Journal of clinical monitoring and computing
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J Clin Monit Comput · Feb 2013
ReviewShedding light on mitochondrial function by real time monitoring of NADH fluorescence: I. Basic methodology and animal studies.
Normal mitochondrial function in the process of metabolic energy production is a key factor in maintaining cellular activities. Many pathological conditions in animals, as well as in patients, are directly or indirectly related to dysfunction of the mitochondria. Monitoring the mitochondrial activity by measuring the autofluorescence of NADH has been the most practical approach since the 1950s. ⋯ These studies were the basis for the development of clinical monitoring devices as presented in accompanying article. The encouraging experimental results in animals stimulated us to apply the same technology in patients after technological adaptations as described in the accompanying article. Our medical device was approved for clinical use by the FDA.
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J Clin Monit Comput · Feb 2013
Pulmonary artery pulsatility is the main cause of cardiogenic oscillations.
The genesis of cardiogenic oscillations, i.e. the small waves in airway pressure (COS(paw)) and flow (COS(flow)) signals recorded at the airway opening is under debate. We hypothesized that these waves are originated from cyclic changes in pulmonary artery (PA) pressure and flow but not from the physical transmission of heartbeats onto the lungs. The aim of this study was to test this hypothesis. ⋯ Manual heart massages reproduced COS but they disappeared when PA was clamped during this maneuver. The transmission of PA pulsatilty across the lungs generates COS(paw) and COS(flow) measured at the airway opening. This information has potential applications for respiratory monitoring.
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J Clin Monit Comput · Feb 2013
LetterIndirect calorimetry during non invasive mechanical ventilation. Is the next step for gas exchange monitoring?
We analyze validation and some technical aspects of indirect calorimetry for measurement of energy expenditure in healthy volunteers undergoing pressure controlled non-invasive ventilation (NIMV). This validation study assess the reliability of gas exchange measurement with indirect calorimetry among subjects who undergo, oxygen consumption and carbon dioxide production measure. These comments of indirect calorimetry during NIMV should take it into account for real situations in clinical practice.
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J Clin Monit Comput · Dec 2012
Multicenter StudyThe ability of a new continuous cardiac output monitor to measure trends in cardiac output following implementation of a patient information calibration and an automated exclusion algorithm.
A new non-invasive continuous cardiac output (esCCO) monitoring system solely utilizing a routine cardiovascular monitor was developed, even though a reference cardiac output (CO) is consistently required. Subsequently, a non-invasive patient information CO calibration together with a new automated exclusion algorithm was implemented in the esCCO system. We evaluated the accuracy and trending ability of the new esCCO system. ⋯ The percentage error was 69.6 %. Polar plots analysis showed that the mean polar angle was -1.6° and radial limits of agreement were ±53.3°. This study demonstrates that the patient information calibration is clinically useful as ICO, but trending ability of the new esCCO system is not clinically acceptable as judged by percentage error and polar plots analysis, even though it's trending ability is comparable with currently available arterial waveform analysis methods.