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1.
Diving Hyperb Med ; 49(4): 245-252, 2019 Dec 20.
Artigo em Inglês | MEDLINE | ID: mdl-31828742

RESUMO

INTRODUCTION: A temporary myopic shift is a well-recognized complication of hyperbaric oxygen treatment (HBOT). Oxidation of proteins in the crystalline lens is the likely cause. Direct exposure of the eye to hyperbaric oxygen may exacerbate the effect. Our aim was to measure the magnitude of the myopic shift over a course of HBOT when using two different methods of oxygen delivery. METHODS: We conducted a randomised trial of oxygen delivery via hood versus oronasal mask during a course of 20 and 30 HBOT sessions. Subjective refraction was performed at baseline and after 20 and 30 sessions. We repeated these measurements at four and 12 weeks after completion of the course in those available for assessment. RESULTS: We enrolled 120 patients (mean age 57.6 (SD 11.2) years; 81% male). The myopic shift was significantly greater after both 20 and 30 sessions in those patients using the hood. At 20 treatments: refractory change was -0.92 D with hood versus -0.52 D with mask, difference 0.40 D (95% CI 0.22 to 0.57, P < 0.0001); at 30 treatments: -1.25 D with hood versus -0.63 with mask, difference 0.62 D (95% CI 0.39 to 0.84, P < 0.0001). Recovery was slower and less complete in the hood group at both four and 12 weeks. CONCLUSIONS: Myopic shift is common following HBOT and more pronounced using a hood system than an oronasal mask. Recovery may be slower and less complete using a hood. Our data support the use of an oronasal mask in an air environment when possible.


Assuntos
Oxigenação Hiperbárica , Miopia , Feminino , Humanos , Oxigenação Hiperbárica/efeitos adversos , Oxigenação Hiperbárica/instrumentação , Oxigenação Hiperbárica/métodos , Masculino , Máscaras , Pessoa de Meia-Idade , Miopia/etiologia , Oxigênio/administração & dosagem
2.
Mo Med ; 116(3): 184-187, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31527937

RESUMO

Hyperbaric oxygen therapies may have grown out of emergencies such as those for Decompression Sickness (DCS), but more commonly in the U.S., hyperbaric oxygen is used for much more elective problems. Wound healing applications lead this trend. Nationally many more hyperbaric centers exist to treat elective problems adjunctively, and this is a concise review of these indications as well as pointing out where even elective centers might be able to broaden their practices.


Assuntos
Intoxicação por Monóxido de Carbono/terapia , Estado Terminal/terapia , Oxigenação Hiperbárica/instrumentação , Cicatrização , Lesões por Esmagamento/terapia , Doença da Descompressão/terapia , Humanos , Osteomielite/terapia
3.
S Afr Med J ; 109(4): 12574, 2019 03 29.
Artigo em Inglês | MEDLINE | ID: mdl-31084683

RESUMO

Hyperbaric oxygen therapy is defined as an intervention in which an individual breathes near 100% oxygen while wholly enclosed inside a hyperbaric chamber at a pressure ≥1.4 atmosphere absolute (ATA). The Southern African Underwater and Hyperbaric Medical Association (SAUHMA)-approved indications commence at pressures ≥2 ATA. Low-pressure hyperbaric chambers, at pressures ≤1.4 ATA, are approved for acute mountain sickness only. Mild hyperbaric exposures with air deliver no more oxygen to the body than breathing oxygen by mask at sea level pressure. Exposure to treatment pressures <2.0 ATA while breathing air does not meet the SAUHMA definition of therapeutic hyperbaric oxygen therapy and does not achieve the minimum pressure and oxygen levels required for any SAUHMA-approved indication. All SAUHMA-approved indications require that the patient breathe near 100% oxygen while enclosed in a chamber pressurised to a minimum of 2 ATA. SAUHMA does not recommend the use of mild hyperbaric therapy for any medical purpose other than acute mountain sickness.


