Journal of clinical monitoring and computing
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J Clin Monit Comput · Dec 2013
Comparative Study Clinical TrialCardiac index assessment using bioreactance in patients undergoing cytoreductive surgery in ovarian carcinoma.
This clinical study compared the cardiac index (CI) assessed by the totally non-invasive method of bioreactance (CIBR) (NICOM™, Cheetah Medical, Vancouver, USA) to transpulmonary thermodilution (CITD) during cytoreductive surgery in ovarian carcinoma. The hypothesis was that CI could be assessed by bioreactance in an accurate and precise manner including accurate trending ability when compared to transpulmonary thermodilution. In 15 patients CIBR and CITD were assessed after induction of anesthesia, after opening of the peritoneum, hourly during the operative procedure, and 30 min after extubation. ⋯ CI assessment by bioreactance showed acceptable accuracy and trending ability. However, its precision was poor. Therefore, CI measurement can not be solely based on bioreactance in patients undergoing cytoreductive surgery in ovarian carcinoma.
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J Clin Monit Comput · Dec 2013
Survey of muscle relaxant effects management with a kinemyographic-based data archiving system: a retrospective quantitative and contextual quality control approach.
In a retrospective quality control study of muscle relaxant management, we assessed unbiased files provided by an automatic archiving system using quantitative monitoring generated by a kinemyographic transducer and suggest improvements for a possible future design. 200 randomly selected files were double checked to collect the values of twitch height ratio (THr), train of four ratio (TOFr) and TOF count in four periods: references values acquisition (REF), maximal level of paralysis, paralysis maintenance, pre-tracheal extubation residual paralysis assessment (RPA). The parameter values were selected according to period-specific predefined rules. A quantitative quality control was based upon standardized cut-offs values. ⋯ Presence of "difficult to interpret" episodes started with 18 files for the REF period and increased to 42, 86 and 52 in the subsequent ones most of them probably related to the absence of initial calibration procedure. In the real life conditions, a near to optimal quality control is not always observable with the quantitative neuromuscular monitoring studied. To improve the NMT monitoring, the calibration of the sensor should be performed vigorously by the anaesthesia provider and the quality of this calibration must be displayed on the screen of the monitor.
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Here we report results of non-invasive measurements of indirect markers of soft tissue healing of traumatic wounds in an observational swine study and describe the quantification of analog physiological signals. The primary purpose of the study was to measure bone healing of fractures with four different wound treatments. A second purpose was to quantify soft tissue wound healing by measuring the following indirect markers: (1) tissue oxygenation, (2) fluid content, and (3) blood flow, which were all measured by non-invasive modalities, measured with available devices. ⋯ Further studies are needed to establish standards for healthy wound healing and for detection of pathological alterations such as infection. Non-invasive measurement and quantification of indirect markers of soft tissue wound healing support the goals and principles of evidence-based medicine and show potential as easy to administer tools for clinicians and battlefield medical personnel to apply when procedures such as the PET scan are not available or affordable. The method we developed for storing analog physiological signals could be used for maintaining electronic health records, by incorporating vital signs such as ECG and EEG, etc.
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J Clin Monit Comput · Dec 2013
Randomized Controlled TrialThe effect of preoperative consumption of potatoes on succinylcholine-induced block and recovery from anesthesia.
Potatoes contain solanaceous glycoalkaloids (SGAs), which inhibit both butyrylcholinesterase (BuChE) and acetylcholinesterase (AChE). The present study investigated the effect of preoperative consumption of potatoes on succinylcholine-induced block and recovery from anesthesia. ASA I-II, adult patients, scheduled for elective surgery, were included in a randomized, blind and controlled study. ⋯ In addition, in both groups, BuChE levels markedly decreased after succinylcholine blockade, increased thereafter, but did not return to baseline within 24 h of consumption start. None of these differences observed in BuChE levels was statistically significant. This study suggests that potatoes eaten before anesthesia can prolong the duration of succinylcholine-induced neuromuscular block and delay recovery from anesthesia.