Anesthesia, Pain, Intensive Care and Emergency Medicine — by W. A. Zin (auth.), Prof. Antonino Gullo M.D. (eds.)

By W. A. Zin (auth.), Prof. Antonino Gullo M.D. (eds.)

The finish of the second one millenium is special for the expanding curiosity within the box of severe care medication, not just between physicians and medical scientists but in addition at the a part of the mass media. this can be an interdisciplinary quarter of medication drawing upon the specialties of anesthesiology, inner medication and surgical procedure, and depending upon the basic contributions and help from simple learn. Advances in serious care medication depend upon the appliance of latest applied sciences to the medical institution, the total integration of desktops and informatics, the continuous education of physicians and technicians, and the glory of moral matters within the medical atmosphere. inside this complicated landscape of complementary techniques and viewpoints, it really is obvious that severe care drugs is among the most sensible examples of evidence-based medicine.

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Additional info for Anesthesia, Pain, Intensive Care and Emergency Medicine — A.P.I.C.E.: Proceeding of the 14th Postgraduate Course in Critical Care Medicine Trieste, Italy — November 16–19, 1999

Sample text

This curve has been used with success to measure the anatomical dead space, by retrograde linear extrapolation of the increase in V'C0 2 with volume [24, 25]. Furthermore, using the V'C0 2(V) curve the fraction of the volume flow corresponding to alveolar gas exhalation (Vae) can be calculated [26, 27]. Alveolar ejection volume (Vae) can be defined as the fraction of tidal volume (Vt) with minimal dead space (Vd) contamination. O = [FAC02 V'C0 2/Vt,] VC0 2 versus Vt relationships tends asyntotically to a constant slope as it approaches endtidal volume.

No inflection point was found in four patients, but one patient had an inflection bend that ranged from 6 to 12 cm H20 which demonstrates the difficulty in picking up a single number [I 1]. We have proposed that the curves be analysed with a moving regression curve and that the linear part can be defined as the segment of the curve consecutive sub segment with compliance above 80% of the steepest subsegments. This has the advantage of providing a mathematical description, and the inflection points are defined as the points at which compliance starts to fall below 80% of the large value.

The difference in the V/Q between units can be caused by both incomplete mixing of the gases (alveolar mixing defect), and by the fact that the maximum ventilation and the maximum perfusion of that unit are out of phase (temporal mismatching - the perfusion is greater during the last part of expiration when the ventilation is less). b) Between the terminal respiratory units. This can be the consequence of regional variations in the ventilation per unit of perfusion which produces a range of VIQ ratios (spatial mismatching).

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