Assuntos
Oxigenação Hiperbárica/instrumentação , Humanos , Oxigenação Hiperbárica/métodos , Oxigenação Hiperbárica/normas , Guias de Prática Clínica como Assunto , Sociedades Médicas , África do Sul
4.
Undersea Hyperb Med ; 46(2): 135-143, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31051058

RESUMO

Purpose: Hyperbaric medicine is nascent in Korea when compared to other developed countries, such as the United States and Japan. Our facility has been managed by physicians with certifications from the Undersea and Hyperbaric Medical Society (UHMS) and National Oceanic and Atmospheric Administration in diving and clinical diseases since October 2016. This study was conducted to share similar issues that are encountered during the establishment of a program in a new area through our experiences in the operation of a hyperbaric oxygen (HBO2) therapy center. Methods: In this retrospective observational study we collected data on HBO2 patients treated at our center between October 2016 and June 2018 after HBO2 was conducted by HBO2-certified physicians. We then compared demographic data of patients with data from January 2011 to September 2015 - before HBO2 operations were conducted by HBO2-certified physicians. Result: A total of 692 patients received 5,130 treatments. Twelve indicated diseases were treated using HBO2 therapy. Fifty-six critically ill patients with intubation received HBO2. Although two patients experienced seizure due to oxygen toxicity during the study period, certified physicians and inside attendant took immediate corrective action. Conclusion: After the establishment of the HBO2 center operated by physicians with certification, more patients, including critically ill patients, received HBO2 safely for various diseases. In order to improve the practice of hyperbaric medicine in Korea, the Korean Academy of Undersea and Hyperbaric Medicine (KAUHM), an advanced and well-organized academic society, should communicate often with HBO2 centers, with the aim to set Korean education programs at UHMS course levels and increase reimbursement for HBO2 therapy.


Assuntos
Hospitais Especializados/estatística & dados numéricos , Oxigenação Hiperbárica/estatística & dados numéricos , Desenvolvimento de Programas , Idoso , Intoxicação por Monóxido de Carbono/terapia , Certificação , Estado Terminal/terapia , Doença da Descompressão/terapia , Feminino , Perda Auditiva Neurossensorial/terapia , Perda Auditiva Súbita/terapia , Hospitais Especializados/organização & administração , Humanos , Oxigenação Hiperbárica/efeitos adversos , Oxigenação Hiperbárica/instrumentação , Masculino , Pessoa de Meia-Idade , Objetivos Organizacionais , Oxigênio/efeitos adversos , República da Coreia , Estudos Retrospectivos , Suspensão de Tratamento/estatística & dados numéricos
5.
Rev. Asoc. Méd. Argent ; 131(4): 12-20, Dic. 2018. ilus, graf, tab
Artigo em Espanhol | LILACS | ID: biblio-1009724

RESUMO

El uso clínico de la terapia de oxigenación hiperbárica (TOHB) consiste en respirar oxígeno en una concentración cercana al 100% en una cámara presurizada al menos a 1,4 atmósferas absolutas (atm). TOHB actúa produciendo hiperoxia y especies reactivas del oxígeno que desencadenan mecanismos bioquímicos variados. Se presenta una revisión de todas las nuevas aplicaciones emergentes de TOHB en varias especialidades médicas debido a que alcanza beneficios en la cicatrización de heridas, enfermedades inflamatorias y con componente neurológico o isquémico. Las nuevas cámaras realizan el tratamiento a presiones más seguras y con la misma eficiencia demostrada por métodos matemáticos y bioquímicos. El Grupo BioBárica Clinical Research presenta la estadística de las indicaciones en 559 pacientes tratados con estas cámaras en algunos centros médicos y las especialidades médicas implicadas. El uso de TOHB a media presión está en emergencia y podría proveer a futuro evidencia de su efectividad en otras especialidades médicas. (AU)


The clinical use of Hyperbaric Oxygen Therapy (HBOT) consists in breathing oxygen (O2) near to 100% in a pressurized chamber of at least at 1.4 absolute atmospheres (ATA). HBOT acts producing both hyperoxia and reactive oxygen species (ROS) and triggers others biochemical events. The BioBarica Clinical Research Group is developing clinical evidence in diverse pathologies because of accessibility and safety of the new Revitalair hyperbaric oxygen chamber. Because of working at "mild pressure", HBOT performed by these chamber are safer demonstrated by mathematical and biochemical methods. The BioBarica Clinical Research Group presents the statistics of the indications in 559 patients treated with these cameras in some medical centers and the medical specialties involved. Their accessibility to the physicians would become mild pressure HBOT used more frequently proving its effectiveness in other clinical specialties. (AU)


