Journal of clinical monitoring and computing
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J Clin Monit Comput · Dec 2016
A combination of experimental and finite element analyses of needle-tissue interaction to compute the stresses and deformations during injection at different angles.
One of the main clinical applications of the needles is its practical usage in the femoral vein catheterization. Annually more than two million peoples in the United States are exposed to femoral vein catheterization. How to use the input needles into the femoral vein has a key role in the sense of pain in post-injection and possible injuries, such as tissue damage and bleeding. ⋯ Experimental results were also well confirmed the numerical observations since the lowest pain score was seen at the angle of 90°. The results suggest that the most effective angle of injection would be 90° due to a lower amount of stresses and deformations compared to the other angles of injection. These findings may have implications not only for understating the stresses and deformations induced during injection around the needle-tissue interaction, but also to give an outlook to the doctors to implement the most suitable angle of injection in order to reduce the pain as well as post injury of the patients.
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J Clin Monit Comput · Dec 2016
Estimation of extravascular lung water using the transpulmonary ultrasound dilution (TPUD) method: a validation study in neonatal lambs.
Increased extravascular lung water (EVLW) may contribute to respiratory failure in neonates. Accurate measurement of EVLW in these patients is limited due to the lack of bedside methods. The aim of this pilot study was to investigate the reliability of the transpulmonary ultrasound dilution (TPUD) technique as a possible method for estimating EVLW in a neonatal animal model. ⋯ The accuracy of EVLWItpud was good compared to the gold standard gravimetric method but the TPUD lacked precision in its current prototype. Based on these limited data, we believe that TPUD has potential for future use to estimate EVLW after adaptation of the algorithm. Larger studies are needed to support our findings.
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J Clin Monit Comput · Dec 2016
Adaptive online monitoring for ICU patients by combining just-in-time learning and principal component analysis.
Offline general-type models are widely used for patients' monitoring in intensive care units (ICUs), which are developed by using past collected datasets consisting of thousands of patients. However, these models may fail to adapt to the changing states of ICU patients. Thus, to be more robust and effective, the monitoring models should be adaptable to individual patients. ⋯ The proposed method was compared with the traditional PCA and fast moving-window PCA (Fast MWPCA). The experimental results demonstrated that the fault detection rates respectively increased by 20 % and 47 % compared with PCA and Fast MWPCA. L-PCA is first introduced into ICU patients monitoring and achieves the best monitoring performance in terms of adaptability to changes in patient status and sensitivity for abnormality detection.
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J Clin Monit Comput · Dec 2016
Effect of using a Planecta™ port with a three-way stopcock on the natural frequency of blood pressure transducer kits.
Blood pressure transducer kits are equipped with two types of Planecta™ ports-the flat-type Planecta™ port (FTP) and the Planecta™ port with a three-way stopcock (PTS). We reported that FTP application decreased the natural frequency of the kits. However, Planecta™ is an invaluable tool as it prevents infection, ensures technical simplicity, and excludes air. ⋯ The insertion of ≥2 FTPs in pressure transducer kits should be avoided, as they markedly decrease the natural frequency and lead to underdamping. However, the effect of PTS insertion in pressure transducer kits on the frequency characteristics is minimal. Thus, we found that the use of PTS markedly improved the frequency characteristics as compared to the use of FTP.
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J Clin Monit Comput · Dec 2016
Capnodynamic assessment of effective lung volume during cardiac output manipulations in a porcine model.
A capnodynamic calculation of effective pulmonary blood flow includes a lung volume factor (ELV) that has to be estimated to solve the mathematical equation. In previous studies ELV correlated to reference methods for functional residual capacity (FRC). The aim was to evaluate the stability of ELV during significant manipulations of cardiac output (CO) and assess the agreement for absolute values and trending capacity during PEEP changes at different lung conditions. ⋯ ELV trending capability between PEEP steps, showed a concordance rate of 100 %. ELV was closely related to FRC and remained stable during significant changes in CO. The trending capability was excellent both before and after surfactant depletion.