Desflurane and sevoflurane are expensive. These fluorocarbons also have an environmental impact. Low fresh gas flow rates help decrease the total amount of volatile anesthesia used for a case. When sevoflurane was first introduced the teaching was that low flows were not safe due to the formation of fluoromethyl-2,2-difluoro-1-(tri-fluoromethyl)vinyl ether (Compound A). Subsequent research demonstrated […]
Technology, Computing, and Simulation
You may think you are walking around with the equivalent of a Cray computer in your pocket, but you aren’t. Your cell phone would flail solving large systems of differential equations. Cray computers can’t make phone calls. However, using crude measurements like megaflops (e.g. LinPack), your cell phone approximately matches the computational horsepower of a […]
Anesthesiologists are known to wear stethoscopes around their neck. We use the stethoscope to make sure breath sounds are equal after a patient’s trachea has been intubated, to check lung physiology during anesthesia, and occasionally place the stethoscope earpiece on the ears of deaf patients and speak into the bell to amplify our own voices […]
The Nexfin is an non-invasive monitor of of cardiac output. Does it work? How does it compare to thermodilution measured using a pulmonary artery catheter?
Cardiac output is classically measured using thermodilution, which requires a pulmonary artery catheter (PAC). Pulmonary artery catheters are invasive and, as highlighted in 2 posts last month on AA2day (post 1; post 2), have multiple risks. The Nexfin determines cardiac output by analyzing the arterial pulse contour using an inflatable finger cuff. In the article “Noninvasive […]