Journal of clinical monitoring and computing
-
New developments in speech interaction technology warrant the assumption that some of the interaction problems at anesthesia workplaces can be solved using speech interaction. One application might be the documentation of the anesthetic procedure. ⋯ Modern speech recognition tools are still not advanced enough to facilitate the design of applications with an almost natural speech interface and widespread user acceptance. Nevertheless, many tasks in anesthesia have the necessary characteristics to be optimally supported by speech interaction. In contrast to earlier approaches to speech-interactive anesthesia workplaces, successful application today depends on the question of design rather than solely on that of technology. Many of the constraints and drawbacks of current technology can be overcome through appropriate design measures. The goals must focus first on identifying task areas in intensive care where speech-interaction can yield real benefit in terms of work efficiency, and second on developing and evaluating an ergonomic design of speech interaction. The intended users seem to look forward to the incorporation of speech interaction at the workplace.
-
J Clin Monit Comput · Jan 2000
Monitoring of isoflurane and desflurane breakdown: interfering gases and infrared detection.
The reaction of isoflurane, enflurane or desflurane with dried CO2 absorbents produces carbon monixide (CO), a highly toxic gas which cannot be detected by gas monitors typically available in the operating room. Trifluoromethane (CHF3) is produced along with CO when this reaction occurs with isoflurane and desflurane, and can be detected by gas monitors. This study will determine the ability of a modified SAM module (Smart Anesthesia Multigas Module, GE/Marquette Medical Systems, Milwaukee, WI) to identify the presence of CHF3, and provide a clinically useful indirect warning of CO production. ⋯ We have shown that the SAM module is capable of measuring CHF3 due to anesthetic breakdown. With appropriate changes in the display programming and reference cell spectra the monitor would be able to provide an early warning of CO exposure, although the amount of CO would not be reported.
-
J Clin Monit Comput · Jan 2000
Determining the artifact sensitivity of recent pulse oximeters during laboratory benchmarking.
This study aimed to investigate and compare the performance of the algorithms contained in the newest generation of pulse oximeters (Masimo SET in IVY2000, Nellcor Oxismart N-3000, Agilent M3 rev. B) against a traditional pulse oximeter (Agilent CMS rel. A.0). ⋯ Very pronounced improvements (between 2.3 and 3.4 fold) on all of the newer devices were found for the pulse rate. The NMC turned out to be a very useful tool for generating a standard signal set for algorithm development and benchmarking purposes that eliminates repetitive clinical testing in early stages. The applicability of its results needs confirmation by clinical live studies.
-
J Clin Monit Comput · Jan 2000
Local cardiac wall stabilization influences the reproducibility of regional wall motion during off-pump coronary artery pass surgery.
Myocardial ischemia is a risk factor during off-pump coronary artery bypass procedures. The development of new regional wall motion abnormalities assessed by transesophageal echocardiography (TEE) is a very sensitive sign of myocardial ischemia. To facilitate anastomosis, the epicardial area of the anastomosis site is often immobilized by a "stabilizer." This study was designed to investigate whether cardiac wall stabilization with an epicardial stabilizer could affect the interpretation of wall motion during coronary anastomosis without cardiopulmonary bypass. ⋯ Cardiac wall stabilization affects the reproducibility in the interpretation of regional wall motion during off-pump coronary artery bypass surgery. Caution should be used when monitoring for myocardial ischemia using TEE during coronary artery bypass surgery with epicardial stabilizer.
-
The measurement of exhaled pulmonary nitric oxide concentrations requires that contamination from the upper respiratory tract and inhaled gases be eliminated. This can be achieved with no risk in the clinical setting of intubated patients of all ages in the operating room or intensive care unit. Further modifications of the anesthetic/ventilatory circuit allow for accurate determination of tidal volume and minute ventilation.