Journal of clinical monitoring and computing
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To describe a new pulse oximetry technology and measurement paradigm developed by Masimo Corporation. ⋯ The technological strategies implemented in Masimo SET pulse oximetry effectively permit continuous monitoring of SpO2 during challenging clinical conditions of motion and poor tissue perfusion.
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J Clin Monit Comput · Jan 2000
Effects of one-lung ventilation on cardiac autonomic nervous activity as evaluated by power spectral analysis of heart rate variability.
The purpose of this prospective study was to evaluate the effects of one-lung ventilation on the activity of the cardiac autonomic nervous system. Ten adult patients who underwent thoracotomy were endotracheally intubated with a double-lumen tube under general anesthesia using isoflurane. After induction of anesthesia, a continuous, 256-sec electrocardiogram (ECG) was obtained during bilateral lung ventilation (control) followed by recordings during one-lung ventilation of each side. ⋯ Log(LF), which represents sympathetic and parasympathetic activity, increased similarly to log(HF) on both sides. Log(HF/LF), the balance of the sympathetic and parasympathetic activity, did not change during one-lung ventilation. We suggest that one-lung ventilation alone does not substantially affect the cardiac autonomic nervous system.
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J Clin Monit Comput · Jan 2000
Using an anesthesia information management system to prove a deficit in voluntary reporting of adverse events in a quality assurance program.
A deficit is suspected in the manual documentation of adverse events in quality assurance programs in anesthesiology. In order to verify and quantify this, we retrospectively compared the incidence of manually recorded perioperative adverse events with automatically detected events. ⋯ Using automatic detection, we were able to prove a considerable deficit in the documentation of adverse events according to the guidelines of the German quality assurance program in anesthesiology. Based on the data from manual recording, the results of the quality assurance of our department match those of other comparable German departments. Thus, we are of the opinion that manual incident reporting seriously underestimates the true occurrence rate of incidents. This brings into question the validity of quality assurance comparisons based on manually recorded data.
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J Clin Monit Comput · Jan 2000
Computerisation and decision making in neonatal intensive care: a cognitive engineering investigation.
This paper reports results from a cognitive engineering study that looked at the role of computerised monitoring in neonatal intensive care. A range of methodologies was used: interviews with neonatal staff, ward observations, and experimental techniques. ⋯ Factors that seemed to affect staff use of the computer were the lack (or shortage) of training on the system, the specific clinical conditions involved, and the availability of alternative sources of information. These findings have relevant repercussions for the design of computerised decision support in intensive care and suggest ways in which computerised monitoring can be enhanced, namely: by systematic staff training, by making available online certain types of clinical information, by adapting the user interface, and by developing intelligent algorithms.