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July 11, 1990, Vol 264, No. 2 >
ARTICLE | July 11, 1990

Respiratory Monitoring FREE

Martin J. Tobin, MD
[+] Author Affiliations

Reprint requests to Division of Pulmonary and Critical Care Medicine, Edward Hines Veterans Administration Hospital, Hines, IL 60141 (DrTobin).


JAMA. 1990;264(2):244-251. doi:10.1001/jama.1990.03450020096034
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Article
References

SIGNIFICANT improvements in respiratory monitoring have occurred over the last decade based on both technologic advances and a better understanding of the pathophysiologic characteristics of respiratory failure.1 The major goals of monitoring are to provide alarms that alert the patient's attendants of a significant change in his/her condition, providing an opportunity for the timely institution of lifesaving measures, to aid with diagnosis and therapy, and to create trends that assist in assessing therapeutic response and predicting prognosis. Since many patients admitted to an intensive care unit never receive interventional therapy, the possibility arises that intensive care unit costs could be decreased by the employment of intermediate care units, where patients are admitted for monitoring until a need for interventional therapy has been demonstrated.2-6 The features of an ideal monitoring system are listed in Table 1. In considering the various monitoring devices, it is useful to group the phenomena

REFERENCES

1 +
Tobin MJ.  Respiratory monitoring in the intensive care unit . Am Rev Respir Dis. 1988;;138:1625-1642.
2 +
Henning RJ, McGlish D, Daly B, Nearman H, Franklin C, Jackson D.  Clinical characteristics and resource utilization of ICU patients: implications for organization of intensive care . Crit Care Med. 1987;;15:264-269.
3 +
Wagner DP, Knaus WA, Draper EA.  Identification of low-risk monitor admissions to medical-surgical ICUs . Chest . 1987;;92:423-428.
4 +
Spivack D.  The high cost of acute health care: a review of escalating costs and limitations of such exposure in intensive care units . Am Rev Respir Dis. 1987;;137:1007-1011.
5 +
Bone RC, Balk RA.  Noninvasive respiratory care unit: a cost-effective solution for the future . Chest . 1988;;93:390-394.
6 +
Krieger BP, Ershowsky P, Spivack D, Thorstenson J, Sackner MA.  Initial experience with a central respiratory monitoring unit as a cost-saving alternative to the intensive care unit for Medicare patients who require long-term ventilator support . Chest . 1988;;93:395-397.
7 +
Shapiro BA, Cane RD.  Blood gas monitoring: yesterday, today, and tomorrow . Crit Care Med. 1989;;17:573-581.
8 +
Shapiro BA, Harrison RA, Walton JR. Clinical Application of Blood Gases . 2nd ed. Chicago, Ill: Year Book Medical Publishers Inc; 1977;.
9 +
Tobin MJ. Essentials of Critical Care Medicine . New York, NY: Churchill Livingstone Inc; 1989;.
10 +
Narins RG, Emmett M.  Simple and mixed acidbase disorders: a practical approach . Medicine . 1980;;59:161-187.
11 +
Bratanow N, Polk N, Bland R, Kram HB, Lee TS, Shoemaker WC.  Continuous polarographic monitoring of intra-arterial oxygen in the perioperative period . Crit Care Med. 1985;;13:859-860.
12 +
Barker SJ, Tremper KK.  Intra-arterial oxygen tension monitoring . Int Anesthesiol Clin. 1987;;25: 199-208.
13 +
Lubbers DW, Opitz N.  Die pCO2 / pO2-Optode: eine neue pCO2-bzw pO2-Messonde zur Messung des pCO2 oder pO2 von Gasen und Flussigkeiten . Z Naturforsch. 1975;;30:532-533.
14 +
Opitz N, Lubbers DW.  Theory and development of fluorescence based optical sensors: oxygen optodes . Int Anesthesiol Clin. 1987;;25:177-197.
15 +
Green GE, Hassell KT, Mahutte CK.  Comparison of arterial blood gas with continuous intraarterial and transcutaneous PO2 sensors in adult critically ill patients . Crit Care Med. 1987;;15:491-494.
16 +
Shapiro BA, Cane RD, Chomka CM, Bandala LE, Peruzzi WT.  Preliminary evaluation of an intra-arterial blood gas system in dogs and humans . Crit Care Med. 1989;;17:455-460.
17 +
Severinghaus JW, Astrup PB.  History of blood gas analysis, VI: oximetry . J Clin Monit. 1986;;2:270-288.
18 +
Severinghaus JW, Honda Y.  History of blood gas analysis, VII: pulse oximetry . J Clin Monit. 1987;;3:135-138.
19 +
Pologe JA.  Pulse oximetry: technical aspects of machine design . Int Anesthesiol Clin. 1987;;25:137-153.
20 +
Wukitsch, MW.  Pulse oximetry: historical review and Ohmeda functional analysis . Int J Clin Monit Comput. 1987;;4:161-166.
21 +
Wukitsch MW, Petterson MT, Tobler DR, Pologe JA.  Pulse oximetry: analysis of theory, technology, and practice . J Clin Monit. 1988;;4:290-301.
22 +
 Pulse oximeters . Health Devices . 1989;;18:185-230.
23 +
Severinghaus JW, Naifeh KH.  Accuracy of response of six pulse oximeters to profound hypoxia . Anesthesiology . 1987;;67:551-558.
24 +
Alexander CM, Teller LE, Gross JB.  Principles of pulse oximetry: theoretical and practical considerations . Anesth Analg. 1989;;68:368-376.
25 +
Altman DG, Bland JM.  Measurement in medicine: the analysis of method comparison studies . Statistician . 1983;;32:307-317.
26 +
Severinghaus JW, Naifeh KH, Koh SO.  Errors in 14 pulse oximeters during profound hypoxia . J Clin Monit. 1989;;5:72-81.
27 +
West P, George CF, Kryger MH.  Dynamic in vivo response characteristics of three oximeters: Hewlett-Packard47201A, Biox III, and Nellcor N-100 . Sleep . 1987;;10:263-271.