Assuntos
Humanos , Resultado do Tratamento , Contraindicações de Procedimentos , Oxigenação Hiperbárica/instrumentação , Oxigenação Hiperbárica/métodos , Ferimentos e Lesões/terapia , Intoxicação por Monóxido de Carbono/terapia , Doenças Reumáticas/terapia , Pé Diabético/terapia , Condicionamento Físico Humano/métodos , Neoplasias/terapia
6.
J Med Invest ; 65(3.4): 286-288, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30282875

RESUMO

Hyperbaric oxygen therapy (HBOT) for carbon monoxide (CO) poisoning is widely performed to prevent delayed neuropsychiatric syndrome. Although HBOT can generally be performed with safety, the appropriate management of HBOT still remains unestablished. A 31-year-old man was transferred to our facility to undergo HBOT in a multiplace chamber with a diagnosis of CO poisoning. The first HBOT session ended uneventfully. During the second HBOT session, the patient suddenly experienced convulsive seizures. The accompanying doctor administered intravenous propofol to stop the convulsion and terminated the HBOT. Soon after the convulsion, the patient developed frothy secretions through the endotracheal-tube with impaired oxygenation. Head computed tomography scan showed no abnormalities, suggesting the seizure was associated with complications of HBOT. A chest X-ray revealed bilateral pulmonary edema, and echocardiography revealed normal cardiac function, indicating that the pulmonary edema resulted from HBOT or neurogenic mechanism secondary to the seizure. The patient's respiratory status improved without recurrence of the seizure and no delayed neurological sequelae was seen afterwards. Here we report unexpected rare adverse events during HBOT. Hyperbaric oxygen therapy for acute indications should be performed in multiplace chambers, with appropriate preparation and medical equipment. J. Med. Invest. 65:286-288, August, 2018.


Assuntos
Oxigenação Hiperbárica/efeitos adversos , Edema Pulmonar/etiologia , Convulsões/etiologia , Adulto , Intoxicação por Monóxido de Carbono/terapia , Humanos , Oxigenação Hiperbárica/instrumentação , Japão , Masculino , Edema Pulmonar/diagnóstico por imagem , Edema Pulmonar/fisiopatologia , Convulsões/fisiopatologia
8.
Sanid. mil ; 74(3): 179-184, jul.-sept. 2018. ilus, tab
Artigo em Espanhol | IBECS | ID: ibc-182297

RESUMO

Introducción: Las principales patologías que requieren tratamiento en cámara hiperbárica son la enfermedad descompresiva y el embolismo arterial gaseoso. Ambas comparten la necesidad de cambios de la presión ambiental y del contenido gaseoso en el organismo. Además del buceo, existen otras situaciones que suponen cambios de presión y por tanto propician el riesgo de presentar lesiones que requieran recompresión. Objetivos: Describir los principales lugares de producción de estas patologías y los mecanismos fisiopatológicos que las generan. Material y Método: Expedientes de accidentes de buceo recogidos en el Centro de Buceo de la Armada desde 1970 hasta 2017. Resultados: Total 392 casos, 345 (88%) se producen en la mar, 36 (9,18%) en cámara hiperbárica, 6 (1,53%) en relación con submarinos y 4 (1,02%) en actividades hipobáricas. Conclusiones: Cualquier situación que suponga un cambio de presión expone al sujeto a presentar una patología descompresiva y a necesitar un tratamiento hiperbárico. El lugar más frecuente es en la mar pero pruebas, en principio no lesivas, como un tratamiento hiperbárico, pueden predisponer a estas lesiones


Introduction: The main pathologies that require a recompression therapy are decompression sickness (DCS) and arterial gas embolism (AGE), boths can be caused by pressure-related activites and certain amount of gas (dissolved or not) in the victim's blood. Besides diving other pressure-related activities put the person in risk of this pathologies. Aim: To investigate the main place of production of these pathologies and their physiological base. Methods: we reviewed all charts of patients with DCS and AGE from 1970-2017 at Centro de Buceo de la Armada (Cartagena). Results: There were 392 cases, 345 (88%) diving related, 36 (9,18%) hyperbaric chamber-related, 6 (1,53%) submarine activities related and 4 (1,02%) hypobaric activities-related. Conclusions: Diving injuries rates are the most important but any pressure-related activity can be risky even hyperbaric chamber activity, considered the safest pressure-related activity


