Journal of clinical monitoring and computing
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J Clin Monit Comput · Aug 2013
ReviewConnecting the dots: rule-based decision support systems in the modern EMR era.
The intensive care unit (ICU) environment is rich in both medical device and electronic medical record (EMR) data. The ICU patient population is particularly vulnerable to medical error or delayed medical intervention both of which are associated with excess morbidity, mortality and cost. ⋯ False alerts and alert fatigue remain prevalent. In the coming era of widespread EMR implementation novel medical informatics methods may be adaptable to the development of next generation, rule-based DSS.
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J Clin Monit Comput · Aug 2013
ReviewTranslational applications of evaluating physiologic variability in human endotoxemia.
Dysregulation of the inflammatory response is a critical component of many clinically challenging disorders such as sepsis. Inflammation is a biological process designed to lead to healing and recovery, ultimately restoring homeostasis; however, the failure to fully achieve those beneficial results can leave a patient in a dangerous persistent inflammatory state. ⋯ Here, we discuss our approaches towards addressing this problem through computational systems biology, with a particular focus on how the presence of biological rhythms and the disruption of these rhythms in inflammation may be applied in a translational context. By leveraging the information content embedded in physiologic variability, ranging in scale from oscillations in autonomic activity driving short-term heart rate variability to circadian rhythms in immunomodulatory hormones, there is significant potential to gain insight into the underlying physiology.
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J Clin Monit Comput · Aug 2013
ReviewPotential of surface acoustic wave biosensors for early sepsis diagnosis.
Early diagnosis of sepsis is a difficult problem for intensivists and new biomarkers for early diagnosis have been difficult to come by. Here we discuss the potential of adapting a technology from the electronics industry, surface acoustic wave (SAW) sensors, for diagnosis of multiple markers of sepsis in real time, using non-invasive assays of exhaled breath condensate. The principles and advantages of the SAW technology are reviewed as well as a proposed plan for adapting this flexible technology to early sepsis detection.