Journal of clinical monitoring and computing
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J Clin Monit Comput · Jun 2019
Thoracic fluid content: a novel parameter for detection of pulmonary edema in parturients with preeclampsia.
Acute pulmonary oedema is a serious complication of preeclampsia. Early detection of pulmonary edema in preeclampsia would improve fluid management and would also allow earlier detection of severe cases. The aim of this work is to evaluate the ability of thoracic fluid content measured by electrical cardiometry for early detection of pulmonary edema in parturients with preeclampsia. ⋯ In parturients with preeclampsia, both lung ultrasound score and thoracic fluid content showed excellent properties for detection pulmonary edema. The high negative predictive value of both tests makes them useful screening tests to rule out pulmonary edema. The excellent correlation between both measures suggests that electrical cardiometry could be a promising surrogate to ultrasound for assessment of extravascular lung water.
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J Clin Monit Comput · Jun 2019
Change in staff anesthesiologists' opinions of an Anesthesia Information Management System (AIMS).
Following introduction of an Anesthesia Information Management System (AIMS) at a tertiary care, academic health sciences centre, a quality assurance initiative was conducted to assess staff opinions of the AIMS using a previously published, anonymous survey tool at 1 and 5 years following AIMS introduction. At 5 years compared to 1 year after implementation of AIMS, the majority (18 of 24, 75%) of responses to the survey questions had a statistically significant change (P < 0.05) in the proportion of respondents favoring AIMS compared to the 1 year survey. Domains noted to be more favorable 5 years compared to 1 year after AIMS introduction included patient safety in the Operating Rooms and Post-Anesthesia Care Unit, quality of handover and overall documentation, and communication amongst healthcare workers. The ideal time period at which to assess AIMS after introduction is not clear.
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J Clin Monit Comput · Jun 2019
Randomized Controlled TrialValidation of a mobile app for reducing errors of administration of medications in an emergency.
Medication errors occur frequently and are a risk to patient safety. To reduce mistakes in the medication process in emergencies, a mobile app has been developed supporting the calculation of doses and administration of drugs. A simulation study was performed to validate the app as a tool to reduce medication errors. ⋯ The probability of giving an "accurate" dosage was increased from 77.7 (70.9-84.5%) in control scenarios to 93.9 (90-97.8%) in app scenarios. Calculation errors were the main cause for wrong dosing. The app is an appropriate and feasible tool to reduce calculation and handling errors and may increase patient safety.
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J Clin Monit Comput · Jun 2019
Assessment of central hemodynamic effects of phenylephrine: an animal experiment.
Phenylephrine is an α1-adrenergic receptor agonist widely used to treat perioperative hypotension. Its other hemodynamic effects, in particular on preload and contractility, remain controversial. We, therefore, investigated the effect of continuously applied phenylephrine on central hemodynamics in eight mechanically ventilated domestic pigs. ⋯ Phenylephrine does not only affect cardiac afterload, but also increases effective preload. In contrast to CVP and Pmsfa, this effect can be monitored by GEDV. Further, phenylephrine affects contractility.