28 +
Barker SJ, Tremper KK.  The effect of carbon monoxide inhalation on pulse oximetry and transcutaneous PO2 . Anesthesiology . 1987;;66:667-669.
29 +
Barker SJ, Tremper KK, Hyatt J.  Effects of methemoglobinemia on pulse oximetry and mixed venous oximetry . Anesthesiology . 1989;;70:112-117.
30 +
Eisenkraft JB.  Pulse oximeter desaturation due to methemoglobinemia . Anesthesiology . 1988;; 68:279-282.
31 +
Chaudhary BA, Burki NK.  Oximetry in clinical practice . Am Rev Respir Dis. 1978;;117:173-175.
32 +
Veyckemans F, Baele P, Guillaume JE, Willems E, Robert A, Clerbaux T.  Hyperbilirubinemia does not interfere with hemoglobin saturation measured by pulse oximetry . Anesthesiology . 1989;; 70:118-122.
33 +
Chelluri L, Snyder JV.  Comparison of pulse oximetry with co-oximeter (Hexometer OSM III, Radiometer) in patients with hyperbilirubinemia . Chest . 1989;;96:288S. Abstract.
34 +
Sidi A, Paulus DA, Rush W, Gravenstein N, Davis RF.  Methylene blue and indocyanine green artifactually lower pulse oximetry readings of oxygen saturation studies in dogs . J Clin Monit. 1987;;3:249-256.
35 +
Scheller MS, Unger RJ, Kelner MJ.  Effects of intravenously administered dyes on pulse oximetry readings . Anesthesiology . 1986;;65:550-552.
36 +
Ries AL, Farrow JT, Clausen JL.  Accuracy of two ear oximeters at rest and during exercise in pulmonary patients . Am Rev Respir Dis. 1985;;132: 685-689.
37 +
Cote CJ, Goldstein A, Fuchsman WH, Hoaglin DC.  The effect of nail polish on pulse oximetry . Anesth Analg. 1988;;67:683-686.
38 +
Costarino AT, Davis DA, Keon TP.  Falsely normal saturation reading with the pulse oximeter . Anesthesiology . 1987;;67:830-831.
39 +
Hanowell L, Eisele JH, Donns D.  Ambient light affects pulse oximeters . Anesthesiology . 1987;;67:864-865.
40 +
Amar D, Neidzwski J, Wald A, Finck AD.  Fluorescent light interferes with pulse oximetry . J Clin Monit. 1989;;5:135-136.
41 +
Tremper KK, Hufstedler SM, Barker SJ, et al.  Accuracy of a pulse oximeter in the critically ill adult: effect of temperature and hemodynamics . Anesthesiology . 1985;;63:A175.
42 +
Palve H, Vuori A.  Pulse oximetry during low cardiac output and hypothermia states immediately after open heart surgery . Crit Care Med. 1989;;17:66-69.
43 +
Severinghaus JW.  Simple, accurate equations for human blood O2 dissociation computations . J Appl Physiol. 1979;;46:599-602.
44 +
Roughton FJW, Severinghaus JW.  Accurate determination of O2 dissociation curve of human blood above 98.7% saturation with data on O2 solubility in unmodified human blood from 0° to 37° C. J Appl Physiol. 1973;;6:861-869.
45 +
Ries AL.  Oximetry: know thy limits . Chest . 1987;;91:316.
46 +
Cote CJ, Goldstein EA, Cote MA, Hoaglin DC, Ryan JF.  A single-blind study of pulse oximetry in children . Anesthesiology . 1988;;68:184-188.
47 +
Lubbers DW.  Theory and development of transcutaneous oxygen pressure measurement . Int Anesthesiol Clin. 1987;;25:31-65.
48 +
Tremper KK, Barker SJ.  Transcutaneous oxygen measurement: experimental studies and adult applications . Int Anesthesiol Clin. 1987;;25:67-96.
49 +
Tremper KK, Barker SJ, Hufstedler SM, Weiss M.  Transcutaneous and liver surface PO2 during hemorrhagic hypotension and treatment with phenylephrine . Crit Care Med. 1989;;17:537-540.
50 +
McLellan PA, Goldstein RS, Ramcharan V, Rebuck AS.  Transcutaneous carbon dioxide monitoring . Am Rev Respir Dis. 1981;;124:199-201.
51 +
Stradling JR, Cover ND, Hughes JMB.  Speed of response and accuracy of two transcutaneous carbon dioxide monitors . Bull Eur Physiopathol Respir. 1983;;19:407-410.
52 +
Stock CM.  Noninvasive carbon dioxide monitoring . Crit Care Clin. 1988;;4:511-526.
53 +
Leasa WJ, Sibbald WJ.  Respiratory monitoring in a critical care unit . In: Simmons DH, ed. Current Pulmonology . Chicago, Ill: Year Book Medical Publishers Inc; 1988;;9:209-266.
54 +
Franconi S, Sigrist H.  Transcutaneous carbon dioxide and oxygen tension in newborn infants: reliability of a combined monitor of oxygen tension and carbon dioxide tension . J Clin Monit. 1988;;4:103-106.
55 +
Tremper KK, Shoemaker WC.  Transcutaneous oxygen monitoring of critically ill adults, with and without low flow shock . Crit Care Med. 1981;;9:706-709.
56 +
Pilsbury D, Hibbert G.  An ambulatory system for long-term continuous monitoring of transcutaneous PCO2 . Bull Eur Physiopathol Respir. 1987;;23:9-13.
57 +
Fahey PJ, Harris K, Vanderwarf C.  Clinical experience with continuous monitoring of mixed venous oxygen saturation in respiratory failure . Chest . 1984;;86:748-752.
58 +
Divertie MB, McMichan JC.  Continuous monitoring of mixed venous oxygen saturation in respiratory failure . Chest . 1984;;85:423-428.
59 +
Kuff JV, Vaughn S, Yang SC, Raheja R, Puri VK.  Continuous monitoring of mixed venous oxygen saturation in patients with acute myocardial infarction . Chest . 1989;;95:607-611.
