Journal of clinical monitoring and computing
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J Clin Monit Comput · Jan 2002
The automatic lung parameter estimator (ALPE) system: non-invasive estimation of pulmonary gas exchange parameters in 10-15 minutes.
Clinical measurements of pulmonary gas exchange abnormalities might help prevent hypoxaemia and be useful in monitoring the effects of therapy. In clinical practice single parameters are often used to describe the abnormality e.g., the "effective shunt." A single parameter description is often insufficient, lumping the effects of several abnormalities. A more detailed picture can be obtained from experiments where FiO2 is varied and two parameters estimated. These experiments have previously taken 30-40 minutes to complete, making them inappropriate for routine clinical use. However with automation of data collection and parameter estimation, the experimental time can be reduced to 10-15 minutes. ⋯ The ALPE system provides quick, non-invasive estimation of pulmonary gas exchange parameters and may have several clinical applications. These include, monitoring pulmonary gas exchange abnormalities in the ICU, assessing post-operative gas exchange abnormalities, and titrating diuretic therapy in patients with heart failure.
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Computer simulation models can be extremely valuable for teaching and for understanding real world processes. The discipline of creating a model forces the investigator to carefully define each relationship and test the result. ⋯ Models are typically comprised of systems of differential equations and are solved by numerical integration with computer programs. Spreadsheets, simulation software and custom programs may be used to calculate the numerical solution, draw graphs and animate the result.
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The World Wide Web is increasingly important for medical education. Internet served pages may also be used on a local hard disk or CD-ROM without a network or server. This allows authors to reuse existing content and provide access to users without a network connection. ⋯ Issues include file names, relative links, directory names, default pages, server created content, image maps, other file types and embedded programming. With care, it is possible to create server based pages that can be copied directly to CD-ROM. In addition, Web pages on CD-ROM may reference Internet served pages to provide the best features of both methods.
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J Clin Monit Comput · Jan 2000
Bispectral index (BIS) and burst suppression: revealing a part of the BIS algorithm.
The bispectral index (BIS) is a complex EEG parameter which integrates several disparate descriptors of the EEG into a single variable. One of the subparameters incorporated in the BIS is the suppression ratio, quantifying the percentage of suppression during burst suppression pattern. The exact algorithm used to synthetize the information to the BIS value is unpublished and still unknown. This study provides insight into the integration of the suppression ratio into the BIS algorithm. ⋯ Suppression ratio values > 40% are linearly correlated with BIS values from 30 to 0. An increasing anesthetic drug effect resulting in an increase of the duration of suppression to a suppression ratio up to 40% is not adequately reflected by the BIS value.
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J Clin Monit Comput · Jan 2000
Randomized Controlled Trial Clinical TrialDoes monitoring of post-tetanic count prevent alarms of airway pressure or visible muscle activity during intratracheal jet ventilation? A prospective study with five different neuromuscular blocking agents.
Profound neuromuscular block (NMB) quantified by post-tetanic count (PTC) may prevent all muscle activity during anesthesia. We studied whether monitoring of PTC prevents airway pressure alarms or visible movements of the vocal cords and the abdomen during endolaryngeal procedures (ELPs). ⋯ PTC-monitoring following 50 Hz stimulation does not ensure total inactivity of muscles during alfentanil-propofol anesthesia, regardless which relaxant has been chosen. During ELPs, simultaneous observation of the vocal cords and the abdomen is more sensitive in detecting early recovery of NMB compared to our method of airway pressure monitoring.