Journal of clinical monitoring and computing
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J Clin Monit Comput · Oct 2011
Comparative StudyNoninvasive cardiac output monitoring during exercise testing: Nexfin pulse contour analysis compared to an inert gas rebreathing method and respired gas analysis.
Exercise testing is often used to assess cardiac function during physical exertion to obtain diagnostic information. However, this procedure is limited to measuring the electrical activity of the heart using electrocardiography and intermittent blood pressure (BP) measurements and does not involve the continuous assessment of heart functioning. In this study, we compared continuous beat-to-beat pulse contour analysis to monitor noninvasive cardiac output (CO) during exercise with inert gas rebreathing and respired gas analysis. ⋯ Nexfin continuous beat-to-beat pulse contour analysis is an appropriate method for noninvasive assessment of CO during exercise.
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J Clin Monit Comput · Oct 2011
A quantitative EEG method for detecting post clamp changes during carotid endarterectomy.
To apply univariate and multivariate analyses of EEG spectral features in order to detect subtle post-clamp changes during carotid endarterectomy, and to devise a data-driven, multivariate classification method for rapid, real-time detection of small post-clamp EEG changes. ⋯ By applying automatic data-driven feature extraction and classification to short EEG records, it is possible to construct subject-independent computational models that can detect subtle post clamp changes possibly caused by small perturbations in cerebral blood flow. These subtle changes are missed by visual inspection of the EEG and by other quantitative EEG techniques such as r-sBSI and r-tBSI. Within our subject group, the intricate post-clamp EEG signatures were predominantly anterior, bilateral, and had a strong delta rhythm presence.
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J Clin Monit Comput · Oct 2011
Bi-spectral index, entropy and predicted plasma propofol concentrations with target controlled infusions in Indian patients.
Many processed electroencephalographic signals are used now to help the anaesthesiologist titrate the depth of sedation. We investigated the relationship between target plasma propofol concentration and objective end-points of sedation- Bispectral Index (BIS), State Entropy (SE) and Response Entropy (RE)-at clinical end-points as assessed by Modified Observer Assessment of Alertness/sedation Scale (MOAAS) in Indian patients. ⋯ The target plasma propofol concentrations required to produce unconsciousness and loss of response to painful stimuli in Indian patients have been estimated. Also, the relations between target plasma concentration and objective measures of different levels of anaesthesia have been established.
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J Clin Monit Comput · Oct 2011
Comparative StudySingle-channel amplitude integrated EEG recording for the identification of epileptic seizures by nonexpert physicians in the adult acute care setting.
Although several studies have shown the potential of amplitude integrated electroencephalography (aEEG) in detecting neonatal seizures, no publications have evaluated the diagnostic use of aEEG for the detection of seizures in adult patients. ⋯ Recording of aEEG without access to the raw EEG data is not a reliable diagnostic tool for the identification of epileptic seizures in the hands of nonexpert ICU physicians.
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Humans have a limited ability to accurately and continuously analyse large amount of data. In recent times, there has been a rapid growth in patient monitoring and medical data analysis using smart monitoring systems. Fuzzy logic-based expert systems, which can mimic human thought processes in complex circumstances, have indicated potential to improve clinicians' performance and accurately execute repetitive tasks to which humans are ill-suited. The main goal of this study is to develop a clinically useful diagnostic alarm system based on fuzzy logic for detecting critical events during anaesthesia administration. ⋯ The diagnostic alarm system FLMS demonstrated that evidence-based expert diagnostic systems can diagnose hypovolaemia, with a substantial degree of accuracy, in anaesthetized patients and could be useful in delivering decision support to anaesthetists.