Journal of clinical monitoring and computing
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The measurement of exhaled pulmonary nitric oxide concentrations requires that contamination from the upper respiratory tract and inhaled gases be eliminated. This can be achieved with no risk in the clinical setting of intubated patients of all ages in the operating room or intensive care unit. Further modifications of the anesthetic/ventilatory circuit allow for accurate determination of tidal volume and minute ventilation.
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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.