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17ABBSPT - Equipments for Anaesthesiology and Resuscitation

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

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:

Required:

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

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.

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.

Suggested:

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

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

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

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

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

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

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

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

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

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.

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.

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

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

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.

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

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

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

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

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

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:
Downloads:

Lectures: 
AttachmentSize
PDF icon 0. Introduction and course organisation (Summer semester 2019/2020)131.32 KB
PDF icon 1. CPR and blood gas analysis (Summer semester 2019/2020)349.79 KB
PDF icon 3. Conventional Mechanical Ventilaton (Summer semester 2019/2020)915.27 KB
PDF icon 4. Unconventional Lung Ventilation (Summer semester 2019/2020)926.09 KB
PDF icon 5. Equipment for Anesthesia (Summer semester 2019/2020, rev. 2020-05-18)1.12 MB
PDF icon 6. Monitoring of Hemodynamics (Summer semester 2019/2020)990.83 KB
PDF icon 6b. Capnometry and Capnography306.2 KB
PDF icon Bunnell: High frequency ventilation1.47 MB
PDF icon Chatburn: Fundamentals of Mechanical Ventilation4.37 MB
PDF icon Datex-Ohmeda: Compact airway modules1.61 MB
PDF icon Datex-Ohmeda S/5: Technical reference manual730.66 KB
PDF icon Davis: 11 Vaporizers2.33 MB
PDF icon Davis: 12 Humidifications2.08 MB
PDF icon Donovan: Indicator dillution measurement of cardiac output671.75 KB
PDF icon Elsharydah: Blood gas measurement1.79 MB
PDF icon Jensen: Meta-analysis of arterial oxygen saturation monitoring by pulse oximetry in adults111.36 KB
PDF icon Loeb: Anesthesia machines4.38 MB
PDF icon Lumb: Principles of measurement of compliance207.12 KB
PDF icon Lumb: Principles of measurement of respiratory resistance311.45 KB
PDF icon Lumb: Respiratory support and artificial ventilation740.29 KB
PDF icon Mosier: ECMO (review)2.56 MB
PDF icon Nunn: Elastic resistance to ventilation7.06 MB
PDF icon Nunn: Mechanisms of pulmonary ventilation7.68 MB
PDF icon Nunn: Physical and structural features of gas exchange3.7 MB
PDF icon Nunn: Resistance to gas flow8.71 MB
PDF icon Pilbeam: Arterial blood gas review680.38 KB
PDF icon Trautman: Thermodilution946.65 KB
PDF icon Soubani: Noninvasive monitoring of oxygen and carbon dioxide55.77 KB
PDF icon White: What is ECMO?340.92 KB

Lectures - link: 

Mechanical Ventilation Explained Clearly (1/5): https://www.youtube.com/watch?v=gk_Qf-JAL84

Mechanical Ventilation Explained Clearly (2/5): https://www.youtube.com/watch?v=K0maLgTzIto

Mechanical Ventilation Explained Clearly (3/5): https://www.youtube.com/watch?v=6Bdv7QhNNy4

Mechanical Ventilation Explained Clearly (4/5): https://www.youtube.com/watch?v=KHpJ21UWbhg

Mechanical Ventilation Explained Clearly (5/5): https://www.youtube.com/watch?v=Jx7oeJKzI9g&t=635s

ECMO: Educational Animation HD: https://www.youtube.com/watch?v=FiETnE4as5M

Introduction to Dual Circulations and Blood Mixing During Veno-Arterial ECMO: https://www.youtube.com/watch?v=zjFjRG2Kqkg

High Frequency Ventilation: https://www.youtube.com/watch?v=O3YQBC9I-HY

Record of the online session on April 27, 2020 (authorized users only): https://web.microsoftstream.com/video/bc5ca9ff-beb1-4419-9641-fe074df258af

An introduction to Anaesthesia: https://www.youtube.com/watch?v=R3sOJc4imUs

Anesthesia Machine Fundamentals: https://www.youtube.com/watch?v=UX3lUZRiqXc

Record of the online session on May 11, 2020 (authorized users only): https://web.microsoftstream.com/video/01d49dec-02f5-461b-8453-416b8c0ad6a4

Narrated presentation on "Monitoring hemodynamics" (authorized users only): https://web.microsoftstream.com/video/542c1dd3-4025-4b19-9777-a17cf902dc9d

Exercises: