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  • 1990-1994  (2)
  • 1985-1989  (2)
  • 1955-1959
  • Cardiac output  (2)
  • Lung stretch  (2)
  • 1
    Electronic Resource
    Electronic Resource
    Springer
    Intensive care medicine 12 (1986), S. 71-79 
    ISSN: 1432-1238
    Keywords: Cardiac output ; Flow modulation ; Mechanical ventilation ; Thermodilution method
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The reliability of cardiac output estimation by thermodilution during artificial ventilation was studied in anesthetized pigs at the right side of the heart. The estimates exhibited a cyclic modulation related to the ventilation. The amplitude of the modulation was independent of the level of positive end-expiratory pressure, ventilatory pattern and volemic loading of the animals. However, a non-constant phase relation existed between the ventilatory cycle and the modulation. Single observations at a fixed moment in the ventilatory cycle are therefore not appropriate for estimation of mean cardiac output nor for studying its relative changes. The averaging of estimates spread equally over the ventilatory cycle led to a much larger reduction in the deviation of the averages from the mean cardiac output than an averaging procedure of randomly selected estimates. The accracy of estimation of mean cardiac output by two estimates equally spread in the ventilatory cycle was equal to the accuracy obtained by averaging five randomly selected estimates. Averaging four estimates, equally spread in the cycle, appeared to be the optimal procedure. For 89% of all averages an accuracy of 5% around the mean was obtained and for 99% an accuracy of ±10%.
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Springer
    Intensive care medicine 13 (1987), S. 315-322 
    ISSN: 1432-1238
    Keywords: PEEP ; Lung stretch ; Respiratory drive ; Carbon dioxide ; Piglets
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The effect of ventilatory frequency of high-frequency jet ventilation (HFJV) from 1 to 5 Hz, apart from changes in thoracic volume, on spontaneous breathing activity was studied in Yorkshire piglets under pentobarbital anesthesia. The highest PaCO2 at which the animals did not breathe against the ventilator (apnea point) was established either by changing minute volume of ventilation or by adding CO2 to the respiratory gas. The higher the apnea point, the higher the suppression of spontaneous breathing activity was assumed to be. If the apnea point was searched for by changing minute volume a progressive increase of suppression of spontaneous respiratory activity was found at ventilatory rates of 3 Hz or more, concomitantly with a rise in end-expiratory pressure (PEE). In case the tidal volume was kept constant, increase of ventilatory rate resulted in a tremendous increase of lung volume, together with considerably higher levels of PEE. When under these conditions the apnea point was searched for by adding CO2 to the respiratory gas a much higher CO2-drive was needed for spontaneous breathing and therefore a much stronger inhibition of spontaneous breathing was concluded. By placing the animals in a body box in which pressure could be varied, thoracic volume could be kept constant during HFJV. When thoracic volume was kept constant in this way a constant tidal volume at increasing jet frequencies resulted in only a slight increase in suppression of spontaneous breathing. We conclude that the increase in lung volume is a major factor in suppressing central respiratory activity during HFJV. Jet frequency by itself might be an additional suppressive factor. Airway CO2 did not seem to have an important effect.
    Type of Medium: Electronic Resource
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  • 3
    Electronic Resource
    Electronic Resource
    Springer
    Intensive care medicine 16 (1990), S. 33-40 
    ISSN: 1432-1238
    Keywords: Intrinsic PEEP ; Ventilatory pattern ; Lung volume ; Lung stretch ; piglets
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract We studied the influence of ventilatory frequency (1–5 Hz), tidal volume, lung volume and body position on the end-expiratory alveolar-to-tracheal pressure difference during high-frequency jet ventilation (HFJV) in Yorkshire piglets. The animals were anesthetized and paralysed. Alveolar pressure was estimated with the clamp off method, which was performed by a computer controlled ventilator and which had been extensively tested on its feasibility. The alveolar-to-tracheal pressure difference increased with increasing frequency and with increasing tidal volume, the common determinant appearing to be the mean expiratory flow. The effects in prone and in supine position were similar. Increasing thoracic volume decreased the alveolar-to-tracheal pressure difference indicating a dependence of this pressure difference on airway resistance. We concluded that the main factors determining the alveolar-to-tracheal pressure difference (ΔP) during HFJV are expiratory flow (V′E) and airway resistance (R), ΔP≃V′E×R.
    Type of Medium: Electronic Resource
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  • 4
    ISSN: 1432-1238
    Keywords: Cardiac output ; Mechanical ventilation ; Multiple injections ; Thermodilution
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The application of the thermodilution method in conditions associated with variations in blood flow implies a misuse of the Stewart Hamilton equation. Therefore, we studied the reliability of the thermodilution method for the estimation of mean cardiac output (CO) during mechanical ventilation in patients (n=9). Variation of the injection moment in the ventilatory cycle elicited a cyclic variation of CO estimates. This variation was not the same for all patients neither in phase nor in amplitude. Therefore, no specific phase in the ventilatory cycle could be selected for an accurate estimation of mean CO. Averaging CO estimates randomly distributed in the ventilatory cycle led to an improvement of accuracy with the square root of the number of observations. The averaging of CO estimates spread equally over the ventilatory cycle led to a much better result, e.g., the variation in the average of two estimates equally spread in the ventilatory cycle was similar to the variation in the average of four random estimates. We conclude that averaging of 3 or 4 estimates spread equally over the ventilatory cycle is an adequate strategy to estimate mean cardiac output in patients reliably.
    Type of Medium: Electronic Resource
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