Practical Applications of Fiberoptics in Critical Care Monitoring

Stimulating and provocative work with fiberoptic technology is reported in this volume. Invasive fiberoptic reflectometry has only been used up to now for monitoring intravascular oxygen saturation. These contributions examine how this technique can be clinically applied to measure other parameters in the critically ill patient. Methodological aspects are discussed, but the main focus is on clinical value and application. The authors look at measurements that can be evaluated using a flowdirected fiberoptic pulmonary artery catheter and an arterial fiberoptic thermodulution catheter. These measurements deal with oxygen saturation, intrathoracic and total blood volume, indocyanine green dye liver function, and extravascular lung water. Considering the advanced state of the technology and the innovative physiologic concepts presented here, this book lays the foundation for a new, integrated monitoring system of cardiopulmonary physiology.

I. Monitoring of Oxygen Saturation.- Oxygen Saturation: Its Significance — Its Calculation — Its Measurement.- Monitoring of Mixed and Central Venous Oxygen Saturation in the Critically Ill.- II. Intrathoracic Blood Volume — Total Blood Volume.- Sensitivity of Central Venous Pressure, Pulmonary Capillary Wedge Pressure, and Intrathoracic Blood Volume as Indicators for Acute and Chronic Hypovolemia.- PEEP-Induced Changes of Pulmonary Capillary Wedge Pressure, Prepulmonary and Total Intrathoracic Blood Volume in Anesthetized Dogs.- Intrathoracic Blood Volume Is a Useful Guide for Volume Substitution in Intensive Care Patients.- Determination of Plasma Volume by Indocyanine Green.- III. Quantification of Liver Function with Indocyanine Green.- Indocyanine Green: Evaluation of Liver Function — Application in Intensive Care Medicine.- Evaluation of Liver Function Using Indocyanine Green Elimination (ICGE) and Galactose Elimination Capacity (GEC): Animal Experiments and Clinical Investigations.- Quantitative Liver Function Tests: A Comparison of Indocyanine Green Elimination, Aminopyrine Breath Test, Galactose Elimination Capacity and Fasting Serum Bile Acids.- Indocyanine Green — A Substance for Evaluation of Excretory Liver Capacity.- IV. Right Ventricular Ejection Fraction.- Thermal Right Ventricular Ejection Fraction: Modulation and Reproducibility During Controlled Mechanical Ventilation.- V. Thermal Dye Dilution — Methods Section.- A Comparison of Extrapolation and Deconvolution of Thermo-Dye Dilution Curve, with Special Emphasis on States with Early Indicator Recirculation.- Effect of Positive End-Expiratory Airway Pressure (PEEP) on Extravascular Thermal Lung Water Estimation in the Dog.- Methodical Problems in Extravascular Lung Water Measurement Using the Edwards Lung Water Computer.- Influence of Thermal Loss Error in Lung Water Measurement with the Double-Indicator Thermal-Dye Method.- A Fiberoptics Based System for Integrated Monitoring of Cardiac Output, Intrathoracic Blood Volume, Extravascular Lung Water, O2 Saturation, and a-v Differences.- VI. Lung Water Measurement — Clinical Relevance.- Development and Significance of Lung Water Measurement in Clinical and Experimental Practice.- Extravascular Lung Water Following Liver Transplantation.- Lung Water Measurement for Control of Therapeutic Interventions in Critically Ill Patients.- Measurement of Extravascular Lung Water in Cardiac Surgery.- Determination of Extravascular Lung Water May Facilitate Respiratory Therapy Decision Making.- Clinical Relevance of Lung Water Measurement with the Thermal-Dye Dilution Technique.- The Adult Respiratory Distress Syndrome: An Objective Clinical Definition.