s simulation platform. Methods A Windows Presentation Foundation application that emulates an Aespire anesthesia workstation was created. The Gas Man simulator (Med Man Simulations) was used as a reference for the pharmacokinetic model. A concordance analysis was made between the results obtained by our model and the reference, in open and semiclosed circuit, in both 70- and 140-kg patients. Results The mean of the differences between the compartments was less than 0.01 vol% in all circumstances. The percentile rank P2.5 to P97.5 was less than 0.5 vol% in all compartments, except for the open circuit compartment. Conclusions No significant differences were found between both pharmacokinetic models. We consider that our software-based anesthesia workstation can be useful for simulating mechanical ventilation and halogenated administration in different scenarios....

Alternatives to animal tests are often cheaper, quicker and more effective.

Background Pulmonary function tests (PFTs) are routinely performed in the upright position due to measurement devices and patient comfort. This systematic review investigated the influence of body position on lung function in healthy persons and specific patient groups. Methods A search to identify English-language papers published from 1/1998–12/2017 was conducted using MEDLINE and Google Scholar with key words: body position, lung function, lung mechanics, lung volume, position change, positioning, posture, pulmonary function testing, sitting, standing, supine, ventilation, and ventilatory change. Studies that were quasi-experimental, pre-post intervention; compared ≥2 positions, including sitting or standing; and assessed lung function in non-mechanically ventilated subjects aged ≥18 years were included. Primary outcome measures were forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC, FEV1/FVC), vital capacity (VC), functional residual capacity (FRC), maximal expiratory pressure (PEmax), maximal inspiratory pressure (PImax), peak expiratory flow (PEF), total lung capacity (TLC), residual volume (RV), and diffusing capacity of the lungs for carbon monoxide (DLCO). Standing, sitting, supine, and right- and left-side lying positions were studied. Results Forty-three studies met inclusion criteria. The study populations included healthy subjects (29 studies), lung disease (nine), heart disease (four), spinal cord injury (SCI, seven), neuromuscular diseases (three), and obesity (four). In most studies involving healthy subjects or patients with lung, heart, neuromuscular disease, or obesity, FEV1, FVC, FRC, PEmax, PImax, and/or PEF values were higher in more erect positions. For subjects with tetraplegic SCI, FVC and FEV1 were higher in supine vs. sitting. In healthy subjects, DLCO was higher in the supine vs. sitting, and in sitting vs. side-lying positions. In patients with chronic heart failure, the effect of position on DLCO varied. Conclusions Body position influences the results of PFTs, but the optimal position and magnitude of the benefit varies between study populations. PFTs are routinely performed in the sitting position. We recommend the supine position should be considered in addition to sitting for PFTs in patients with SCI and neuromuscular disease. When treating patients with heart, lung, SCI, neuromuscular disease, or obesity, one should take into consideration that pulmonary physiology and function are influenced by body position.

Abstract. Summary: Assessing and improving the safety of chemicals and the efficacy of drugs depends on an understanding of the biodistribution, clearance and b