Journal of clinical monitoring and computing
-
J Clin Monit Comput · May 2021
Patterns in continuous pulse oximetry data prior to pulseless electrical activity arrest in the general care setting.
The study objective was to understand if features derived from continuous pulse oximetry data can provide advanced warning of pulseless electrical activity arrest in the general care inpatient setting. Retrospective analysis of SpO2 and pulse rate data derived from continuous pulse oximetry was performed for pulseless electrical activity (n = 38) and control (n = 42) patient cohorts. Measures of central tendency and variation over time intervals ranging from 1 min to 1 h were used for inter- and intra-group comparisons. ⋯ Similar results were found for SpO2 features 10 min before the event (> 4% difference in mean, > 60% difference in range). There is a significant difference in SpO2 and pulse rate features derived from continuous pulse oximetry between pulseless electrical activity and control groups. Integration of automated feature calculation and clinician notification into clinical monitoring and information systems may increase patient safety by supporting early detection of such events.
-
J Clin Monit Comput · May 2021
Refeeding syndrome: multimodal monitoring and clinical manifestation of an internal severe neurotrauma.
Refeeding syndrome (RFS) is a rare, potentially life-threatening, condition seen in malnourished patients starting refeeding. RFS may provoke seizures and acute encephalopathy and can be considered an internal severe neurotrauma in need of specific treatment. The objective was to describe course of disease, treatment and, for the first time, multimodal monitoring output in a comatose patient suffering RFS. ⋯ RFS was associated with serious deviations in homeostasis, high ICP levels, ECG abnormalities, kidney and lung affections. It is of utmost importance to recognize this rare syndrome and to treat appropriately. Despite the severe clinical state, cerebral autoregulation and compensatory reserve were generally normal, questioning the applicability of indirect measurements such as PRx and RAP during neuro-intensive care treatment of RFS patients with cerebral engagement.
-
J Clin Monit Comput · May 2021
Case ReportsLocating stridor caused by tumor compression by using a multichannel electronic stethoscope: a case report.
A 67-year-old male patient with chronic obstructive pulmonary disease was admitted to a hospital in northern Taiwan for progressive dyspnea and productive cough with an enlarged left upper lobe tumor (5.3 × 6.8 × 3.9 cm3). Previous chest auscultation on outpatient visits had yielded diffuse wheezes. A localized stridor (fundamental frequency of 125 Hz) was captured using a multichannel electronic stethoscope comprising four microelectromechanical system microphones. ⋯ We demonstrated a potential diagnostic aid for pulmonary diseases through sound-source localization technology based on respiratory monitoring. The proposed technique can facilitate detection when advanced imaging tools are not immediately available. Continuing effort on the development of more precise estimation is warranted.
-
J Clin Monit Comput · May 2021
LetterConductive heating mattress leads to ECG changes that mimic pacemaker spikes.
Hypothermia is a common perioperative complication. To prevent perioperative hypothermia amongst other things electrical heating mattresses are used. ⋯ In this case the ECG monitoring suddenly showed spikes that looked like spikes from an implanted pacemaker. When turning off the heating mattress the spikes disappeared and returned after turning on the heating mattress again.