International journal of clinical monitoring and computing
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Int J Clin Monit Comput · Jan 1984
Case ReportsPractical aspects of differential ventilation with selective peep in acute respiratory failure.
Hypoxaemia in association with acute respiratory failure continues to be a severe problem in some intensive care patients. Among strategies proposed, we want to focus attention on differential ventilation with selective PEEP, administered in the lateral position. ⋯ The rationale of this concept is briefly presented in this paper, where the main emphasis is laid on the practical aspects of its clinical application. Two case reports are included as examples of our experiences.
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A review of the literature and of our recent data (obtained by computer-based analysis of multiple inert gas elimination) re-emphasizes the significant gas exchange disturbances found to occur during general anesthesia which develop for probably several reasons. In this report we suggest firstly that the reduction in functional residual capacity (FRC) may well be an effect of anesthesia just as is abnormal gas exchange. In other words, the reduction in FRC is not per se the cause of gas exchange disturbances, but rather occurs alongside them. ⋯ Such factors include altered hypoxic vasoconstriction, a change in airway secretions and clearance of those secretions, changes in bronchomotor tone, changes in surfactant activity, and alveolar volume loss due to rapid uptake of soluble anesthetic gases like nitrous oxide. To qualitatively and quantitatively distinguish amongst these various potential factors will require experimental protocols and techniques of a highly controlled and accurate nature. That in 1983 we still do not understand the basic mechanisms behind abnormal gas exchange during anesthesia attests to the difficulty of mounting such an experiment.
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A data base system has been designed at the pediatric intensive care unit of St. Görans Hospital in Stockholm. Information on all cases treated during 1982 was retrieved, including information from another file containing data on inpatient stays in the county of Stockholm. ⋯ High mortality and long hospitalization after discharge from the ICU was seen in cases with neurological complications. All information was retrieved interactively from a display terminal at the department. This could be done at any hour of the day.
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Int J Clin Monit Comput · Jan 1984
Computer application for respiratory data processing in closed circuit anesthesia.
A computerized respiratory monitor system for closed circuit anesthesia is described. The system consists of a mass spectrometer, a hot-wire respiratory flow meter, a microcomputer, a central display and a recorder. Respiratory parameters obtained by the computerized system include O2 consumption, carbon dioxide production, expiratory minute volume and respiratory rate. ⋯ Closed circuit anesthesia is being used with increasing frequency in recent years. The patient's condition must be monitored continuously during the closed circuit anesthesia to maintain optimal depth of anesthesia and to prevent hypoxia or hypercarbia; however, monitoring of the respiratory gas exchange is difficult. We have developed a computerized respiratory monitor system for the closed circuit anesthesia.