Journal of clinical monitoring and computing
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J Clin Monit Comput · Dec 2017
A nurses' alarm fatigue questionnaire: development and psychometric properties.
Alarm fatigue can adversely affect nurses' efficiency and concentration on their tasks, which is a threat to patients' safety. The purpose of the present study was to develop and test the psychometric accuracy of an alarm fatigue questionnaire for nurses. This study was conducted in two stages: in stage one, in order to establish the different aspects of the concept of alarm fatigue, the researchers reviewed the available literature-articles and books-on alarm fatigue, and then consulted several experts in a meeting to define alarm fatigue and develop statements for the questionnaire. ⋯ The test of the reliability of nurses' alarm fatigue questionnaire based on the internal homogeneity and retest methods yielded the following results: test-retest correlation coefficient = 0.99; Guttman split-half correlation coefficient = 0.79; Cronbach's alpha = 0.91. Regarding the importance of recognizing alarm fatigue in nurses, there is need for an instrument to measure the phenomenon. The results of the study show that the developed questionnaire is valid and reliable enough for measuring alarm fatigue in nurses.
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J Clin Monit Comput · Dec 2017
Ventilation/perfusion ratio and right to left shunt in healthy newborn infants.
Oxygenation impairment can be assessed non-invasively by determining the degree of right-to-left shunt and ventilation/perfusion (VA/Q) inequality. These indices have been used in sick newborn infants, but normative values have not been reported which are essential to determine the magnitude of the abnormality. We, therefore, aimed to measure the shunt and VA/Q in infants with no history of respiratory conditions and determine if there was any effect of supine or prone position and the reproducibility of the data. ⋯ No significant differences were found in VA/Q in the supine compared to the prone position. The intraclass correlation coefficient of VA/Q between two independent raters was 0.968 (95% CI 0.947-0.980), p < 0.001. Right-to-left shunt and VA/Q ratio in healthy newborn infants were similar in the prone compared to the supine position.
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J Clin Monit Comput · Dec 2017
Observational StudyEvaluation of different near-infrared spectroscopy technologies for assessment of tissue oxygen saturation during a vascular occlusion test.
An increasing number of NIRS devices are used to provide measurements of peripheral tissue oxygen saturation (StO2). The aim of the present study is to test the hypothesis that despite technological differences between devices, similar trend values will be obtained during a vascular occlusion test. The devices compared are NIRO-200NX, which measures StO2 and oxyhemoglobin by spatially resolved spectroscopy and the Beer-Lambert law, respectively, and INVOS 5100C and Foresight Elite, which both measure StO2 with the Beer-Lambert law, enhanced with the spatial resolution technique. ⋯ Oxyhemoglobin measured with NIRO responded faster than the other NIRS technologies to changes in peripheral tissue oxygenation (20 vs. 27-40 s, p ≤ 0.01). When comparing INVOS with Foresight, oxygenation changes were prompter (upslope 311 [92-523]%/min vs. 114[65-199]%/min, p ≤ 0.01) and more pronounced (minimum value 36 [21-48] vs. 45 [40-51]%, p ≤ 0.01) with INVOS. Significant differences in tissue oxygen saturation measurements were observed, both within the same device as between different devices using the same measurement technology.
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J Clin Monit Comput · Dec 2017
Comparative StudyComparison of pneumotachography and anemometery for flow measurement during mechanical ventilation with volatile anesthetics.
Volatile anesthetics alter the physical properties of inhaled gases, such as density and viscosity. We hypothesized that the use of these agents during mechanical ventilation would yield systematic biases in estimates of flow ([Formula: see text]) and tidal volume (V T) for two commonly used flowmeters: the pneumotachograph (PNT), which measures a differential pressure across a calibrated resistive element, and the hot-wire anemometer (HWA), which operates based on convective heat transfer from a current-carrying wire to a flowing gas. We measured [Formula: see text] during ventilation of a spring-loaded mechanical test lung, using both the PNT and HWA placed in series at the airway opening. ⋯ A simple compensation factor based on density reduced observed differences between the flowmeters, regardless of the anesthetic or concentration. These data indicate that the choice and concentration of anesthetic agents are primary factors for differences in estimated V T between the PNT and HWA. Such discrepancies may be compensated by accounting for alterations in gas density.
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J Clin Monit Comput · Dec 2017
ReviewCerebral hemodynamics in sepsis assessed by transcranial Doppler: a systematic review and meta-analysis.
Cerebral microcirculation is gradually compromised during sepsis, with significant reductions in the function of capillaries and blood perfusion in small vessels. Transcranial Doppler ultrasound (TCD) has been used to assess cerebral circulation in a typical clinical setting. This study was to systematically review TCD studies, assess their methodological quality, and identify trends that can be associated with the temporal evolution of sepsis and its clinical outcome. ⋯ Cerebral haemodynamic is impaired in sepsis. Modifications in cerebral blood flow may be consequence to the endothelial dysfunction of the microvasculature induced by the release of inflammatory mediators. A better understanding of cerebral hemodynamics may improve the clinical management of patients with sepsis and, consequently, improve clinical outcomes.