The Multiple Inert Gas Elimination Technique (MIGET)

The Multiple Inert Gas Elimination Technique (MIGET)
Author: Susan R. Hopkins
Publisher: Springer
Total Pages: 338
Release: 2017-12-01
Genre: Medical
ISBN: 1493974416

The Multiple Inert Gas Elimination Technique (MIGET) is a complex methodology involving specialized gas chromatography and sophisticated mathematics developed in the early 1970’s. Essentially, nobody possesses knowledge of all its elements except for its original developers, and while some practical and theoretical aspects have been published over the years, none have included the level of detail that would be necessary for a potential user to adopt and understand the technique easily. This book is unique in providing a highly detailed, comprehensive technical description of the theory and practice underlying the MIGET to help potential users set up the method and solve problems they may encounter. But it is much more than a reference manual – it is a substantial physiological and mathematical treatise in its own right. It also has a wide applicability – there is extensive discussion of the common biological problem of quantitative inference. The authors took measured whole-lung gas exchange variables, and used mathematical procedures to infer the distribution of ventilation and blood flow from this data. In so doing, they developed novel approaches to answer the question: What are the limits to what can be concluded when inferring the inner workings from the “black box” behavior of a system? The book details the approaches developed, which can be generalized to other similar distributed functions within tissues and organs. They involve engineering approaches such as linear and quadratic programming, and uniquely use mathematical tools with biological constraints to obtain as much information as possible about a “black box” system. Lastly, the book summarizes the hundreds of research papers published by a number of groups over the decades in a way never before attempted in order to marshal the world’s literature on the topic and to provide in one place the wealth of important discoveries, both physiological a nd clinical, enabled by the technique.

The Multiple Inert Gas Elimination Technique: Current Methodology at the U.S. Army Institute of Surgical Research

The Multiple Inert Gas Elimination Technique: Current Methodology at the U.S. Army Institute of Surgical Research
Author:
Publisher:
Total Pages: 56
Release: 2002
Genre:
ISBN:

The intrapulmonary causes of hypoxemia include alveolar hypoventilation, ventilation- perfusion (VA/Q) inequality, shunt, and diffusion limitation to oxygen. In the late 1970s, P.D. Wagner developed the Multiple Inert Gas Elimination Technique (MIGET), a method of assessing VA/Q inequality (VA/Q mismatch) and shunt. It can also be used to measure diffusion limitation. In MIGET, the lung is considered as a set of 50 respiratory units, each with a different VA/Q ratio. Six inert gases of varying solubility are infused, and the arterial, mixed venous, and expired air concentrations of the gases are measured under steady-state conditions. Then, distribution of blood flow and ventilation to each of the 50 compartments is calculated. Although technically challenging, this method can be applied in a wide range of basic and clinical settings, and enables the evaluation Of VA/Q mismatch in a relatively low-risk, non-invasive fashion. This report describes the MIGET methodology from a technical standpoint, as currently performed at this Institute. General set-up; assessment of the gas chromatograph instrument's linearity; preparation and infusion of the 6-gas solution; specimen collection; specimen processing, and data analysis are covered in detail. Creation of a new, complex, multi-ramped GC program is described. Instructional videos form part of the multimedia CD-R0M version of this report.

Applied Physiology in Intensive Care Medicine

Applied Physiology in Intensive Care Medicine
Author: Michael R. Pinsky
Publisher: Springer Science & Business Media
Total Pages: 367
Release: 2007-05-19
Genre: Medical
ISBN: 3540373632

Te practice of intensive care medicine is at the very forefront of titration of treatment andmonitoringresponse. Te substrateofthiscareisthe criticallyill patientwho,by defnition, is at the limits of his or her physiologic reserve. Such patients need immediate, aggressive but balanced life-altering interventions to minimize the detrimental aspects of acute illness and hasten recovery. Treatmentdecisionsandresponsetotherapyareusually assessed by measures of physiologic function, such as assessed by cardio-respiratory monitoring. However, how one uses such information is ofen unclear and rarely supported by prospective clinical trials. In reality, the bedside clinician is forced to rely primarily on physiologic principles in determining the best treatments and response to therapy. However, the physiologic foundation present in practicing physicians is uneven and occasionally supported more by habit or prior training than science. A series of short papers published in Intensive Care Medicine since 2002 under the heading Physiologic Notes attempts to capture the essence of the physiologic perspectives that underpin both our understanding of disease and response to therapy. Tis present volume combines the complete list of these Physiologic Notes up until July 2006 with the ass o cia t ed r e vie w a r tic les o v er t h e s a m e in t er val t ha t a ls o addr ess e d t hes e cen tral issues.

