The Multiple Inert Gas Elimination Technique (MIGET) is a complex methodology involving specialized gas chromatography and sophisticated mathematics developed in the early 1970’s. Essentially, nobody possesses knowledge of all its elements except for its original developers, and while some practical and theoretical aspects have been published over the years, none have included the level of detail that would be necessary for a potential user to adopt and understand the technique easily. This book is unique in providing a highly detailed, comprehensive technical description of the theory and practice underlying the MIGET to help potential users set up the method and solve problems they may encounter. But it is much more than a reference manual – it is a substantial physiological and mathematical treatise in its own right. It also has a wide applicability – there is extensive discussion of the common biological problem of quantitative inference. The authors took measured whole-lung gas exchange variables, and used mathematical procedures to infer the distribution of ventilation and blood flow from this data. In so doing, they developed novel approaches to answer the question: What are the limits to what can be concluded when inferring the inner workings from the “black box” behavior of a system? The book details the approaches developed, which can be generalized to other similar distributed functions within tissues and organs. They involve engineering approaches such as linear and quadratic programming, and uniquely use mathematical tools with biological constraints to obtain as much information as possible about a “black box” system. Lastly, the book summarizes the hundreds of research papers published by a number of groups over the decades in a way never before attempted in order to marshal the world’s literature on the topic and to provide in one place the wealth of important discoveries, both physiological a nd clinical, enabled by the technique.

Te practice of intensive care medicine is at the very forefront of titration of treatment andmonitoringresponse. Te substrateofthiscareisthe criticallyill patientwho,by defnition, is at the limits of his or her physiologic reserve. Such patients need immediate, aggressive but balanced life-altering interventions to minimize the detrimental aspects of acute illness and hasten recovery. Treatmentdecisionsandresponsetotherapyareusually assessed by measures of physiologic function, such as assessed by cardio-respiratory monitoring. However, how one uses such information is ofen unclear and rarely supported by prospective clinical trials. In reality, the bedside clinician is forced to rely primarily on physiologic principles in determining the best treatments and response to therapy. However, the physiologic foundation present in practicing physicians is uneven and occasionally supported more by habit or prior training than science. A series of short papers published in Intensive Care Medicine since 2002 under the heading Physiologic Notes attempts to capture the essence of the physiologic perspectives that underpin both our understanding of disease and response to therapy. Tis present volume combines the complete list of these Physiologic Notes up until July 2006 with the ass o cia t ed r e vie w a r tic les o v er t h e s a m e in t er val t ha t a ls o addr ess e d t hes e cen tral issues.

The lung receives the entire cardiac output from the right heart and must load oxygen onto and unload carbon dioxide from perfusing blood in the correct amounts to meet the metabolic needs of the body. It does so through the process of passive diffusion. Effective diffusion is accomplished by intricate parallel structures of airways and blood vessels designed to bring ventilation and perfusion together in an appropriate ratio in the same place and at the same time. Gas exchange is determined by the ventilation-perfusion ratio in each of the gas exchange units of the lung. In the normal lung ventilation and perfusion are well matched, and the ventilation-perfusion ratio is remarkably uniform among lung units, such that the partial pressure of oxygen in the blood leaving the pulmonary capillaries is less than 10 Torr lower than that in the alveolar space. In disease, the disruption to ventilation-perfusion matching and to diffusional transport may result in inefficient gas exchange and arterial hypoxemia. This volume covers the basics of pulmonary gas exchange, providing a central understanding of the processes involved, the interactions between the components upon which gas exchange depends, and basic equations of the process.

Nunn's Applied Respiratory Physiology

Part of the Oxford Textbooks in Anaesthesia series, this title covers the anatomy and physiology, pharmacology, post-operative complications, critical care, and all clinical aspects of cardiac and thoracic anaesthesia. Practical aspects, such as team working, and designing and equipping cardiothoracic theatre and critical care, are also included. The expert and international author team use their experience to ensure this title reflects current world-wide practice across the globe.

The two previous editions of Applied Physiology in Intensive Care Medicine proved extremely successful, and the book has now been revised and split into two volumes to enhance ease of use. This first volume comprises three elements -- "physiological notes," “technical notes,” and seminal studies. The physiological notes concisely and clearly capture the essence of the physiological perspectives underpinning our understanding of disease and response to therapy. The technical notes then succinctly explain some of the basics of “how to” in this technology-centered field of critical care medicine. Finally, a number of seminal studies are provided on diverse topics in intensive care. Applied Physiology in Intensive Care, written by some of the most renowned experts in the field, is an up-to-date compendium of practical bedside knowledge that will serve the clinician as an invaluable reference source on key issues regularly confronted in everyday practice.