Journal of clinical monitoring and computing
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J Clin Monit Comput · May 1998
Nocturnal body movements and hypoxemia in middle-aged females after lower abdominal surgery under general anesthesia: a study with the static-charge-sensitive bed (SCSB).
The aim of this study was to evaluate the feasibility of the static-charge-sensitive-bed (SCSB) combined with pulse oximetry (SpO2) for postoperative monitoring and to determine variables which could be used for evaluating the quality of postoperative sleep and breathing. ⋯ Postoperative periodic movement activity was suppressed, but sleep remained fragmented with frequent body movements. In our middle-aged non-obese females (ASA I-II), no severe postoperative hypoxemia was observed during the three-nights postoperative survey. Perioperative movement monitoring with the SCSB was a valuable tool in rejecting movement artefacts of SpO2 and in evaluating general sleep quality.
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J Clin Monit Comput · May 1998
Performance of a plastic optical fiber stylet for tracheal intubation of a dog.
We set out to establish whether a novel plastic optical fiber incorporated into an endotracheal tube (ETT) stylet could be used for intubation of a dog. A secondary objective examined the need for a direct illumination source from a laryngoscope. Lastly, the fragility of the system was tested. ⋯ A novel plastic optical fiber incorporated into an ETT stylet can be used with a laryngoscope for intubation of a dog. Direct illumination from a laryngoscope provides a better television monitor image than when only ambient light is used. The system was durable, withstanding over 20 uses and 40 sharp bend-and-straighten cycles before a lens separation failure occurred.
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We have previously shown in a mechanical lung model [1] that bronchial flap-valve expiratory obstruction results in sequential lung expiration, best detected by prolonged and low magnitude tracheal expired flow (V) from the obstructed lung. However, the normal expiratory resistance of clinical ventilation circuits might also generate prolonged, low value exhaled V, that could be confused with bronchial flap-valve obstruction. We reasoned that bronchial flap-valve obstruction would also cause sequential CO2 unloading from each lung and result in a biphasic tracheal capnogram. ⋯ During moderate or severe left bronchial flap-valve obstruction, left bronchial V was delayed so that the left lung anatomical dead space (devoid of CO2) mixed with normal right exhalate to depress the expiratory upstroke or early plateau of the tracheal capnogram. During severe obstruction, decreased perfusion of the left lung caused lower alveolar PCO2. Then, prolonged low V from the left bronchus also resulted in depression of the end of the tracheal alveolar plateau. In general, the low magnitude of bronchial V from the obstructed lung limited its effect on the tracheal capnogram and the best marker of sequential lung emptying during bronchial flap-valve obstruction may be late exhaled V without reduction in total tidal volume.
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J Clin Monit Comput · May 1998
Functional residual capacity measurement during tracheal gas insufflation.
Tracheal gas insufflation (TGI) is considered an adjunctive method to enhance carbon dioxide elimination during permissive hypercapnia in patients with acute respiratory distress syndrome. Due to increasing tidal volume and/or expiratory resistance, TGI may cause intrinsic PEEP (PEEPi), and may lessen the advantages of permissive hypercapnia. There is no reliable method to measure PEEPi during TGI. Using an argon washout method to evaluate dynamic hyperinflation, we developed a method to measure FRC with TGI flow. ⋯ The system developed in this study can be used as a method to detect air-trapping during TGI.