Journal of clinical monitoring and computing
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J Clin Monit Comput · Aug 2004
Clinical TrialThe correlation of the bispectral index with propofol effect site concentrations is not altered by epochs indicated as artefact-loaded by narcotrend.
Artefact detection is an essential feature of automatic EEG monitoring systems used in anaesthesia. Clinical experience indicates that Narcotrend monitoring (MonitorTechnik, Bad Bramstedt, Germany, version 4.0) excludes more EEG epochs because of artefacts than bispectral index monitoring (BIS, Aspect Medical Systems, Newton, MA, version XP). Whether this increased exclusion of epochs is justified has not been investigated yet. ⋯ Exclusion of data pairs that were detected as artefacts by Narcotrend but not by BIS did not change the performance of bispectral index as an indicator of propofol effect site concentration.
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J Clin Monit Comput · Aug 2004
Clinical TrialCorrelation of Narcotrend Index, entropy measures, and spectral parameters with calculated propofol effect-site concentrations during induction of propofol-remifentanil anaesthesia.
The aim of this study was to compare the EEG parameter Narcotrend Index with the spectral and entropy-based EEG parameters median frequency, 95% spectral edge frequency, burst-compensated 95% spectral edge frequency, spectral entropy, amplitude entropy, and approximate entropy with regard to their ability to describe cerebral anaesthetic drug effects during induction of propofol-remifentanil anaesthesia. ⋯ In all groups Narcotrend Index showed the highest correlation with the propofol effect-site concentration and the lowest variability of individual correlation values. Furthermore, only the Narcotrend Index showed a monophasic behaviour over the entire time period analysed. In the group of entropy parameters approximate entropy yielded the best results. Among the spectral parameters the burst-compensated 95% spectral edge frequency had the highest correlation with the propofol effect-site concentration. It was markedly higher than for the standard spectral edge frequency. The correlations of median frequency and amplitude entropy with propofol effect-site concentration were the lowest. CONCLUSIONS. Changes in the propofol effect-site concentration during induction of anaesthesia were best described by the multivariate Narcotrend Index compared to conventional spectral EEG parameters and different entropy measures.
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J Clin Monit Comput · Aug 2004
Validation of a noninvasive blood pressure monitoring device in normotensive and hypertensive pediatric intensive care patients.
To evaluate the performance and to define limitations of a noninvasive blood pressure monitoring device in the critically ill pediatric population. ⋯ The noninvasive blood pressure monitor is capable of producing an accurate blood pressure measurement every 12-15 heartbeats in addition to providing a pulse waveform and digital display of the heart rate. Our study showed good agreement between the methods in the normotensive and hypertensive critically ill pediatric population with a wrist circumference limitation defined at > or =11 cm.
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J Clin Monit Comput · Aug 2004
Hipocrates: a robust system for the control of neuromuscular blockade.
Development of an automatic system (software package Hipocrates) for the control of neuromuscular blockade by continuous infusion of the non-depolarising types of muscle relaxant drugs presently used in anaesthesia, namely atracurium, cisatracurium, vecuronium and rocuronium. ⋯ Hipocrates is an advanced standalone application for the control of neuromuscular blockade with a friendly graphic interface. It has been extensively validated, and it can be used on patients undergoing surgery as well as for simulation studies. Therefore Hipocrates also provides an excellent environment for education and training purposes.