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Anaesthetic Records
Published in T.M. Craft, P.M. Upton, Key Topics In Anaesthesia, 2021
Anaesthesia. Airway: airway type, size, cuff and shape used. Breathing system used. Ventilation —type and mode. Use of humidifier, filter, throat pack. Difficulties encountered. Intravenous cannula used — type, size and site. Drugs and fluids used together with doses, route of administration and time given.
Physics and Clinical Measurement
Published in Elizabeth Combeer, The Final FRCA Short Answer Questions, 2019
Breathing system: System patent, leak-free, two-bag test.Vaporisers correctly fitted, filled, leak free, plugged in if necessary.Alternative systems (Bain, T-piece) checked.Correct gas outlet selected.
Breathing Systems
Published in Lara Wijayasiri, Kate McCombe, Paul Hatton, David Bogod, The Primary FRCA Structured Oral Examination Study Guide 1, 2017
Lara Wijayasiri, Kate McCombe, Paul Hatton, David Bogod
There are three main objectives when using a breathing system: To supply O2 to the patientTo allow removal of CO2 from the system and avoid rebreathingTo supply anaesthetic gases to the patient
Relationship between epilarynx tube shape and the radiated sound pressure level during phonation is gender specific
Published in Logopedics Phoniatrics Vocology, 2023
Alexander Mainka, Ivan Platzek, Anna Klimova, Willy Mattheus, Mario Fleischer, Dirk Mürbe
Voice production involves a complex interaction of the breathing system, the generator of static air pressure, the glottal vibratory mechanism, the converter into acoustic pressure fluctuations and the vocal tract (VT) which filters the sound. The result is the voice sound as emitted by the mouth opening. So far, there is no way to measure all three components simultaneously. One way to resolve this issue are models, which in turn lack sufficient detail. Especially, the functioning of the VT remains challenging to elucidate. On the one hand, it acts as a resonator and transmits the acoustic energy in a frequency dependent way, thereby, bestowing vowel and timbre characteristics to the emitted voice sound. On the other hand, it exerts a backward effect onto the vibration pattern of the vocal folds. Hence, it alters the energy input – a mechanism known as source-filter-interaction [1]. The VT can be actively adjusted, which is utilized for the production of vowels and consonants but furthermore for the improvement of the perceived voice quality [2]. Both aspects – source-filter-interaction and voice quality – have been linked to the epilaryngeal tube, which is the downstream chamber of the inner larynx just above the vibrating vocal folds [1–4].
Lung and diaphragm protective ventilation: a synthesis of recent data
Published in Expert Review of Respiratory Medicine, 2022
Vlasios Karageorgos, Athanasia Proklou, Katerina Vaporidi
Finally, another tool to facilitate lung and diaphragm protective ventilation is the use of proportional modes of assist [74], like neurally adjusted ventilatory assist, NAVA and proportional assist ventilation, PAV. With these modes, the level of assist is proportional to the patient’s effort, thus enabling the patient’s control-of-breathing system to regulate ventilation and limit over- and under-assist [74], enhancing diaphragm recovery [137]. Moreover, because the duration of inspiration is determined by the patient’s effort, proportional modes are associated with reduced asynchronies [138]. Finally, proportional modes may also contribute to lung-protective ventilation by allowing the operation of the protective feedback mechanisms of the control of breathing system. During un-assisted breathing, inspiratory effort is normally decreasing with increasing lung volumes, as a result of the change in force-length relationship in the diaphragm, and the decrease of respiratory system compliance. Because, in proportional modes, the delivered tidal volume is proportional to inspiratory effort, it decreases at higher lung volumes, thus preventing alveolar over-stretch [14].
Reflection efficiencies of AnaConDa-S and AnaConDa-100 for isoflurane under dry laboratory and simulated clinical conditions: a bench study using a test lung
Published in Expert Review of Medical Devices, 2021
Azzeddine Kermad, Jacques Speltz, Philipp Daume, Thomas Volk, Andreas Meiser
Our work took place under controlled laboratory conditions. During clinical use of the ACD, many factors may affect efficiency of the device and increase anesthetic consumption. Using volume-controlled ventilation with constant breathing pattern is uncommon in ICU patients since augmented spontaneous breathing is advantageous for the weaning process. Sporadic deeper breaths will provoke spill over and decrease reflection efficiency. We used a chloroprene test lung because this material is impermeable to isoflurane and – unlike a patient – does not take up anesthetic. Coughed up secretions could contaminate the reflector and decrease its efficiency. Isoflurane molecules will get lost during endotracheal suctioning, even if closed suctioning systems are used. The sampled gas is discarded and not given back to the patient to respect hygiene rules, in contrast to our experimental setup. In addition, leakages in the breathing system are inevitable when clinically using the ACD in contrast to our setup where leakage was closely checked, and the measurement interrupted when the system was leaky.