60 +
Barratt-Boyes BG, Wood EH.  The oxygen saturation of blood in the venae cavae, right heart chambers, and pulmonary vessels of healthy subjects . J Lab Clin Med. 1957;;50:93-105.
61 +
Kasnitz P, Druger GL, Frederick Y, Simmons DH.  Mixed venous oxygen tension and hyperlactatemia: survival in severe cardiopulmonary disease . JAMA. 1976;;236:570-574.
62 +
Simmons DH, Alpas AP, Tashkin DP, Coulson A.  Hyperlactatemia due to arterial hypoxemia or reduced cardiac output, or both . J Appl Physiol. 1978;;45:195-202.
63 +
Cain SM.  Peripheral oxygen uptake and delivery in health and disease . Clin Chest Med. 1983;;4:139-148.
64 +
Boutros AR, Lee C.  Value of continuous monitoring of mixed venous blood oxygen saturation in the management of critically ill patients . Crit Care Med. 1986;;14:132-134.
65 +
Jastremski MS, Chelluri L, Beney KM, Bailly RT.  Analysis of the effects of continuous on-line monitoring or mixed venous oxygen saturation on patient outcome and cost-effectiveness . Crit Care Med. 1989;;17:148-153.
66 +
Rajput MA, Richey HM, Busch BA, Glendening DL, Matthews JI.  A comparison between a conventional and a fiberoptic flow-directed thermal dilution pulmonary artery catheter in critically ill patients . Arch Intern Med. 1989;;149:83-85.
67 +
Milic-Emili J.  Recent advances in clinical assessment of control of breathing . Lung . 1982;;160:1-17.
68 +
Lind FG, Truve AB, Lindborg BPO.  Microcomputer-assisted on-line measurement of breathing pattern and occlusion pressure . J Appl Physiol. 1984;;56:235-239.
69 +
Murciano D, Aubier M, Bussi S, Derenne JP, Pariente R, Milic-Emili J.  Comparison of esophageal, tracheal, and mouth occlusion pressure in patients with chronic obstructive pulmonary disease during acute respiratory failure . Am Rev Respir Dis. 1982;;126:837-841.
70 +
Herrera M, Blasco J, Venegas J, Barba R, Dublas A, Marquez E.  Mouth occlusion pressure (P0.1) in acute respiratory failure . Intensive Care Med. 1985;;11:134-139.
71 +
Sassoon CSH, Te TT, Mahutte CK, Light RW.  Airway occlusion pressure: an important indicator for successful weaning in patients with chronic obstructive pulmonary disease . Am Rev Respir Dis. 1987;;135:107-113.
72 +
Murciano D, Boczkowski J, Lecocguic Y, Milic-Emili J, Pariente R, Aubier M.  Tracheal occlusion pressure: a simple index to monitor respiratory muscle fatigue during acute respiratory failure in patients with chronic obstructive pulmonary disease . Ann Intern Med. 1988;;108:800-805.
73 +
Montgomery AB, Holle RHO, Neagley SR, Pierson DJ, Schoene RB.  Prediction of successful ventilator weaning using airway occlusion pressure and hypercapnic challenge . Chest . 1987;;91:496-499.
74 +
Black LF, Hyatt RE.  Maximal respiratory pressures: normal values and relationship to age and sex . Am Rev Respir Dis. 1971;;103:641-650.
75 +
Koulouris, Malvey DA, Laroche CM, Sawicka EH, Green M, Moxham J.  The measurement of inspiratory muscle strength by sniff esophageal, nasopharyngeal, and mouth pressures . Am Rev Respir Dis. 1989;;139:641-646.
76 +
Marini JJ, Smith TC, Lamb V.  Estimation of inspiratory muscle strength in mechanically ventilated patients: the measurement of maximal inspiratory pressure . J Crit Care. 1986;;1:32-38.
77 +
Sahn SA, Lakshminarayan S.  Bedside criteria for discontinuation of mechanical ventilation . Chest . 1973;;63:1002-1005.
78 +
Tahvanainen J, Salenpera M, Nikki P.  Extubation criteria after weaning from intermittent mandatory ventilation and continuous positive airway pressure . Crit Care Med. 1983;;11:702-707.
79 +
Fiastro JF, Habib MP, Shon BY, Campbell SC.  Comparison of standard weaning parameters and mechanical work of breathing in mechanically ventilated patients . Chest . 1988;;94:232-238.
80 +
Tobin MJ.  Respiratory muscles in disease . Clin Chest Med. 1988;;9:263-286.
81 +
Green M, Moxham J.  The respiratory muscles . Clin Sci. 1985;;68:1-10.
82 +
Laroche CM, Moxham J, Green M.  Respiratory muscle weakness and fatigue . Q J Med. 1989;;71:373-397.
83 +
Rochester DF.  Tests of respiratory muscle function . Clin Chest Med. 1988;;9:249-261.
84 +
Celli BR.  Clinical and physiological evaluation of respiratory muscle function . Clin Chest Med. 1989;;10:199-214.
85 +
Cohen C, Zagelbaum G, Gross D, Roussos C, Macklem PT.  Clinical manifestations of inspiratory muscle fatigue . Am J Med. 1982;;73:308-316.
86 +
Roussos CS, Macklem PT.  The respiratory muscles . N Engl J Med. 1982;;307:786-797.
87 +
Tobin MJ, Perez W, Guenther SM, et al.  Does ribcage abdominal paradox signify respiratory muscle fatigue? J Appl Physiol. 1987;;63:851-860.
88 +
Tobin MJ.  Assessment of pulmonary function in critically-ill patients . In: Shoemaker WC, Ayres SM, Grenvik A, Holbrook PR, Thompson WL, eds. The Society of Critical Care Medicine Textbook of Critical Care Medicine . 2nd ed. Philadelphia, Pa: WB Saunders Co; 1989;:668-676.
89 +
Feeley TW, Hedley-Whyte J.  Weaning from controlled ventilation and supplemental oxygen . N Engl J Med. 1975;;292:903-906.
