Journal of clinical monitoring and computing
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Identification of humoral markers of acute lung injury may lead to insights into pathologic mechanisms. In addition, specific markers may be useful for predicting development of acute respiratory distress syndrome (ARDS) or for assessing prognosis. Ultimately, studies of lung injury markers may help define interventions that prevent or moderate ARDS. ⋯ Surfactant apoproteins may be important markers of injury or for prognosis. Levels of surfactant apoprotein A (SP-A) fall 50-75% in patients with severe lung injury compared to normal patients. Serum levels of SP-A in patients dying of acute respiratory distress syndrome are double serum levels of survivors.
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J Clin Monit Comput · Jan 2000
Hierarchical rule-based monitoring and fuzzy logic control for neuromuscular block.
The important task for anaesthetists is to provide an adequate degree of neuromuscular block during surgical operations, so that it should not be difficult to antagonize at the end of surgery. Therefore, this study examined the application of a simple technique (i.e., fuzzy logic) to an almost ideal muscle relaxant (i.e., rocuronium) at general anaesthesia in order to control the system more easily, efficiently, intelligently and safely during an operation. ⋯ The results showed that a hierarchical rule-based monitoring and fuzzy logic control architecture can provide stable control of neuromuscular block despite the considerable individual variation in neuromuscular block required among patients. Also, there was less variation in T1% error compared with that of previous study on mivacurium. Meanwhile, the consistent medium CV of the MIR of both rocuronium and mivacurium indicated a good controller activity which is able to withstand noise, diathermy effect, artifacts and surgical disturbances.
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J Clin Monit Comput · Jan 2000
ReviewNon-invasive imaging of regional lung function using x-ray computed tomography.
The use of imaging technologies has progressed beyond the depiction of anatomic abnormalities to providing non-invasive regional structure and functional information in intact subjects. These data are particularly valuable in studies of the lung, since lung disease is heterogeneous and significant loss of function may occur before it is detectable by traditional whole lung measurements such as oxygenation, compliance, or spirometry. ⋯ In addition, using the radiodense gas xenon (Xe) as a contrast agent, regional ventilation or gas transport may also be obtained. This communication will review recent advances in CT based techniques for the measurement of regional lung function.
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J Clin Monit Comput · Jan 2000
Comparative Study Clinical TrialNon-invasive estimation of cardiac output in critical care patients.
This study was carried out to compare cardiac output measurements determined by thermodilution and by Portapres, a non-invasive system. ⋯ To date, Portapres measurements cannot replace thermodilution cardiac output estimations. Fluctuations of finger arterial perfusion due to hemodynamic instability, hypothermia and catecholamines may be responsible for problems of Portapres use in critically ill patients.
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J Clin Monit Comput · Jan 2000
Evaluation of two new ecological interface approaches for the anesthesia workplace.
Currently, vital parameters are commonly displayed as trends along a timeline. However, clinical decisions are more often based upon concepts, such as the depth of anesthesia, that are derived by combining parameter relationships and additional context information. The current displays do not visualize such concepts and therefore do not optimally support the decision process. A new display should present an ecological interface (EI). The principle of EI design is to visualize all of the information necessary for decision making in one single display. ⋯ The results have shown that appropriately designed EIs may improve the anesthetist's decision making and focus attention on specific problems. Now, the findings have to be tested in future studies by widening the scope using other simulated scenarios and being closer to reality under real conditions in the OR. Eye tracking proved to be a useful method to analyze the anesthetists' decision making and appropriately re-design interfaces.