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  • 1
    Electronic Resource
    Electronic Resource
    The automatic selection of ventilation parameters during the initial phase of mechanical ventilation (1996)
    Springer
    Intensive care medicine 22 (1996), S. 199-207 
    Details
    ISSN: 1432-1238
    Keywords: Closed-loop controlled ventilation ; Human ; Initial settings ; Computer ; Mechanical ventilation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objective To test a method that allows automatic set-up of the ventilator controls at the onset of ventilation. Design Prospective randomized crossover study. Setting ICUs in one adult and one children's hospital in Switzerland. Patients Thirty intubated stable, critically ill patients (20 adults and 10 children). Interventions The patients were ventilated during two 20-min periods using a modified Hamilton AMADEUS ventilator. During the control period the ventilator settings were chosen immediately prior to the study. During the other period individual settings were automatically determined by the ventilator (AutoInit). Measurements and results Pressure, flow, and instantaneous CO2 concentration were measured at the airway opening. From these measurements, series dead space (V DS), expiratory time constant (RC), tidal volume (V T), total respiratory frequency (f tot), minute ventilation (MV), and maximal and mean airway pressure (P aw, max andP aw, mean) were calculated. Arterial blood gases were analyzed at the end of each period.P aw, max was significantly less with the AutoInit ventilator settings whilef tot was significantly greater (P〈0.05). The other values were not statistically significant. Conclusions The AutoInit ventilator settings, which were automatically derived, were acceptable for all patients for a period of 20 min and were not found to be inferior to the control ventilator settings. This makes the AutoInit method potentially useful as an automatic startup procedure for mechanical ventilation.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01712237
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    Paper (German National Licenses)
    Fulltext
  • 2
    Electronic Resource
    Electronic Resource
    Hemodynamic effects of sodium bicarbonate in critically ill neonates (1993)
    Springer
    Intensive care medicine 19 (1993), S. 65-69 
    Details
    ISSN: 1432-1238
    Keywords: Sodium bicarbonate ; Neonates ; Metabolic acidosis ; Hemodynamics ; Pulsed Doppler ; Cardiac output
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objective To analyze the cardiovascular effects of sodium bicarbonate in neonates with metabolic acidosis. Design Prospective, open, non-randomized, before-after intervention study with hemodynamic measurements performed before and 1, 5, 10, 20, and 30 min after bicarbonate administration. Setting Neonatal intensive care unit, tertiary care center. Patients Sequential sample of 16 paralysed and mechanically ventilated newborn infants with a metabolic acidosis (pH〈7.25 in premature and 〈7.30 in term infants, base deficit〉−8). Intervention An 8.4% sodium bicarbonate solution diluted 1∶1 with water (final osmolality of 1000 mOsm/l) was administered in two equal portions at a rate of 0.5 mmol/min. The dose in mmol was calculated using the formula “base deficit x body weight (kg)×1/3×1/2”. Measurements and results Sodium bicarbonate induced a significant but transient rise in pulsed Doppler cardiac output (CO) (+27.7%), aortic blood flow velocity (+15.3%), systolic blood pressure (BP) (+9.3%), (+14.6%), transcutaneous carbon dioxide pressure (PtcCO2) (+11.8%), and transcutaneous oxygen pressure (PtcO2) (+8%). In spite of the PaCO2 elevation, pH significantly improved (from a mean of 7.24 to 7.30), and the base deficit decreased (−39.3%). Calculated systemic vascular resistance (SVR) (−10.7%) and diastolic BP (−11.7%) decreased significantly, while PaO2 and heart rate (HR) did not change. Central venous pressure (CVP) (+6.5%) increased only slightly. By 30 min after bicarbonate administration all hemodynamic parameters, with the exception of the diastolic BP, had returned to baseline. Conclusion Sodium bicarbonate in neonates with metabolic acidosis induces an increase in contractility and a reduction in afterload.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01708362
    Library Location Call Number Volume/Issue/Year Availability
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    Paper (German National Licenses)
    Fulltext
  • 3
    Electronic Resource
    Electronic Resource
    The automatic selection of ventilation parameters during the initial phase of mechanical ventilation (1996)
