Articles: monitoring.
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To evaluate instrument placement and accuracy of indirect physiologic monitoring techniques in anesthetized domestic ferrets. ⋯ Pulse oximetry is a convenient and accurate method for monitoring oxygen saturation in domestic ferrets. Capnography is useful for monitoring respiratory rate and pattern, but may present difficulties in interpretation of actual PaCO2. Indirect blood pressure monitoring is not accurate by use of current methods in ferrets.
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Research-based guidelines regarding patient positioning and hemodynamic measurement are compared with nonscientific routines. Published research is critiqued and synthesized. ⋯ The challenge is to balance the many patient care activities that critically ill patients require with the need for positioning and hemodynamic measurement. The duration patients are left in the supine position can be minimized, and accurate and reliable measurements can still be obtained.
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We describe the development and implementation of a new open configuration magnetic resonance imaging (MRI) system, with which neurosurgical procedures can be performed using image guidance. Our initial neurosurgical experience consists of 140 cases, including 63 stereotactic biopsies, 16 cyst drainages, 55 craniotomies, 3 thermal ablations, and 3 laminectomies. The surgical advantages derived from this new modality are presented. ⋯ Intraoperative MRI allows lesions to be precisely localized and targeted, and the progress of a procedure can be immediately evaluated. The constantly updated images help to eliminate errors that can arise during frame-based and frameless stereotactic surgery when anatomic structures alter their position because of shifting or displacement of brain parenchyma but are correlated with images obtained preoperatively. Intraoperative MRI is particularly helpful in determining tumor margins, optimizing surgical approaches, achieving complete resection of intracerebral lesions, and monitoring potential intraoperative complications.
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Comparative Study Clinical Trial
Comparison of cerebral oximeter and evoked potential monitoring in carotid endarterectomy.
To assess the cerebral oximeter, which measures regional oxygen saturation (rSO2) continuously and noninvasively, as a cerebral monitor during carotid endarterectomy (CEA). The rSO2 was compared with Somatosensory Evoked Potentials (SSEPs) as an indicator for shunting and as a predictor of postoperative neurological deficits. ⋯ Clinical experience with this evolving technology is ongoing. Its role in neurovascular procedures has yet to be established.