Journal of clinical monitoring and computing
-
J Clin Monit Comput · Oct 2009
Comparative StudyA comparison of vital signs charted by nurses with automated acquired values using waveform quality indices.
(1) To investigate if there exist any discrepancies between the values of vital signs charted by nurses and those recorded by bedside monitors for a group of patients admitted for neurocritical care. (2) To investigate possible interpretations of discrepancies by exploring information in the alarm messages and the raw waveform data from monitors. ⋯ Charted vital signs reflect in large the raw data as reported by bedside monitors. Poor signal quality could partially explain the existence of cases of large discrepancies.
-
J Clin Monit Comput · Oct 2009
Comparative Study Controlled Clinical TrialComparative pharmacodynamic modeling of desflurane, sevoflurane and isoflurane.
We compared dose-response curves of the hypnotic effects of desflurane, sevoflurane and isoflurane. In addition, we analyzed the k(e0) values of the different anesthetics. The EEG parameters Bispectral index (BIS, Aspect Medical Systems, Natick, MA, version XP) and Narcotrend index (MonitorTechnik, Bad Bramstedt, Germany, version 4.0) were used as measures of the pharmacodynamic effect. ⋯ The first order rate constant (k(e0) value) determining the equilibration between age-related MAC values and MAC effect site concentration is substantially higher for desflurane than for sevoflurane or isoflurane.
-
The Systolic pressure variation (SPV) is known to be a sensitive indicator of hypovolemia. However, the SPV may be elevated due to other reasons, such as changes in lung compliance or tidal volumes. Using the SPV to monitor the hemodynamic status of patients in the prone position may, therefore, be problematic due to possible effects of increased abdominal pressure on both venous return and lung compliance. The purpose of this study is to examine whether or not the SPV changes significantly when placing the patient in the prone position. ⋯ This study is important because it shows for the first time that the SPV does not change significantly in the prone position, and may therefore continue to be used as an indicator of the volume status. It also would appear to indicate that our methods for protecting the chest and abdomen in the prone position are effective.
-
J Clin Monit Comput · Oct 2009
Monitoring of reactive hyperemia using photoplethysmographic pulse amplitude and transit time.
Peripheral arterial tonometry and Ultrasound measurement of flow mediated dilation have been the widely reported noninvasive techniques to assess vasodilation during reactive hyperemia (RH). ⋯ Results suggests that PTT response reflects the myogenic components in the early part of RH and PPG amplitude response reflects the metabolic component reinforcing the later course of RH. PPG amplitude and PTT can be used to quantify the changes in diameter and tone of the vessel wall, respectively during RH. The collective responses of PPG amplitude and PTT can be more appropriate to facilitate PPG technique for monitoring of vasodilation caused by RH.
-
J Clin Monit Comput · Oct 2009
ReviewSpinal cord stimulation: principles of past, present and future practice: a review.
Electric energy have been in use for the treatment of various ailments, including pain, since the time of Pharaohs. The theoretical basis of electrotherapy of pain was provided by the Gate Control Theory of Melzak and Wall. ⋯ The indications for SCS is growing and the technology involved in this is rapidly advancing, however, high level of scientific evidence is still lacking to support this form of therapy due to difficulties in blinding and comparing with control groups. Future developments in SCS could include, combined SCS-drug delivery system, bio feedback and closed loop systems.