Journal of clinical monitoring and computing
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J Clin Monit Comput · May 1999
Comparative StudyAssessment of short-term blood pressure variability in anesthetized children: a comparative study between intraarterial and finger blood pressure.
Continuous blood pressure (BP) measurement provides instantaneous information on hemodynamic status, and allows for assessment of sympathetic modulation of vasomotor tone using spectral analysis. As an alternative to intraarterial blood pressure (IABP) measurement, the Finapres, a photoplethysmographic device, allows for non-invasive continuous measurement of finger blood pressure (FBP). This study was designed to evaluate the accuracy of spectral measurements of FBP variability in children during anesthesia and recovery. For this purpose, reliability of BP measurement and short-term BP variability assessed by FBP were calculated and compared with IABP. ⋯ The differences evidenced between FBP and IABP spectral profiles might result from specific physiological properties of digital arteries, which are sympathetic effectors. This study supports the use of FBP in children to assess non-invasively the vascular sympathetic component of the autonomic nervous system during anesthesia and recovery.
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J Clin Monit Comput · May 1999
Optimal sequencing of urgent surgical cases. Scheduling cases using operating room information systems.
Optimal sequencing of urgent cases (i.e., selecting which urgent case should be performed first and which second) may enhance patient safety, increase patient satisfaction with timeliness of surgery, and minimize surgeons' complaints. Before determining the optimal sequence of urgent cases, an operating room (OR) suite must identify the primary scheduling objective to be satisfied when prioritizing pending urgent cases. ⋯ We provide mathematical structure which can be used to program a computerized surgical services information system to assist in optimizing the sequence of urgent cases. We use an example to illustrate that the optimal sequence varies depending on the scheduling objective chosen.
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J Clin Monit Comput · May 1999
Amount of air infused to patient increases as fluid flow rates decrease when using the Hotline HL-90 fluid warmer.
The intraoperative use of fluid warming devices has been recommended to avoid perioperative hypothermia and related adverse outcomes. To evaluate whether these devices might introduce risks of their own, we measured the volume of air escaping from a warmed intravenous solution that might be delivered to a patient. ⋯ We conclude that the use of the Hotline fluid warmer can result in infusion of air into the patient, introducing possible risk of air embolism.
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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
Inter observer variability of the transcranial Doppler ultrasound technique: impact of lack of practice on the accuracy of measurement.
Published data on the observer variability with the transcranial doppler (TCD) ultrasound are limited by the use of the product moment correlation coefficient. This study was designed to quantify the intra and inter observer variability with the TCD in terms of the intra class correlation coefficient (ICC) and to assess the impact of lack of practice on the observer variability and the accuracy of data generated. ⋯ A high level of observer agreement is possible with the TCD for measurement of cerebral blood flow velocities. Lack of regular practice with the system reduces the accuracy of measurements and impacts on both measured and calculated indices.