Innovations in Physiological Anaesthesia and Monitoring PDF
Preview Innovations in Physiological Anaesthesia and Monitoring
R. Droh R. Spintge (Eds.) Innovations in Physiological Anaesthesia and Monitoring With 98 figures Springer-Verlag Berlin Heidelberg New York London Paris Tokyo Hong Kong Dr. med. R. Droh Dr. med. R. Spintge Sportkrankenhaus Hellersen Paulmannshoher StraBe 17 D-5880 Liidenscheid, FRG ISBN-13: 978-3-540-50331-6 e-ISBN-13:978-3-642-74114-2 DOl: 10.1007/978-3-642-74114-2 Library of Congress Cataloging-in-Publication Data Innovations in physiological anaesthesia and monitoring 1 R. Droh. R. Spintge (eds.) p. cm. ISBN-13:978-3-S40-S0331-6 (U.S.: alk. paper) 1. Anesthesia. 2. Patient monitoring. I. Droh, R. (Roland) II. Spintge, R. [DNLM: 1. Anesthesia. Monitoring, Physiologic. WO 200 158] RD82.I53 1989 617.9'6--dc20 DNLMlDLC for Library of Congress 89-21627 This work is subject to copyright. All rights are reserved, whether the whole or part of the materials is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting reproduction on microfilms or in other ways, and storage in data banks. Duplication of this publication or parts thereof is only permitted under the provisions of the German Copyright Law of September 9, 1965, in its version of June 24, 1985, and a copyright fee must always be paid. Violations fall under the prosecution act of the German Copyright Law. © Springer-Verlag Berlin Heidelberg 1989 The use of registered names, trademarks, etc. in the publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. Product Liability: The publisher can give no guarantee for information about drug dosage and application thereof contained in this book. In every individual case the respective user must check its accuracy by consulting other pharmaceutical literature. 2119/3140-543210 - Printed on acid-free paper Preface At present there are going on decisive developments in the introduc tion of physiological thinking into anaesthesiological practice. These innovative motion comprises applications taken from space physiolo gy, closed-circuit ventilation systems, neurophysiologic control of cir culation and ventilation together with innovative aspects of circulation physiology and respiration physiology. Involved are innovative aspects of neuromuscular blockade, volatile anaesthetics, cardiorespiratoric monitoring, haemodilution and blood substitution. Special emphasis is put on demonstrating the closed circuit system as a combination of anaesthesia system and monitoring system in daily clinical routine. Additional knowledge and investigation are stimu lated in the fields of anaesthesia, neurophysiology, pharmacology, space medicine and metabolic physiology using non-invasive methods of monitoring like the evaluation or the neurovegetative status of man and its addaptive changes. Combining these aspects and systems will provide a quite new analytic and synergetic power in the direction of physiological anaesthesia and monitoring which finally will result in a totally new system of a physiological "micro-anaesthesia". We recommend this bock therefore to all anaesthetists, clinical physiologists and pharmacologists as well as to physicists and engi neers interested in innovative and non-invasive methods in physiologi cal anaesthesia with special emphasis to the use of closed systems. The editors Contents Terrestrial And Extraterrestrial Applied Physiology . . . . 1 Physiological Concepts of Cardiovascular and Respiratory Control: Theoretical Basis and Applicability in Man H. P. KOEPCHEN, H.-H. ABEL and D. KLUBENDORF .... 3 New Approach to Analysing the Neurovegetative State in Man H.-H. ABEL, D. KLUBENDORF and H.-P. KOEPCHEN ..... 21 Rhythms of Eating and Drinking in Sportsmen and Possible Applications in Space Medicine K. A. KIRSCH and L. ROCKER . . . . . . . . . . . . . . . . . . . 