Journal of clinical monitoring and computing
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J Clin Monit Comput · Aug 2004
Hipocrates: a robust system for the control of neuromuscular blockade.
Development of an automatic system (software package Hipocrates) for the control of neuromuscular blockade by continuous infusion of the non-depolarising types of muscle relaxant drugs presently used in anaesthesia, namely atracurium, cisatracurium, vecuronium and rocuronium. ⋯ Hipocrates is an advanced standalone application for the control of neuromuscular blockade with a friendly graphic interface. It has been extensively validated, and it can be used on patients undergoing surgery as well as for simulation studies. Therefore Hipocrates also provides an excellent environment for education and training purposes.
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J Clin Monit Comput · Aug 2004
Clinical TrialPresentation of laboratory and sonoclot variables using principal component analysis: identification of hypo- and hypercoagulation in the HELLP syndrome.
The HELLP (Hemolysis, Elevated Liver enzyme, and Low Platelet) syndrome requires close monitoring of rapid changes in hemostasis. A bedside viscoelastic test--Sonoclot--was used together with coagulation, liver and hemolysis laboratory analyses in three parturients with the HELLP syndrome up to 10 days postpartum. Principal component analysis (PCA) was used to reduce the dimensionality of this multivariate problem and to visualize this process in a two-dimensional plot. ⋯ The effects of emergency delivery, correction of low plasma-antithrombin with plasma and antithrombin factor concentrate, plasma exchange and individualized dosages of low molecular weight heparin to counteract postpartum Sonoclot detected hypercoagulation were evaluated. The efficiency of each treatment strategy was visualized in the PCA plot by movement towards an area with normocoagulation. In conclusion, PCA of viscoelastic and laboratory coagulation analysis data facilitated the detection of both hypo- and hypercoagulative events and represents an alternative way to evaluate treatment strategies in patients with complex coagulative disorders, like the HELLP syndrome.
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J Clin Monit Comput · Aug 2004
Model-based prediction of expiratory resistance index in patients with asthma.
Develop a sensitive algorithm and index for detection of asthma patients using forced expiratory flow curves. ⋯ The estimated parameters were sensitive indicators of the degree of lung function impairment and were able to accurately distinguish between healthy and asthmatic patients.
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J Clin Monit Comput · Aug 2004
The pulse in reflectance pulse oximetry: modeling and experimental studies.
Reflectance pulse oximetry permits the use of alternative monitoring sites such as the face or torso, and is the approach commonly employed in fetal pulse oximetry systems. The purpose of this study is to investigate the impact of assumptions about the nature of arterial pulsatility on the calibration of such systems. ⋯ The sensitivity of reflectance pulse oximetry calibration to the depth and magnitude of arterial pulsatility reinforces the observation that monitoring site selection is of importance in optimizing reflectance pulse oximetry performance, particularly fetal pulse oximetry. Sites with palpable pulsatility should be avoided.