Applied cardiopulmonary pathophysiology : ACP
-
Appl Cardiopulm Pathophysiol · Jun 1995
ReviewNew developments in perioperative cardiovascular monitoring.
Substantial technological progress has been made recently in the area of perioperative cardiovascular monitoring. Specialized monitoring may be performed for problems identified by preoperative evaluation. New technologies have been developed for monitoring the blood pressure continuously and non-invasively. ⋯ Improved rules for the differentiation of ventricular from supraventricular tachycardia have been developed. Detection of MI has been facilitated by new scintigraphic and enzymatic techniques. In critically ill patients, multi-system monitoring may be required to adequately assess the cardiovascular system.
-
Appl Cardiopulm Pathophysiol · Jan 1995
Experiences with the new inhalational agents in low-flow anesthesia and closed-circuit technique. Monitoring and technical equipment.
During recent years interest has focused on two completely fluorinated ethers, desflurane and sevoflurane, which promise a shorter induction of and emergence from anesthesia. Their physicochemical properties differ from isoflurane, enflurane and halothane, thus requiring new technical equipment and leading to a change in anesthesiological procedures. Low-flow anesthesia with desflurane can be performed, the technical equipment is available, especially vaporizers and gas analyzers. ⋯ Isoflurane, desflurane or sevoflurane needed the same time for wash-in. Wash-out was slower with isoflurane; however, the technical equipment should be adapted to increase the elimination of the new agents. The consumption of desflurane and sevoflurane is effectively reduced by low-flow and closed circuit anesthesia.
-
Appl Cardiopulm Pathophysiol · Jan 1992
Review Historical ArticleLung transplantation: state of the art.
Since the first long term successful single lung transplant in 1983, followed by a successful double lung transplant in 1986, lung transplantation has become established world-wide as an accepted option in the treatment of end-stage respiratory disease of various etiologies. Both procedures carry acceptable morbidity and mortality rates with the actuarial 5 year survivor rate of 80%. Single or double lung transplantation offers many advantages over heart-lung transplantation and is gradually supplanting the latter in most centers with certain exceptions. Differentiating injection from rejection continues to be a major problem but with added experience and new diagnostic tools this obstacle will be overcome.
-
Fiberoptic bronchoscopy has revolutionized the practice of modern pulmonary medicine. It is estimated that as many as 98% of all bronchoscopies are currently performed using the flexible instrument, and most bronchoscopists have never been trained in the technique of rigid bronchoscopy.
-
Reversal of cardiac arrest is contingent on rapid and effective restoration of myocardial blood flow. Thirty years have elapsed since closed-chest cardiopulmonary resuscitation (CPR) was introduced in clinical practice. ⋯ More invasive interventions by which blood flow is restored such as open-chest cardiac massage or extracorporeal circulation are consistently more effective than conventional CPR. Experimentally, both methods restore systemic and myocardial perfusion to viable levels and thereby increase the likelihood of restoring spontaneous circulation even after prolonged cardiac arrest or failure of conventional CPR.