Journal of clinical monitoring and computing
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J Clin Monit Comput · Dec 2002
Comparison of local measurement of cerebral metabolism and to cerebral PvO2 during alterations in intracranial pressure, PaCO2 and arterial pressure--an experimental study in goat.
to assess the changes in local brain PO2, PCO2, pH (PO2br, PCO2br, pHbr) measured by a intraparenchymal probe (Neurotrend, Codeman) and compare them to simultaneous recording of cerebral PvO2 and blood flow (CBF). ⋯ The direct metabolic monitoring of cerebral tissue locally compressed show fast response. At steady state, it shows alterations which are not detected by the measurement of the oxygen saturation in the longitudinal sinus or that of CBF. It confirms that the threshold for ICP which may require therapy in presence of focal brain compression is around 20 mm Hg even in the presence of a CPP > 90 mm Hg.
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J Clin Monit Comput · Dec 2002
How to develop a low cost, in-house distance learning center for continuing medical education. Part I.
Continuing medical education is essential to improve the quality of health care. Residential courses are expensive for small hospitals but videoconferencing is an economical alternative. Models of distance learning centers are described along with an explanation of INTERNET basics and the use of INTERNET protocol for local area networks (INTRANET). Hardware, software and other technology required and the advantages and disadvantages of different communication methods are reported.
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J Clin Monit Comput · Dec 2002
How to develop a low cost, in-house distance learning center for continuing medical education. Part II.
The first part of this paper discussed the advantages and communication tools needed to create a Distance Learning Center for continuing medical education by using an Intranet or the Internet. This part continues with an explanation of the hardware, software (largely free) and human resources needed for videoconferencing as well as the costs. Suitable even for small hospitals Distance Learning Centers can be of higher quality than traditional methods of continuing medical education.
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J Clin Monit Comput · Dec 2002
Mismatched concepts in a neonatal intensive care unit (NICU): further issues for computer decision support?
Common concepts and definitions are important for the effective practice of medicine. In an intensive care unit clear understanding of terminology and communication between different staff groups may be critical for optimal care. If computerised decision support tools are to be successfully deployed in these high intensity environments, all staff must understand the concepts and information that is to be portrayed. ⋯ Concepts are used differently by various staff groups in a neonatal unit: this may have an impact on the effectiveness of computerised decision aids unless it is taken into account during their development.
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In mechanically ventilated patients a high fraction of the pressure can be dissipated to overcome the viscoelastic components of the respiratory system. Recently it was demonstrated that sigh improved oxygenation in mechanically ventilated ARDS patients. We evaluated if, in acute lung injury (ALI) patients, the sigh can be used to measure the respiratory viscoelastic properties. ⋯ The long inflation time characteristic of the sigh allowed the determination of the viscoelastic constants by means of a simpler and faster method. Moreover it does not require very small tidal volumes, which can increase reabsorption atelectasis in ALI patients and can improve alveolar recruitment and oxygenation in these patients.