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A modified breathin...
A modified breathing pattern improves the performance of a continuous capnodynamic method for estimation of effective pulmonary blood flow
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- Hällsjö Sander, Caroline (författare)
- Karolinska Institutet
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- Sigmundsson, Thorir (författare)
- Karolinska Institutet
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- Hallbäck, Magnus (författare)
- Maquet Crit Care AB, Solna, Sweden.
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- Suarez-Sipmann, Fernando (författare)
- Uppsala universitet,Anestesiologi och intensivvård,Hedenstiernalaboratoriet,Inst Carlos III, CIBER Enfermedades Resp CIBERES, Madrid, Spain.
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- Wallin, Mats (författare)
- Karolinska Inst, Dept Physiol & Pharmacol, Stockholm, Sweden.;Maquet Crit Care AB, Solna, Sweden.
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- Oldner, Anders (författare)
- Karolinska Institutet
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- Björne, Hakan (författare)
- Karolinska Institutet
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Karolinska Institutet Maquet Crit Care AB, Solna, Sweden (creator_code:org_t)
- 2016-06-01
- 2017
- Engelska.
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Ingår i: Journal of clinical monitoring and computing. - : SPRINGER HEIDELBERG. - 1387-1307 .- 1573-2614. ; 31:4, s. 717-725
- Relaterad länk:
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https://urn.kb.se/re...
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https://doi.org/10.1...
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http://kipublication...
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Abstract
Ämnesord
Stäng
- In a previous study a new capnodynamic method for estimation of effective pulmonary blood flow (COEPBF) presented a good trending ability but a poor agreement with a reference cardiac output (CO) measurement at high levels of PEEP. In this study we aimed at evaluating the agreement and trending ability of a modified COEPBF algorithm that uses expiratory instead of inspiratory holds during CO and ventilatory manipulations. COEPBF was evaluated in a porcine model at different PEEP levels, tidal volumes and CO manipulations (N = 8). An ultrasonic flow probe placed around the pulmonary trunk was used for CO measurement. We tested the COEPBF algorithm using a modified breathing pattern that introduces cyclic end-expiratory time pauses. The subsequent changes in mean alveolar fraction of carbon dioxide were integrated into a capnodynamic equation and effective pulmonary blood flow, i.e. non-shunted CO, was calculated continuously breath by breath. The overall agreement between COEPBF and the reference method during all interventions was good with bias (limits of agreement) 0.05 (-1.1 to 1.2) L/min and percentage error of 36 %. The overall trending ability as assessed by the four-quadrant and the polar plot methodology was high with a concordance rate of 93 and 94 % respectively. The mean polar angle was 0.4 (95 % CI -3.7 to 4.5)A degrees. A ventilatory pattern recurrently introducing end-expiratory pauses maintains a good agreement between COEPBF and the reference CO method while preserving its trending ability during CO and ventilatory alterations.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Anestesi och intensivvård (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Anesthesiology and Intensive Care (hsv//eng)
Nyckelord
- Monitoring
- Carbon dioxide
- Cardiac output
- Perioperative
Publikations- och innehållstyp
- ref (ämneskategori)
- art (ämneskategori)
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