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Download e-book for iPad: Anesthesia, Pain, Intensive Care and Emergency Medicine — by W. A. Zin (auth.), Prof. Antonino Gullo M.D. (eds.)

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

ISBN-10: 8847000955

ISBN-13: 9788847000957

ISBN-10: 884702286X

ISBN-13: 9788847022867

The finish of the second one millenium is extraordinary for the expanding curiosity within the box of serious care drugs, not just between physicians and scientific scientists but additionally at the a part of the mass media. this is often an interdisciplinary quarter of drugs drawing upon the specialties of anesthesiology, inner drugs and surgical procedure, and depending upon the fundamental contributions and help from simple learn. Advances in serious care drugs depend upon the appliance of recent applied sciences to the medical institution, the entire integration of desktops and informatics, the continuous education of physicians and technicians, and the respect of moral matters within the medical atmosphere. inside this advanced landscape of complementary ways and viewpoints, it truly is obvious that severe care drugs is among the most sensible examples of evidence-based medicine.

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Extra resources 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

Example text

Lucangelo, G. Berlot, A. 4 0 l ~--- Expiratory Phase ----tl~ 0 3 2 5 6 Time (s) Fig. 1. Representative example of the capnographic wave related to flow, volume and the phases of the respiratory cycle PetC0 2 --.. 40 paC0 2 .... D (mmHg) 20 o E A 3 2 Time 4 (5) Fig. 2. e (I) Fig. 3. The three phases of the volumetric capnogram 2. Late emptying of the alveoli with the lowest ventilation-perfusion (VIQ) ratio and, thus, with relatively higher PC0 2 . If all the alveoli had the same PC0 2 , phase III would be almost horizontal.

The mainstay of treatment consists of ameliorating the underlying disease; however, pharmacological manipulation of pulmonary vascular tone is feasible in ARDS, and is better accomplished by the inhaled route of administration with NO and PGI 2. Although until now there is no clear proof that decreasing PH can 68 A. Brienza, N. Brienza affect prognosis of ARDS, inhaled substances through the combined effects of reducing mPAP, improving oxygenation and preventing/treating right ventricular dysfunction playa key role in ARDS treatment.

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.

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


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