Journal of clinical monitoring and computing
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J Clin Monit Comput · May 1999
Comparative StudyTranscranial Doppler monitoring compared with invasive monitoring of intracranial pressure during acute intracranial hypertension.
To determine whether a simple transcanial Doppler waveform variable-pulsatility difference (systolic - diastolic blood flow velocity) can serve as a measure of critical changes in cerebral perfusion. ⋯ In pigs with induced diffuse intracranial hypertension, noninvasive transcranial Doppler waveform monitoring of pulsatility difference can identify increased cerebral oxygen extraction and dangerously decreased cerebral perfusion pressure.
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The Hb-Quick is a new portable hemoglobinometer that uses disposable cuvettes to measure the total hemoglobin concentration of capillary, venous, or arterial blood. Therefore, the objectives of this study were 1) to evaluate the performance of this compact, battery-powered hemoglobinometer by assessing its precision, accuracy, and linearity, 2) to determine whether its measurements suffer from interference by hemolysis, bilirubin, fetal hemoglobin, or hemodilution, and 3) to establish whether it can easily be used by clinical personnel with little or no laboratory training. ⋯ The new hemoglobinometer is fast and easy to operate. No sample preparation or pipetting is required. To operate the instrument, the user simply allows a drop of blood to fill the disposable cuvette by capillary action and inserts the cuvette into the instrument. The instrument analyzes the 10 microl sample and displays the results in less than 10 seconds. The interference caused by hemolysis, hemodilution with saline, fetal hemoglobin, and bilirubin were too small to be of any dinical importance. Tests in physician's offices indicated that clinical personnel with little or no formal laboratory training could successfully use this device. The observed precision, accuracy, linearity, and freedom from interference indicate that this hemoglobinometer is suitable for near-patient testing in a wide range of clinical settings including physicians' offices.
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J Clin Monit Comput · May 1999
Randomized Controlled Trial Comparative Study Clinical TrialOn the dynamic performance of the Abbott Safeset blood-conserving arterial line system.
Critically ill patients frequently have indwelling arterial lines placed during their Intensive Care Unit stay. The lines are used to monitor blood pressure continuously, administer drugs and to draw blood for a variety of physiologic tests. Several blood-conserving arterial line systems have been developed to eliminate the need to discard blood in the process of obtaining undiluted and uncontaminated blood samples. The purpose of this study was to evaluate the dynamic performance of one such system the Abbott Clinical Care System Safeset blood conserving arterial line system - in comparison to a conventional arterial line system. ⋯ Because the Abbott Safeset blood-conserving arterial line system is underdamped and has a lower resonant frequency compared to the traditional arterial system, it may overestimate systolic blood pressure, particularly in patients with high heart rates.
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J Clin Monit Comput · May 1999
Problem-based learning in residency education: a novel implementation using a simulator.
We developed a problem-based learning exercise with a full-scale human patient simulator to teach residents the emergency management and differential diagnosis of acute intraoperative hypotension. ⋯ Exercises on a full-scale patient simulator are a natural extension of problem-based learning. Recent research in learning theory provides the rationale for this teaching modality's potential as a learning tool.
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To design and evaluate a clinical monitor of respiratory drive (P0.1) and other respiratory variables in a simple way, using a commercial ventilator. ⋯ At rest, the ventilator introduced a minor influence on inspiratory time and P0.1, but not in ventilation, tidal volume, expiratory duration and respiratory frequency. During exercise, the influence was more evident. This effect could also be noticed in the coefficients of variation. The responses to mechanical loads were easily recorded and can be used as a simple test of central load-compensating mechanisms. CONCLUSIONS. The ventilator, with limitations, may be an alternative to conventional techniques, especially in clinical studies of the central inspiratory activity with and without respiratory loading.