    Springer
    Intensive care medicine 22 (1996), S. 199-207 
    Details
    ISSN: 1432-1238
    Keywords: Key words Closed-loop controlled ventilation ; Human ; Initial settings ; Computer ; Mechanical ventilation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objective: To test a method that allows automatic set-up of the ventilator controls at the onset of ventilation. Design: Prospective randomized crossover study. Setting: ICUs in one adult and one children’s hospital in Switzerland. Patients: Thirty intubated stable, critically ill patients (20 adults and 10 children). Interventions: The patients were ventilated during two 20-min periods using a modified Hamilton AMADEUS ventilator. During the control period the ventilator settings were chosen immediately prior to the study. During the other period individual settings were automatically determined by the ventilator (AutoInit). Measurements and results: Pressure, flow, and instantaneous CO2 concentration were measured at the airway opening. From these measurements, series dead space (V DS), expiratory time constant M28.6n(RC), tidal volume (V T), total respiratory frequency (f tot), minute ventilation (MV), and maximal and mean airway pressure (P aw,max and P aw,mean) were calculated. Arterial blood gases were analyzed at the end of each period. P aw,max was significantly less with the AutoInit ventilator settings while f tot was significantly greater (P〈0.05). The other values were not statistically significant. Conclusions: The AutoInit ventilator settings, which were automatically derived, were acceptable for all patients for a period of 20 min and were not found to be inferior to the control ventilator settings. This makes the AutoInit method potentially useful as an automatic start-up procedure for mechanical ventilation.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01712237
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
  • 4
    Electronic Resource
    Electronic Resource
    Long-term transcutaneous monitoring of oxygen tension and carbon dioxide at 42° C in critically ill neonates: improved performance of the tcpo2 monitor with topical metabolic inhibition (1996)
    Springer
    European journal of pediatrics 155 (1996), S. 1043-1046 
    Details
    ISSN: 1432-1076
    Keywords: Key words Transcutaneous ; monitoring ; Carbon dioxide ; tension ; Oxygen tension ; Neonates ; Infants
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Whereas during the last few years handling of the transcutaneous PO2 (tcPO2) and PCO2 (tcPCO2) sensor has been simplified, the high electrode temperature and the short application time remain major drawbacks. In order to determine whether the application of a topical metabolic inhibitor allows reliable measurement at a sensor temperature of 42° C for a period of up to 12 h, we performed a prospective, open, nonrandomized study in a sequential sample of 20 critically ill neonates. A total of 120 comparisons (six repeated measurements per patient) between arterial and transcutaneous values were obtained. Transcutaneous values were measured with a control sensor at 44° C (conventional contact medium, average application time 3 h) and a test sensor at 42° C (Eugenol solution, average application time 8 h). Comparison of tcPO2 and PaO2 at 42° C (Eugenol solution) showed a mean difference of +0.16 kPa (range +1.60 to –2.00 kPa), limits of agreement +1.88 and –1.56 kPa. Comparison of tcPO2 and PaO2 at 44° C (control sensor) revealed a mean difference of +0.02 kPa (range +2.60 to –1.90 kPa), limits of agreement +2.12 and –2.08 kPa. Comparison of tcPCO2 and PaCO2 at 42° C (Eugenol solution) showed a mean difference of +0.91 (range +2.30 to +0.10 kPa), limits of agreement +2.24 and –0.42 kPa. Comparison of tcPCO2 and PaCO2 at 44° C (control sensor) revealed a mean difference of +0.63 kPa (range 1.50 to –0.30 kPa), limits of agreement +1.73 and –0.47 kPa. Conclusion Our results show that the use of an Eugenol solution allows reliable measurement of tcPO2 at a heating temperature of 42° C; the application time can be prolongued up to a maximum of 12 h without aggravating the skin lesions. The performance of the tcPCO2 monitor was slightly worse at 42° C than at 44° C suggesting that for the Eugenol solution the metabolic offset should be corrected.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004310050531
    Library Location Call Number Volume/Issue/Year Availability
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    Paper (German National Licenses)
    Fulltext
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