Journal of clinical monitoring and computing
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The eye lens is one of the most sensitive organs for radiation injury and exposure might lead to radiation induced cataract. Eye lens dosimetry in anesthesiology has been published in few clinical trials and an active debate about the causality of radiation induced cataract is still ongoing. Recently, the International Commission on Radiological Protection (ICRP) recommended a reduction in the annual dose limit for occupational exposure for the lens of the eye from 150 to 20 mSv, averaged over a period of 5 years, with the dose in a single year not exceeding 50 mSv. ⋯ However, we demonstrated high maximum and average doses during neuro-embolisation, cardiac ablation and vertebro-/kyphoplasty procedures. With radiation induced cataract being explained as a possible stochastic effect, without a threshold dose, anesthesiologists who regularly work in a radiological environment should remain vigilant and maintain radiation safety standards at all times. This includes adequately protective equipment (protection shields, apron, thyroid shield and leaded eye wear), keeping distance, routine monitoring and appropriate education.
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J Clin Monit Comput · Apr 2017
ReviewPrecision diagnosis: a view of the clinical decision support systems (CDSS) landscape through the lens of critical care.
Improving diagnosis and treatment depends on clinical monitoring and computing. Clinical decision support systems (CDSS) have been in existence for over 50 years. While the literature points to positive impacts on quality and patient safety, outcomes, and the avoidance of medical errors, technical and regulatory challenges continue to retard their rate of integration into clinical care processes and thus delay the refinement of diagnoses towards personalized care. ⋯ The aggregate of those processes-CDSS-is currently primitive. Despite technical and regulatory challenges, the apparent clinical and economic utilities of CDSS must lead to greater engagement. These tools play the key role in realizing the vision of a more 'personalized medicine', one characterized by individualized precision diagnosis rather than population-based risk-stratification.
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J Clin Monit Comput · Apr 2017
ReviewJournal of clinical monitoring and computing 2016 end of year summary: monitoring cerebral oxygenation and autoregulation.
In the perioperative and critical care setting, monitoring of cerebral oxygenation (ScO2) and cerebral autoregulation enjoy increasing popularity in recent years, particularly in patients undergoing cardiac surgery. Monitoring ScO2 is based on near infrared spectroscopy, and attempts to early detect cerebral hypoperfusion and thereby prevent cerebral dysfunction and postoperative neurologic complications. ⋯ As a consequence, intraoperative hypotension will be poorly tolerated, and might cause ischemic events and postoperative neurological complications. This article summarizes research investigating technologies for the assessment of ScO2 and cerebral autoregulation published in the Journal of Clinical Monitoring and Computing in 2016.
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J Clin Monit Comput · Apr 2017
ReviewJournal of Clinical Monitoring and Computing 2016 end of year summary: respiration.
This paper reviews 16 papers or commentaries published in Journal of Clinical Monitoring and Computing in 2016, within the field of respiration. Papers were published covering peri- and post-operative monitoring of respiratory rate, perioperative monitoring of CO2, modeling of oxygen gas exchange, and techniques for respiratory monitoring.