90 +
Bone RC.  Monitoring ventilatory mechanics in acute respiratory failure . Respir Care. 1983;;28: 597-604.
91 +
Fallat RJ, McQuitty JC.  Bedside testing and intensive care monitoring of pulmonary function . In: Clausen JL. ed. Pulmonary Function Testing, Guidelines and Controversies . New York, NY: Grune & Stratton; 1982;:294-310.
92 +
Pepe PE, Marini JJ.  Occult positive end-expiratory pressure in mechanically ventilated patients with airflow obstruction . Am Rev Respir Dis. 1982;;126:166-170.
93 +
Rossi A, Gottfried SB, Zocchi L, et al.  Measurement of static lung compliance of the total respiratory failure during mechanical ventilation: the effect of intrinsic positive end-expiratory pressure . Am Rev Respir Dis. 1985;;131:672-677.
94 +
Milic-Emili J, Ploysongsang Y.  Respiratory mechanics in the adult respiratory distress syndrome . Crit Care Clin. 1986;;2:573-584.
95 +
Yang KL, Tobin MJ.  Decision analysis of parameters used to predict outcome of a trial of weaning from mechanical ventilation . Am Rev Respir Dis. 1989;;139:A98. Abstract.
96 +
Tobin MJ, Chadha TS, Jenouri G, et al.  Breathing patterns, I: normal subjects . Chest . 1983;; 84:202-205.
97 +
Tobin MJ, Perez W, Guenther SM, et al.  The pattern of breathing during successful and unsuccessful trials of weaning from mechanical ventilation . Am Rev Respir Dis. 1986;;134:1111-1118.
98 +
Krieger BP, Ershowsky P.  Noninvasive detection of respiratory failure in the intensive care unit . Chest . 1988;;94:254-261.
99 +
Gravelyn TR, Weg JR.  Respiratory rate as an indicator of acute respiratory dysfunction . JAMA. 1980;;244:1123-1125.
100 +
McFadden JP, Price RC, Eastwood HD, Briggs RS.  Raised respiratory rate in elderly patients: a valuable physical sign . Br Med J. 1982;;284:626-627.
101 +
Browning IB, D'Alonzo GE, Tobin MJ.  Importance of respiratory rate as an indicator of respiratory dysfunction in patients with cystic fibrosis . Chest . 1990;;97:1317-1321.
102 +
Krieger B, Feinerman D, Zaron A, Bizousky F.  Continuous noninvasive monitoring of respiratory rate in critically ill patients . Chest . 1986;; 90:632-634.
103 +
Tobin MJ.  Noninvasive evaluation of respiratory movement . In: Nochomovitz ML, Cherniack NS, eds. Noninvasive Respiratory Monitoring . New York, NY: Churchill Livingstone Inc; 1986;:29-57.
104 +
Perez W, Tobin MJ.  Separation of factors responsible for change in breathing pattern induced by instrumentation . J Appl Physiol. 1985;;59:1515-1520.
105 +
Sackner MA, Krieger BP.  Noninvasive respiratory monitoring . In: Scharf SM, Cassidy SS, eds. Heart-Lung Interactions in Health and Disease . New York, NY: Marcel Dekker Inc; 1989;:663-805.
106 +
Tobin MJ, Mador MJ, Guenther SM, et al.  Variability of resting respiratory drive and timing in healthy subjects . J Appl Physiol. 1988;;65:309-317.
107 +
Tobin MJ, Chadha TS, Jenouri G, et al.  Breathing patterns, II: diseased subjects . Chest . 1983;;84:286-294.
108 +
Bellemare F, Grassino A.  Effect of pressure and timing of contraction on human diaphragm fatigue . J Appl Physiol. 1982;;53:1190-1195.
109 +
Tobin MJ, Guenther SM, Perez W, et al.  Konno-Mead analysis of ribcage-abdominal motion during successful and unsuccessful trials of weaning from mechanical ventilation . Am Rev Respir Dis. 1987;;135:1320-1328.
110 +
Tobin MJ, Jenouri G, Birch S, et al.  Effect of positive end-expiratory pressure on breathing patterns of normal subjects and intubated patients with respiratory failure . Crit Care Med. 1983;;11:859-867.
111 +
Hoffman RA, Ershowsky P, Krieger BP.  Determination of auto-PEEP during spontaneous and controlled ventilation by monitoring changes in end-expiratory thoracic gas volume . Chest . 1989;; 96:613-616.
112 +
Tobin MJ, Lodato RF.  PEEP, auto-PEEP, and waterfalls . Chest . 1989;;96:449-451.
113 +
Rebuck AS, Chapman KR.  Measurement and monitoring of exhaled carbon dioxide . In: Nochomovitz ML, Cherniack NS, eds. Noninvasive Respiratory Monitoring . New York, NY: Churchill Livingstone Inc; 1986;:189-201.
114 +
Mogue LR, Ranrala B.  Capnometers . J Clin Monit. 1988;;4:115-121.
115 +
Snyder JV, Elliot FL, Grenvik A.  Capnography . In: Spence AA, ed. Respiratory Monitoring in Intensive Care . New York, NY: Churchill Livingstone Inc; 1982;:100-121.
116 +
Bowe EA, Boysen PG, Broome JA, Klein EF Jr.  Accurate determination of end-tidal carbon dioxide during administration of oxygen by nasal cannulae . J Clin Monit. 1989;;5:105-110.
117 +
Severinghaus JW.  Water vapor calibration errors in some capnometers: respiratory conventions misunderstood by manufacturers? Anesthesiology . 1989;;70:996-998.
118 +
Pascucci RC, Schena JA, Thompson JE.  Comparison of a sidestream and mainstream capnometer in infants . Crit Care Med. 1989;;17:560-562.
119 +
Rahn H, Farhi LE.  Ventilation, perfusion, and gas exchange—the VA/Q concept . In: Fenn WD, Rahn H, eds. Handbook of Physiology: Respiration . Baltimore, Md: Waverly Press; 1964;;1:735-766.
