Journal of clinical monitoring and computing
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J Clin Monit Comput · Dec 2017
A feasability study of color flow doppler vectorization for automated blood flow monitoring.
An ongoing issue in vascular medicine is the measure of the blood flow. Catheterization remains the gold standard measurement method, although non-invasive techniques are an area of intense research. We hereby present a computational method for real-time measurement of the blood flow from color flow Doppler data, with a focus on simplicity and monitoring instead of diagnostics. ⋯ Errors on synthetic images ranged from nonexistent to substantial depending on experimental conditions. Mean errors on measurements from our phantom flow simulation ranged from 1.2 to 40.2% for angle estimation, and from 3.2 to 25.3% for real-time flow estimation. This study is a proof of concept showing that accurate measurement can be done from automated color flow Doppler signal extraction, providing the industry the opportunity for further optimization using raw ultrasound data.
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J Clin Monit Comput · Dec 2017
The influence of PEEP and positioning on central venous pressure and venous hepatic hemodynamics in patients undergoing liver resection.
In order to assess the occurrence of blood congestion in the liver during liver resection, we aimed to evaluate the influence of a positive-end-expiratory-pressure (PEEP) and positioning of patients on central venous pressure (CVP) and venous hepatic blood flow parameters. We further analyzed correlations between CVP and venous hepatic blood flow parameters. ⋯ Changes of central venous pressure due to changes of PEEP and positioning were not correlated with changes of venous hepatic blood flow parameters as measured after equilibration. Strategies aiming for low central venous pressure cannot be supported by these results. However, before ruling out low-CVP-strategies during liver resections these results should be confirmed by further studies.
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J Clin Monit Comput · Dec 2017
Design and α-testing of an electronic rounding tool (CERTAINp) to improve process of care in pediatric intensive care unit.
Increasing process complexity in the pediatric intensive care unit (PICU) can lead to information overload resulting in missing pertinent information and potential errors during morning rounds. An efficient model using a novel electronic rounding tool was designed as part of a broader critical care decision support system-checklist for early recognition and treatment of acute illness and injury in pediatrics (CERTAINp). We aimed to evaluate its impact on improving the process of care during rounding. ⋯ Rounding time (mean ± SD) increased by 2 min/patient (8.0 ± 5.8 min pre-intervention vs. 9.9 ± 5.7 min post-intervention, p = 0.002). Staff reported improved perception of all aspects of rounding. Utilization of the CERTAINp rounding tool led to perfect compliance to the discussion of best practice guidelines; had minimal impact on rounding time and improved PICU staff satisfaction.
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J Clin Monit Comput · Dec 2017
Observational StudyEvaluation of different near-infrared spectroscopy technologies for assessment of tissue oxygen saturation during a vascular occlusion test.
An increasing number of NIRS devices are used to provide measurements of peripheral tissue oxygen saturation (StO2). The aim of the present study is to test the hypothesis that despite technological differences between devices, similar trend values will be obtained during a vascular occlusion test. The devices compared are NIRO-200NX, which measures StO2 and oxyhemoglobin by spatially resolved spectroscopy and the Beer-Lambert law, respectively, and INVOS 5100C and Foresight Elite, which both measure StO2 with the Beer-Lambert law, enhanced with the spatial resolution technique. ⋯ Oxyhemoglobin measured with NIRO responded faster than the other NIRS technologies to changes in peripheral tissue oxygenation (20 vs. 27-40 s, p ≤ 0.01). When comparing INVOS with Foresight, oxygenation changes were prompter (upslope 311 [92-523]%/min vs. 114[65-199]%/min, p ≤ 0.01) and more pronounced (minimum value 36 [21-48] vs. 45 [40-51]%, p ≤ 0.01) with INVOS. Significant differences in tissue oxygen saturation measurements were observed, both within the same device as between different devices using the same measurement technology.
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J Clin Monit Comput · Dec 2017
Editorial CommentCan spirometry be a new tool to predict the difficult airway?