Journal of clinical monitoring and computing
-
J Clin Monit Comput · Feb 2022
ReviewThe contemporary pulmonary artery catheter. Part 2: measurements, limitations, and clinical applications.
Nowadays, the classical pulmonary artery catheter (PAC) has an almost 50-year-old history of its clinical use for hemodynamic monitoring. In recent years, the PAC evolved from a device that enabled intermittent cardiac output measurements in combination with static pressures to a monitoring tool that provides continuous data on cardiac output, oxygen supply and-demand balance, as well as right ventricular performance. ⋯ Limitations of all of these measurements are highlighted as well. We conclude that thorough understanding of measurements obtained from the PAC is the first step in successful application of the PAC in daily clinical practice.
-
J Clin Monit Comput · Feb 2022
In vitro performance evaluation of AnaConDaTM-100 and AnaConDaTM-50 compared to a circle breathing system for control and consumption of volatile anaesthetics.
To identify the better volatile anaesthetic delivery system in an intensive care setting, we compared the circle breathing system and two models of reflection systems (AnaConDa™ with a dead space of 100 ml (ACD-100) or 50 ml (ACD-50)). These systems were analysed for the parameters like wash-in, consumption, and wash-out of isoflurane and sevoflurane utilising a test lung model. The test lung was connected to a respirator (circle breathing system: Aisys CS™; ACD-100/50: Puriton Bennett 840). ⋯ Wash-out was comparable in ACD-100 and ACD-50. Wash-in and wash-out were generally quicker with the circle breathing system than in ACD-100/-50. However, consumption at 0.5 minimum alveolar concentration was comparable at flows of 0.5 and 1.0 l/min.
-
J Clin Monit Comput · Feb 2022
Accuracy of a battery-powered portable capnometer in premature infants.
Carbon dioxide measurement is useful for confirmation of successful tracheal intubation and ensuring adequate ventilation. There are two types of CO2 detectors, i.e., single-use-only colorimetric devices and capnometers. Although portable capnometers are widely used for resuscitation, there have been no reports regarding their clinical utility in neonates. ⋯ Therefore, PetCO2 readings obtained with a battery-powered portable capnometer were likely to be underestimated. This became more pronounced with decreasing infant body weight at examination as the net difference in measurements of PaCO2 and PetCO2 was significantly positively correlated with infant body weight at examination (r = 0.451, P < 0.001). The observations presented here may be helpful in the use of battery-powered portable capnometers in neonates requiring controlled ventilation with tracheal intubation.
-
J Clin Monit Comput · Feb 2022
Safety aspects of the PiCCO thermodilution-cardiac output catheter during magnetic resonance imaging at 3 Tesla.
Thermodilution cardiac output monitoring, using a thermistor-tipped intravascular catheter, is used in critically ill patients to guide hemodynamic therapy. Often, these patients also need magnetic resonance imaging (MRI) for diagnostic or prognostic reasons. As thermodilution catheters contain metal, they are considered MRI-unsafe and advised to be removed prior to investigation. ⋯ No magnetically induced catheter displacements were observed. Under the tested circumstances, no heating or dislocation of the PiCCO™ catheter was observed in a tissue mimicking phantom during 3T-MRI. Leaving the catheter in the critically ill patient during MRI investigation might pose a lower risk of complications than catheter removal and replacement.
-
J Clin Monit Comput · Feb 2022
Review Meta AnalysisEffectiveness of consumer-grade contactless vital signs monitors: a systematic review and meta-analysis.
The objective of this systematic review and meta-analysis was to analyze the effectiveness of contactless vital sign monitors that utilize a consumer-friendly camera versus medical grade instruments. A multiple database search was conducted from inception to September 2020. Inclusion criteria were as follows: studies that used a consumer-grade camera (smartphone/webcam) to examine contactless vital signs in adults; evaluated the non-contact device against a reference medical device; and used the participants' face for measurement. ⋯ Currently available consumer-friendly contactless monitors measure HR accurately compared to standard medical devices. More studies are needed to assess the accuracy of contactless BP and RR monitors. Implementation of contactless vital sign monitors for clinical use will require validation in a larger population, in a clinical setting, and expanded to encompass other vital signs including BP, RR, and SpO2.