Journal of clinical monitoring and computing
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J Clin Monit Comput · Feb 2007
Variation in blood pressure as a guide to volume loading in children following cardiopulmonary bypass.
Intravascular volume loading is used to optimize cardiac output in children following weaning from cardiopulmonary bypass. Central venous pressure (CVP) is frequently used to titrate fluid administration but it is often misleading in predicting fluid responsiveness. Variation in the arterial pressure waveform is exaggerated in patients with deficient intravascular volume and has been shown to be a good predictor of fluid responsiveness in adults following cardiac surgery. The aim of this study was to compare the measures of variation in blood pressure as a guide to volume loading in children following cardiopulmonary bypass. ⋯ Variation in blood pressure was a better guide to volume loading in children than CVP. Delta down was not useful in predicting fluid responsiveness in children with open chests following bypass surgery. SPV and SVV require further testing in prospective clinical trials.
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J Clin Monit Comput · Feb 2007
A new index of the autonomic nervous balance and its clinical usefulness; a power law 1/f like scale of a spectral analysis of the heart rate variability.
This study was undertaken to develop a new autonomic scoring scale distinct from the conventional sympathetic or parasympathetic parameters cardiac autonomic response. ⋯ One application of new parameters 'Balance Index' is its ability to evaluate the vital or emotional functions of unconscious patients in a critical condition undergoing a sense challenge test. This method assists in improving our ability to measure the early stage of conscious recovery with greater accuracy by using our novel analysis method for performing senses challenge test, with the aid of media such as music.
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J Clin Monit Comput · Feb 2007
Hemodynamic response to exercise as measured by the solar IKG impedance cardiography module and correlation with metabolic variables.
Impedance Cardiography (ICG) has been shown to be a feasible and accurate method for non-invasive measurement of cardiac index (CI). Aim of this investigation was the correlation of hemodynamic variables under exercise as measured by a specific ICG-monitor (Solar IKG-Modul, Version 3.0, GE-Healthcare, Freiburg, Germany) with metabolic variables. ⋯ CI in healthy volunteers, as measured by the Solar IKG-Modul, correlates well with O(2)-consumption and CO(2)-production in individual subjects, thus indicating the metabolic needs under exercise conditions in healthy individuals.
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J Clin Monit Comput · Feb 2007
Measurement of respiratory rate from the photoplethysmogram in chest clinic patients.
We studied the application of our algorithm for the robust extraction of respiratory information from the pulse oximeter signal acquired from a selection of patients attending the chest clinic. ⋯ The technique allows the measurement of respiratory rate directly from the photoplethysmogram of a pulse oximeter, and leads the way for development of a simple non-invasive combined respiration and saturation monitor useful for patients with all forms of breathlessness.
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J Clin Monit Comput · Feb 2007
Conductivity-based hematocrit measurement during cardiopulmonary bypass.
In a recent clinical study on the reliability of a point-of-care (POC) analyzer, we described a downward bias in hematocrit measurement during cardiopulmonary bypass leading potentially to overtreatment with packed red cells. We hypothesized that the detected deviation is caused by variations in electrolyte concentration rather than by colloids used. ⋯ Conductivity-based POC hematocrit measurement suffers from biases due to changes of the plasma constituents. The downward bias in hematocrit as often seen during cardiopulmonary bypass is driven by changes of different electrolyte concentration rather than by colloids used per se.