Journal of clinical monitoring and computing
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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.
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J Clin Monit Comput · Jan 2000
Teaching respiratory physiology: clinical correlation with a human patient simulator.
In recent years students have increasingly objected to laboratory exercises involving animal subjects. We have replaced the valuable animal experiments with demonstrations using a full-scale human patient simulator. In small groups first-year medical students observe realistic clinical situations such as opioid-induced hypoventilation, pneumothorax, and pulmonary edema. ⋯ They practice interventions such as providing supplemental oxygen and mask ventilation, monitor the results, and develop a basic differential diagnosis and treatment plan. We utilize the clinical context to review fundamental concepts of respiratory physiology including the alveolar air equation and oxyhemoglobin dissociation curve. The students give these laboratory exercises uniformly superior evaluations.
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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.
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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.