120 +
Yamanaka MK, Sue DY.  Comparison of arterial-end-tidal PCO2 difference and dead space/tidal volume ratio in respiratory failure . Chest . 1987;; 92:832-835.
121 +
Carlon GC, Ray C, Mee SM, Kopec I.  Capnography in mechanically ventilated patients . Crit Care Med. 1988;;16:550-556.
122 +
Robin ED.  The cult of the Swan-Ganz catheter: overuse and abuse of pulmonary flow catheters . Ann Intern Med. 1985;;103:445-449.

Figures

Tables

Interactive Graphics

Video

Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

1 +
Tobin MJ.  Respiratory monitoring in the intensive care unit . Am Rev Respir Dis. 1988;;138:1625-1642.
2 +
Henning RJ, McGlish D, Daly B, Nearman H, Franklin C, Jackson D.  Clinical characteristics and resource utilization of ICU patients: implications for organization of intensive care . Crit Care Med. 1987;;15:264-269.
3 +
Wagner DP, Knaus WA, Draper EA.  Identification of low-risk monitor admissions to medical-surgical ICUs . Chest . 1987;;92:423-428.
4 +
Spivack D.  The high cost of acute health care: a review of escalating costs and limitations of such exposure in intensive care units . Am Rev Respir Dis. 1987;;137:1007-1011.
5 +
Bone RC, Balk RA.  Noninvasive respiratory care unit: a cost-effective solution for the future . Chest . 1988;;93:390-394.
6 +
Krieger BP, Ershowsky P, Spivack D, Thorstenson J, Sackner MA.  Initial experience with a central respiratory monitoring unit as a cost-saving alternative to the intensive care unit for Medicare patients who require long-term ventilator support . Chest . 1988;;93:395-397.
7 +
Shapiro BA, Cane RD.  Blood gas monitoring: yesterday, today, and tomorrow . Crit Care Med. 1989;;17:573-581.
8 +
Shapiro BA, Harrison RA, Walton JR. Clinical Application of Blood Gases . 2nd ed. Chicago, Ill: Year Book Medical Publishers Inc; 1977;.
9 +
Tobin MJ. Essentials of Critical Care Medicine . New York, NY: Churchill Livingstone Inc; 1989;.
10 +
Narins RG, Emmett M.  Simple and mixed acidbase disorders: a practical approach . Medicine . 1980;;59:161-187.
11 +
Bratanow N, Polk N, Bland R, Kram HB, Lee TS, Shoemaker WC.  Continuous polarographic monitoring of intra-arterial oxygen in the perioperative period . Crit Care Med. 1985;;13:859-860.
12 +
Barker SJ, Tremper KK.  Intra-arterial oxygen tension monitoring . Int Anesthesiol Clin. 1987;;25: 199-208.
13 +
Lubbers DW, Opitz N.  Die pCO2 / pO2-Optode: eine neue pCO2-bzw pO2-Messonde zur Messung des pCO2 oder pO2 von Gasen und Flussigkeiten . Z Naturforsch. 1975;;30:532-533.
14 +
Opitz N, Lubbers DW.  Theory and development of fluorescence based optical sensors: oxygen optodes . Int Anesthesiol Clin. 1987;;25:177-197.
15 +
Green GE, Hassell KT, Mahutte CK.  Comparison of arterial blood gas with continuous intraarterial and transcutaneous PO2 sensors in adult critically ill patients . Crit Care Med. 1987;;15:491-494.
16 +
Shapiro BA, Cane RD, Chomka CM, Bandala LE, Peruzzi WT.  Preliminary evaluation of an intra-arterial blood gas system in dogs and humans . Crit Care Med. 1989;;17:455-460.
17 +
Severinghaus JW, Astrup PB.  History of blood gas analysis, VI: oximetry . J Clin Monit. 1986;;2:270-288.
18 +
Severinghaus JW, Honda Y.  History of blood gas analysis, VII: pulse oximetry . J Clin Monit. 1987;;3:135-138.
19 +
Pologe JA.  Pulse oximetry: technical aspects of machine design . Int Anesthesiol Clin. 1987;;25:137-153.
20 +
Wukitsch, MW.  Pulse oximetry: historical review and Ohmeda functional analysis . Int J Clin Monit Comput. 1987;;4:161-166.
21 +
Wukitsch MW, Petterson MT, Tobler DR, Pologe JA.  Pulse oximetry: analysis of theory, technology, and practice . J Clin Monit. 1988;;4:290-301.
22 +
 Pulse oximeters . Health Devices . 1989;;18:185-230.
23 +
Severinghaus JW, Naifeh KH.  Accuracy of response of six pulse oximeters to profound hypoxia . Anesthesiology . 1987;;67:551-558.
24 +
Alexander CM, Teller LE, Gross JB.  Principles of pulse oximetry: theoretical and practical considerations . Anesth Analg. 1989;;68:368-376.
25 +
Altman DG, Bland JM.  Measurement in medicine: the analysis of method comparison studies . Statistician . 1983;;32:307-317.
26 +
Severinghaus JW, Naifeh KH, Koh SO.  Errors in 14 pulse oximeters during profound hypoxia . J Clin Monit. 1989;;5:72-81.
27 +
West P, George CF, Kryger MH.  Dynamic in vivo response characteristics of three oximeters: Hewlett-Packard47201A, Biox III, and Nellcor N-100 . Sleep . 1987;;10:263-271.
28 +
Barker SJ, Tremper KK.  The effect of carbon monoxide inhalation on pulse oximetry and transcutaneous PO2 . Anesthesiology . 1987;;66:667-669.
29 +
Barker SJ, Tremper KK, Hyatt J.  Effects of methemoglobinemia on pulse oximetry and mixed venous oximetry . Anesthesiology . 1989;;70:112-117.
30 +
Eisenkraft JB.  Pulse oximeter desaturation due to methemoglobinemia . Anesthesiology . 1988;; 68:279-282.
