Journal of clinical monitoring and computing
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J Clin Monit Comput · Jun 2010
Cardiac index measurements by transcutaneous Doppler ultrasound and transthoracic echocardiography in adult and pediatric emergency patients.
Non-invasive hemodynamic monitoring may facilitate resuscitation in critically ill patients. Validation studies examining a transcutaneous Doppler ultrasound technology, USCOM-1A, using pulmonary artery catheter as the reference standard showed varying results. In this study, we compared non-invasive cardiac index (CI) measurements by USCOM-1A with transthoracic echocardiography (TTE). ⋯ The USCOM-1A hemodynamic monitoring technology showed poor correlation and agreement to standard transthoracic echocardiography measures of cardiac function. The utility of USCOM-1A in the management of critically ill patients remains to be determined.
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Here we comment on the paper entitled "A novel laparoscopic pulse oximeter device. An easy, efficient and cost-effective way of detecting arterial structures." authored by Theodosopoulos et al., and recently published in the April issue of the Journal of Clinical Monitoring and Computing.
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J Clin Monit Comput · Jun 2010
Comparative StudyThe mean prehospital machine; accurate prehospital non-invasive blood pressure measurement in the critically ill patient.
Non-invasive blood pressure recordings may be inaccurate in the critically ill patient and measurement difficulties are intensified in the prehospital setting. This may adversely impact upon outcomes for many critically ill patients, particularly those with traumatic brain injury and/or lengthy prehospital times. This study aimed to validate a non-invasive, oscillometric, ambulatory blood pressure measuring device, the Oscar 2, Model 222 (SunTech Medical, Morrisville, USA) during the ambulance transport of critically ill patients. ⋯ When the Oscar 2 does not indicate a fault has occurred, clinicians may be confident the mean pressure, within acceptable limits, is accurate, even during ambulance motion, administration of high doses of vasopressors and mechanical ventilation. The Oscar 2 appears to be an accurate and rugged out-of-hospital device.
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J Clin Monit Comput · Jun 2010
Relations between respiratory changes in R-wave amplitude and arterial pulse pressure in mechanically ventilated patients.
R-wave obtained from the electrocardiogram depends on ventricular stroke volume. We assessed the relationship between respiratory variations in R-wave (DeltaRDII) and in pulse pressure (DeltaPP) during general anesthesia. ⋯ DeltaRDII and DeltaPP are related in this setting.
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J Clin Monit Comput · Jun 2010
The standard strong ion difference, standard total titratable base, and their relationship to the Boston compensation rules and the Van Slyke equation for extracellular fluid.
A general formalism for calculating physiological acid-base balance in multiple compartments is extended to the combined interstitial, plasma, and erythrocyte multicompartment system in humans using the Siggaard-Andersen approximation for interstitial fluid. The resulting equations for total titratable base and strong ion difference reproduce the experimental in vivo carbon dioxide titration curve as well as the experimental strong ion difference value of the interstitial, plasma, and erythrocyte system in normal man. The "Boston rules" for compensation in acute respiratory acidosis and alkalosis are then derived analytically from the model. The Van Slyke equation for the interstitial, plasma, and erythrocyte system is also derived and shown to approximate the Van Slyke equation for standard base excess.