Journal of clinical monitoring
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In this study, we evaluated the usefulness of end-tidal oxygen monitoring during intratracheal jet ventilation (ITJV) for endolaryngeal laser surgery. ⋯ ETO2 concentration should be maintained well over 21% during ITJV to prevent alveolar and arterial hypoxia. Monitoring of respiratory oxygen concentrations at jet cycle rates of 20 cycles/min and less verifies safe oxygen levels during laser surgery, and confirms adequate alveolar oxygenation.
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Respiratory monitoring, using a novel flow sensor based on an acoustic principle, has been investigated in 30 patients during postoperative analgesia. Each patient was subjected to monitoring and human observation for 8 hr. The study was performed by independent observers at three clinics. ⋯ More than 800 apnea alarms were noted, using an alarm setting of 30 sec; 61% of the categorized alarms were noted by the observers as true apneas. From the recordings it was shown that the number of alarms can be reduced by a factor of four if the alarm setting is changed to 45 sec. We conclude that the suggested technique, with slight modifications, provides adequate respiratory monitoring of patients during postoperative analgesia.
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Our objective was to determine if rebreathing would reduce the gradient between arterial and end-tidal CO2 tension during positive-pressure ventilation. ⋯ Rebreathing with a Mapleson D circuit and a VF equal to VA permitted normal CO2 elimination. Arterial PCO2 to PECO2 gradient decreased significantly during rebreathing, thus improving the reliability of capnography for estimating arterial PCO2. Consideration should be given to using the Mapleson D as a rebreathing circuit.