31 +
Chaudhary BA, Burki NK.  Oximetry in clinical practice . Am Rev Respir Dis. 1978;;117:173-175.
32 +
Veyckemans F, Baele P, Guillaume JE, Willems E, Robert A, Clerbaux T.  Hyperbilirubinemia does not interfere with hemoglobin saturation measured by pulse oximetry . Anesthesiology . 1989;; 70:118-122.
33 +
Chelluri L, Snyder JV.  Comparison of pulse oximetry with co-oximeter (Hexometer OSM III, Radiometer) in patients with hyperbilirubinemia . Chest . 1989;;96:288S. Abstract.
34 +
Sidi A, Paulus DA, Rush W, Gravenstein N, Davis RF.  Methylene blue and indocyanine green artifactually lower pulse oximetry readings of oxygen saturation studies in dogs . J Clin Monit. 1987;;3:249-256.
35 +
Scheller MS, Unger RJ, Kelner MJ.  Effects of intravenously administered dyes on pulse oximetry readings . Anesthesiology . 1986;;65:550-552.
36 +
Ries AL, Farrow JT, Clausen JL.  Accuracy of two ear oximeters at rest and during exercise in pulmonary patients . Am Rev Respir Dis. 1985;;132: 685-689.
37 +
Cote CJ, Goldstein A, Fuchsman WH, Hoaglin DC.  The effect of nail polish on pulse oximetry . Anesth Analg. 1988;;67:683-686.
38 +
Costarino AT, Davis DA, Keon TP.  Falsely normal saturation reading with the pulse oximeter . Anesthesiology . 1987;;67:830-831.
39 +
Hanowell L, Eisele JH, Donns D.  Ambient light affects pulse oximeters . Anesthesiology . 1987;;67:864-865.
40 +
Amar D, Neidzwski J, Wald A, Finck AD.  Fluorescent light interferes with pulse oximetry . J Clin Monit. 1989;;5:135-136.
41 +
Tremper KK, Hufstedler SM, Barker SJ, et al.  Accuracy of a pulse oximeter in the critically ill adult: effect of temperature and hemodynamics . Anesthesiology . 1985;;63:A175.
42 +
Palve H, Vuori A.  Pulse oximetry during low cardiac output and hypothermia states immediately after open heart surgery . Crit Care Med. 1989;;17:66-69.
43 +
Severinghaus JW.  Simple, accurate equations for human blood O2 dissociation computations . J Appl Physiol. 1979;;46:599-602.
44 +
Roughton FJW, Severinghaus JW.  Accurate determination of O2 dissociation curve of human blood above 98.7% saturation with data on O2 solubility in unmodified human blood from 0° to 37° C. J Appl Physiol. 1973;;6:861-869.
45 +
Ries AL.  Oximetry: know thy limits . Chest . 1987;;91:316.
46 +
Cote CJ, Goldstein EA, Cote MA, Hoaglin DC, Ryan JF.  A single-blind study of pulse oximetry in children . Anesthesiology . 1988;;68:184-188.
47 +
Lubbers DW.  Theory and development of transcutaneous oxygen pressure measurement . Int Anesthesiol Clin. 1987;;25:31-65.
48 +
Tremper KK, Barker SJ.  Transcutaneous oxygen measurement: experimental studies and adult applications . Int Anesthesiol Clin. 1987;;25:67-96.
49 +
Tremper KK, Barker SJ, Hufstedler SM, Weiss M.  Transcutaneous and liver surface PO2 during hemorrhagic hypotension and treatment with phenylephrine . Crit Care Med. 1989;;17:537-540.
50 +
McLellan PA, Goldstein RS, Ramcharan V, Rebuck AS.  Transcutaneous carbon dioxide monitoring . Am Rev Respir Dis. 1981;;124:199-201.
51 +
Stradling JR, Cover ND, Hughes JMB.  Speed of response and accuracy of two transcutaneous carbon dioxide monitors . Bull Eur Physiopathol Respir. 1983;;19:407-410.
52 +
Stock CM.  Noninvasive carbon dioxide monitoring . Crit Care Clin. 1988;;4:511-526.
53 +
Leasa WJ, Sibbald WJ.  Respiratory monitoring in a critical care unit . In: Simmons DH, ed. Current Pulmonology . Chicago, Ill: Year Book Medical Publishers Inc; 1988;;9:209-266.
54 +
Franconi S, Sigrist H.  Transcutaneous carbon dioxide and oxygen tension in newborn infants: reliability of a combined monitor of oxygen tension and carbon dioxide tension . J Clin Monit. 1988;;4:103-106.
55 +
Tremper KK, Shoemaker WC.  Transcutaneous oxygen monitoring of critically ill adults, with and without low flow shock . Crit Care Med. 1981;;9:706-709.
56 +
Pilsbury D, Hibbert G.  An ambulatory system for long-term continuous monitoring of transcutaneous PCO2 . Bull Eur Physiopathol Respir. 1987;;23:9-13.
57 +
Fahey PJ, Harris K, Vanderwarf C.  Clinical experience with continuous monitoring of mixed venous oxygen saturation in respiratory failure . Chest . 1984;;86:748-752.
58 +
Divertie MB, McMichan JC.  Continuous monitoring of mixed venous oxygen saturation in respiratory failure . Chest . 1984;;85:423-428.
59 +
Kuff JV, Vaughn S, Yang SC, Raheja R, Puri VK.  Continuous monitoring of mixed venous oxygen saturation in patients with acute myocardial infarction . Chest . 1989;;95:607-611.
60 +
Barratt-Boyes BG, Wood EH.  The oxygen saturation of blood in the venae cavae, right heart chambers, and pulmonary vessels of healthy subjects . J Lab Clin Med. 1957;;50:93-105.
61 +
Kasnitz P, Druger GL, Frederick Y, Simmons DH.  Mixed venous oxygen tension and hyperlactatemia: survival in severe cardiopulmonary disease . JAMA. 1976;;236:570-574.
