Journal of clinical monitoring and computing
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J Clin Monit Comput · Dec 1999
Comparative Study Clinical TrialMonitoring of heart and respiratory rates in newborn infants using a new photoplethysmographic technique.
A new photoplethysmographic (PPG) device for respiratory and heart rate monitoring has been evaluated in the neonatal care units at the University Children's Hospital of Uppsala, Sweden. The purpose of this study was to compare this new device with more established techniques, i.e., transthoracic impedance plethysmography (TTI) for monitoring of respiratory rate and ECG for heart rate monitoring. ⋯ Electrode and motion artefacts seem to disturb the ECG signals and, particularly, the impedance signals. During periods of high quality ECG and impedance signals, the new optical device produces signals of equal quality to these traditional methods, and is in some cases even better. The new device is non-invasive and has a small optical probe. These factors indicate further advantages of the photoplethysmographic method.
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J Clin Monit Comput · Dec 1999
The influence of left lateral position on cardiac output changes after head up tilt measured by impedance cardiography.
The value of the impedance cardiography (IC) method for measuring cardiac output (CO) with the subject in the left lateral position has not yet been established. We compared the CO after a 30 degrees head-up tilt with the subjects in the supine and left lateral position. ⋯ When using the IC method of SV measurement, the absolute value of the CI changes when moving from the supine to lateral positions. It is not clear whether this change is physiologic or an artifact of the measurement technique. However, changes in CI in response to a 30 degree head up tilt are the same in either position. We conclude that changes in CI can be measured with the IC method in the lateral position.
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J Clin Monit Comput · Dec 1999
Comparative StudyA comparison of the Internet and the standard textbook in preparing for the professional anaesthetic examination.
The Internet is increasingly being recognised as a source of information in different fields, and medicine is no exception. We investigated the use of the Internet as an aid in preparing for the professional medical examinations. The Internet was compared to a standard textbook in answering a randomly selected past examination paper. ⋯ In contrast, the textbook provided adequate information in only 73.3% of the questions. The time required to search for information on the Internet was more than that required for a single textbook. (approximately 2 hours per question compared to 30 minutes per question respectively). However, with the rapid development of computer technology and the cyberspace, the Internet may prove to be a viable alternative or a good supplement to the standard textbook when trainee anaesthetists are preparing for their professional medical examinations.
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J Clin Monit Comput · Dec 1999
Patient's perceptions of an anesthesia preoperative computerized patient interview.
Our desire to elicit a more complete medical history from our patients led to the implementation of a preoperative computerized interview. We previously demonstrated the effectiveness of the interview by computing its mean completion time for the overall patient population (n = 120), and further examined the effects of age, gender, and educational level. In this study, we investigated patient perception of the interview itself. ⋯ The Stuart-Maxwell test was used to determine statistically significant differences in answers before and after the interview. Initial questionnaire responses reflected a positive attitude toward computer usage which became even stronger after the interview. The only negative responses elicited were really more "doctor positive" than "computer negative." We conclude that patients looked favorably upon participating in a computerized medical interview provided that physician-patient contact is maintained.
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J Clin Monit Comput · Dec 1999
Ergonomic evaluation of an ecological interface and a profilogram display for hemodynamic monitoring.
Comprehensive monitoring of the patient state and subsequent decision making is an essential part of the task of an anaesthetist. The physicians' decision making process is based upon a concept of partly abstract physiologic parameters such as depth of anaesthesia or contractility. This concept is derived from the measured parameters given on todays' trend displays in addition to context information available for the anaesthetist. We investigated two alternative approaches of display design for hemodynamic monitoring: 1) integrated displays based on ecological interface design, and 2) profilogram displays based on intelligent alarms. ⋯ Our results have shown that subjects came to more effective solutions with the traditional trend display. The main reason for this result may be their years of experience with this kind of display type. Regarding safe and goal-intended decision finding, the results are encouraging for further experiments with redesigned ecological displays. But these displays ought to have smoother changes with respect to the traditional trend displays. Furthermore, new experiments have to be performed under real or fairly real (e.g. together with an anaesthesia simulator) conditions to underline the positive results for ecological interfaces.