Editor-in-Chief: "We start a new series on the evolution of medical technology and physiology"

Ilkka Kalli MD, PhD, MBA
Anesthesiologist

2006 was a busy year for Clinical Window since we started organizing Scientific Symposia at medical congresses to reach our audience on several fronts. Coordinating four symposia in 12 months turned the editor inside me around with the result that we published only two web journal issues in 2006. Now approaching steady state, our presence will be more regular.

"Evolution of mechanical ventilation": This 22nd issue completes our 7th volume of Clinical Window Web Journal (CWWJ). I liked the idea of having a bit of historical perspective along with some neonatal aspects. That made me combine a historical article on the evolution of ventilation with another on the newborn’s first attempts at breathing.

First, to tune our readers to the point of view, Mr. Andras Gedeon writes about “Mechanical ventilation, a historical perspective”. He brings us through nearly 500 years of history since the first experiments by Vesalius - but that’s all I am releasing here. The rest you can come and read yourself. (More...)

Mechanical ventilation, a historical perspective

Andras Gedeon, M.Sc. (Eng.), D.Sc.(Physics)
Stockholm, Sweden

“De humani coporis fabrica” published in 1543: The original Latin text by Andreas Vesalius is the first account of mechanical ventilation.

It is also the first description of the physiological effects produced when the technique is applied after lung collapse is induced by piercing “the inner lining of the ribs”. The experiment was performed on a pregnant sow (Figure) over 450 years ago. (More...)

Optimal PEEP - what we can learn from neonates

Javier García Fernández, MD, PhD
Madrid, Spain

The very first breath at delivery is a great effort for the newborn. It may generate iinspiratory pressures of 80-90 cm H2O. As neonates may have a closing volume larger than their FRC, newborn lungs would collapse at the end of normal expiration, and a neonate would need to recruit the lungs again at each inspiration.

Photo©Kalli-06

Hence, a newborn utilizes a glottic closure reflex. Consequently, in a situation where there is an inhibited glottic closure reflex, such as at anesthesia induction, neonates rapidly become hypoxemic. (More...)

Future activities

In March CWWJ plans to publish our 23rd issue on spirometry and assessment of lung function. There will be material from Prof. Stenqvist’s research team at the University of Gothenburg - which is where Spirodynamics was invented. Other exciting articles on pulmonary function and ventilatory support are also waiting for publication. As always, anesthesiology is our other important focus, and before summer we will be publishing articles on physiologic monitoring, clinical pharmacology and intravenous anesthesia.

In general, Clinical Window continues to reshape and widen its scope. We will find new topics for cardiology or for maternal and infant care, and move to new applications of ultrasound (anesthesiology, emergency medicine). Let me hint that we are also studying some new environments like NICU, and technologies like MRI.

In Clinical Window we want to be near our audience. Be seeing you!