Journal of clinical monitoring and computing
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J Clin Monit Comput · Feb 2015
The effects of cardiac output and pulmonary arterial hypertension on volumetric capnography derived-variables during normoxia and hypoxia.
The aim of this study was to test the effect of cardiac output (CO) and pulmonary artery hypertension (PHT) on volumetric capnography (VCap) derived-variables. Nine pigs were mechanically ventilated using fixed ventilatory settings. Two steps of PHT were induced by IV infusion of a thromboxane analogue: PHT25 [mean pulmonary arterial pressure (MPAP) of 25 mmHg] and PHT40 (MPAP of 40 mmHg). ⋯ The elimination of CO2 per breath decreased by 7% in PHT40 and by 12% in COdown but increased only slightly with COup. Dead space variables did not change significantly along the protocol. At constant ventilation and body metabolism, pulmonary artery hypertension and decreases in CO had the biggest effects on the SnIII of the volumetric capnogram and on the elimination of CO2.
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J Clin Monit Comput · Feb 2015
Controlled Clinical TrialThe effect of endotracheal tube cuff pressure change during gynecological laparoscopic surgery on postoperative sore throat: a control study.
Postoperative respiratory complications related to endotracheal intubation usually present as cough, sore throat, hoarseness. The aim of the study was to examine the effects of endotracheal tube cuff pressure changes during gynecological laparoscopic surgery on postoperative sore throat rates. Thirty patients who underwent gynecological laparoscopic surgery and 30 patients who underwent laparotomy under general anesthesia with endotracheal intubation were included. ⋯ In both groups, the endotracheal tube cuff pressure and peak airway pressure were significantly correlated (R=0.9431, P<0.01; R=0.8468, P<0.01). Compared to patients who had undergone laparotomy, patients who had undergone laparoscopic surgery showed significantly higher sore throat scores at both 2 and 24 h after surgery (P<0.01). Pneumoperitoneum and Trendelenburg position may increase airway pressure and cuff pressure, resulting in increased incidence of postoperative sore throat.
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J Clin Monit Comput · Feb 2015
Observational StudyThe use of a clinical database in an anesthesia unit: focus on its limits.
Anesthesia information management system (AIMS) can be used a part of quality assurance program to improve patient care, however erroneous or missing data entries may lead to misinterpretation. This study assesses the accuracy of information extracted for six consecutive years from a database linked to an automatic anesthesia record-keeping system. An observational study was conducted on a database linked AIMS system. ⋯ However exhaustivity/completeness of some other variable, such as nausea and vomiting started as low as 50% to reach 20% at 2008. After cross analysing pain and post-operative nausea and vomiting scores with related medication consumption, (morphine and ondansetron) we conclude that missing data was due to omission of a zero score rather than human error. The follow-up of quality assurance program may use data from AIMS provided that missing or erroneous values be mentioned and their impact on calculations accurately analysed.
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J Clin Monit Comput · Feb 2015
Accuracy of bedside glucometry in critically ill children with peripheral hypoperfusion.
The accuracy of glucose test strip in critically care has been questioned. We investigated the accuracy of glucose test strip in critically ill children. Patients, aged from 1 month to 18 years admitted in pediatric intensive care unit. ⋯ The CBG test strip must be interpreted carefully in critically ill children. A low PI was associated with poor CBG strip accuracy. WBG test strip from arterial blood was more appropriate for glucose monitoring in children with peripheral hypoperfusion.