Journal of clinical monitoring and computing
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J Clin Monit Comput · Jun 2017
Assessment of continuous acoustic respiratory rate monitoring as an addition to a pulse oximetry-based patient surveillance system.
Technology advances make it possible to consider continuous acoustic respiratory rate monitoring as an integral component of physiologic surveillance systems. This study explores technical and logistical aspects of augmenting pulse oximetry-based patient surveillance systems with continuous respiratory rate monitoring and offers some insight into the impact on patient deterioration detection that may result. Acoustic respiratory rate sensors were introduced to a general care pulse oximetry-based surveillance system with respiratory rate alarms deactivated. ⋯ Continuous respiratory rate monitoring can be successfully added to a pulse oximetry-based surveillance system without significant technical, logistical or workflow issues and is moderately well-tolerated by patients. Respiratory rate sensor alarms did not significantly impact overall system alarm burden. Respiratory rate and oxygen saturation distributions suggest adding continuous respiratory rate monitoring to a pulse oximetry-based surveillance system may not significantly improve patient deterioration detection.
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J Clin Monit Comput · Jun 2017
Clinical TrialEfficacy of bioelectrical impedance analysis during the perioperative period in children.
We evaluated the efficacy of bioelectrical impedance analysis (BIA) during the perioperative period by estimating the preoperative and postoperative body fluid status. After obtaining informed consent, we enrolled 100 children (3-12 years of age) scheduled for elective surgeries. All children had been fasted preoperatively. ⋯ The baseline and postoperative ICW showed a strong positive correlation (Pearson correlation coefficient = 0.992, P < 0.001), as did the baseline and postoperative ECW (Pearson correlation coefficient = 0.990, P < 0.001). Also there was no dehydration and irritability on medical recording preoperatively. BIA may be an alternative method for estimating the perioperative fluid status in children and determining details of fluid administration.
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J Clin Monit Comput · Jun 2017
Randomized Controlled TrialPreheating of streamlined liner of pharyngeal airway (SLIPA) reduced the related complications: a randomized control study.
This study was designed to verify whether preheating could decrease the complications that may be associated with the use of streamlined liner of pharyngeal airway (SLIPA). We evaluated the incidence of sore throat, maximum sealing pressure, hoarseness and blood stains after preheating of SLIPA. Eighty patients scheduled for hysteroscopic surgery to whom the SLIPA was considered suitable were randomly allocated to preheating group or control group. ⋯ However there was no statistical difference in the maximum sealing pressure. Our results suggest preheating of the SLIPA decreased the complications related with the insertion of SLIPA. Clinical Trials.gov Identifier NCT02539485.
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J Clin Monit Comput · Jun 2017
Monitoring of total positive end-expiratory pressure during mechanical ventilation by artificial neural networks.
Ventilation treatment of acute lung injury (ALI) requires the application of positive airway pressure at the end of expiration (PEEPapp) to avoid lung collapse. However, the total pressure exerted on the alveolar walls (PEEPtot) is the sum of PEEPappand intrinsic PEEP (PEEPi), a hidden component. To measure PEEPtot, ventilation must be discontinued with an end-expiratory hold maneuver (EEHM). ⋯ ANN agreement with reference PEEPtotwas assessed with the Bland-Altman method. Bland Altman analysis of estimation error by ANN showed -0.40 ± 2.84 (expressed as bias ± precision) and ±5.58 as limits of agreement (data expressed as cmH2O). The ANNs estimated the PEEPtotwell at different levels of PEEPappunder dynamic conditions, opening up new possibilities in monitoring PEEPiin critically ill patients who require ventilator treatment.
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Understanding the use of patient monitoring systems in emergency and acute facilities may help to identify reasons for failure to identify risk patients in these settings. Hence, we investigate factors related to the utilization of automated monitoring for patients admitted to an acute admission unit by introducing monitor load as the proportion between monitored time and length of stay. A cohort study of patients admitted and registered to patient monitors in the period from 10/10/2013 to 1/10/2014 at the acute admission unit of Odense University Hospital in Denmark. ⋯ Higher levels of severity were related to higher degrees of monitoring, but being admitted to the surgical wing reduce how much patients were monitored, and periods with many concurrent patients lead to a small increase in monitoring. We found a significant variation concerning how much patients were monitored during admission to an acute admission unit. Our results point to potential patient safety improvements in clinical procedures, and advocate an awareness of how patient monitoring systems are utilized.