Journal of clinical monitoring and computing
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J Clin Monit Comput · Jun 2014
Clinical TrialIntraoperative flash VEPs are reproducible in the presence of low amplitude EEG.
Flash visual evoked potentials (FVEPs) are often irreproducible during surgery. We assessed the relationship between intraoperative FVEP reproducibility and EEG amplitude. Left then right eyes were stimulated by goggle light emitting diodes, and FVEPs were recorded from Oz–Fz′ (International 10-20 system) in 12 patients. ⋯ Raising the low cut filter to 10 and 30 Hz (in two patients) progressively reduced EEG and FVEP amplitude, reduced amplifier blocking time and improved FVEP reproducibility. FVEPs were more reproducible in the presence of low amplitude EEG than high amplitude EEG. This is the first report describing the effect of EEG amplitude on FVEP reproducibility during surgery
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J Clin Monit Comput · Jun 2014
An active one-lobe pulmonary simulator with compliance control for medical training in neonatal mechanical ventilation.
Mechanical ventilation is a current support therapy for newborns affected by respiratory diseases. However, several side effects have been observed after treatment, making it mandatory for physicians to determine more suitable approaches. High fidelity simulation is an efficient educational technique that recreates clinical experience. ⋯ An innovative software-based simulator for training neonatologists and nurses within the continuing medical education program on respiratory disease management was validated. Following the clinical needs, three friendly graphic user interfaces were implemented for simulating three different clinical scenarios (spontaneous breathing, controlled breathing and triggered/assisted ventilation modalities) thus providing physicians with an active experience. The proposed pulmonary simulator has the potential to be included in the range of computer-driven technologies used in medical training, adding novel functions and improving simulation results.
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J Clin Monit Comput · Jun 2014
Respiratory induced dynamic variations of stroke volume and its surrogates as predictors of fluid responsiveness: applicability in the early stages of specific critical states.
Respiratory induced dynamic variations of stroke volume and its surrogates are very sensitive and specific predictors of fluid responsiveness, but their use as targets for volume management can be limited. In a recent study, limiting factors were present in 53 % of surgical patients with inserted arterial line. In the intensive care unit (ICU) population the frequency is presumably higher, but the real prevalence is unknown. ⋯ The prevalence was similar in patients with shock. Occurrence of minor factors can pose further bias in evaluation of these patients. General use of dynamic variations guided protocols for initial resuscitations seems not universally applicable.
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J Clin Monit Comput · Jun 2014
Case ReportsBeware of "curare cleft" like changes during unilateral capnothorax.
Capnography is a standard monitoring tool during general anaesthesia. Diaphragmatic movement with the weaning of muscle relaxant effect produces the characteristic "curare cleft" on capnography. ⋯ Cautious interpretation and identification of these is essential to avoid any undue overdosing of the patients with muscle relaxants. We report "curare cleft" like artefact during ventilation with a single lumen tube in a patient with unilateral capnothorax undergoing minimally invasive esophagectomy.