35 Closed-Circuit System . . . . . . . . . . . . . . . . . . . . . 41 The Closed-Circuit System - A Perfect Anesthesia and Monitoring Unit R. DROH . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43 Determination of Anesthetics in Aqueous Solution by Infrared A TR Spectrometry R. WYZGOL, P. HEINRICH, B. SCHRADER and D. W. LUBBERS 89 Experiences with a New Wavelength Scanning Oximeter D. W. LUBBERS, U. MERSCHEBROCK and H. P. KELLER. . . . 97 Innovative Aspects in Ventilation and Lung Function . . . . . 105 Use of the VG Spectralab-M Quadrupole Mass Spectrometer in the Determination of Breath-by-Breath Gas Uptake P. C. W. BEATTY, B. KAy and T. E. J. HEALY. . . . . . . . .. 107 Critial Oxygen Delivery Levels During Shock N. S. FAITHFULL and S. M. CAIN ... 117 Highly Efficient Jet Ventilation W. L. DEN DUNNEN and T. MOSTERT . 125 VIn Contents Innovative Aspects in Circulation . 135 Physics of the Circulatory System T. MOSTERT and W. L. DEN DUNNEN . 137 The Effect of Peripheral Vascular Resistance on the Systolic Blood Pressure Difference Along an Extremity J. C. DORLAS and A. W. CUIPER ............... 143 Haemodilution and Myocardial Ischaemia - Studies with Fluorocarbons and Dextran in Pigs N. S. FAITHFUL, M. FENNEMA and W. ERDMANN .. 151 Innovative Aspects in Different Medical Specialities 159 Sevofturane - A New Inhalant Anesthetic Agent T. MURAKAWA, Y. SATOH, A. MATSUKI and T. OYAMA. 161 Magnetic Resonance Imaging of the Peridural Space H. LAUBOECK and W. ISCHEBECK ............ . 165 Hepatic Drug Metabolism in Multiple Organ Failure W. SCHREGEL, H.-D. KUNTZ and M. VITI ....... . 171 List of Contributors H.-H. ABEL, Institut fur Physiologie der Freien Universitat Berlin, Arnimallee 22, 1000 Berlin (West) 33, Germany P. C. W. BEATIY, Regional Department of Medical Physics and Bioengineering, University Hospital of South Manchester, Withington, Manchester M20 8LR, UK S. M. CAIN, Department of Physiology and Biophysics, University of Alabama at Birmingham, Alabama 35294, USA A. W. CUIPER, Institute of Anaesthesiology, Oostersingel 59, 9713-EZ Groningen, The Netherlands W. L. DEN DUNNEN, Department of Anaesthesia, Municipal Hospital Dordrecht, Dordrecht, The Netherlands J. C. DORLAS, Instituut voor Anaesthesiologie, Academisch Ziekenhuis Groningen, 9700 RB Groningen, The Netherlands R.DRoH, Sportkrankenhaus Hellersen, Paulmannshoher Str. 17, 5880 Liidenscheid, FRG W. ERDMANN, Department of Anaesthesiology, Erasmus University, Academisch Ziekenhuis, Molewaterplein 40, 3015-GD Rotterdam, The Netherlands N. S. FAITHFULL, Department of Anaesthesia, University of Manchester, Manchester, UK M. FENNEMA, Department of Anaesthesiology, Erasmus University, Academisch Ziekenhuis, Molewaterplein 40, 3015-GD Rotterdam, The Netherlands T. E. J. HEALY, Department of Anaesthesia, University Hospital of South Ma,nchester, Withington, Manchester M20 8LR, UK P. HEINRICH, Institut fur Physikalische und Theoretische Chemie, Universitat Essen, 4300 Essen 1, FRG W. ISCHEBECK, Neurochirurg. Abteilung und Institut fur Kernspintomographie, Gemeinschaftskrankenhaus Witten/Herdecke, 5804 Witten/Herdecke, FRG X List of Contributors B. KAy, University Department of Anaesthesia, University Hospital of South Manchester, Withington, Manchester M20 8LR, UK H. P. KELLER, Universitatsklinik Wiirzburg, 8700 Wiirzburg, FRG K. A. KIRSCH, Institut fur Physiologie der Freien Universitat Berlin, Arnimallee 22, 1000 Berlin (West) 33, Germany D. KLUBENDORF, Institut fur Physiologie der Freien Universitat Berlin, Arnimallee 22, 1000 Berlin (West) 33, Germany H.-P. KOEPCHEN, Institut fur Physiologie der Freien Universitat Berlin, Arnimallee 22, 1000 Berlin (West) 33, Germany H.