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17ABBSPT - Equipments for Anaesthesiology and Resuscitation

Code Completion Credits Range Language
17ABBSPT Z,ZK 4 1+1
Grading of the course requires grading of the following courses:
Physical Chemistry (17ABBFCH)
Lecturer:
Jakub Ráfl (guarantor), Karel Roubík
Tutor:
Martin Rožánek, Václav Ort
Supervisor:
Department of Biomedical Technology
Synopsis:

Basic concept or resuscitation. Importance of circulation, respiration, consciousness and internal environment, their control. Equipment overview, common requirements. Specific requirements for equipment at intensive care units (ICU) and departments of anaesthesia and critical care medicine (ACCM). Blood gases, their measurement and interpretation. Modelling of the fluidic systems, parameters and properties of the fluidic models. Principles and adverse effects of artificial lung ventilation (ALV). Conventional and unconventional lung ventilation, corresponding ventilators. Equipment for anaesthesia. Anaesthetic vaporisers, their thermodynamic principles. Humidification of ventilatory gases. Equipment for monitoring and support of blood circulation. Dilution methods. Bed-side monitors. Other diagnostic and therapeutic equipment at ICU and ACCM. Design of ICU and ACCM.

Requirements:

Assessment requirements:

Active lab attendance including pre-lab homework. All lab exercise assignments submitted by the following lab session.

Examination conditions:

The final exam is closed-book, made of a written test based on content of lectures and laboratory exercises including assigned individual study and home preparation. The final test score is included into the total course score if at least a half of the maximum points of the written test is reached.

The mid-term exam is closed-book, made of a written test based on content of lectures and laboratory exercises before the week of the exam (including assigned individual study and home preparation). The final test score is included into the total course score if at least a half of the maximum points of the written test is reached.

Grading according to the ECTS scale (100 points at most):

Mid-term exam: 20%

Final exam: 80%

Syllabus of lectures:

1. Basic concept or anaesthesia and resuscitation. Basic physiological parameters. Description of a patients status. Importance of circulation, respiration, consciousness and internal environment, their control. Blood gases, their measurement and interpretation. Blood gas analysers.

2. Description of fluidic systems - circulation and ventilation. Mechanical parameters of the biological and technical fluidic systems. Modelling of the fluidic systems, parameters and properties of the fluidic models.

3. Principles and adverse effects of artificial lung ventilation (ALV). Conventional lung ventilation, conventional ventilators.

4. Unconventional regimens of artificial lung ventilation. Unconventional ventilators.

5. Equipment for anaesthesia. Anaesthetic vaporisers, their thermodynamic principles. Humidification of ventilatory gases.

6. Equipment for monitoring and support of blood circulation. Dilution methods of flow rate measurement (thermodilution, LiDCO, PiCCO), pulse oxymetry, bedside monitors.

7. Other diagnostic and therapeutic equipment at ICU and ACCM. Design of ICU and ACCM. Medical gases and their distribution.

Syllabus of tutorials:

1. Introduction, modelling of the respiratory system using electro-acoustic analogy I.

2. Modelling of the respiratory system using electro-acoustic analogy II.

3. Dilution method of flow rate measurement.

4. Heliox and flow-pressure characteristics of fluidic elements. Flow resistance.

5. Frequency dependence of pressure transfer function within the respiratory system.

6. Gas humidification.

7. The influence of the respiratory system disease on lung mechanics.

Study Objective:

The aim of the subject is to give the students overview of the basic equipment of the intensive care units or departments of anaesthesia and critical care medicine. It involves life-supporting devices, especially for artificial lung ventilation, monitors of the patient's physiologic parameters, equipment for anaesthesia, etc.

Study materials:

[1] West JB. Respiratory physiology: the essentials. 7th ed. Philadelphia: Lippincott Williams and Wilkins; 2004.

[2] Davis PD, Kenny GNC. Basic physics and measurement in anaesthesia. 5th ed. Oxford: Butterworth-Heinemann; 2003.

