Expert review of medical devices
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Expert Rev Med Devices · Sep 2011
ReviewA new electronic device for subcutaneous injection of IFN-β-1a.
Disease-modifying drugs (DMDs) can provide important benefits for patients with multiple sclerosis (MS), but nonadherence to treatment is associated with an increased risk of relapse. All first-line DMDs used in MS require regular injection, but injection-related problems are common barriers to treatment adherence. Autoinjectors that allow automatic injection at the press of a button have increased the ease and convenience of injection, compared with manual injection. ⋯ This device is the first electronic autoinjector for use with any MS therapy, and includes several innovative features that may be advantageous to patients. One of these features is an accurate electronic dosing log, which can be viewed by the patient and the healthcare provider. This article discusses this new electronic device in the context of other autoinjectors currently used to self-inject first-line DMDs in MS.
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Expert Rev Med Devices · Sep 2011
ReviewUsing arterial pressure waveform analysis for the assessment of fluid responsiveness.
Predicting the effects of volume expansion on cardiac output and oxygen delivery is of major importance in different clinical scenarios. Functional hemodynamic parameters based on pulse waveform analysis, which are relying on the effects of mechanical ventilation on stroke volume and its surrogates, have been shown to be reliable predictors of fluid responsiveness during anesthesia and intensive care unit treatment, as demonstrated by several clinical studies and meta-analyses. ⋯ These parameters have been introduced into the concept of perioperative fluid management and hemodynamic optimization - an approach that may positively impact postoperative patients' outcomes. In this article, technical aspects of the assessment of the functional hemodynamic parameters derived from pulse waveform analysis are summarized, emphasizing their advantages, limitations and potential applications, primarily in a perioperative setting in order to improve patient outcome.