Journal of clinical monitoring and computing
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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
Comparative StudyPerformance of computer simulated inhalational anesthetic uptake model in comparison with real time isoflurane concentration.
Gas Man software was developed to enhance our understanding of the pharmacokinetics of inhalational anaesthetics. To date the Gas Man software has not been validated in humans. In this study we compared the Gas Man software with real time measured end tidal isoflurane concentrations while using a semi closed circle system in anesthetised patients. ⋯ The end-tidal concentration values of isoflurane in real patients are very close to those predicted by Gas Man software. The pharmocokinetics of inhalational anesthetic administration in patients can be taught accurately using Gas Man technology. This technology may also help in developing different kinetic models of inhalational agents in the body.
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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
Sensor fusion methods for reducing false alarms in heart rate monitoring.
Automatic patient monitoring is an essential resource in hospitals for good health care management. While alarms caused by abnormal physiological conditions are important for the delivery of fast treatment, they can be also a source of unnecessary noise because of false alarms caused by electromagnetic interference or motion artifacts. One significant source of false alarms is related to heart rate, which is triggered when the heart rhythm of the patient is too fast or too slow. ⋯ Twenty recordings selected from the MIMIC database were used to validate the system. The results showed that neural networks fusion had the best false alarm reduction of 92.5 %, while the Bayesian technique had a reduction of 84.3 %, fuzzy logic 80.6 %, majority voter 72.5 % and the heart rate variability index 67.5 %. Therefore, the proposed algorithms showed good performance and could be useful in bedside monitors.
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J Clin Monit Comput · Dec 2016
Utility of the bispectral index for assessing natural physiological sleep stages in children and young adults.
Polysomnography (PSG) is the gold standard for the analysis of sleep architecture but is not always available in routine practice, as it is time consuming and cumbersome for patients. Bispectral index (BIS), developed to quantify the deepness of general anesthesia, may be used as a simplified tool to evaluate natural sleep depth. We objectively recorded sleep architecture in young patients using the latest BIS Vista monitor and correlated BIS values with PSG sleep stages in order to determine BIS thresholds. ⋯ BIS threshold that identified stage N3 was <55 (AUC = 0.964, p < 0.001) with an 87 %-sensitivity and a 93 %-specificity. BIS identified stage N3 with satisfactory sensitivity and specificity but is limited by its inability to distinguish REM sleep from wake. Further studies combining BIS with chin electromyogram and/or electrooculogram could be of interest.