Pulmonary Gas Exchange

Pulmonary Gas Exchange
Author: G. Kim Prisk
Publisher: Biota Publishing
Total Pages: 88
Release: 2013-08-01
Genre: Science
ISBN: 1615044515

The lung receives the entire cardiac output from the right heart and must load oxygen onto and unload carbon dioxide from perfusing blood in the correct amounts to meet the metabolic needs of the body. It does so through the process of passive diffusion. Effective diffusion is accomplished by intricate parallel structures of airways and blood vessels designed to bring ventilation and perfusion together in an appropriate ratio in the same place and at the same time. Gas exchange is determined by the ventilation-perfusion ratio in each of the gas exchange units of the lung. In the normal lung ventilation and perfusion are well matched, and the ventilation-perfusion ratio is remarkably uniform among lung units, such that the partial pressure of oxygen in the blood leaving the pulmonary capillaries is less than 10 Torr lower than that in the alveolar space. In disease, the disruption to ventilation-perfusion matching and to diffusional transport may result in inefficient gas exchange and arterial hypoxemia. This volume covers the basics of pulmonary gas exchange, providing a central understanding of the processes involved, the interactions between the components upon which gas exchange depends, and basic equations of the process.

Pulmonary Function Testing

Pulmonary Function Testing
Author: David A. Kaminsky
Publisher: Springer
Total Pages: 322
Release: 2018-10-04
Genre: Medical
ISBN: 3319941593

This book serves as a unique, comprehensive resource for physicians and scientists training in pulmonary medicine and learning about pulmonary function testing. Pulmonary function testing and the physiological principles that underlie it are often poorly understood by medical students, residents, fellows and graduate students training in the medical sciences. One reason is that students tend to get overwhelmed by the basic mathematical descriptions that explain the working of the respiratory system and the principles of pulmonary function testing. Another reason is that too many approaches focus on the math without explaining the clinical relevance of these principles and the laboratory testing that enables us to measure the very lung function that these principles are describing. This book answers that need by providing a series of chapters that guide the reader in a natural order of learning about the respiratory system. In particular, after a general overview of the structure-function design of the lung and the history of pulmonary function testing, authors begin with the drive to breathe, and then follow the pathway of air as it is drawn into the lung, undergoes gas exchange, and is then exhaled back out again. Each chapter focuses on the key principles and corresponding pulmonary function tests that explain each step in this pathway. Each chapter is written by at least two experts, one with expertise in the underlying physiology, and the other with expertise in the clinical testing and application of pulmonary function testing in practice. Many figures and tables highlight key points, and multiple case studies in each section provide specific examples of the clinical application of each pulmonary function test. This is an ideal guide to pulmonary function tests for practicing pulmonologists, residents, fellows, and medical students.

Oxford Textbook of Cardiothoracic Anaesthesia

Oxford Textbook of Cardiothoracic Anaesthesia
Author: R. Peter Alston
Publisher: Oxford Textbook in Anaesthesia
Total Pages: 545
Release: 2015
Genre: Medical
ISBN: 019965347X

Part of the Oxford Textbooks in Anaesthesia series, this title covers the anatomy and physiology, pharmacology, post-operative complications, critical care, and all clinical aspects of cardiac and thoracic anaesthesia. Practical aspects, such as team working, and designing and equipping cardiothoracic theatre and critical care, are also included. The expert and international author team use their experience to ensure this title reflects current world-wide practice across the globe.

Applied Physiology in Intensive Care Medicine 1

Applied Physiology in Intensive Care Medicine 1
Author: Michael R. Pinsky
Publisher: Springer Science & Business Media
Total Pages: 430
Release: 2013-05-22
Genre: Medical
ISBN: 3642282709

The two previous editions of Applied Physiology in Intensive Care Medicine proved extremely successful, and the book has now been revised and split into two volumes to enhance ease of use. This first volume comprises three elements -- "physiological notes," “technical notes,” and seminal studies. The physiological notes concisely and clearly capture the essence of the physiological perspectives underpinning our understanding of disease and response to therapy. The technical notes then succinctly explain some of the basics of “how to” in this technology-centered field of critical care medicine. Finally, a number of seminal studies are provided on diverse topics in intensive care. Applied Physiology in Intensive Care, written by some of the most renowned experts in the field, is an up-to-date compendium of practical bedside knowledge that will serve the clinician as an invaluable reference source on key issues regularly confronted in everyday practice.