Journal of clinical monitoring and computing
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Respiratory rate has been shown to be an important predictor of cardiac arrest, respiratory adverse events and intensive care unit admission and has been designated a vital sign. However it is often inadequately monitored in hospitals. We test the hypothesis that RespiraSense, a piezoelectric-based novel respiratory rate (RR) monitor which measures the differential motion of the chest and abdomen during respiratory effort, is not inferior to commonly used methods of respiratory rate measurement. ⋯ The 95 % confidence interval for the difference in average RR between RespiraSense and ECG was calculated to be [-3.9, 3.1]. The 95 % confidence interval for the difference in average RR between RespiraSense and nurses' evaluation was [-5.5, 4.3]. We demonstrate a clinically relevant agreement between RR monitored by the RespiraSense device with both ECG-derived and manually observed RR in 48 post-surgical patients in a PACU environment.
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J Clin Monit Comput · Apr 2016
Case ReportsEndovascular coil detachment causing EMG artefact in BIS: a mechanistic exploration.
Deployment of endovascular coils used in interventional neuroradiology commonly involves electrolytic detachment of the coil from the pusher catheter. This report describes a case of artefactual increase in electromyography (EMG) values of bispectral index (BIS) monitor during coil detachment. An explanation of this event is provided connecting mechanism of coil detachment and derivation of EMG values in a BIS monitor. While rising EMG values are thought to arise from frontalis contraction, they may as well be an unrecognized electrical artefact, especially in context of undistorted electroencephalography waveform.
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J Clin Monit Comput · Apr 2016
The effects of oxygen induced pulmonary vasoconstriction on bedside measurement of pulmonary gas exchange.
In patients with respiratory failure measurements of pulmonary gas exchange are of importance. The bedside automatic lung parameter estimator (ALPE) of pulmonary gas exchange is based on changes in inspired oxygen (FiO2) assuming that these changes do not affect pulmonary circulation. This assumption is investigated in this study. ⋯ Changes were immediately reversed on returning FiO2 towards baseline. In this study changes in MPAP and PVR are small and immediately reversible consistent with small changes in pulmonary gas exchange. This indicates that mild deoxygenation induced pulmonary vasoconstriction does not have significant influences on the ALPE parameters in patients after CABG.
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J Clin Monit Comput · Feb 2016
Multicenter Study Comparative StudyContinuous cardiac output measurement by un-calibrated pulse wave analysis and pulmonary artery catheter in patients with septic shock.
Septic shock is a serious medical condition. With increased concerns about invasive techniques, a number of non-invasive and semi-invasive devices measuring cardiac output (CO) have become commercially available. The aim of the present study was to determine the accuracy, precision and trending abilities of the FloTrac and the continuous pulmonary artery catheter thermodilution technique determining CO in septic shock patients. ⋯ Trend analysis showed a concordance of 85 and 81 % for APCO and CCO, respectively. In contrast to CCO, APCO was influenced by systemic vascular resistance and by mean arterial pressure. In septic shock patients, APCO measurements assessed by FloTrac but also the established CCO measurements using the PAC did not meet the currently accepted statistical criteria indicating acceptable clinical performance.