Journal of clinical monitoring and computing
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J Clin Monit Comput · Jun 2014
Randomized Controlled Trial Comparative StudyE-O technique is superior to E-C technique in manikins during single person bag mask ventilation performed by novices.
Conventional E-C technique of mask holding is unreliable during single person bag mask ventilation (BMV) due mainly to leak around the mask and inexperience of the persons. In this manikin study, conventional E-C technique was compared with E-O technique during single person BMV both with experienced (n = 50) and novice (n = 50) volunteers. The E-O technique involved encircling the mask neck with the web between thumb and index finger while the other digits provided chin lift. ⋯ The conventionally taught E-C technique of single person BMV provides acceptable chest expansion on most occasions with experienced operators than novices. Novices should use E-O technique as the first choice for single person BMV. Both techniques may be used interchangeably when one fails.
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J Clin Monit Comput · Jun 2014
Application of internal electrodes to the oesophageal and tracheal tube in an animal trial: evaluation of its clinical and technical potentiality in electrical impedance tomography.
Electrical impedance tomography (EIT) is of potential medical interest e.g., to optimize ventilator settings during mechanical ventilation. Nevertheless there are still several challenges. Although electrode belts are commonly used and promoted, they are not necessarily adequate for the long-term monitoring of patients in intensive-care units (ICU). ⋯ Distinguishability of lungs was improved in reconstructed frames. The resulting sensitivity of measured electrical impedance was enhanced around the mediastinal region and even cardiac-related activity was significantly increased by a factor of up to 6. In conclusion the application of internal electrodes appears to be beneficial for diverse clinical purposes and should be addressed in further studies.
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J Clin Monit Comput · Jun 2014
Randomized Controlled TrialThe use of train of four monitoring for clinical evaluation of the axillary brachial plexus block.
The axillary approach of brachial plexus anesthesia is the most commonly used technique for forearm and hand surgery. Dynamometer is known as objective test for the clinical assessment of motor block of the nerves in brachial plexus block. However, the use of this device may not always be practical in operating room. ⋯ TOF values were gradually decreased and significant difference was observed between the development of a complete and partial motor block at 30th minute. TOF values were also significantly less in patients of complete sensory block than the patients of partial sensory block at 30th minute. The use of TOF monitoring may be beneficial to assess the objective clinical effect of motor block in the patients with axillary brachial plexus nerve block.
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J Clin Monit Comput · Jun 2014
Case ReportsThe use of regional cerebral oximetry monitoring during controlled hypotension: a case series.
Regional cerebral oximetry monitoring was used to guide nitroglycerin infusion and IV fluid administration during controlled hypotension in order to optimize each individual patient's mean arterial pressure in a series of 20 consecutive patients who underwent major open urological or abdominal surgery. Although controlled hypotension offers a definite benefit in patients undergoing complex surgery where blood loss will be elevated or would severely compromise the surgical field, it is not without risk as low arterial pressure may compromise tissue perfusion and promote ischemia. In this case series, despite an average mean arterial pressure decrease of 19.5 % (p < 0.001), cerebral oximetry values increased by an average of 22.7 % (p < 0.001) after the nitroglycerin infusion had been initiated (220 mcg/min average). Patients received an average of 3.15L crystalloid and 437 ml albumin in fluid resuscitation.