A research oriented microcomputer based patient monitoring system.
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Biomedical subjects
Publications and source records attributed to J Spierdijk.
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A comparative study on the effects on circulation and respiration of buprenorphine and methadone was performed on a group of four healthy volunteers in a double blind way. Both drugs were given by continuous slow i.v. infusion. Before and after administration of the drugs, the subjects breathed in an open, resp. closed system, gas mixtures of 50% O2 / 50% N2 resp. 50% O2 / 43% N2 / 7% CO2. After each breathing/rebreathing period pupil diameters were measured photographically. The effects on respiration were calculated as shifts in vol. % CO2 necessary to obtain a standard respiratory minute volume. Analysis of variance showed a dose-independent inhibition of respiration of buprenorphine and a dose-dependent inhibition of methadone. Both drugs caused a weakly dose-dependent miosis. There were no significant dose-dependent effects on circulation and both drugs caused a similar side effect profile.
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The Leiden scavenging system, a device to reduce air pollution by anesthetic gases and vapours in operating rooms, is described. The system can be used in combination with different suction sources (vacuum pipeline, injector, fan or pump, air conditioning system). A special disposal network, to be used in combination with the scavenging system, is also shown.
A survey was conducted to get to know the 'state of the art' in trend prediction as a basis for optimal therapy, with emphasis on research being done in the countries of the European Community. Special areas of interest are quantitative prognosis (prognostic indices), the detection and use of trends in the patient's state, the use of models in prediction and their possible use for deciding which therapy is optimal for a specific patient. An extensive list of centres working in these fields as well as an extensive reference list is included.
A method for the sampling of small amounts of halothane and enflurane in ambient air is described. Sampling is performed by drawing air through a sampling tube packed with Porapak Q, which absorbs the anesthetic agent. The amount absorbed is determined by gas chromatography after thermal desorption. This method can be used for "spot" or personal sampling or for determining mean whole-room concentrations over relatively long periods (several hours).
Unanesthetized rats and rats anesthetized with a number of anesthetics were bled according to different bleeding schedules. In rats bled for 60 min against 30-50 mm Hg marked protection against mortality and the occurrence of kidney lesions was obtained with pentobarbital-Na, enflurane, halothane and methoxyflurane. Less protection was provided by diethylether while little or no protection was obtained with ethylurethane, trichloroethylene and ketamine. Protection was afforded by pentobarbital-Na in the dose range of 50 mg/kg to 6.2 mg/kg. Slight protection was afforded by dehydrobenzperidol. If pentobarbital-Na was administered after the bleeding the protection was slight. At bleeding pressures below 30 mm Hg the protective effect disappeared for all anesthetics used. Protection was not correlated with either depth of anesthesia, hypotensive effect or reduction of the maximum bleeding volume. However, a correlation was found between protective effect and the retardation of bleeding and the prolongation of survival time caused by the different anesthetics.
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The effects of droperidol and fentanyl on three samples of human bone marrow with regard to their colony forming in culture was studied in more than 256 multiple experiments. There was no evidence of any toxic effect of droperidol and fentanyl on the bone marrow cells.
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Hazards of monitoring during anaesthesia are burns, cardiac arrest or ventricular fibrillation, electric shock and false alarms caused by interference with the traces. The causative and contributory factors and the measures for the prevention of burns are discussed.
The authors' technique of balanced neuroleptanaesthesia with droperidol, fentanyl, nitrous oxide, pancuronium and nitroprusside is outlined. It is suggested that this is the anaesthetic method of choice for the surgical removal of catecholamine secreting tumours since it is associated with good operating conditions and an uneventful post-operative period.
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A literature survey indicates that some complaints occur relatively frequently among anesthetists and nurses working in operating rooms. Pollution of the air in the operating rooms by anesthetic gases is often considered as a possible cause. On account of this the degree of pollution has been determined. Concentrations of nitrous oxide and halothane were measured using an infrared absorption spectrophotometer. In each room the concentrations were measured at several different sites. In naturally ventilated operating rooms the concentrations increased steadily during operation. The measured values lied mostly between 1500 and 3000 ppm (vol/vol) for nitrous oxide and between 15 and 35 ppm for halothane. In mechanically ventilated operating rooms where no recirculation is applied a constant level was found some time after the beginning of an operation. The concentrations varied from about 100 to 500 ppm for nitrous oxide and from 1 to 5 ppm for halothane. In naturally ventilated operating rooms the anesthetic gases were rather homogeneously spread, while in mechanically ventilated rooms there was an inhomogeneous distribution. Scavenging of waste anesthetics is recommended.
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