Continuous measurement of cardiac output by the Fick principle in infants and children: comparison with the thermodilution method

OBJECTIVE: To compare a system that continuously monitors cardiac output by the Fick principle with measurements by the thermodilution technique in pediatric patients. DESIGN: Prospective direct comparison of the above two techniques. SETTING: Pediatric intensive care unit of a university hospital. PATIENTS: 25 infants and children, aged 1 week to 17 years (median 10 months), who had undergone open heart surgery were studied. Only patients without an endotracheal tube leak and without a residual shunt were included. METHODS: The system based on the Fick principle uses measurements of oxygen consumption taken by a metabolic monitor and of arterial and mixed venous oxygen saturation taken by pulse- and fiberoptic oximetry to calculate cardiac output every 20s. INTERVENTIONS: In every patient one pair of measurements was taken. Continuous Fick and thermodilution cardiac output measurements were performed simultaneously, with the examiners remaining ignorant of the results of the other method. RESULTS: Cardiac output measurements ranged from 0.21 to 4.55 l/min. A good correlation coefficient was found: r2 = 0.98; P < 0.001; SEE = 0.41 l/min. The bias is absolute values and in percent of average cardiac output was - 0.05 l/min or - 4.4% with a precision of 0.32 l/min or 21.3% at 2 SD, respectively. The difference was most marked in a neonate with low cardiac output. CONCLUSION: Continuous measurement of cardiac output by the Fick principle offers a convenient method for the hemodynamic monitoring of unstable infants and children.     

The regularization ofNB-scheme in differential games

The optimality principles in non-zero sum differential games and multicriterial control problems taken from the corresponding static (simultaneous) game theory are usually dynamic unstable (time inconsistent), thus their use becomes questionable if special regularization attempts are not made. This important aspect was first considered in [1], but also in the earlier paper of Strotz [7] this was shown for a special control problem with discount payoff. We have shown in [2] that many of the known procedures (excluding those based on scalarization of the payoff vector), of selecting of a special Pareto-optimal solution from the set of all Pareto-optimal solutions are dynamic unstable (time-inconsistent) and therefore the regularization procedures leading to the dynamic stable optimality principles are purposed [3]. It turns out that also in the Nash [4] bargaining process the regularization attempt can be made by constructng a special equation for the conflict point. The idea of the method is closely connected with the paper [5]. The special attention to the time-consistency problem is given also in the recent publications [6,8].This paper is financially supported by Russian Fundamental Research Foundation (project N 93-011-1714).     

Closed-loop expressions of minimum energy control for single-inputlinear digital systems

Closed-loop expressions for the minimum energy control of a single-input linear digital system are described. They are obtained by two different methods. The optimal inputs are given by state feedback with the bounded variable gains. The gains are independent of the initial state of the system     

TQM implementation in hospitals

This paper discusses the essential elements for successful Total Quality Management (TQM) implementation in hospital, and the challenges that occur with such implementation. Guidelines for this implementation are provided to show how TQM tools can be used effectively in hospitals.     

Deformation and fracture of glass bead/ CTBN-rubber/epoxy composites

Carboxyl-terminated butadiene-acrylonitrile-rubber decreases modulus and yield stress of the studied epoxy but increases fracture toughness. The addition of glass bead compensates for the loss in modulus but has little effect on yield stress. However, it significantly contributes to the fracture toughness by providing additional mechanisms for toughening of both the unmodified and rubber-modified epoxy. For the toughened epoxies studied, fracture surfaces gave only limited information on fracture mechanisms since significant energy absorption also occurs in the material below the fracture surface. Suggestions for suitable material compositions for fiber composite matrices are given.     

Correlation of the leakage current and charge pumping in silicon oninsulator gate-controlled diodes

The leakage and charge pumping currents were measured in gate-controlled MOS p-i-n diodes fabricated on thin SIMOX substrates. The efficiencies of the techniques as well as their complementary features are analyzed for various experimental conditions. The interface properties of device-grade SIMOX wafers are characterized and shown to be compatible with VLSI requirements. Special interface coupling effects, which occur only in fully depleted SOI devices and modify the conventional signature of charge pumping and leakage current, are thoroughly investigated     

Biodegradation of monoaromatic hydrocarbons in aquifer columns amended with hydrogen peroxide and nitrate

The ability of indigenous microorganisms to degrade benzene, toluene, ethylbenzene and xylenes (BTEX) in laboratory scale flow-through aquifer columns was tested separately with hydrogen peroxide (110 mg/l) and nitrate (330 mg/l as NO₃⁻) amendments to air-saturated influent nutrient solution. The continuous removal of individual components from all columns relative to the sterile controls provided evidence for biodegradation. In the presence of hydrogen peroxide, the indigeneous microorganisms degraded benzene and toluene (> 95%), meta- plus para-xylene (80%) and ortho-xylene (70%). Nitrate addition resulted in 90% removal of toluene and 25% removal of ortho-xylene. However, benzene, ethylbenzene, meta- and para-xylene concentrations were not significantly reduced after 42 days of operation. Following this experiment, low dissolved oxygen (< 1 mg/l) conditions were initiated with the nitrate-amended column influent in order to mimic contaminated groundwater conditions distal from a nutrient injection well. Toluene continued to be effectively degraded (> 90%), and more than 25% of the benzene, 40% of the ethylbenzene, 50% of the meta- plus para-xylenes and 60% of the ortho-xylene were removed after several months of operation.     

R&D activities on wireless systems in China

Various wireless systems and the research preceding their practical use in China are described. The topics discussed include research establishments, research and development projects underway, challenges inherent to digital radio, and expansion opportunities afforded by satellite communications