Assuntos
Humanos , Oxigenação Hiperbárica/instrumentação , Doença da Descompressão/diagnóstico , Doença da Descompressão/terapia , Embolia/terapia , Acidentes , Oxigenação Hiperbárica/métodos , Mergulho
9.
PLoS One ; 13(8): e0200407, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30074998

RESUMO

This work presents the automation of a multiplace hyperbaric chamber. It includes the system modeling, identification, controller calculation and system validation. With the proposed approach a good pressure profile tracking and repeatability are achieved. Moreover, the proposed automation includes the implementation of powerful treatment tools such as Pause and Alleviation procedures. The control system implemented is based on a special zero-pole cancellation regulator. Experimental results are provided to illustrate the behavior of the automated chamber. It is important to remark that the chamber automated in this work is being successfully used in a real hospital since 2015 treating more than 40 patients per day, five days a week.


Assuntos
Barotrauma/prevenção & controle , Desenho de Equipamento , Oxigenação Hiperbárica/instrumentação , Oxigenação Hiperbárica/normas , Monitorização Fisiológica , Humanos , Pressão
11.
Rev Infirm ; 67(242): 23-24, 2018.
Artigo em Francês | MEDLINE | ID: mdl-29907173

RESUMO

Nursing practice in the hyperbaric environment draws on very specific skills. This setting, which is presented as a therapeutic tool in a range of indications, is also a hostile care environment for health professionals. A team from Lyon reveals the characteristics of nursing practice in a hyperbaric chamber.


Assuntos
Adaptação Fisiológica , Oxigenação Hiperbárica/instrumentação , Doenças Profissionais/etiologia , Local de Trabalho , Meio Ambiente , Pessoal de Saúde , Humanos , Oxigenação Hiperbárica/enfermagem , Equipe de Assistência ao Paciente/normas , Padrões de Prática em Enfermagem
12.
Diving Hyperb Med ; 48(2): 102-106, 2018 Jun 30.
Artigo em Inglês | MEDLINE | ID: mdl-29888382

RESUMO

INTRODUCTION: The management of mechanically ventilated patients in the hyperbaric environment requires knowledge of how the physical properties of gases change under pressure and how this affects the operation of the ventilator. The primary objective of this study was to test the performance of the Dräger Oxylog 1000® ventilator in a hyperbaric environment. METHODS: Each of two ventilators was connected to a mechanical test lung system with an in-built pressure gauge. We used a Wright's respirometer to measure the tidal volumes. The same ventilator settings were tested under varying environmental pressures from ambient (101.3 kPa) to 18 meters' sea water (284 kPa) in a multiplace hyperbaric chamber. RESULTS: A decrease was found in tidal volume, decrease in airway pressure and increase in respiratory rate delivered by the Dräger Oxylog 1000 portable ventilator with increasing pressures to 284 kPa. DISCUSSION: These findings can be explained by the operating principles of the Oxylog 1000, which is a time-controlled, constant-volume ventilator that functions as a flow chopper. Even between the two Oxylog 1000 ventilators tested there were different absolute changes in tidal volume, airway pressures and respiratory rates at various depths. Hence, the trend of changes in these variables is probably more important than absolute values. CONCLUSION: In summary, understanding the trend of changes in ventilator variables will allow clinicians to make appropriate corrections in ventilator settings and carefully monitor adequacy of ventilation to prevent adverse ventilator-associated events. The Dräger Oxylog 1000 portable ventilator is an adequate back-up ventilator for use with straight-forward, ventilator-dependent patients undergoing hyperbaric treatment.


