Journal of clinical monitoring and computing
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J Clin Monit Comput · Jan 2000
Limits of corrected flow time to monitor hemodynamic status in children.
Doppler corrected flow time (i.e., corrected left ventricular ejection time) as a noninvasive tool for assessing hemodynamic changes has been previously reported for adult patients. Its use in paediatrics seems to be worthwhile but no data concerning its accuracy are presently available in this population. The purpose of this work was to study the relationships between corrected flow time (FT) and indices of systemic vascular resistance (SVR) and of myocardial contractility in healthy children. ⋯ These results show that the use of Bazett's formula correct FT could lead to hemodynamic misinterpretations, because it does not rule out all the heart rate effect. Moreover, in healthy children corrected FT appears as an inaccurate index to monitor physiological afterload alterations, because of the involvment of other hemodynamic factors such as contractility in its variation.
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This review provides a practical clinical guide to the measurement of pulmonary mechanics. Although these measurements are now commonly available in a variety of clinical settings, there is considerable confusion regarding their interpretation and significance. A basic understanding of the principles involved will help prevent the misuse of this important information.
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J Clin Monit Comput · Jan 2000
Non-invasive cardiac output monitoring by aortic blood flow measurement with the Dynemo 3000.
The operating principles and methods for the continuous determination of aortic blood flow (ABF) with the Dynemo 3000 system are described in detail. The system uses a novel transesophageal ultrasonic Echo-Doppler probe simultaneously to measure aortic diameter and blood flow velocity at the same anatomic level, in real-time. Non-invasive ABF measurement is combined with vital sign data from standard monitors to provide a composite hemodynamic profile including volume, afterload and contractility data used by the physician to optimize therapy. A review of the clinical validation and comparison to thermodilution measurements showing a significant positive correlation over a wide range of clinical flow situations is also briefly presented.
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New developments in speech interaction technology warrant the assumption that some of the interaction problems at anesthesia workplaces can be solved using speech interaction. One application might be the documentation of the anesthetic procedure. ⋯ Modern speech recognition tools are still not advanced enough to facilitate the design of applications with an almost natural speech interface and widespread user acceptance. Nevertheless, many tasks in anesthesia have the necessary characteristics to be optimally supported by speech interaction. In contrast to earlier approaches to speech-interactive anesthesia workplaces, successful application today depends on the question of design rather than solely on that of technology. Many of the constraints and drawbacks of current technology can be overcome through appropriate design measures. The goals must focus first on identifying task areas in intensive care where speech-interaction can yield real benefit in terms of work efficiency, and second on developing and evaluating an ergonomic design of speech interaction. The intended users seem to look forward to the incorporation of speech interaction at the workplace.
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J Clin Monit Comput · Jan 2000
Representation and classification of breath sounds recorded in an intensive care setting using neural networks.
Develop and test methods for representing and classifying breath sounds in an intensive care setting. ⋯ Long term monitoring of lung sounds is not feasible unless several barriers can be overcome. Several choices in signal representation and neural network design greatly improved the classification rates of breath sounds. The analysis of transmitted sounds from the trachea to the lung is suggested as an area for future study.