Journal of clinical monitoring and computing
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J Clin Monit Comput · Aug 1998
Detection of lung injury with conventional and neural network-based analysis of continuous data.
To test if analysis of pressure and flow waveform patterns with an artificial intelligence neural network could distinguish between normal and injured lungs. ⋯ Normal and fully injured lungs display distinct flow and pressure waveform patterns which are independent of changes in calculated pulmonary mechanics variables. These patterns can be recognized by a neural network. Further research is needed to determine the full potential of automated pattern recognition for lung monitoring.
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Mixtures of helium and oxygen are regaining a place in the treatment of obstruction of the upper and lower respiratory tract. The parenchymal changes during the course of IRDS or ARDS may also benefit from the reintroduction of helium/oxygen. In order to monitor and document the effect of low-density gas mixtures, we evaluated the Datex AS/3 Side Stream Spirometry module with D-lite (Datex-Engstrom Instrumentarium Corporation, Finland) against two golden standards. ⋯ Measurements with the D-lite using low-density gases are satisfactorily contained in best-fit equations with a standard deviation of less than 5% during all ventilatory modes and mixtures.
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J Clin Monit Comput · Aug 1998
Reflectance pulse oximetry--principles and obstetric application in the Zurich system.
Transmission and reflectance are the two main modes of pulse oximetry. In obstetrics, due to the absence of a transilluminable fetal part for transmission oximetry, the only feasible option is the reflectance mode, in which sensor and detector are located on the same surface of the body part. ⋯ We have designed, developed, constructed and tested a reflectance pulse oximeter with the possibility to adjust the electronic circuits and signal processing in order to determine the effects of various parameters on signal amplitude and wave-form and to optimize the sensitivity and spatial arrangement of the optical elements. Following an explanation of the principles of reflectance pulse oximetry, we report our experience with the design, development, construction and field-testing of an in-house reflectance pulse oximetry system for obstetric application.
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J Clin Monit Comput · Aug 1998
Availability of records in an outpatient preanesthetic evaluation clinic.
Despite efforts to develop electronic access to medical records, there are few data on availability of past evaluations. Typical analyses assess only availability of paper charts. We studied the availability of prior internal and external medical documentation in the preanesthetic clinic of our tertiary teaching institution, which has had access to hospital-wide electronic records for five years. ⋯ Anesthesiologists retrieved, and added to the perioperative evaluation, information from previous encounters for 16% of patients. Despite our hospital-wide electronic records, internal information was missing for 22% of patients. Uneven deployment, and reliance on transcription may contribute to failures. A national electronic medical records system would benefit the 8% (one out of twelve) of outpatients missing external records identified in this study. For many patients, optimal medical understanding was not achieved during the planned preanesthetic evaluation.
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J Clin Monit Comput · Aug 1998
A real-time algorithm to improve the response time of a clinical multigas analyser.
An algorithm to improve the response time of a clinical respiratory multigas analyser is presented. ⋯ The algorithm provides an improvement on the relatively slow response times of the clinical gas analyser for breath-by-breath time-dependent applications. The same algorithm can also be applied to other instruments which have slow response times.