Journal of clinical monitoring and computing
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J Clin Monit Comput · Jun 2018
Observational StudyNear-infrared spectroscopy monitoring during immediate transition after birth: time to obtain cerebral tissue oxygenation.
Feasibility of cerebral tissue oxygenation measurements immediately after birth has been published starting with first values 2 min after birth. Aim of this study was to evaluate, the time periods from birth and from arrival at the resuscitation table to obtain the first cerebral tissue oxygenation values with two different near infrared spectroscopy (NIRS) devices. The present study is an analysis of exploratory parameters of two prospective observational studies. ⋯ The first displayed value tended to be higher for cTOI [54% (18-80)] compared to crSO2 [35% (15-87)]. There were no significant differences between devices in time periods and first values displayed. Cerebral tissue oxygenation can be measured within 1 min after arriving at the resuscitation table in term and preterm neonates after birth without difference between devices.
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J Clin Monit Comput · Jun 2018
Technical challenges related to implementation of a formula one real time data acquisition and analysis system in a paediatric intensive care unit.
Most existing, expert monitoring systems do not provide the real time continuous analysis of the monitored physiological data that is necessary to detect transient or combined vital sign indicators nor do they provide long term storage of the data for retrospective analyses. In this paper we examine the feasibility of implementing a long term data storage system which has the ability to incorporate real-time data analytics, the system design, report the main technical issues encountered, the solutions implemented and the statistics of the data recorded. McLaren Electronic Systems expertise used to continually monitor and analyse the data from F1 racing cars in real time was utilised to implement a similar real-time data recording platform system adapted with real time analytics to suit the requirements of the intensive care environment. ⋯ Recording data from bed-side monitors in intensive care/wards is feasible. It is possible to set up real time data recording and long term storage systems. These systems in future can be improved with additional patient specific metrics which predict the status of a patient thus paving the way for real time predictive monitoring.
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J Clin Monit Comput · Jun 2018
Efficiency of oxygen delivery through different oxygen entrainment devices during sedation under low oxygen flow rate: a bench study.
Sedative anesthetic procedures outside the operating room may depend on cylinders as oxygen source. Cylinders have limited storage capacity and a low oxygen flow rate improves the durability. We conducted the bench study to evaluate the fraction of inspired oxygen (FiO2) in different oxygen entrainment devices under low oxygen flow rate. ⋯ In the hypoventilation group, oxygen reservoir units helped oxygen retention in local area and maintained a higher oxygen concentration. There were multiple factors lead to different oxygen fraction that we measured, such as different devices, respiratory patterns, and oxygen reservoir units. The result of our bench study provided some information for anesthesiologist to choose appropriate oxygen entrainment devices in various sedative anesthetic procedures.
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J Clin Monit Comput · Jun 2018
Comparative StudyDiscrepancy between in vivo and in vitro comparisons of forced oscillation devices.
The forced oscillation technique (FOT) is an emerging clinical lung function test, with commercial devices becoming increasingly available. However comparability across existing devices has not been established. We evaluated in vivo and in vitro measurements made using three commercial devices against a custom-built device (WIMR): Resmon Pro Diary (Restech srl, Italy), tremoFlo C-100 (Thorasys Medical Systems, Canada), Jaeger Masterscope CT IOS (CareFusion, Hoechberg, Germany). ⋯ No differences were observed using test standards; deviation from theoretical value was <2% for resistance and <5% for reactance. The WIMR, tremoFlo and Resmon Pro but not IOS devices measure similar Rrs, whereas there was more disparity across devices in the estimation of Xrs parameters. The discrepancy between in vivo and in vitro measurements suggest that FOT validation procedures need to take into account the breathing pattern, either using biological controls or a breathing model.
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J Clin Monit Comput · Jun 2018
Comparative StudyComparing volume-clamp method and intra-arterial blood pressure measurements in patients with atrial fibrillation admitted to the intensive or medium care unit.
International guidelines highlight the importance of blood pressure (BP) in patients with atrial fibrillation (AF). However, BP measurement in AF is complicated by beat-to-beat fluctuation. Automated BP measurement devices are not validated for patients with AF and no consensus exists on how to measure BP in AF manually. ⋯ Accuracy of VCM in AF was similar to sinus rhythm. In conclusion, in patients with AF, accurate and precise measurement of non-invasive beat-to-beat BP measurement using the VCM is possible, the one exception being the precision of systolic BP. Beat-to-beat variability can be accurately reproduced.