Assuntos
Oxigenação Hiperbárica , Ventiladores Mecânicos , Humanos , Oxigenação Hiperbárica/instrumentação , Inalação , Capacidade Inspiratória , Pulmão , Volume de Ventilação Pulmonar
13.
Monaldi Arch Chest Dis ; 88(1): 882, 2018 01 29.
Artigo em Inglês | MEDLINE | ID: mdl-29557574

RESUMO

Few studies have analyzed the prevalence and accessibility of home mechanical ventilation (HMV) in Italy. We aimed to investigate the prevalence and prescription variability of HMV as well as of long-term oxygen therapy (LTOT) and continuous positive airway pressure (CPAP), in the Lombardy Region. Prescribing rates of HMV (both noninvasive and tracheostomies), CPAP (auto-CPAP, CPAP/other sleep machines) and LTOT (liquid-O2, O2-gas, concentrators) in the 15 Local Healthcare districts of Lombardy were gathered from billing data for 2012 and compared. Crude rates (per 100,000 population) and rates for the different healthcare districts were calculated. In 2012, 6325 patients were on HMV (crude prescription rate: 63/100,000) with a high variation across districts (8/100,000 in Milano 1 vs 150/100,000 in Pavia). There were 14,237 patients on CPAP (crude prescription rate: 142/100,000; CPAP/other sleep machines 95.3% vs auto-CPAP 4.7%) with also high intra-regional variation (56/100,000 in Mantova vs. 260/100,000 in Pavia). There were 21,826 patients on LTOT (prescription rate: 217/100,000 rate; liquid-O2 94%, O2-gas 2.08%, O2-concentrators 3.8%), with again high intra-regional variation (100/100,000 in Bergamo vs 410/100,000 in Valle Camonica). The crude rate of HMV prescriptions in Lombardy is very high, with a high intra-regional variability in prescribing HMV, LTOT and CPAP which is partly explainable by the accessibility to specialist centers with HMV/sleep-study facilities. Analysis of administrative data and variability mapping can help identify areas of reduced access for an improved standardization of services. An audit among Health Payer and prescribers to interpret the described huge variability could be welcomed.


Assuntos
Acesso aos Serviços de Saúde/normas , Respiração Artificial/estatística & dados numéricos , Ventiladores Mecânicos/provisão & distribução , Pressão Positiva Contínua nas Vias Aéreas/instrumentação , Pressão Positiva Contínua nas Vias Aéreas/estatística & dados numéricos , Humanos , Oxigenação Hiperbárica/instrumentação , Oxigenação Hiperbárica/estatística & dados numéricos , Itália/epidemiologia , Estudos Observacionais como Assunto , Assistência Centrada no Paciente , Prevalência , Respiração Artificial/instrumentação , Respiração Artificial/tendências
16.
Undersea Hyperb Med ; 44(3): 243-256, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28779581

RESUMO

This paper presents the replacement of a traditional wired communication link of the hyperbaric chambers with a wireless ZigBee-based system. This move allows a reduction in the costs of seals capable of withstanding the internal pressures and gives rise to a more versatile system. The new system is able to capture and process individual vital signs like the electrocardiography signal, and other analog sources, sending the data to an external computer and allowing analysis, representation and sharing with medical staff. This system solves such problems as the attenuation of the signal produced by the metal walls of the hyperbaric chamber and has a coverage area large enough to manage up to six patients with an effective data rate conversion of 2kHz. Furthermore, a battery-based and multiparameter platform is designed for multipatient hyperbaric chambers.


Assuntos
Oxigenação Hiperbárica/instrumentação , Sinais Vitais/fisiologia , Tecnologia sem Fio/instrumentação , Monitorização Transcutânea dos Gases Sanguíneos , Temperatura Corporal , Confidencialidade , Eletrocardiografia/instrumentação , Eletroencefalografia/instrumentação , Desenho de Equipamento , Humanos , Monitorização Fisiológica/instrumentação , Interface Usuário-Computador
17.
Am J Emerg Med ; 35(10): 1536-1541, 2017 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-28501324

RESUMO

OBJECTIVES: To validate the effects of the new plateau hyperbaric chamber on alleviating high altitude hypoxia on Mount Kun Lun. METHODS: A prospective, controlled study of rabbits and adult volunteers was conducted at altitudes of 355, 2880 and 4532m. We obtained arterial blood samples from rabbits and volunteers before and after hyperbaric treatment. The respiratory rate, heart rate, and blood pressure (BP) of adult volunteers were monitored during hyperbaric treatment. RESULTS: The mean PaO2 levels of experimental group rabbits and volunteers increased significantly after 60min of hyperbaric treatment at 350, 2880 and 4532m. The mean PaCO2 and pH levels of rabbits were not significant different before and after hyperbaric treatment at each altitude. The mean PaCO2 and pH levels were not significant different at 355m in the human study. However, at 2880 and 4532m, pH fell with increasing PaCO2 levels in humans before and after hyperbaric treatment. CONCLUSIONS: The new multiplace plateau hyperbaric chamber may be used to alleviate plateau hypoxia by increasing patient PaO2. However, its value in treating AMS must be confirmed in field conditions.


