Journal of clinical monitoring and computing
-
J Clin Monit Comput · Apr 2011
Case ReportsECG myogenic artifacts during clonic seizures: a disturbing (and interesting) finding.
During motor seizures myogenic artifacts may appear on ECG. We report a patient with recurring convulsive seizures involving left side of his body in whom ECG served as a surrogate of electromyography (EMG), showing myogenic artifacts strongly correlated with clonic jerks. ⋯ However, using standard ECG acquisition parameters, muscular activity may be recorded without excessive attenuation of high-frequency myogenic potentials, permitting to indicate the frequency of clonic movements. On the other hand, whenever possible, positioning of ECG surface electrodes on limbs not (or less) involved in clonic epileptic movements may permit to obtain a sufficiently informative ECG recording with less amount of myogenic artifacts, thus providing essential information on heart rate and rhythm.
-
J Clin Monit Comput · Apr 2011
Adoption of anesthesia information management systems by US anesthesiologists.
Electronic medical records (EMR) may increase the safety and efficiency of healthcare. Anesthesia care is a significant component of the perioperative period, yet little is known about the adoption of anesthesia information management systems (AIMS) by US anesthesiologists, particularly in non-academic settings. Herein, we report the results of a survey of US anesthesiologists regarding adoption of AIMS and anesthesiologist-perceived advantages and barriers to AIMS adoption. ⋯ At least 50% of our survey respondents were currently using, installing, planning to install, or searching for an AIMS. However, the strength of any conclusion is undermined by a low survey response rate and potential bias as respondents using or searching for an AIMS may be more likely to participate. Nonetheless, challenges exist for anesthesiologists considering AIMS adoption including cost. Furthermore, important questions remain regarding payment for anesthesia services and the relationship of AIMS and "meaningful use" as defined by the Centers for Medicare & Medicaid Services.
-
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.
-
Visual scoring of 30-s epochs of sleep data is not always adequate to show the dynamic structure of sleep in sufficient details. It is also prone to considerable inter- and intra-rater variability. Moreover, it involves considerable training and experience, and is very tedious, time-consuming, labor-intensive and costly. Hence, automatic sleep staging is needed to overcome these limitations. Since naturally occurring NREM sleep and anesthesia have been reported to possess various underlying neurophysiological similarities, EEG-based depth-of-anesthesia monitors have started to penetrate into sleep research. This study investigates the ability of WAV(CNS) index (as implemented in NeuroSENSE depth-of-anesthesia monitor) to detect NREM sleep stages and wake state for full overnight PSG data. ⋯ This study demonstrates that changes in the depth of natural NREM sleep are reflected sensitively by changes in the WAV(CNS) index. Hence, WAV(CNS) index may serve as an automatic real-time indicator of depth of natural sleep with high temporal resolution, and can possibly be of great use for automated sleep staging in routine/postoperative somnographic studies.