Journal of clinical monitoring and computing
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J Clin Monit Comput · Dec 2021
Simulation study on flow rate accuracy of infusion pumps in vibration conditions during emergency patient transport.
Infusion pumps are frequently used when transferring critically ill patients via patient transport cart, ambulance, or helicopter. However, the performance of various infusion pumps under these circumstances has not been explored. The aim of this study was to evaluate the flow rate accuracy of infusion pumps under various clinical vibration conditions. ⋯ However, in moderate vibration, flow rates in syringe pumps increased beyond their known error ranges, while flow rates in peristaltic pumps remained stable. In extreme vibration, accidental fluid bolus occurred in syringe pumps but not in peristaltic pumps. The newly developed cylinder pump maintained stable performance and was unaffected by external vibration environments.
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J Clin Monit Comput · Dec 2021
Non-invasive indirect monitoring of intra-abdominal pressure using microwave reflectometry: system design and proof-of-concept clinical trial.
Monitoring intra-abdominal pressure (IAP) has become a standard in intensive care units. Correlation between the abdominal wall's thickness (AWTh) and IAP has been reported previously. The abdominal wall can be modeled as a compound of parallel dielectric slabs; changes in their width have a direct effect on the reflection coefficient of the abdominal wall at microwave frequencies. ⋯ C95.1-2005 concerning exposure of humans to microwave electromagnetic fields in controlled environments. The results putatively show an inverse correlation between IAP and the reflection coefficient, and a strong dependence on the body mass index. A better understanding of the dynamics in the changes of the AWTh (during intra-abdominal hypertension) will allow further development of a microwave-based technique for the continuous non-invasive indirect monitoring of IAP in critical patients.
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J Clin Monit Comput · Dec 2021
Letter Case ReportsLoss of spectral alpha power during spine surgery: what could be wrong?
The electroencephalographic signatures of anesthetic drugs relate to a specific set of action mechanisms within the neural circuits. During intraoperative care, the recognition and correct interpretation of the EEG spectrogram can be used as a tool to guide anesthetic administration. For example, loss of alpha power during propofol anesthesia may be a sign of lighter level of hypnosis and/or of an increase in nociceptive inputs. We describe a case report of inadvertent interruption of propofol delivery that was first detected by changes in the electroencephalogram spectrogram.
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Awake fibreoptic intubation has always been considered the gold standard for expected difficult airway management. However, the use of fibreoptic intubation was limited because it is time-consuming, requires skillful operators and easily affected by blood or secretions in the oral or nasopharynx. We reported a modified technique of awake fibreoptic nasal intubation with the aid of End-tidal carbon dioxide (ETCO2) monitoring, aiming to improve the efficiency and safety of awake fibreoptic intubation.
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J Clin Monit Comput · Dec 2021
Artifact reduction by using alternating polarity stimulus pairs in intraoperative peripheral nerve action potential recording.
Intraoperative nerve action potential (NAP) recording permits direct study of an injured nerve for functional assessment of lesions in continuity. Stimulus artifact contamination often hampers NAP recording and interferes with its interpretation. In the present study, we evaluated the artifact reduction method using alternating polarity in peripheral nerve recording. ⋯ Finally, we applied the method during nerve inching and demonstrated its usefulness in intraoperative NAP recordings as the method made the recording more resilient to short conduction distances. Thus, our findings demonstrate that this artifact reduction method can be used as a supplemental tool together with our previously described bridge grounding technique or the nonlifting nerve recording configuration to further improve intraoperative peripheral nerve recording. The method can be applied in clinical settings.