By J. L. Atlee (auth.), J. L. Atlee, J.-L. Vincent (eds.)

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This is the ratio of oxygen demand to delivery and, by rearranging the Pick equation, can be seen to be simple to calculate and independent of haemoglobin concentration. (5) Plotting data points on a graph of cardiac index against 0 2 ER, we can see that patients with inadequate cardiac function will fall below a reference line drawn through the normal values of cardiac index and 0 2ER, as increases in oxygen demand in these patients will be met by a proportionately larger increase in oxygen extraction [12].

Since QRS corresponds to the beginning of ventricular systole and that point S" marks the opening of the aortic valve (and the beginning of the ejection phase) and that T" marks the closing of the aortic valve and the end of ejection, two important components of the systolic cycle can be measured beat by beat. Therefore: QS" = Pre Ejection Period (PEP) and S"T" = Ejection Time (ET). 34 B. Allaria, M. Dei Poli, F. D'Elia, M. Favaro R Fig. 1. Signals obtained by impedance cardiography compared to ECG (By the courtesy of Levi Medical, Rome, Italy) From these values it is possible to calculate the PEP/ET ratio which is universally recognized to reflect left ventricular contractility.

There evidently had been an intrathoracic volume shift. 7 L, with a drastic reduction in extracellular fluid and a slight increase in the intracellular compartment volume. The clinical picture was felt to be due to cisplatinum nephrotoxicity, dehydration and malnutrition. 5 L/min and a normalization of total body water and the intraand extracellular compartment hydration levels as well as correction of the serum electrolyte levels. We have presented this case because it shows the usefulness of the computer in conducting complex monitoring (CO and BV with pulse dye densitometry plus total body water and intra-extracellular compartment fluid through body impedance analysis).

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