Journal of clinical monitoring and computing
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J Clin Monit Comput · Dec 2013
Case ReportsMethohexital in total intravenous anesthesia during intraoperative neurophysiological monitoring.
Total intravenous anesthesia (TIVA) is usually recommended during spinal surgery when transcranial motor evoked potentials (tcMEPs) are used to monitor. A shortage of propofol has prompted a search for an alternative sedative-hypnotic agent. We explored the use of methohexital as an alternative. ⋯ TcMEPs and somatosensory evoked potentials were acquired to monitor neurological function and electroencephalogram was used to titrate the methohexital dose. Two cases are presented in which the anesthesia and monitoring that was provided were successful. These cases indicate that methohexital can be a suitable alternative to propofol in some patients.
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J Clin Monit Comput · Dec 2013
Exploration of key stakeholders' preferences for pre-hospital physiologic monitoring by emergency rescue services.
To gather preferences for novel pre-hospital physiologic monitoring technologies from emergency rescue services. Qualitative semi-structured interviews and focus groups were conducted with three groups from UK Search and Rescue (SAR); (1) Extractors (e.g. SAR teams), (2) Transporters (personnel primarily responsible for casualty transport), and (3) Treaters (e.g. ⋯ A range of more intuitive, physical properties was also raised (e.g. small/compact, lightweight). SAR-specific technology should be simple to operate by those with less medical training, which means that clinical data interpretation and presentation should be carefully considered. It would be beneficial if novel monitors carried out a majority of the interpretation, allowing rescuers to proceed with their priority task of removing the casualty to safety.
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J Clin Monit Comput · Dec 2013
Quantification of the proportion of motor neurons recruited by transcranial electrical stimulation during intraoperative motor evoked potential monitoring.
Transcranial motor evoked potentials (TcMEPs) are widely used to monitor motor function during spinal surgery. However, they are much smaller and more variable in amplitude than responses evoked by maximal peripheral nerve stimulation, suggesting that a limited number of spinal motor neurons to the target muscle are excited by transcranial stimulation. The aim of this study was to quantify the proportion of motor neurons recruited during TcMEP monitoring under general anesthesia. ⋯ The average ratios (test:control) were 17.1 % (range 1.8-38 %) for the amplitudes and 21.6 % (range 2.9-40 %) for the areas. The activity of approximately 80 % of the motor units to the target muscle cannot be detected by TcMEP monitoring. Therefore, changes in evoked potentials must be interpreted cautiously when assessing segmental motor function with TcMEP monitoring.
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J Clin Monit Comput · Dec 2013
Polyvinylidene fluoride film based nasal sensor to monitor human respiration pattern: An initial clinical study.
Design and development of a piezoelectric polyvinylidene fluoride (PVDF) thin film based nasal sensor to monitor human respiration pattern (RP) from each nostril simultaneously is presented in this paper. Thin film based PVDF nasal sensor is designed in a cantilever beam configuration. Two cantilevers are mounted on a spectacle frame in such a way that the air flow from each nostril impinges on this sensor causing bending of the cantilever beams. ⋯ It was observed that any change/alterations in the pattern of RIP is followed by same amount of change/alterations in the pattern of PVDF nasal sensor with k = 0.815 indicating strong agreement between the PVDF nasal sensor and RIP respiratory air-flow pattern. The developed sensor is simple in design, non-invasive, patient friendly and hence shows promising routine clinical usage. The preliminary result shows that this new method can have various applications in respiratory monitoring and diagnosis.
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A review of the literature shows that current "standard" laboratory measurements for hemoglobin are subject to numerous factors that affect both accuracy and reliability. In addition, total hemoglobin concentration measurements are subject to numerous factors that affect the "true" hemoglobin value. This article discusses both the physiologic factors that influence hemoglobin levels and the technical aspects and variability among the different measurement methodologies currently available.