Compliance and dead space fraction indicate an optimal level of positive end-expiratory pressure after recruitment in anesthetized patients.

Background: "Optimal" positive end-expiratory pressure (PEEP) can be defined as the PEEP that prevents recollapse after a recruitment maneuver, avoids over-distension, and, consequently, leads to optimal lung mechanics at minimal dead space ventilation. In this study, we analyzed the effects of PEEP and recruitment on functional residual capacity (FRC), compliance, arterial oxygen partial pressure (Pao2) and dead space fraction, and we determined the most suitable variables indicating optimal PEEP.

Methods: We studied 20 anesthetized patients with healthy lungs undergoing faciomaxillary surgery.

Determination of functional residual capacity by oxygen washin-washout: a validation study.

Objective: To validate a new system for functional residual capacity (FRC) measurements using oxygen washin/washout in spontaneously breathing humans. The system (LUFU, Drägerwerk AG, Lübeck, Germany) consists of an unmodified EVITA 4 ventilator, a side-stream paramagnetic oxygen sensor and a dedicated software.

Design: Laboratory study and measurements in spontaneously breathing volunteers.

[Realisation of material costs in anaesthesia. Alternatives to the reimbursement via diagnosis-related groups].

Background And Goal: For reimbursement via diagnosis-related groups (DRG), lump compensation-based payment of medical cases in German hospitals requires a case-related measuring and billing of resources that has to be consistent with DRG guidelines. Only through this, can the real costs be compared with the standard costs as calculated by the hospital reimbursment system (InEK) on a case-related basis and the DRG-specific break-even level be identified.

Methods: In the present paper the authors introduce and validate two newly created alternative methods for case-related allocation of material costs in the field of anaesthesia.

Use of dynamic compliance for open lung positive end-expiratory pressure titration in an experimental study.

Objective: We tested whether the continuous monitoring of dynamic compliance could become a useful bedside tool for detecting the beginning of collapse of a fully recruited lung.

Design: Prospective laboratory animal investigation.

Setting: Clinical physiology research laboratory, University of Uppsala, Sweden.

Monitoring dead space during recruitment and PEEP titration in an experimental model.

Objective: To test the usefulness of dead space for determining open-lung PEEP, the lowest PEEP that prevents lung collapse after a lung recruitment maneuver.

Design: Prospective animal study.

Setting: Department of Clinical Physiology, University of Uppsala, Sweden.