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Biomedical subjects

J H van Oostrom

Publications and source records attributed to J H van Oostrom.

4 recordsLinked to original sources

Modeling in anesthesia.

A model can be defined as an abstraction of reality which accounts for those properties ofa phenomenon that are pertinent to the purpose of the model. Models are used in anesthesia to understand the various physiologic, pharmacological and physical processes that occur during anesthesia. Indeed, many different types of models that comply with our definition can be distinguished. Early models consisted of electrical models of the arterial blood dynamics and cardiovascular system. Physical models of drug uptake and distribution have been developed to explain the kinetics of volatile anesthetics in the body. The goal of this paper is to introduce the reader to some of the types of models that been used to facilitate education and research in anesthesia. These examples will elucidate the steps involved in developing a model and the various types of models that have proven useful.

Algorithms

A comparison of traditional textbook and interactive computer learning of neuromuscular block.

We designed an educational software package, RELAX, for teaching first-year anesthesiology residents about the pharmacology and clinical management of neuromuscular blockade. The software uses an interactive, problem-based approach and moves the user through cases in an operating room environment. It can be run on personal computers with Microsoft Windows (Microsoft Corp., Redmond, WA) and combines video, graphics, and text with mouse-driven user input. We utilized test scores 1) to determine whether our software was beneficial to be the educational progress of anesthesiology residents and 2) to compare computer-based learning with textbook learning. Twenty-three residents were divided into two groups matched for age and sex, and a pretest was administered to all 23 residents. There was no significant difference (P > 0.05) in the pretest scores of the two groups. Three weeks later, both groups were subjected to an educational intervention; one with our computer software and the other with selected textbooks. Both groups took a posttest immediately after the intervention. The test scores of the computer group improved significantly more (P < 0.05) than those of the textbook group. Although prior to the study the two groups showed no statistical difference in their familiarity with computers, the computer group reported much higher satisfaction with their learning experience than did the textbook group (P < 0.0001).

Anesthesiology

Acceptable ranges for vital signs during general anesthesia.

OBJECTIVE: Define the ranges for normal vital signs during general anesthesia. METHODS: We studied 50 patients undergoing general anesthesia. We asked residents to state desirable ranges for each patient's systolic and diastolic blood pressure (BP), heart rate (HR), SpO2, and PETCO2 during induction, intubation, maintenance, and emergence from anesthesia. We called these ranges the clinical operating range (COR) and observed the frequency, duration, and magnitude of transgressions of these CORs. We also recorded whether the transgressions were treated or tolerated, or whether the COR values were changed. RESULTS: Upper COR values in the maintenance phase for systolic BP were 38% +/- 20% above the preoperative values and 30% +/- 20% above the values recorded just before induction of anesthesia. Lower COR values in the maintenance phase for systolic BP were 27% +/- 9% below preoperative, and 31% +/- 11% below preinduction values. For HR, upper and lower COR values in the maintenance phase were 53% +/- 44% above and 38% +/- 17% below preinduction values, respectively. Transgressions of COR values for BP and HR were common, treatment frequent, and redefinition of COR values rare. CONCLUSION: Clinicians recognize ranges for vital signs during uneventful anesthesia. These CORs may differ from one stage of anesthesia to the next. Transgressions of these ranges are common. Not all transgressions are treated.

Adolescent