Acta anaesthesiologica Belgica
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The use of computers in the practice of anesthesiology appears to be very promising--therefore the time has come to reflect on ways to utilize the possibilities of computers in this field. The anesthesiologist is faced with an existing "medical information science" and system developments and must now address these questions: How do computers fit in these systems? What is the kind of support and help one can expect from the use of computers? Next one attempts to define the needs for computer support, taking into account the specific working conditions of various anesthesia teams. A description is made of how a system for medical information is automatized--and by way of an example--how such a computer system for anesthesiologists is linked to a larger regional facility. Advantages and disadvantages of such a system are discussed.
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Acta Anaesthesiol Belg · Jan 1984
Case ReportsThoracic epidural analgesia in the treatment of rib fractures.
Rib fractures and flail chest could be fatal if gas exchange is impaired. Efficient pain relief with continuous thoracic epidural analgesia allows a good physiotherapy management without central sedation and impairment of cough reflex, this prevents pulmonary atelectasis and infection. Eighteen patients/19 were treated with success in spite of flail chest, chronic obstructive pulmonary disease and minor pulmonary contusion. Intermittent positive pressure ventilation must be reserved to severe pulmonary contusion and other crushing injuries of the chest as bronchial or great vessels ruptures.
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Acta Anaesthesiol Belg · Jan 1984
Real time mathematical analysis of instantaneous respiratory signals at the bedside by a multiprocessor system (PAMS).
The authors address the following problems: How to turn a mass spectrometer, or a set of individual gas sensors, into a real and useful medical instrument? In other words, how to transform the instantaneous gas composition signals into meaningful physiological variables? The parameters that can be computed breath by breath from the real time processing of gas concentration signals, combined with flow and pressure signals at the mouth are first described. Particularly, we point out the theoretical and practical importance of alveolo-capillary gas exchange parameters, as opposed to gas exchange parameters estimated at the mouth level: A-c exchange parameters are a more sensitive and more specific indicator of any physiological change and they are less sensitive to breath by breath fluctuations of ventilation. We discuss the clinical usefulness of breath by breath computations, as a more sensitive way to monitor the patient as well as the anesthesia circuit, and to generate all the information required for on line analysis of functional tests. ⋯ Based on three microprocessors it takes over the calibration, the offset correction of each signal ... It also corrects for the dynamics of each sensor and resynchronizes all the signals. It computes breath by breath more than 50 physiological variables that can be either recorded analogically, either printed, either acquired by a general monitoring system of the patient, which then combines respiratory data with other physiological. therapeutical and medical data from the patient.
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Acta Anaesthesiol Belg · Jan 1984
Pediatric regional anesthesia. Its use in the pre-, per- and postoperative period.
Accidents in children can occur at any moment of the day. A child has rarely an empty stomach and it is very difficult to determine when he ate or drank for the last time. The stress of the accident can slow the digestion and even stop completely. ⋯ Pain and anxiety often present with anatomical deformation may be the cause of panic that should be promptly appeased. For these reasons, there has been an increase in interest in the use of nerve block techniques in children as has been the case in adults. We carry on Brachial Plexus Blocks and Epidural Blocks.