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  • 2000-2004
  • 1995-1999  (2)
  • Functional residual capacity  (1)
  • Key words Anesthesia – pulmonary complication – COPD – asthma  (1)
  • 1
    ISSN: 1432-1238
    Keywords: Key words Aged ; Functional residual capacity ; Lung volume measurement ; Mechanical ventilation ; Critical care ; Chronic obstructive pulmonary disease ; Acute lung injury
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objective: Validation of an open-circuit multibreath nitrogen washout technique (MBNW) for measurement of functional residual capacity (FRC). The accuracy of FRC measurement with and without continuous viscosity correction of mass spectrometer delay time (TD) relative to gas flow signal and the influence of baseline FIO2 was investigated. Design: Laboratory study and measurements in mechanically ventilated patients. Setting: Experimental laboratory and anesthesiological intensive care unit of a university hospital. Patients: 16 postoperative patients with normal pulmonary function (NORM), 8 patients with acute lung injury (ALI) and 6 patients with chronic obstructive pulmonary disease (COPD) were included. Interventions: Change of FIO2 from baseline to 1.0. Measurements and main results: FRC was determined by MBNW using continuous viscosity correction of TD (TDdyn), a constant TD based on the viscosity of a calibration gas mixture (TD0) and a constant TD referring to the mean viscosity between onset and end of MBNW (TDmean). Using TDdyn, the mean deviation between 15 measurements of three different lung model FRCs (FRCmeasured) and absolute volumes (FRCmodel) was 0.2 %. For baseline FIO2 ranging from 0.21 to 0.8, the mean deviation between FRCmeasured and FRCmodel was −0.8 %. However, depending on baseline FIO2, the calculation of FRC using TDmean and TD0 increased the mean deviation between FRCmeasured and FRCmodel to 2–4 % and 8–12 %, respectively. In patients (n = 30) the average repeatability coefficient was 6.0 %. FRC determinations with TDmean and TD0 were 0.8–13.3 % and 4.2–23.9 % (median 2.7 % and 8.7 %) smaller than those calculated with TDdyn. Conclusion: A dynamic viscosity correction of TD improves the accuracy of FRC determinations by MBNW considerably, when gas concentrations are measured in a sidestream. If dynamic TD correction cannot be performed, the use of constant TDmean might be suitable. However, in patient measurements this can cause an FRC underestimation of up to 13 %.
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Springer
    Intensivmedizin und Notfallmedizin 36 (1999), S. S017 
    ISSN: 1435-1420
    Keywords: Key words Anesthesia – pulmonary complication – COPD – asthma ; Schlüsselwörter Anästhesie – pulmonale Komplikationen – COPD – Asthma
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Perioperative pulmonale Komplikationen treten bei Patienten mit vorbestehenden Lungenerkrankungen viel häufiger auf als bei lungengesunden Patienten. Häufigste perioperative respiratorische Komplikationen sind Reduktion der Lungenvolumina, Pneumonie und Bronchospastik. Bei der Identifikation von pulmonalen Risikopatienten stellen Anamnese und klinische Untersuchung die wichtigsten Instrumente dar. Wichtigste pulmonale Risikofaktoren sind chronische Lungenerkrankung, Oberbauch- und Thoraxoperation, Adipositas und Rauchen. Häufigste vorbestehende respiratorische Erkrankungen sind chronisch obstruktive Lungenerkrankungen (COPD und Asthma), während restriktive Lungenerkrankungen eher selten sind. Das Risiko einer pulmonalen Komplikation kann reduziert werden, wenn Genese und Ausprägung der Lungenfunktionsstörung bekannt sind und entweder präoperativ, spätestens aber postoperativ eine adäquate Therapie eingeleitet wird bzw. ein entsprechend geeignetes Anästhesieverfahren und optimale Anästhetika gewählt werden.
    Notes: Summary Patients with pre-existing respiratory diseases have a significantly higher risk for developing perioperative pulmonary complications than patients with healthy lungs. Most common perioperative respiratory complications are reduction of lung volumes, pneumonia, and bronchospasm, which contribute to increased perioperative morbidity and mortality. Patient's history and clinical examination are the most important measures to identify at-risk patients. Important risk factors for perioperative respiratory complications include chronic respiratory diseases, upper abdominal or thoracic surgery, obesity, and cigarette smoking. Most common pre-existing respiratory diseases are chronic obstructive pulmonary disease (COPD) and asthma whereas restrictive lung diseases play a minor role. The incidence of perioperative pulmonary complications can be decreased if the severity of lung function impairment is identified and sufficient measures are implemented either preoperatively or at least postoperatively. This includes the choice of the adequate anesthesia technique as well as the optimal selection of anesthetics.
    Type of Medium: Electronic Resource
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