Monitoring respiratory events is of clinical importance in the early detection of potentially fatal conditions. Current technologies involve contact sensors the individual must wear constantly. Such a requirement can lead to patient discomfort, and consequently may fail due to a variety of reasons including refusal to wear the monitoring device. Elderly patients and neo-natal infants are even more likely to suffer from the adverse effects of continued monitoring. Unobtrusive, non-contact, remote-sensing-based methods are increasingly needed for monitoring patient respiratory function at homes, which can in turn help to establish patterns over time. We propose to use active-stereo-based depth sensing system for forced flow-volume loop measurements and for semi-automatic and automatic assessment of abnormal breathing patterns.
Background: Hepatic cirrhosis is an important cause of morbidity and mortality in the intensive care unit (ICU). Objective: To determine the precipitating factors, presenting complaints, course of the disease and predictors of mortality in patients with liver cirrhosis admitted to the ICU. Methods: This retrospective study was conducted mat Multidisciplinary ICU at tertiary care hospital from April 2013 to March 2014. A total of 107 patients diagnosed with liver cirrhosis were admitted to the ICU. Of these, 17 were discharged against medical advice. The remaining 90 patients were included in the study. Their case notes were examined for data such as severity of disease, precipitating events and their course in the ICU. The survivors were followed up telephonically to assess survival at six months. Results: There were 30 survivors and 60 nonsurvivors. The stage of cirrhosis (based on modified Child-Pugh criteria) had significant association with hospital mortality and disease outcome. Mortality was significantly higher in patients presenting with sepsis and septic shock (P=0.022) and hepatic encephalopathy (P=0.007). Interventions such as mechanical ventilatory support (P=0.002), inotropes (P=0.001) and vasopressors (P=0.048), variceal banding (P=0.005), need for transfusion of fresh frozen plasma (P=0.001) and packed cell transfusion (P=0.036) showed significant association with clinical outcome. Conclusion: Overall mortality rate of patients admitted in the ICU with liver cirrhosis is high (66.7%). Mortality rate is higher in those with Stage C cirrhosis, sepsis and septic shock and hepatic failure. Among the patients who survive, one third may not survive beyond six months after hospital discharge.
Introduction: Bag-mask ventilation does not always guarantee 100% seal around airway opening and hence delivered fraction of oxygen (FDO2) may vary. Aim: To determine the FDO2 via a standard neonatal selfinflating bag with and without application of leak, without a reservoir bag with flow rates of 0.1, 0.2, 0.4, 0.6, 0.8, 1, 2, 4 and 6 L/min. Method: A test lung with a three way rotator to produce 0%, 30%, 50% and 75% leak was connected to a 3.5 mm ID endotracheal tube (ETT) connected to a VBM standard preterm self-inflating bag of 250 mL without a reservoir. The ETT was connected to ENVENTEC oxygen analyser and the bag inlet to a 100% oxygen source. Ventilation was done to a peak pressure of 15-20 cm H2O, at 40 bpm. FDO2 was recorded every 30 s, until the difference between two consecutive values was ≤1%. Result: The change in FDO2 was maximum when compared between 0.1 L/min and 6 L/min. For all leak percentages, the delivered oxygen showed an increasing trend from 0.1 to 0.6 L/min, a plateau from 0.6 to 1 L/min after which it increased. The change in FDO2 was different for different flow rates among various leak percentages. The highest delivered oxygen without leak was 56.15 ± 3.45% with 4 L/min flow. The oxygen delivered with 70% leak was considerably lower when compared to values with different leaks with respective flow rates. Conclusion: FDO2 increases with oxygen flow rates greater than 1 L/min. Leak around the mask has no effect of FDO2. Equilibration of FDO2 is achieved with in 60-90 s.
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