Journal of clinical monitoring and computing
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A review of the literature shows that current "standard" laboratory measurements for hemoglobin are subject to numerous factors that affect both accuracy and reliability. In addition, total hemoglobin concentration measurements are subject to numerous factors that affect the "true" hemoglobin value. This article discusses both the physiologic factors that influence hemoglobin levels and the technical aspects and variability among the different measurement methodologies currently available.
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Duchenne muscular dystrophy (DMD) is an inherited myogenic disorder due to mutations in the dystrophin gene on chromosome Xp21.1. Heart failure is a classical complication in this disease. Little data are available about systolic dyssynchrony in DMD. ⋯ Intra-ventricular asynchrony was present in 6 % of patients with EF < 35 %. We found a high prevalence of LV dysfunction in DMD. Systolic ventricular asynchrony seems frequent particularly in patients with EF < 35 %.
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J Clin Monit Comput · Oct 2013
Review Meta AnalysisHeart rate variability indices for very short-term (30 beat) analysis. Part 1: survey and toolbox.
Heart rate variability (HRV) analysis over very short (<60 s) periods may be useful for monitoring dynamic changes in autonomic nervous system activity where steady-state conditions are not maintained (e.g. during drug administration, or the start or end of exercise). From the 1980s there has been a wealth of HRV indices produced in the quest for better measures of the change in parasympathetic and sympathetic activity. Many of the indices have been sparingly used and have not been investigated for application to short-term use. ⋯ The survey identified a comprehensive list of 115 indices that were subsequently coded and screened. Of these, 70 were unique and produced a finite number with 60 s data, so are included in the Toolbox. These indices require validation against physiological data before they can be applied to short-term HRV analysis of cardiac autonomic nervous system activity.
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J Clin Monit Comput · Oct 2013
Clinical TrialDetermination of breath isoprene allows the identification of the expiratory fraction of the propofol breath signal during real-time propofol breath monitoring.
Real-time measurement of propofol in the breath may be used for routine clinical monitoring. However, this requires unequivocal identification of the expiratory phase of the respiratory propofol signal as only expiratory propofol reflects propofol blood concentrations. Determination of CO2 breath concentrations is the current gold standard for the identification of expiratory gas but usually requires additional equipment. ⋯ Overall bias between the two data extraction methods was -0.12 ppb. The lower and the upper limits of the 95 % CI were -0.69 and 0.45 ppb. Determination of isoprene breath concentrations allows the identification of the expiratory propofol signal during real-time breath monitoring.
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J Clin Monit Comput · Oct 2013
Randomized Controlled TrialUmesh's intubation detector (UID) for rapid and reliable identification of tracheal intubation by novices in anaesthetised, paralysed adult patients.
Oesophageal intubation can lead to life threatening complications if left undetected. Several devices and techniques are available to confirm tracheal intubation and for early detection of oesophageal intubation. This study was carried out to evaluate the utility of the Umesh's intubation detector device for rapid and reliable differentiation of tracheal from oesophageal intubation by novice users. ⋯ Out of the total 100 oesophageal intubations, 99 were correctly identified. There were no complications related to the study. Umesh's intubation detector device can be used by novices for rapid and reliable differentiation of tracheal from oesophageal intubation in healthy adult patients.