Journal of clinical monitoring and computing
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J Clin Monit Comput · Jul 1998
Randomized Controlled Trial Clinical TrialInfluence of pulse oximetry and capnography on time to diagnosis of critical incidents in anesthesia: a pilot study using a full-scale patient simulator.
Many studies (outcome, epidemiological) have tested the hypothesis that pulse oximetry and capnography affect the outcome of anesthetic care. Uncontrollable variables in clinical studies make it difficult to generate statistically conclusive data. In the present study, we eliminated the variability among patients and operative procedures by using a full-scale patient simulator. We tested the hypothesis that pulse oximetry and capnography shorten the time to diagnosis of critical incidents. ⋯ Simulation may offer new approaches to the study of monitoring technology. However, the limitations of current simulators and the resources required to perform simulator-based research are impediments to wide-spread use of this tool.
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J Clin Monit Comput · Jul 1998
Normothermic cardiopulmonary bypass increases heparin requirements necessary to maintain anticoagulation.
With the practice of warm cardiopulmonary bypass (CPB) at our institution we have observed an apparent increase in heparin requirements. CPB temperature predictability affects pharmacokinetics and differences in drug metabolism can be expected. We hypothesized that heparin requirements would increase with increasing CPB temperature. ⋯ Maintenance of adequate heparin anticoagulation during CPB is clinically important. Warm CPB patients required more heparin per minute than those undergoing cold CPB. More frequent assessment of anticoagulation and administration of additional heparin should be considered in patients undergoing warm CPB.
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J Clin Monit Comput · Jul 1998
Sensitivity of near infrared spectroscopy to cerebral and extra-cerebral oxygenation changes is determined by emitter-detector separation.
To examine the effect of two emitter-detector separations (2.7 and 5.5 cm) on the detection of changes in cerebral and extra-cerebral tissue oxygenation using near infrared spectroscopy (NIRS). ⋯ The differing sensitivity of the proximal and distal channels to changes in cerebral and extracerebral oxygenation is compatible with theoretical models of NIR light transmission in the adult head and may provide a basis for spatially resolving these changes. The optimal emitter-detector separation for adult NIRS requires further investigation and may differ between individuals.