Journal of clinical monitoring and computing
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J Clin Monit Comput · Feb 2017
Use of a patient completed iPad questionnaire to improve pre-operative assessment.
Developments in healthcare technology could improve patient care and reduce healthcare costs. There is a need to facilitate communication and increase efficiency in surgical pre-assessment clinics. This study aimed to develop an iPad application to deliver an electronic patient questionnaire, and to evaluate its use in the pre-assessment environment. ⋯ Use of an electronic patient questionnaire reduces consultation time delivering greater efficiency of pre-assessment nurse time. Preconceived ideas about the use of technology in older age groups are likely inaccurate and less of a barrier than previously thought. Electronic pre-assessments could be used routinely to reduce demands on healthcare facilities, improve patient care, and triage patients prior to clinic attendance.
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J Clin Monit Comput · Feb 2017
Assessing the effect of preoperative levosimendan on renal function in patients with right ventricular dysfunction.
The Acute Kidney Injury Network (AKIN) classification considers SCr values, urea and urine output in order to improve timely diagnose ARF and improve patient prognosis by early treatment. Preoperative levosimendan is a new way for cardiac and kidney protection, we try to evaluate this drug in fifteen patients comparing values of AKIN scale parameters pre and post cardiac surgery in patients with right ventricle dysfunction.
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J Clin Monit Comput · Feb 2017
Observational StudyAcoustic method respiratory rate monitoring is useful in patients under intravenous anesthesia.
Respiratory depression can occur during intravenous general anesthesia without tracheal intubation. A new acoustic method for respiratory rate monitoring, RRa® (Masimo Corp., Tokyo, Japan), has been reported to show good reliability in post-anesthesia care and emergency units. The purpose of this study was to investigate the reliability of the acoustic method for measurement of respiratory rate during intravenous general anesthesia, as compared with capnography. ⋯ In the intraoperative period, there was a significant difference in the LOA (95 % limits of agreement of correlation between difference and average of the two methods)/ULLOA (under the lower limit of agreement) in terms of use or non-use of a dental air turbine (P < 0.0001). In comparison between capnography, the acoustic method is useful for continuous monitoring of respiratory rate in spontaneously breathing subjects undergoing dental procedures under intravenous general anesthesia. However, the acoustic method might not accurately detect in cases in with dental air turbine.
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J Clin Monit Comput · Feb 2017
The relationship of the musculocutaneous nerve to the brachial plexus evaluated by MRI.
Axillary plexus blocks (AXB) are widely used for upper limb operations. It is recommend that AXB should be performed using a multiple injection technique. Information about the course and position of the musculocutaneous nerve (MCN) is of relevance for AXB performance. ⋯ In 37 patients the MCN exit point was positioned inside the Q1 quadrant (lateral anterior to the axillary artery) and in 11 patients inside the Q2 quadrant (medial anterior to the axillary artery). There is a wide variability as to where the musculocutaneous nerve (MCN) leaves the axillary sheath. Therefore multiple injection techniques, or the use of a proximally directed catheter, should be appropriate to block the MCN.
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J Clin Monit Comput · Feb 2017
Effect of wearing an N95 filtering facepiece respirator on superomedial orbital infrared indirect brain temperature measurements.
To determine any effect of wearing a filtering facepiece respirator on brain temperature. Subjects (n = 18) wore a filtering facepiece respirator (FFR) for 1 h at rest while undergoing infrared thermography measurements of the superomedial periobital region of the eye, a non-invasive indirect method of brain temperature measurements we termed the superomedial orbital infrared indirect brain temperature (SOIIBT) measurement. Temperature of the facial skin covered by the FFR, infrared temperature measurements of the tympanic membrane and superficial temporal artery region were concurrently measured, and subjective impressions of thermal comfort obtained simultaneously. ⋯ The SOIIBT values did not change significantly, but subjects who switched from nasal to oronasal breathing during the study (n = 5) experienced a slight increase in the SOIIBT measurements. Wearing a FFR for 1 h at rest does not have a significant effect on brain temperatures, as evaluated by the SOIIBT measurements, but a change in the route of breathing may impact these measurements. These findings suggest that subjective impressions of thermal discomfort from wearing a FFR under the study conditions are more likely the result of local dermal sensations rather than brain warming.