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  • 1
    Electronic Resource
    Electronic Resource
    Positive end-expiratory pressure: Implications for tidal volume changes in anesthesia machine ventilation (1989)
    Springer
    Journal of clinical monitoring and computing 5 (1989), S. 100-104 
    Details
    ISSN: 1573-2614
    Keywords: Anesthesia machines ; Ventilation: positive end-expiratory pressure; tidal volume ; Monitoring: oxygen
    Source: Springer Online Journal Archives 1860-2000
    Topics: Computer Science , Medicine
    Notes: Abstract In clinical practice, the addition of positive end-expiratory pressure (PEEP) into a standard anesthesia circle circuit decreases the delivered tidal volume (DTV) to a patient. We studied the magnitude of the ΔDTV/ΔPEEP relationship in two commonly used anesthesia systems. In addition, the magnitude of the ΔDTV/ΔPEEP relationship varies with both pulmonary compliance and volume of gas contained in the patient's breathing system between the ventilator and PEEP valve site, and this was also evaluated. Routine monitoring of expired tidal volume should be used whenever PEEP is added to an anesthesia circuit.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01617882
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    Paper (German National Licenses)
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  • 2
    Electronic Resource
    Electronic Resource
    Model for the physics and physiology of fluid administration (1989)
    Springer
    Journal of clinical monitoring and computing 5 (1989), S. 123-134 
    Details
    ISSN: 1573-2614
    Keywords: Equipment: intravenous systems, intravenous infusion ; Physiology: veins and tissues
    Source: Springer Online Journal Archives 1860-2000
    Topics: Computer Science , Medicine
    Notes: Abstract This article describes a model designed to provide an understanding of fluid flow in intravenous systems and human subjects. Experiments were developed which demonstrate that the model can represent common clinical situations. The model depicts physical devices as ideal resistors, pressure sources, and flow sources. The patient's venous system is depicted as a combination of ordinary and Starling resistors. For flows between 0 and 300 ml/hr, both physical devices and patients are adequately represented by a straight line representing the pressure-flow relationship (PFR): pressure = opening pressure + flow × resistance, where the slope is the resistance to fluid flow and the intercept is the opening pressure. The PFR for a normal vein is characterized by a flat slope (vein resistance =22±20 mm Hg/L/hr, mean ± SD) and a low intercept (opening pressure =15±8 mm Hg). The PFR for a partially obstructed vein has a resistance equal to that of an unobstructed vein and an opening pressure elevated approximately equal to the pressure obstructing the vein. For perivascular tissue, the PFR has a steep slope (tissue resistance =1,125±1,376 mm Hg/L/hr), while tissue opening pressure depends on the amount of fluid infused. At the onset of fluid extravasation (infiltration), tissue pressure usually is lower than venous pressure (8±8 versus 15±8 mm Hg), until fluid fills the distensible tissue compartment. In clinical practice, when infiltration or obstruction occurs, flow decreases and the clinician adjusts the roller clamp until correct flow resumes; no problem is obvious. The combined model for the intravenous tubing and venous systems explains the behavior of current clinical infusion devices.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01617887
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    Paper (German National Licenses)
    Fulltext
  • 3
    Electronic Resource
    Electronic Resource
    An electronic stethoscope is judged better than conventional stethoscopes for anesthesia monitoring (1986)
    Springer
    Journal of clinical monitoring and computing 2 (1986), S. 151-154 
    Details
    ISSN: 1573-2614
    Keywords: Monitoring ; auscultation ; Equipment ; stethoscope ; monitoring ; electronic
    Source: Springer Online Journal Archives 1860-2000
    Topics: Computer Science , Medicine
    Notes: Abstract A prototype electronic monitoring stethoscope was constructed from readily available, high-quality components. It consisted of a conventional precordial or esophageal probe connected to a microphone by a rubber adapter. The microphone was connected by lightweight wire to an amplifier and headphones. Twenty-one anesthesia clinicians evaluated the stethoscope and responded to a multiple-choice preference questionnaire. The electronic stethoscope was judged to perform better than the conventional stethoscope in most categories evaluated. The electronic device was perceived to be louder, clearer in sound reproduction, more efficacious for monitoring, and easier to use continuously, and its head-phones were considered more comfortable than the conventional carpiece. Based on our results, we conclude that amplified stethoscopes have the potential to improve monitoring. Further development of electronic stethoscope monitoring seems warranted and is continuing.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01620547
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    Paper (German National Licenses)
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  • 4
    Electronic Resource
    Electronic Resource
    The theoretical effect of carboxyhemoglobin on the pulse oximeter (1989)
    Springer
    Journal of clinical monitoring and computing 5 (1989), S. 246-249 
    Details
    ISSN: 1573-2614
    Keywords: Blood: carboxyhemoglobin ; Oxygen: saturation ; Measurement techniques: pulse oximetry
    Source: Springer Online Journal Archives 1860-2000
    Topics: Computer Science , Medicine
    Notes: Abstract The relationship between arterial oxygen saturation as measured by the pulse oximeter (SpO2) and the fractional arterial oxygen saturation (SaO2) in the presence and absence of carboxyhemoglobin (COHb) has been derived according to the theory of absorption spectroscopy. We find that our theoretically derived correction equation is similar to that found in the technical literature of Nellcor. However, the correction equations presented by Barker and Tremper and the technical literature of Ohmeda differ substantially from our equation when sufficient quantities of reduced hemoglobin are present and the fractional COHb saturation (SaCO) is high. Our approximated equation, derived from the Lambert-Beer law, is SaO2=SpO2(1−0.932 SaCO)+0.032 SaCO. The equation of Barker and Tremper is SaO2=SpO2−0.9 SaCO. The Nellcor equation is SaO2=SpO2(1−SaCO).
