Journal of clinical monitoring and computing
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J Clin Monit Comput · Dec 2016
Wireless non-invasive continuous respiratory monitoring with FMCW radar: a clinical validation study.
Altered respiratory rate is one of the first symptoms of medical conditions that require timely intervention, e.g., sepsis or opioid-induced respiratory depression. To facilitate continuous respiratory rate monitoring on general hospital wards a contactless, non-invasive, prototype monitor was developed using frequency modulated continuous wave radar. We aimed to study whether radar can reliably measure respiratory rate in postoperative patients. ⋯ Eight patients were included; yielding 796 min of observation time during mechanical ventilation and 521 min during spontaneous breathing. After elimination of movement artifacts the bias and 95 % limits of agreement for mechanical ventilation and spontaneous breathing were -0.12 (-1.76 to 1.51) and -0.59 (-5.82 to 4.63) breaths per minute respectively. The radar was able to accurately measure respiratory rate in mechanically ventilated patients, but the accuracy decreased during spontaneous breathing.
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J Clin Monit Comput · Dec 2016
Randomized Controlled TrialChanges in intraocular pressure during surgery in the lateral decubitus position under sevoflurane and propofol anesthesia.
Intraocular pressure (IOP) has been shown to change with body position. Several studies have shown that the lateral decubitus position (LDP) is associated with a significant increase in IOP in the dependent eye. However, whether anesthetic agents alter IOP in the LDP remains unclear. ⋯ The number of patients in whom IOP increased to ≥28 mmHg was greater in the sevoflurane group than in the propofol group. Propofol may be better than sevoflurane for the maintenance of anesthesia in the LDP. Monitoring of IOP in the LDP might help avoid ophthalmic complications.
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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
Randomized Controlled TrialThe effect of anesthesia depth on the oculocardiac reflex in strabismus surgery.
The aim of this study was to investigate the effect of the bispectral index (BIS) guided depth of anesthesia to inhibition of the oculocardiac reflex (OCR) during pediatric strabismus surgery. Patients between the ages of 3 and 16 years who were scheduled for elective strabismus surgery were randomly assigned to two groups. In Group 1 (n: 32), the BIS values of the patients were maintained at <50; in Group 2 (n: 28), the BIS values of the patients were maintained at levels greater than or equal to 50 with 4-7 % desflurane in a 50 % O2-air mixture by titrating the concentration during the surgery. ⋯ Moreover, the incidence of OCR in group 2 was higher in medial rectus (MR) traction (78.9 %) than in lateral rectus (LR) traction (33.3 %) (p = 0.035), with no significant difference in Group 1 between MR (21.1 %) and LR (26.7 %) tractions (p = 0.83). We found that the lower BIS values are associated with the lower incidence of OCR in pediatric patients undergoing strabismus surgery. And our findings confirmed that the deeper anesthesia has a protective effect against the OCR.
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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.