Assuntos
Doença da Altitude/terapia , Oxigenação Hiperbárica/instrumentação , Hipóxia/terapia , Monitorização Fisiológica/métodos , Oxigênio/sangue , Doença da Altitude/sangue , Doença da Altitude/complicações , Animais , Modelos Animais de Doenças , Humanos , Hipóxia/sangue , Hipóxia/etiologia , Coelhos
19.
Ostomy Wound Manage ; 62(5): 32-6, 2016 May.
Artigo em Inglês | MEDLINE | ID: mdl-27192719

RESUMO

Pyoderma gangrenosum (PG) is a neutrophilic dermatosis of unknown etiology characterized by an ulcerative skin condition and confirmed through a diagnosis of exclusion. Management usually consists of systemic drug therapy, such as corticosteroids, sulfones, or immunosuppressants, either alone or in combination. Long-term use of these medications often has untold side effects. Hyperbaric oxygen therapy (HBOT) has been shown effective in the treatment of PG, reducing pain and tempering the need for medication. A case is presented of a 54-year-old woman with diabetes, hypertension, and a peptic ulcer who presented with painful, purulent ulcers on her buttocks, hands, and lower extremities of 2 weeks' duration. She was ultimately diagnosed with PG and provided 20 mg/day of oral prednisone for 1 week, tapered to 10 mg/day in the next week and then stopped. In addition, she received 12 sessions of HBOT - she breathed in 100% oxygen under 2.5 atmospheres absolute pressure for 90 minutes over 2 weeks. Her wounds healed without scarring. This excellent outcome including good wound healing, decreased pain, and reduced doses of systemic corticosteroids warrants additional study of the adjunctive use of HBOT for PG.


Assuntos
Oxigenação Hiperbárica/métodos , Pioderma Gangrenoso/fisiopatologia , Pioderma Gangrenoso/terapia , Cicatrização , Complicações do Diabetes/terapia , Feminino , Humanos , Oxigenação Hiperbárica/instrumentação , Pessoa de Meia-Idade , Prednisona/uso terapêutico , Esteroides/uso terapêutico
20.
Undersea Hyperb Med ; 43(1): 9-19, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27000009

RESUMO

We evaluated the Zyno Medical Z-800F, CME Body Guard 323 Color Vision, and Baxter Flo-Gard 6201 infusion pumps for monoplace chamber conditions. We adjusted pump occlusion pressure allowing infusion to 3 atmospheres absolute (atm abs). Baxter and Zyno pumps were connected to the chamber pass-through with rigid small-bore tubing. The CME infusion set was connected directly to the pass-through. We infused saline to a collection manifold inside a monoplace chamber at 1-100 mL/ hour under pressures ranging from 0.85-3.0 atm abs. We averaged results from three to five separate tests for each condition. At baseline, pumps performed within ±10% of expected (our measurement capability). However, clinical engineering verified performance within manufacturer specifications (±5% at atmospheric pressure). During a carbon monoxide hyperbaric protocol (3 atm abs/2 atm abs), measured flow with the Baxter, CME and Zyno pumps was ±5% of setting at 10 mL/hour (95%, 103%, 95%, respectively); at 1 mL/hour, average flow were 91%, 83%, 83%, respectively. During timed testing (volume recorded before decompression), pump accuracy was ±10% at 10 and 100 mL/hour. Tubing compliance compromised performance at lower flow rates, magnified by increased pressure. These pumps have potential for monoplace chamber use, although not supported by the manufacturers or FDA-cleared. At low flow rates, tubing compliance affects delivered volumes.


Assuntos
Pressão Atmosférica , Oxigenação Hiperbárica/instrumentação , Bombas de Infusão/normas , Infusões Intravenosas/instrumentação , Teste de Materiais/métodos , Aprovação de Equipamentos , Desenho de Equipamento , Estudos de Avaliação como Assunto , Padrões de Referência , Cloreto de Sódio/administração & dosagem
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