62 +
Simmons DH, Alpas AP, Tashkin DP, Coulson A.  Hyperlactatemia due to arterial hypoxemia or reduced cardiac output, or both . J Appl Physiol. 1978;;45:195-202.
63 +
Cain SM.  Peripheral oxygen uptake and delivery in health and disease . Clin Chest Med. 1983;;4:139-148.
64 +
Boutros AR, Lee C.  Value of continuous monitoring of mixed venous blood oxygen saturation in the management of critically ill patients . Crit Care Med. 1986;;14:132-134.
65 +
Jastremski MS, Chelluri L, Beney KM, Bailly RT.  Analysis of the effects of continuous on-line monitoring or mixed venous oxygen saturation on patient outcome and cost-effectiveness . Crit Care Med. 1989;;17:148-153.
66 +
Rajput MA, Richey HM, Busch BA, Glendening DL, Matthews JI.  A comparison between a conventional and a fiberoptic flow-directed thermal dilution pulmonary artery catheter in critically ill patients . Arch Intern Med. 1989;;149:83-85.
67 +
Milic-Emili J.  Recent advances in clinical assessment of control of breathing . Lung . 1982;;160:1-17.
68 +
Lind FG, Truve AB, Lindborg BPO.  Microcomputer-assisted on-line measurement of breathing pattern and occlusion pressure . J Appl Physiol. 1984;;56:235-239.
69 +
Murciano D, Aubier M, Bussi S, Derenne JP, Pariente R, Milic-Emili J.  Comparison of esophageal, tracheal, and mouth occlusion pressure in patients with chronic obstructive pulmonary disease during acute respiratory failure . Am Rev Respir Dis. 1982;;126:837-841.
70 +
Herrera M, Blasco J, Venegas J, Barba R, Dublas A, Marquez E.  Mouth occlusion pressure (P0.1) in acute respiratory failure . Intensive Care Med. 1985;;11:134-139.
71 +
Sassoon CSH, Te TT, Mahutte CK, Light RW.  Airway occlusion pressure: an important indicator for successful weaning in patients with chronic obstructive pulmonary disease . Am Rev Respir Dis. 1987;;135:107-113.
72 +
Murciano D, Boczkowski J, Lecocguic Y, Milic-Emili J, Pariente R, Aubier M.  Tracheal occlusion pressure: a simple index to monitor respiratory muscle fatigue during acute respiratory failure in patients with chronic obstructive pulmonary disease . Ann Intern Med. 1988;;108:800-805.
73 +
Montgomery AB, Holle RHO, Neagley SR, Pierson DJ, Schoene RB.  Prediction of successful ventilator weaning using airway occlusion pressure and hypercapnic challenge . Chest . 1987;;91:496-499.
74 +
Black LF, Hyatt RE.  Maximal respiratory pressures: normal values and relationship to age and sex . Am Rev Respir Dis. 1971;;103:641-650.
75 +
Koulouris, Malvey DA, Laroche CM, Sawicka EH, Green M, Moxham J.  The measurement of inspiratory muscle strength by sniff esophageal, nasopharyngeal, and mouth pressures . Am Rev Respir Dis. 1989;;139:641-646.
76 +
Marini JJ, Smith TC, Lamb V.  Estimation of inspiratory muscle strength in mechanically ventilated patients: the measurement of maximal inspiratory pressure . J Crit Care. 1986;;1:32-38.
77 +
Sahn SA, Lakshminarayan S.  Bedside criteria for discontinuation of mechanical ventilation . Chest . 1973;;63:1002-1005.
78 +
Tahvanainen J, Salenpera M, Nikki P.  Extubation criteria after weaning from intermittent mandatory ventilation and continuous positive airway pressure . Crit Care Med. 1983;;11:702-707.
79 +
Fiastro JF, Habib MP, Shon BY, Campbell SC.  Comparison of standard weaning parameters and mechanical work of breathing in mechanically ventilated patients . Chest . 1988;;94:232-238.
80 +
Tobin MJ.  Respiratory muscles in disease . Clin Chest Med. 1988;;9:263-286.
81 +
Green M, Moxham J.  The respiratory muscles . Clin Sci. 1985;;68:1-10.
82 +
Laroche CM, Moxham J, Green M.  Respiratory muscle weakness and fatigue . Q J Med. 1989;;71:373-397.
83 +
Rochester DF.  Tests of respiratory muscle function . Clin Chest Med. 1988;;9:249-261.
84 +
Celli BR.  Clinical and physiological evaluation of respiratory muscle function . Clin Chest Med. 1989;;10:199-214.
85 +
Cohen C, Zagelbaum G, Gross D, Roussos C, Macklem PT.  Clinical manifestations of inspiratory muscle fatigue . Am J Med. 1982;;73:308-316.
86 +
Roussos CS, Macklem PT.  The respiratory muscles . N Engl J Med. 1982;;307:786-797.
87 +
Tobin MJ, Perez W, Guenther SM, et al.  Does ribcage abdominal paradox signify respiratory muscle fatigue? J Appl Physiol. 1987;;63:851-860.
88 +
Tobin MJ.  Assessment of pulmonary function in critically-ill patients . In: Shoemaker WC, Ayres SM, Grenvik A, Holbrook PR, Thompson WL, eds. The Society of Critical Care Medicine Textbook of Critical Care Medicine . 2nd ed. Philadelphia, Pa: WB Saunders Co; 1989;:668-676.
89 +
Feeley TW, Hedley-Whyte J.  Weaning from controlled ventilation and supplemental oxygen . N Engl J Med. 1975;;292:903-906.
90 +
Bone RC.  Monitoring ventilatory mechanics in acute respiratory failure . Respir Care. 1983;;28: 597-604.
91 +
Fallat RJ, McQuitty JC.  Bedside testing and intensive care monitoring of pulmonary function . In: Clausen JL. ed. Pulmonary Function Testing, Guidelines and Controversies . New York, NY: Grune & Stratton; 1982;:294-310.
92 +
Pepe PE, Marini JJ.  Occult positive end-expiratory pressure in mechanically ventilated patients with airflow obstruction . Am Rev Respir Dis. 1982;;126:166-170.
