Journal of clinical monitoring and computing
-
J Clin Monit Comput · Jan 1999
Case ReportsIntraoperative diagnosis of aortic pseudoaneurysm with transesophageal echocardiography.
A pseudoaneurysm of the ascending aorta is a rare complication of aortic valve endocarditis that requires prompt diagnosis. Several imaging strategies can be used; however, transesophageal echocardiography (TEE) has been utilized more frequently due to its superior resolution in detection of aortic valve complications. This case presents a patient with prosthetic valve dysfunction in which intraoperative TEE was used to diagnose a previously undetected aortic pseudoaneurysm, thus leading to a change in surgical management.
-
Intensive care and operating room monitors generate data that are not fully utilized. False alarms are so frequent that attending personnel tends to disconnect them. We developed an expert system that could select and validate alarms by integration of seven vital signs monitored on-line from cardiac surgical patients. ⋯ Integration of information from several sources improved the reliability of alarms and markedly decreased the frequency of false alarms. Fuzzy logic may become a powerful tool for integration of physiological data.
-
J Clin Monit Comput · Jan 1999
A simple strategy for faster induction and more cost-effective use of anesthetic vapor.
Inducing general anesthesia often involves mask ventilation using high fresh gas flow (FGF) to administer anesthetic vapor prior to endotracheal intubation. A common practice is to turn the vaporizer off when the mask is removed from the patient's face to avoid room contamination (VAPOff). An alternative approach is to leave the vaporizer on and turn the FGF to minimum to reduce the amount of vapor laden gas that can enter the room (FGFOff). The objective of this study is to compare the relative induction times and vapor costs associated with each induction strategy. ⋯ The strategy of turning the FGF to minimum and leaving the vaporizer on during intubation does not contaminate the room and speeds induction by fostering a greater alveolar concentration than the VAPOff method. Cost savings are derived using FGFOff since a higher alveolar concentration is achieved at the same vapor cost. Additional cost savings are demonstrated since a low flow technique is possible immediately after intubation when using FGFOff. The practice of turning off the vaporizer during endotracheal intubation while FGF remains high should be abandoned.
-
The creation of agent mixtures from the addition of the wrong agent to a vaporizer might pose a risk to the patient. Patient injury would be more likely if the anesthesia gas monitor displayed erroneous concentration values. Conventional inhalation agent monitors do not necessarily distinguish anesthetic agents. ⋯ Patient injury could be more likely in this last case. In this last case and in all cases, piezoelectric crystal monitoring correctly displayed the sum of the two agent concentrations in volumes percent. Automatic agent identification can identify erroneous agents.