Journal of clinical monitoring and computing
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J Clin Monit Comput · Apr 2011
Transcranial Doppler ultrasonography in acute ischemic stroke predicts stroke subtype and clinical outcome: a study in Omani population.
Transcranial Doppler ultrasonography (TCD) is being increasingly used for its ability to provide cerebral hemodynamic information in stroke. Few studies have explored its association with cerebral arteriographic changes and stroke subtype. This study explored the relation of TCD changes in acute stroke with stroke subtypes, MR cerebral arteriography and clinical outcome in Omani population. ⋯ This study of TCD in acute stroke in Omani population demonstrates a relatively higher burden of intracranial arterial disease. TCD changes are associated with type of stroke and outcome in this population. TCD is a simple and fairly useful method of evaluation in patients with acute stroke. Adopting TCD in evaluation of stroke patients may provide useful information regarding the pathophysiology which could enhance patient management.
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J Clin Monit Comput · Apr 2011
Comparative StudyComparison of spectral entropy and BIS VISTA™ monitor during general anesthesia for cardiac surgery.
We compared the primary metrics of the Spectral entropy M-ENTROPY™ module and BIS VISTA™ monitor-i.e., bispectral index (BIS), state entropy (SE), and response entropy (RE) in terms of agreement and correlation during general anesthesia for cardiac surgery. We also evaluated responsiveness of electroencephalogram (EEG)-based and hemodynamic parameters to surgical noxious stimulation, skin incision, and sternotomy, hypothesizing that RE would be a better responsiveness predictor. ⋯ Agreement was poor between the BIS index measured by BIS VISTA™ and SE values at critical anesthesia time points in patients undergoing cardiac surgery. RE was a good predictor of arousal after surgical stimulation regardless of the surgical level of muscle relaxation. Index differences most likely resulted from different algorithms for calculating consciousness level.
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J Clin Monit Comput · Apr 2011
Case ReportsA case of malignant hyperthermia captured by an anesthesia information management system.
Many cases of malignant hyperthermia triggered by volatile anesthetic agents have been described. However, to our knowledge, there has not been a report describing the precise changes in physiologic data of a human suffering from this process. Here we describe a case of malignant hyperthermia in which monitoring information was frequently and accurately captured by an anesthesia information management system.
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J Clin Monit Comput · Apr 2011
Case ReportsTranspulmonary thermodilution in a pediatric patient with an intracardiac left-to-right shunt.
Monitoring of cardiac output (CO) in the perioperative period and in seriously ill pediatric patients is of major importance for medical management. Hemodynamic monitoring, using transpulmonary thermodilution (TPTD) via a single thermal indicator injection, allows for measurements of CO, volumetric variables and extravascular lung water (EVLW). We describe and explain the influence of a left-to-right shunt on TPTD curve characteristics and EVLW measurements in a young child undergoing a surgical atrial septal defect repair. We suggest that these specific changes in the TPTD curve and the overestimation of EVLW detected by current device, in absence of gas exchange abnormalities, could be indicators of existing circulatory shunts in pediatric patients.
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Metabolic measurements using indirect calorimetry aid in nutritional assessment and management in intensive care units. They are used during weaning from mechanical ventilator and can calculate work of breathing also. We would like to report a case in which these monitors helped diagnose and manage a child with hypometabolism.