[3] Webster JG. Encyclopedia of medical devices and instrumentation [Internet]. 2nd ed. Hoboken (NJ): John Wiley and Sons; 2006. Available from: http://onlinelibrary.wiley.com/book/10.1002/0471732877.

[4] Magee P. The physics, clinical measurement, and equipment of anaesthetic practice for the FRCA. 2nd ed. Oxford: Oxford University Press; 2011.

[5] Pilbeam S. Mechanical ventilation: physiological and clinical applications. 2nd ed. St. Louis: Mosby; 1998.

[6] Silverthorn DU. Human physiology: an integrated approach. 4th ed. San Francisco: Pearson/Benjamin Cummings; 2007.

[7] Guyton AC, Hall JE. Textbook of medical physiology. 11th ed. Philadelphia: Elsevier Saunders; 2006.

[8] Cairo JM, Pilbeam SP. Mechanical ventilation: physiological and clinical applications. 5th ed. St. Louis: Elsevier; 2012.

[9] Hasan A. Handbook of blood gas/acid-base interpretation. 1st ed. New York: Springer; 2013.

[10] Lumb AB, Nunn J. Nunn's applied respiratory physiology. 6th ed. Philadelphia: Elsevier Butterworth Heinemann; 2005.

[11] Hasan A. Understanding mechanical ventilation: a practical handbook. 2nd ed. London: Springer; 2010.

[12] Grinnan DC, Truwit J. Clinical review: Respiratory mechanics in spontaneous and assisted ventilation. Crit Care. 2005;9(5):472-484. Available from: http://ccforum.biomedcentral.com/articles/10.1186/cc3516. doi: 10.1186/cc3516.

[13] Grossbach I, Chlan L, Tracy MF. Overview of mechanical ventilatory support and management of patient- and ventilator-related responses. Crit Care Nurse. 2011;31(3):30-44. Available from: http://ccn.aacnjournals.org/cgi/doi/10.4037/ccn2011595. doi: 10.4037/ccn2011595.

[14] Tarczy-Hornoch P, Mayock DE, Jones D, Meo H, Zerom B, Woodrum D. Mechanical ventilators. In: Lane Medical Library [Internet]. 2008 [updated 2008 Jul 08; cited 2016 Nov 18]. https://lane.stanford.edu

[15] Rodriguez-Cruz E, Walters H, Aggarwal S. Extracorporeal membrane oxygenation. In: Medscape [Internet]. [updated 2015 Sep. 16; cited 2016 Nov 18]. http://emedicine.medscape.com/article/1818617-overview

[16] Jensen LA, Onyskiw JE, Prasad NGN. Meta-analysis of arterial oxygen saturation monitoring by pulse oximetry in adults. Heart and Lung. 1998;27(6):387-408. Available from: http://linkinghub.elsevier.com/retrieve/pii/S0147956398900863. doi: 10.1016/S0147-9563(98)90086-3.

[17] Soubani AO. Noninvasive monitoring of oxygen and carbon dioxide. Am J Emerg Med. 2001;19(2):141-146. Available from: http://linkinghub.elsevier.com/retrieve/pii/S0735675701196129. doi: 10.1053/ajem.2001.21353.

[18] Datex-Ohmeda S/5: Technical reference manual. Tewksbury (MA): Datex-Ohmeda Inc.; 2000.

[19] Datex-Ohmeda: Compact Airway Modules. Madison (WI): Datex-Ohmeda Inc.; 2005.

[20] Blom JA. Monitoring of respiration and circulation. 1st ed. Boca Raton (FL): CRC; 2004.

[21] White GC. Equipment theory for respiratory care. 5th ed. Stamford (CT): Cengage Learning; 2015.

[22] Ehrenwert J, Eisenkraft JB, Berry JM. Anesthesia equipment: principles and applications. 2nd ed. Philadelphia: Saunders; 2013.

[23] Shaffer TH, Wolfson MR, Greenspan JS. Liquid Ventilation: Current Status. Pediatr Rev. 1999;20(12):e134-e142.

Note:
The course is a part of the following study plans:
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