Journal of clinical monitoring and computing
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J Clin Monit Comput · Apr 2007
Comparative StudyAssessment of a new prototype hydrogel CO( 2 ) sensor; comparison with air tonometry.
Gastrointestinal ischemia is always accompanied by an increased luminal CO(2). Currently, air tonometry is used to measure luminal CO(2). To improve the response time a new sensor was developed, enabling continuous CO(2) measurement. It consists of a pH-sensitive hydrogel which swells and shrinks in response to luminal CO(2), which is measured by the pressure sensor. We evaluated the potential clinical value of the sensor during an in vitro and in vivo study. ⋯ The hydrogel carbon dioxide sensor enabled fast and accurate pCO(2) measurement in a controlled environment but is very temperature dependent. The current prototype hydrogel sensor is still too unstable for clinical use, and should therefore be improved.
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J Clin Monit Comput · Apr 2007
Randomized Controlled Trial Comparative StudyComparison of effects of rapid colloid loading before and after spinal anesthesia on maternal hemodynamics and neonatal outcomes in cesarean section.
The effects of colloid loading after spinal anesthesia on hemodynamics in parturients during cesarean section have not been fully understood. This study tested the hypothesis that colloid loading after spinal blockade can reduce hypotension compared with preloading, and affect neonatal outcomes. ⋯ Colloid loading after induction of spinal anesthesia was similarly effective in reducing hypo- tension compared with preloading in cesarean section.
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J Clin Monit Comput · Apr 2007
Clinical TrialBeat-by-beat cardiovascular index to predict unexpected intraoperative movement in anesthetized unparalyzed patients: a retrospective analysis.
Unexpected intraoperative movement may be detrimental during delicate surgery. This study tested retrospectively an algorithm based on beat-by-beat circulatory variables (incorporated into a Cardiovascular depth of anesthesia index: CARDEAN in relationship to unexpected movement, and compared its performance to that of the electroencephalogram (EEG)-derived index: BIS-XP 4.0. ⋯ Retrospectively, a cardiovascular index predicted unexpected intraoperative movements. Prospective validation is needed.
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J Clin Monit Comput · Apr 2007
Controlled Clinical TrialHypotension induced by lateral decubitus or supine spinal anaesthesia in elderly with low ejection fraction undergone hip surgery.
The aim of the study was to assess the effect of low ejection fraction (EF) on hypotension during lateral or supine position of spinal anaesthesia in patients older than 75 years old. ⋯ Elderly patients with low EF were more likely to predispose to higher sensorial block level and hypotension was more common during spinal anaesthesia with supine position compared to lateral decubitus position.
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J Clin Monit Comput · Apr 2007
New metabolic lung simulator: development, description, and validation.
Indirect calorimetry, the determination of airway carbon dioxide elimination (V(CO2),and oxygen uptake (V(O2)), can be used to non-invasively detect non-steady state perturbations of gas kinetics and mirror tissue metabolism. Validation of monitoring instruments in patients is difficult because there is no standard reference measurement, a wide range of physiologic values is required, and steady state is difficult to achieve and confirm. We present the development, critical details, and validation of a practical bench setup of a metabolic lung simulator, to generate a wide range of accurate, adjustable, and stable reference values of V(CO2) and V(O2), for development, calibration, and validation of indirect calorimetry methodology and clinical monitors. ⋯ The comprehensive description details the solutions to many problems, to help future investigations of metabolic gas exchange and contribute to improved patient monitoring during anesthesia and critical care medicine.