93 +
Rossi A, Gottfried SB, Zocchi L, et al.  Measurement of static lung compliance of the total respiratory failure during mechanical ventilation: the effect of intrinsic positive end-expiratory pressure . Am Rev Respir Dis. 1985;;131:672-677.
94 +
Milic-Emili J, Ploysongsang Y.  Respiratory mechanics in the adult respiratory distress syndrome . Crit Care Clin. 1986;;2:573-584.
95 +
Yang KL, Tobin MJ.  Decision analysis of parameters used to predict outcome of a trial of weaning from mechanical ventilation . Am Rev Respir Dis. 1989;;139:A98. Abstract.
96 +
Tobin MJ, Chadha TS, Jenouri G, et al.  Breathing patterns, I: normal subjects . Chest . 1983;; 84:202-205.
97 +
Tobin MJ, Perez W, Guenther SM, et al.  The pattern of breathing during successful and unsuccessful trials of weaning from mechanical ventilation . Am Rev Respir Dis. 1986;;134:1111-1118.
98 +
Krieger BP, Ershowsky P.  Noninvasive detection of respiratory failure in the intensive care unit . Chest . 1988;;94:254-261.
99 +
Gravelyn TR, Weg JR.  Respiratory rate as an indicator of acute respiratory dysfunction . JAMA. 1980;;244:1123-1125.
100 +
McFadden JP, Price RC, Eastwood HD, Briggs RS.  Raised respiratory rate in elderly patients: a valuable physical sign . Br Med J. 1982;;284:626-627.
101 +
Browning IB, D'Alonzo GE, Tobin MJ.  Importance of respiratory rate as an indicator of respiratory dysfunction in patients with cystic fibrosis . Chest . 1990;;97:1317-1321.
102 +
Krieger B, Feinerman D, Zaron A, Bizousky F.  Continuous noninvasive monitoring of respiratory rate in critically ill patients . Chest . 1986;; 90:632-634.
103 +
Tobin MJ.  Noninvasive evaluation of respiratory movement . In: Nochomovitz ML, Cherniack NS, eds. Noninvasive Respiratory Monitoring . New York, NY: Churchill Livingstone Inc; 1986;:29-57.
104 +
Perez W, Tobin MJ.  Separation of factors responsible for change in breathing pattern induced by instrumentation . J Appl Physiol. 1985;;59:1515-1520.
105 +
Sackner MA, Krieger BP.  Noninvasive respiratory monitoring . In: Scharf SM, Cassidy SS, eds. Heart-Lung Interactions in Health and Disease . New York, NY: Marcel Dekker Inc; 1989;:663-805.
106 +
Tobin MJ, Mador MJ, Guenther SM, et al.  Variability of resting respiratory drive and timing in healthy subjects . J Appl Physiol. 1988;;65:309-317.
107 +
Tobin MJ, Chadha TS, Jenouri G, et al.  Breathing patterns, II: diseased subjects . Chest . 1983;;84:286-294.
108 +
Bellemare F, Grassino A.  Effect of pressure and timing of contraction on human diaphragm fatigue . J Appl Physiol. 1982;;53:1190-1195.
109 +
Tobin MJ, Guenther SM, Perez W, et al.  Konno-Mead analysis of ribcage-abdominal motion during successful and unsuccessful trials of weaning from mechanical ventilation . Am Rev Respir Dis. 1987;;135:1320-1328.
110 +
Tobin MJ, Jenouri G, Birch S, et al.  Effect of positive end-expiratory pressure on breathing patterns of normal subjects and intubated patients with respiratory failure . Crit Care Med. 1983;;11:859-867.
111 +
Hoffman RA, Ershowsky P, Krieger BP.  Determination of auto-PEEP during spontaneous and controlled ventilation by monitoring changes in end-expiratory thoracic gas volume . Chest . 1989;; 96:613-616.
112 +
Tobin MJ, Lodato RF.  PEEP, auto-PEEP, and waterfalls . Chest . 1989;;96:449-451.
113 +
Rebuck AS, Chapman KR.  Measurement and monitoring of exhaled carbon dioxide . In: Nochomovitz ML, Cherniack NS, eds. Noninvasive Respiratory Monitoring . New York, NY: Churchill Livingstone Inc; 1986;:189-201.
114 +
Mogue LR, Ranrala B.  Capnometers . J Clin Monit. 1988;;4:115-121.
115 +
Snyder JV, Elliot FL, Grenvik A.  Capnography . In: Spence AA, ed. Respiratory Monitoring in Intensive Care . New York, NY: Churchill Livingstone Inc; 1982;:100-121.
116 +
Bowe EA, Boysen PG, Broome JA, Klein EF Jr.  Accurate determination of end-tidal carbon dioxide during administration of oxygen by nasal cannulae . J Clin Monit. 1989;;5:105-110.
117 +
Severinghaus JW.  Water vapor calibration errors in some capnometers: respiratory conventions misunderstood by manufacturers? Anesthesiology . 1989;;70:996-998.
118 +
Pascucci RC, Schena JA, Thompson JE.  Comparison of a sidestream and mainstream capnometer in infants . Crit Care Med. 1989;;17:560-562.
119 +
Rahn H, Farhi LE.  Ventilation, perfusion, and gas exchange—the VA/Q concept . In: Fenn WD, Rahn H, eds. Handbook of Physiology: Respiration . Baltimore, Md: Waverly Press; 1964;;1:735-766.
120 +
Yamanaka MK, Sue DY.  Comparison of arterial-end-tidal PCO2 difference and dead space/tidal volume ratio in respiratory failure . Chest . 1987;; 92:832-835.
121 +
Carlon GC, Ray C, Mee SM, Kopec I.  Capnography in mechanically ventilated patients . Crit Care Med. 1988;;16:550-556.
122 +
Robin ED.  The cult of the Swan-Ganz catheter: overuse and abuse of pulmonary flow catheters . Ann Intern Med. 1985;;103:445-449.

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