Journal of clinical monitoring and computing
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J Clin Monit Comput · Apr 2002
Monitoring pulmonary function with superimposed pulmonary gas exchange curves from standard analyzers.
A repetitive graphic display of the single breath pulmonary function can indicate changes in cardiac and pulmonary physiology brought on by clinical events. Parallel advances in computer technology and monitoring make real-time, single breath pulmonary function clinically practicable. We describe a system built from a commercially available airway gas monitor and off the shelf computer and data-acquisition hardware. ⋯ This paper describes a real-time, single breath pulmonary monitoring system that displays three parameters graphed against time: expired flow rate, oxygen uptake and carbon dioxide production. This system allows for early and rapid recognition of treatable conditions that may lead to adverse events without any additional patient measurements or invasive procedures. Monitoring systems similar to the one described in this paper may lead to a higher level of patient safety without any additional patient risk.
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J Clin Monit Comput · Apr 2002
Comparative StudyComparison of endotracheal tube and hookwire electrodes for monitoring the vagus nerve.
Monitoring the vagus nerve and the recurrent laryngeal nerve during surgical procedures may reduce the probability of significant nerve injury. As such, a number of methods to monitor these nerves have been devised including placing electrodes directly into the vocal cords or recording from surface electrodes. In direct comparison, monitoring the identical muscles, bipolar hookwire electrodes displayed approximately one order of magnitude greater amplitude, of both spontaneously occurring and evoked electrical activity than double wire endotracheal tube electrodes. The enhanced sensitivity of the hookwire electrodes, despite the technical difficulties with placement, suggests their use when maximum sensitivity is required.
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J Clin Monit Comput · Apr 2002
Real-time pulse oximetry artifact annotation on computerized anaesthetic records.
Adoption of computerised anaesthesia record keeping systems has been limited by the concern that they record artifactual data and accurate data indiscriminately. Data resulting from artifacts does not reflect the patient's true condition and presents a problem in later analysis of the record, with associated medico-legal implications. This study developed an algorithm to automatically annotate pulse oximetry artifacts and sought to evaluate the algorithm's accuracy in routine surgical procedures. ⋯ The real-time artifact detection algorithm developed in this study was more accurate than anaesthetists who post-operatively reviewed records produced by an existing computerised anaesthesia record keeping system. Algorithms have the potential to more accurately identify and annotate artifacts on computerised anaesthetic records, assisting clinicians to more correctly interpret abnormal data.
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J Clin Monit Comput · Apr 2002
Xenon washout during in-vitro extracorporeal circulation using different oxygenators.
Xenon anesthesia is known to have no adverse influence on myocardial contractility and cardiocirculatory function even in cardiac compromised patients. To make use of this advantages for cardiac surgery patients undergoing extracorporeal circulation (ECC) it must be known if oxygenators are diffusible for xenon in order to avoid losses of the very expensive noble gas. ⋯ Using common oxygenators xenon is eliminated during ECC and lost into the atmosphere. To maintain anesthesia during ECC continuous xenon application would be necessary to compensate these losses. Due to its high price it would be too expensive to continue xenon anesthesia during ECC. Therefore it is not practicable to use the today's oxygenators and ECC equipment in xenon anesthesia.
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J Clin Monit Comput · Apr 2002
Automated evaluation of functional residual capacity by oxygen washout.
Measurement of functional residual capacity (FRC) is of considerable interest for monitoring ventilated patients in ICUs. However, the lack of instruments that can be used in the clinical setting has so far impeded the routine application of this measurement. It was the aim of our study to evaluate the accuracy and the reproducibility of a simplified oxygen washout technique (FRC[O2]). ⋯ The automated oxygen washout technique is a simple method to measure FRC in the ICU patient.