Journal of clinical monitoring and computing
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J Clin Monit Comput · Apr 2009
Hypotension after spinal anesthesia for cesarean section: identification of risk factors using an anesthesia information management system.
To determine risk factors for developing hypotension after spinal anesthesia for cesarean section to prevent obstetric patients from hypotensive episodes potentially resulting in intrauterine malperfusion and endangering the child. ⋯ Knowledge of these risk factors should increase the anesthesiologist's attention to decide for the necessity to employ prophylactic or therapeutic techniques or drugs to prevent the neonate from any risk resulting of hypotension of the mother.
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J Clin Monit Comput · Apr 2009
Sensor fusion using a hybrid median filter for artifact removal in intraoperative heart rate monitoring.
Intraoperative heart rate is routinely measured independently from the ECG monitor, pulse oximeter, and the invasive blood pressure monitor if available. The presence of artifacts, in one or more of theses signals, especially sustained artifacts, represents a critical challenge for physiological monitoring. When temporal filters are used to suppress sustained artifacts, unwanted delays or signal distortion are often introduced. The aim of this study was to remove artifacts and derive accurate estimates for the heart rate signal by using measurement redundancy. ⋯ The hybrid median filter combines the structural and temporal information from two or more sensors and generates a robust estimate of heart rate without requiring strict assumptions about the signal's characteristics. This method is intuitive, computationally simple, and the performance can be easily adjusted. These considerable benefits make this method highly suitable for clinical use.
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J Clin Monit Comput · Apr 2009
Evaluation of a computerized system for mechanical ventilation of infants.
To evaluate a computerized system for mechanical ventilation of infants. ⋯ A computerized system for mechanical ventilation is evaluated for treatment of infants. The results of the study show that the system has good potential for use in neonatal ventilatory care. Further refinements can be made in the system for very low-birth-weight infants.
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J Clin Monit Comput · Feb 2009
Specificity improvement for network distributed physiologic alarms based on a simple deterministic reactive intelligent agent in the critical care environment.
Automated physiologic alarms are available in most commercial physiologic monitors. However, due to the variability of data coming from the physiologic sensors describing the state of patients, false positive alarms frequently occur. Each alarm requires review and documentation, which consumes clinicians' time, may reduce patient safety through 'alert fatigue' and makes automated physician paging infeasible. ⋯ Alarms generated by patient monitors, the intelligent agent and alerts documented on patient flow sheets were compared. Significant improvements in the specificity of the physiologic alarms based on systolic and mean blood pressure was found on average to be 99% and 88% respectively. Even through significant improvements were noted based on this algorithm much work still needs to be done to ensure the sensitivity of alarms and methods to handle spurious sensor data due to patient or sensor movement and other influences.
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J Clin Monit Comput · Feb 2009
Case ReportsEarly non invasive detection of hypercarbia in two cardiac surgical patients.
The availability of transcutaneous monitors has provided a means of non invasive assessment of CO(2) tension and a trend of the ventilation status commonly in infants and neonates. The authors describe two cases of hypercapnia diagnosed early in adults by the non invasive transcutaneous measurement of carbon dioxide (tcpCO(2)) using TINA TCM4 in postoperative cardiac surgical patients who were mechanically ventilated. Curiously, this increase in tcpCO(2) levels was associated with a false increase in the tcpO(2) values though no changes in the ventilatory parameters to increase oxygenation were made. The probable mechanism of the increase in tcpO(2) levels with hypercarbia is discussed.