The third international symposium on Critical Care and Pulmonary Medicine was held in Norwalk Hospital, Yale University School of Medicine in June 1981. This publication contains the majority of papers that were presented at the three day conference. The book deals with the use of computers in: (1) monitoring (2) pulmonary laboratory (3) anesthesia (4) database management. Extraordinary progress in the use of computers in critical care medicine and pulmonary function testing is evident in the presen tations. I would like to thank the members of the Steering Committee and the International Advisory Committee for their efforts in bring ing together many leaders in the field, and enriching the symposium with their own contributions. My special thanks to Mr. Norman Brady, President of the Norwalk Hospital, for his generous hospitality and his untiring assistance during the three days of the symposium. I would also like to thank Martin H. Floch, M.D., Chairman of the Department of Medicine, Norwalk Hospital, for his advice and support. I sincerely appreciate the cooperation and help from the members of the Section of Pulmonary Medicine and Medical Computer Science of the Norwalk Hospital. Finally I would like to thank Ms. Nancy Smith for the excellent work in the preparation of the manuscripts, and the staff of the Plenum Press for their help in publishing this volume.
Table of ContentsSection I Monitoring in the ICU.- Closing the Loop.- Computerized Multibed Respiratory Monitoring.- Criteria for Successful Use of Computers in Critical Care -- A Manufacturer’s Perspective.- ICU Monitoring of Ventilation Distribution.- A Distributed Microprocessor Respiratory Intensive Care Monitoring System with Mass Spectrometer, Proximal Flowmeter, and Airway Pressure Transducer.- On Line Monitoring of Respiratory Values on a Respiratory Intensive Care Unit.- Use of a Microprocessor Controlled, Mass Spectrometer Based Monitoring System for Risk Management in a Community Hospital ICU.- Rapid Non-Invasive Determination of Cardiac Output at Rest by CO2 Rebreathing using a Computerized System: Application in Normal Adults with Cardiac Disease.- Transcutaneous O2 and CO2 Monitoring in the Adult.- Section II The USE of Computers in the Pulmonary Function Laboratory.- Accuracy of Commercially Available Computerized Spirometers.- The Application of the Sequential Moments of the Forced Expiratory Spirogram to an Exponential Model of the Spirogram.- Automated Pulmonary Analysis by an On Line Microcomputer.- Automatic Correction for the Effects of Changing Gas Viscosity in Pneumotachographic Measurements.- Clinical Assessment of Spirometric Data.- Computer Evaluation of Expiratory Gas Parameters and Alveolar to Arterial Differences in Clinical and Research Pulmonary Medicine.- Computing Circuit for Breath-by-Breath Ventilation.- History Dependence of Maximal Flow.- Immediate Responses to Lung Irritants Detected by Automated Measurements of Airway Resistance and Partial Flow-Volume Curves.- Lower Limits of Normal for Spirometric Reference Values.- Measurement of Specific Diffusing Capacity (DL/VA) in Critically Ill Patients.- A Microcomputer System for the Analysis of Spirograms.- On Line Pulmonary Testing Utilizing a Portable Microcomputer.- Pulmonary Fast Space Measurement from Expired PCO2: A Pulmonary Function Test Designed for Automation.- Signal Processing for Computerized Spirometry.- Spectral Analysis of Pulmonary Artery Pressure.- A Standard Artificial Lung for System Calibration in Physiological Gas Exchange Measurement.- The Measurement of Respiratory Impedance by the Forced Oscillation Method: Clinical Experiments and Their Interpretation.- Section III Database Management.- A Microprocessor Based Data Management System in Operating Room and Intensive Care Unit.- Clinical Experience with a Mini Computer Based Data Management System in Surgical Intensive Care.- Clinical Relevant Data -- What and How Often?.- Effective Anesthesia Record Keeping Utilizing A Computerized Data Management System.- The Data Are Collected. What’s Next?.- Utilization and Cost Effectiveness of Computerized Patient Data Management in the Multispecialty Intensive Care Unit.- Section IV Miscellaneous Subjects.- A Microcomputer Based System for the Screening of Occupational Health Groups.- Gravity Dependence of Crackles.- Effect of the Medical Device Legislation on Automation in Medicine.- Rapid Lung Sound Amplitude Measurement by Automated Flow Gated Phonopheumography.- Implementation of an Integrated Critical Care Computer.- What Can We Measure?.