computerized system for mechanical ventilation of infants.
To evaluate a computerized system for mechanical ventilation of infants. ⋯ A computerized system for mechanical ventilation is evaluated for treatment of infants. The results of the study show that the system has good potential for use in neonatal ventilatory care. Further refinements can be made in the system for very low-birth-weight infants.
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J Clin Monit Comput · Apr 2009
Comparative StudyFlow-through versus sidestream capnometry for detection of end tidal carbon dioxide in the sedated patient.
End tidal carbon dioxide (ETCO(2)) in non-intubated patients can be monitored using either sidestream or flow-through capnometry [Yamamori et al., J Clin Monit Comput 22(3):209-220, 2008]. The hypothesis of this validation study is that, flow-through capnometry will yield a more accurate estimate of ETCO(2) than sidestream capnometry when evaluated in a bench study during low tidal volumes and high oxygen administration via nasal cannula. Secondarily, when ETCO(2) from each is compared to arterial CO(2) (PaCO(2)) during a study in which healthy, non-intubated volunteers are tested under normocapnic, hypocapnic and hypercapnic conditions, the flow-through capnometer will resemble PaCO(2) more closely than the sidestream capnometer. This will be especially true during periods of lower minute ventilation and high oxygen flow rates via mask in non-intubated, remifentanil sedated, healthy volunteers whose physiologic deadspace is small. ⋯ Within a wide limit of agreement between the volunteer and bench study, flow-through and sidestream capnometry performed equally well during bench testing and in non-intubated, sedated patients.
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J Clin Monit Comput · Apr 2009
Hypotension after spinal anesthesia for cesarean section: identification of risk factors using an anesthesia information management system.
To determine risk factors for developing hypotension after spinal anesthesia for cesarean section to prevent obstetric patients from hypotensive episodes potentially resulting in intrauterine malperfusion and endangering the child. ⋯ Knowledge of these risk factors should increase the anesthesiologist's attention to decide for the necessity to employ prophylactic or therapeutic techniques or drugs to prevent the neonate from any risk resulting of hypotension of the mother.
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J Clin Monit Comput · Feb 2009
Case ReportsEarly non invasive detection of hypercarbia in two cardiac surgical patients.
The availability of transcutaneous monitors has provided a means of non invasive assessment of CO(2) tension and a trend of the ventilation status commonly in infants and neonates. The authors describe two cases of hypercapnia diagnosed early in adults by the non invasive transcutaneous measurement of carbon dioxide (tcpCO(2)) using TINA TCM4 in postoperative cardiac surgical patients who were mechanically ventilated. Curiously, this increase in tcpCO(2) levels was associated with a false increase in the tcpO(2) values though no changes in the ventilatory parameters to increase oxygenation were made. The probable mechanism of the increase in tcpO(2) levels with hypercarbia is discussed.
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J Clin Monit Comput · Feb 2009
Technical performance and reflection capacity of the anaesthetic conserving device--a bench study with isoflurane and sevoflurane.
The anaesthetic conserving device (AnaConDa), Sedana Medical, Sundbyberg, Sweden) facilitates administration of isoflurane or sevoflurane by liquid infusion. An anaesthetic reflector inside the device conserves exhaled anaesthetic and re-supplies it during inspiration. In this bench study, we examined the influence of infusion rates and ventilatory settings on the resulting anaesthetic concentrations on patient (C(pat)) and ventilator side of the reflector (C(loss)) to describe its technical performance. ⋯ The triple product minute volume times R(C) times C(pat) describes anaesthetic losses through the reflector. It can easily be calculated as long as the 10 ml reflection capacity is not exceeded and thus R(C) is constant. Increased minute ventilation necessitates increasing the IR to keep C(pat) constant. When using large V(T) and high C(pat) "spill over" occurs. This effect offers some protection against an inadvertent overdose.