-D. Kuntz, Abteilung fur Gasteroenterologie und Hepatologie, Medizinische Universitats-Kliniken, Bergmannsheil Bochum, 4630 Bochum, FRG H. LAUBOECK, Zentrale Anaesthesieabteilung, Bergmannsheil Bochum, 4630 Bochum, FRG D. W. LUBBERS, Max-Planck-Institut fur Systemphysiologie, Rheinlanddamm 201,4600 Dortmund, FRG A. MATsuKI, Department of Anaesthesiology, Hirosaki University School of Medicine, Hirosaki, Aomori-Ken, Japan U. MERSCHEBROCK, Max-Planck-Institut fur Systemphysiologie, Rheinlanddamm 201, 4600 Dortmund, FRG T. MOSTERT, Department of Anaesthesia, Municipal Hospital, Dordrecht, The Netherlands T. MURAKAWA, Department of Anaesthesiology, Hirosaki University School of Medicine, Hirosaki, Aomori-Ken, Japan T. OYAMA, Department of Anaesthesiology, Hirosaki University School of Medicine, Hirosaki, Aomori-Ken, Japan L. ROCKER, Institut fiir Physiologie der Freien Universitat Berlin, Arnimallee 22, 1000 Berlin (West) 33, Germany Y. SATOH, Department of Anaesthesiology, Hirosaki University School of Medicine, Hirosaki, Aomori-Ken, Japan B. SCHRADER, Institut fur Physikalische und Theoretische Chemie, Universitat Essen, 4300 Essen 1, FRG W. SCHREGEL, Abteilung fur Anaesthesie und operative Intensivtherapie, Knappschaftskrankenhaus Bochum-Langendreer, Universitats-Klinik, In der Schornau 23-25, 4630 Bochum, FRG M. VITI, Abteilung fur Anaesthesie und operative Intensivtherapie, Knappschaftskrankenhaus-Universitats-Klinik, In der Schornau 23-25, 4630 Bochum, FRG R. WYZGOL, Institut fur Physikalische und Theoretische Chemie, Universitat Essen, 4300 Essen 1, FRG Terrestrial And Extraterrestrial Applied Physiology Physiological Concepts of Cardiovascular and Respiratory Control: Theoretical Basis and Applicability in Man H.P. KOEPCHEN, H.-H. ABEL and D. KLUSSENDORF Introduction Key concepts of the present symposium are: anaesthesia - physiology - internal medicine - innovation. What are the relationships among these concepts? We believe one of the innovations to lie precisely in their com bination. Internal medicine, and especially anaesthesia, is to a consider able extent applied physiology. The still too rigid borders between the disciplines, especially in Germany, must be overcome to make the con cepts and methods developed in one field fruitful for application in other fields. This is especially important for the application of basic physiologi cal concepts to man. In this context we will confine our attention to one central point of view, that of neurovegetative regulation, in particular of the cardiovascular and respiratory systems. The term neurovegetative means neuronal regulation of the functions of vegetative organs and organ systems. Within this general framework the cardiovascular and respiratory regulatory systems form part of an interacting complex of many kinds of regulatory processes. The special importance of cardiovascular and respiratory regulation in this context is based on several facts. Circulation and respiration are basic, vital functions of the body. Their adequate maintenance is one of the most important aims of the anaesthesiologist. In this area there is therefore a convergence of the interests of physiology and those of practi cal medicine. Both functions are dependent on central control systems which are intimately linked with the functional-state of general brain function. This is true even during rest and anaesthesia. In addition, these control systems are influenced by higher cortical functions during wakeful ness, mental load and exertion, i.e. during the different degrees of human activity. The consequence is that the behaviour of respiratory and cardio vascular parameters mirrors the state of central nervous regulations and can be used as an indicator of them. Modern techniques allow one (a) to record these parameters continuously without harm to the patient and (b) to evaluate automatically correlations between single parameters so as to reveal their time structures and to process a great amount of data within a short time.
The list of books you might like
