Justin S. Clark

Automated PO2, PCO2 and pH monitoring of infants

A system has been developed for monitoring PaO2, PaCO2, and pH, which can be connected to an infant for automatic and frequent monitoring while servicing the Intensive Care Unit. The system, called CABAS (Computerized Automated Blood Analysis System) was primarily designed for pediatric monitoring, but could be used for adult monitoring as well. CABAS incorporates the following functions: 1. 1. Patient blood loss is 0.3 ml per determination of PO2, PCO2 and pH. 2. 2. The blood sampling catheter (or catheters) is also used for pressure monitoring, infusing, sampling, etc. 3. 3. Blood from other patients can be manually inserted into CABAS for analysis while connected to a patient without damage or cross-contamination. 4. 4. Monitored data is recorded chronologically in the patients computerized file. Initial clinical experience with CABAS has proven it to be very useful in the management of infants with respiratory distress syndrome.

“NEONATE”—an expert application for the “HELP” system; Comparison of the computer's and the physician's problem list

NEONATE is a prototype of an expert application for the HELP Hospital Information System. Its goal is to improve documentation in the Newborn Intensive Care Unit. The decision module of NEONATE is designed to produce an admission problem list. In this paper, the admission problem list that NEONATE generates was compared to the admission problem list of the current CETUS system for 30 patients. These were compared to a retrospectively constructed gold standard problem list. Of 101 problems in the gold standard list, 56 were on the current admission reports; 82 were found by NEONATE. NEONATE found 31 problems missed on the current admission reports; the current admission reports contained 5 problems missed by NEONATE. The current admission reports contained 9 false positives; whereas NEONATEs reports contained 27. Of the 27, 16 were caused by a single rule in NEONATE. We conclude that an expert system has great potential for improving the documentation of the patient problem list.

Decision Support for Early Intervention through Gas Exchange Ventilation - Perfusion Analysis

Recent studies show a drastic decrease in the mortality of sepsis when it is diagnosed within the first two hours of arrival to Emergency and immediate implementation of Early Goal Directed Therapy (EGDT) occurs. Therapy is normally guided by central venous oxygen content (CcvO2) which serves as a surrogate for mixed venous oxygen content (CvO2). Either parameter requires catheterization, adding one to two hours delay in establishing therapy and furthering septic risk. This paper proposes a quick, accurate, and noninvasive method to measure CvO2 and other significant physiological parameters. Clinicians could be guided in trauma patients as well. ARDS (Acute Respiratory Distress Syndrome) is a devastating illness which would benefit from early pre-clinical detection, i.e. before clinical symptoms present. Often resulting from severe trauma, patients with ARDS insidiously lose their pulmonary reserve at a time when effective EGDT could be most beneficial.

The elucidation of the kinetics and mechanisms of the catalytic oxidation of trace amounts of dimethyl ether in oxygen by transient phenomena

Thermal desorption experiments with different heating schemes were used to study the kinetics and mechanisms of the catalytic oxidation of dimethyl ether (DME) on supported Pt catalysts. The experimental apparatuses were fully automated by using a microcomputer control system. This made possible direct evaluations of several key kinetic parameters as well as long-term evaluations of the catalysts. The oxidation of DME catalyzed by Pt/SiO2-Al2O3, catalyst has been shown to involve the chemisorption of DME on the support and the chemisorption of oxygen on Pt metal sites. The surface reaction between chemisorbed DME and oxygen was found to be the rate-determining step under the experimental conditions investigated. The proposed reaction mechanism using the kinetic parameters estimated from the thermal desorption experiments predicts the experimental results very well. Acetylene was found to have a promotional effect for the reaction. It is believed that carbon from acetylene plays a key role in this reaction...