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01618255
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    Paper (German National Licenses)
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  • 5
    Electronic Resource
    Electronic Resource
    Gas Man® — An example of goal oriented computer-assisted teaching which results in learning (1986)
    Springer
    Journal of clinical monitoring and computing 3 (1986), S. 165-173 
    Details
    ISSN: 1573-2614
    Keywords: Computer Assisted Instruction (CAI) ; anesthesia uptake and distribution ; inhalation anesthesia ; computer education
    Source: Springer Online Journal Archives 1860-2000
    Topics: Computer Science , Medicine
    Notes: Summary Gas Man® is an educational computer simulation program (8). The goal of the program is for the user to learn the theory and application of inhalation anesthesia uptake and distribution. The program and accompanying text are designed to be used by medical students, pharmacy students, anesthesia residents, nurses, practicing anesthesiologists, and medical equipment technicians and engineers. After using the program, the learner should understand the time course of patient response to inhalation anesthesia. He should know the factors which influence patient response and be able to predict their impact in specific situations. The key to Gas Man's success are: 1. A well-defined and valid educational goal, teaching anesthesia uptake and distribution. 2. An identifiable and testable set of educational objectives. 3. A specific set of learner tasks to achieve those objectives, the acutal simulation exercises. 4. The appropriate educational medium, computer simulation and graphics. 5. Effective software implementation, the Gas Man Program.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01716358
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    Paper (German National Licenses)
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  • 6
    Electronic Resource
    Electronic Resource
    The prevalence of hypoxemia detected by pulse oximetry during recovery from anesthesia (1988)
    Springer
    Journal of clinical monitoring and computing 4 (1988), S. 16-20 
    Details
    ISSN: 1573-2614
    Keywords: Complications: hypoxemia ; Monitoring: oxygen ; Measurement techniques: pulse oximetry ; Anesthesia: post-operative period
    Source: Springer Online Journal Archives 1860-2000
    Topics: Computer Science , Medicine
    Notes: Abstract Pulse oximetry was used to assess the prevalence of hypoxemia (arterial oxygen saturation of 90% or less) at various times in the immediate postoperative period: five minutes after arrival, 30 minutes later, and just before discharge. Among 149 inpatients studied, one or more hypoxemic measurements were made in 21 (14%) during their postoperative course. Of 92 outpatients, 1 (1%) was found to be hypoxemic. For inpatients, the prevalence of hypoxemia preoperatively, 5 minutes after arrival in recovery, 30 minutes later, and at discharge was 2%, 4%, 6%, and 9%, respectively. Patient factors associated with a significantly higher prevalence of hypoxemia were obesity (22%), body cavity surgical procedures (24%), age over 40 years (18%), American Society of Anesthesiologists physical status (I, 7%; II, 17%; III, 18%; IV, 100%), duration of anesthesia longer than 90 minutes (18%), and intraoperative administration of greater than 1,500 ml of fluid (20%). Unrecognized hypoxemia in postsurgical inpatients with or without these risk factors is common. Therefore routine monitoring of these patients with a pulse oximeter is suggested.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01618102
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    Paper (German National Licenses)
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  • 7
    Electronic Resource
    Electronic Resource
    Overview: Creating practical alarms for the future (1989)
    Springer
    Journal of clinical monitoring and computing 5 (1989), S. 194-195 
    Details
    ISSN: 1573-2614
    Source: Springer Online Journal Archives 1860-2000
    Topics: Computer Science , Medicine
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01627454
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    Paper (German National Licenses)
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