Journal of clinical monitoring and computing
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J Clin Monit Comput · Apr 2013
Comparative StudyNon-invasive measurement of cardiac output in obese children and adolescents: comparison of electrical cardiometry and transthoracic Doppler echocardiography.
The objective of this study was to evaluate the reliability and accuracy of electrical cardiometry (EC) for the noninvasive determination of cardiac output (CO) in obese children and adolescents. We compared these results with those obtained by transthoracic echocardiography. Sixty-four participants underwent simultaneous measurement of CO. ⋯ The mean difference between the two methods (COEC - COEcho) was 0.015 l min(-1). According to the Bland and Altman method, the upper and lower limits of agreement, defined as mean difference ±2 SD, were +1.21 and -0.91 l min(-1), respectively. Compared to the transthoracic Doppler echocardiography, Electrical Cardiometry provides accurate and reliable CO measurements in obese children and adolescents.
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J Clin Monit Comput · Apr 2013
Parameter selection in permutation entropy for an electroencephalographic measure of isoflurane anesthetic drug effect.
The permutation entropy (PE) of the electroencephalographic (EEG) signals has been proposed as a robust measure of anesthetic drug effect. The calculation of PE involves the somewhat arbitrary selection of embedding dimension (m) and lag (τ) parameters. Previous studies of PE include the analysis of EEG signals under sevoflurane or propofol anesthesia, where different parameter settings were determined using a number of different criteria. ⋯ Further comparison with previously suggested PE measures, as well as other unrelated EEG measures, indicates the superiority of the NPEI. The PE can be utilized to indicate the dynamical changes of EEG signals under isoflurane anesthesia. In this study, the NPEI measure that combines the PE with m = 3, τ = 2 and that with m = 3, τ = 3 is optimal.
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J Clin Monit Comput · Apr 2013
Comparative StudyCardiac output measured by uncalibrated arterial pressure waveform analysis by recently released software version 3.02 versus thermodilution in septic shock.
To evaluate the 3.02 software version of the FloTrac/Vigileo™ system for estimation of cardiac output by uncalibrated arterial pressure waveform analysis, in septic shock. Nineteen consecutive patients in septic shock were studied. FloTrac/Vigileo™ measurements (COfv) were compared with pulmonary artery catheter thermodilution-derived cardiac output (COtd). ⋯ Eighty-five percent of the measurements were within the 30°-330° of the polar axis. COfv with the latest software still underestimates COtd at low SVR in septic shock. The tracking capacities of the 3.02 software are moderate-good when clinically relevant changes are considered.
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J Clin Monit Comput · Apr 2013
Spinal cord injury from electrocautery: observations in a porcine model using electromyography and motor evoked potentials.
We have previously investigated electromyographic (EMG) and transcranial motor evoked potential (MEP) abnormalities after mechanical spinal cord injury. We now report thermally generated porcine spinal cord injury, characterized by spinal cord generated hindlimb EMG injury activity and spinal cord motor conduction block (MEP loss). Electrocautery (EC) was delivered to thoracic level dural root sleeves within 6-8 mm of the spinal cord (n = 6). ⋯ Depolarization and facilitation of lumbar motor neurons by thermally excited descending spinal tracts likely explains both hindlimb EMG and an enhanced MEP signal (seen before conduction block) respectively. A thermal mechanism may play a role in some unexplained MEP losses during intraoperative monitoring. EMG recordings might help to detect abnormal discharges and forewarn the monitorist during both mechanical and thermal injury to the spinal cord.