Physiological measurement
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Physiological measurement · Aug 2005
Clinical Trial Controlled Clinical TrialInfluence of data resolution and interpolation method on assessment of secondary brain insults in neurocritical care.
Continuous monitoring of physiologic vital signs is routine in neurocritical care. However, this patient information is usually only recorded intermittently (most often hourly) in the medical record. It is unclear whether this is sufficient to represent the occurrence of secondary brain insults (SBIs) or whether more frequent data collection will provide more comprehensive information for patient care. ⋯ MR data tended to underestimate the number of total events. 95% limits of agreement were most narrow for trapezoidal interpolation of MR data, but even these limits were fairly broad. Assessment of secondary brain insults is highly dependent on (1) the temporal resolution of the method used to acquire patient data and on (2) the interpolation method if data are acquired intermittently. High frequency data acquisition may be necessary for more precise evaluation of secondary brain injury in neurocritical care.
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Physiological measurement · Aug 2005
Coordinated FA-MS and SIFT-MS analyses of breath following ingestion of D2O and ethanol: total body water, dispersal kinetics and ethanol metabolism.
A coordinated study of the dispersal of water between the various body compartments (stomach and gut, blood stream and tissue) and the similar dispersal kinetics of ethanol and its metabolism has been carried out involving two healthy volunteers using flowing afterglow mass spectrometry, FA-MS, and selected ion flow tube mass spectrometry, SIFT-MS. Thus, using these techniques, the variations of HDO and ethanol in breath, measured in successive single exhalations, were followed in real time after the ingestion of measured quantities of D2O and ethanol in proportion to the body weights of the subjects at the dose rates D2O approximately 0.283 g kg-1, ethanol approximately 0.067 g kg-1. During the FA-MS experimental periods (about 2 h), the dispersion of HDO into the body water and finally its equilibration in the total body water is observed from which total body water for each subject was determined. ⋯ Thus, in one subject 30% and in the other subject 40% of the ingested alcohol is metabolized in the first 20 min following ingestion. The good time resolution allowed by non-invasive breath analysis ensures that the rates of processes such as ethanol metabolism can be accurately measured. Simultaneous measurements of breath acetaldehyde (largely formed via the ethanol metabolism) and acetone were also performed during the SIFT-MS single breath exhalations.
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Physiological measurement · Jun 2005
Compliance and resistance levels and unloading in proportional assist ventilation.
During proportional assist ventilation (PAV), resistive and elastic unloading relieve the work of breathing. Excessive unloading, however, results in resonant oscillations and runaway pressures. Our aim was to determine the appropriate levels of unloading that could be applied to clinical practice. ⋯ When the level of unloading fully compensated for the model's compliance, peak inflating pressures greater than 40 cmH(2)O were delivered; peak pressure limits of 20 cmH(2)O, however, resulted in very short (0.2 s or less) inflation times. High peak pressures were not delivered if the level of elastic unloading used was limited to that which reduced the model's elastance to that of a 'normal lung'. In conclusion, these results suggest that when using PAV, it is important to assess the compliance and resistance of the infant and endotracheal tube, so that levels of unloading that fully compensate for the resistance and compliance levels can be avoided.
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Physiological measurement · Jun 2005
Inertance measurements by jet pulses in ventilated small lungs after perfluorochemical liquid (PFC) applications.
Perfluorochemical liquid (PFC) liquids or aerosols are used for assisted ventilation, drug delivery, lung cancer hyperthermia and pulmonary imaging. The aim of this study was to investigate the effect of PFC liquid on the inertance (I) of the respiratory system in newborn piglets using partial liquid ventilation (PLV) with different volumes of liquid. End-inspiratory (I(in)) and end-expiratory (I(ex)) inertance were measured in 15 ventilated newborn piglets (age < 12 h, mean weight 724 +/- 93 g) by brief flow pulses before and 80 min after PLV using a PFC volume (PF5080, 3 M) of 10 ml kg(-1) (N = 5) or 30 ml kg(-1) (N = 10). ⋯ Measurements of I by jet pulses in intubated small animals are reproducible. PFC increases the respiratory inertance, but the magnitude depends considerably on its spatial distribution which changes during the breathing cycle. Large differences between I(in) and I(ex) are an indicator for liquid in airways or the ETT.
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Physiological measurement · Apr 2005
Comparative StudyMonitoring lung edema using the pacemaker pulse and skin electrodes.
Previous clinical studies have shown that impedance measurements using right ventricular (RV) leads can monitor congestion due to heart failure. We previously reported on a three-fold advantage of bipolar left ventricular (LV) leads, which are near the lung, over RV leads in detecting pulmonary edema with impedance. A combined system of internal and external electrodes is now investigated using computer models, for use with conventional cardiac resynchronization (CRT) systems with unipolar LV leads. ⋯ The computer models suggest that combined internal-external systems can be as sensitive as the totally implanted ones. Lung edema may be monitored at follow up or home for LV paced patients with only two external electrodes. Using very low impedance configurations optimized by computer can greatly maximize the response, with a cost of poor stability.