Journal of clinical monitoring and computing
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J Clin Monit Comput · Apr 2014
Review Case ReportsGlideScope video laryngoscopy use tracheal intubation in patients with ankylosing spondylitis: a series of four cases and literature review.
Airway management in patients with ankylosing spondylitis (AS) is a challenging problem for anesthesiologists. The GlideScope video laryngoscope (GVL) is designed to assist tracheal intubation for patients with a difficult airway. The aim of the study was to report the successful intubation by GVL of four AS patients, and to discuss the use of GVL for tracheal intubation in patients with AS by performing a review of the literature. ⋯ As with any challenging airway management, it is essential to have a rescue strategy. We believe that GVL can be a good alternative for oral endotracheal intubation in patients with AS. This series is very small and the reader should be very cautious about drawing broad conclusions regarding the GVL and patients with AS.
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A review of the literature shows that current "standard" laboratory measurements for hemoglobin are subject to numerous factors that affect both accuracy and reliability. In addition, total hemoglobin concentration measurements are subject to numerous factors that affect the "true" hemoglobin value. This article discusses both the physiologic factors that influence hemoglobin levels and the technical aspects and variability among the different measurement methodologies currently available.
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J Clin Monit Comput · Oct 2013
Review Meta AnalysisHeart rate variability indices for very short-term (30 beat) analysis. Part 1: survey and toolbox.
Heart rate variability (HRV) analysis over very short (<60 s) periods may be useful for monitoring dynamic changes in autonomic nervous system activity where steady-state conditions are not maintained (e.g. during drug administration, or the start or end of exercise). From the 1980s there has been a wealth of HRV indices produced in the quest for better measures of the change in parasympathetic and sympathetic activity. Many of the indices have been sparingly used and have not been investigated for application to short-term use. ⋯ The survey identified a comprehensive list of 115 indices that were subsequently coded and screened. Of these, 70 were unique and produced a finite number with 60 s data, so are included in the Toolbox. These indices require validation against physiological data before they can be applied to short-term HRV analysis of cardiac autonomic nervous system activity.
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J Clin Monit Comput · Aug 2013
ReviewConnecting the dots: rule-based decision support systems in the modern EMR era.
The intensive care unit (ICU) environment is rich in both medical device and electronic medical record (EMR) data. The ICU patient population is particularly vulnerable to medical error or delayed medical intervention both of which are associated with excess morbidity, mortality and cost. ⋯ False alerts and alert fatigue remain prevalent. In the coming era of widespread EMR implementation novel medical informatics methods may be adaptable to the development of next generation, rule-based DSS.