Journal of clinical monitoring and computing
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J Clin Monit Comput · Apr 2008
Multicenter Study Comparative StudyMulticenter evaluation of noninvasive cardiac output measurement by bioreactance technique.
Bioreactance, the analysis of intrabeat variations in phase of a transthoracic voltage in response to an applied high frequency transthoracic current, was recently introduced for noninvasive cardiac output measurement (NICOM). We evaluated NICOM compared to thermo- dilution (TD) in several clinical settings. ⋯ On average, compared to TD, bioreactance- based NICOM has acceptable accuracy in challenging clinical environments. Availability of such a tool may allow clinicians to have information about CO in patients where this information is not currently available to help diagnosis and guide therapy.
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J Clin Monit Comput · Apr 2008
Clinical TrialSpectral entropy as a monitor of depth of propofol induced sedation.
The aim of this prospective, observational study was to evaluate State and Response entropy (Entropy(TM) Monitor, GE Healthcare, Finland), indices as measures of moderate ("conscious") sedation in healthy adult patients receiving a low dose propofol infusion. Sedation was evaluated using: (I) the responsiveness component of the OAA/S scale (Observer's Assessment of Alertness/Sedation scale) and (II) multi-channel electroencephalogram (EEG) interpretation by a clinical expert. ⋯ A statistically significant decrease in SE and RE values was demonstrated in patient/time units in which clinical or EEG evidence of sedation was present. We conclude that spectral entropy offers potential as a monitor of propofol induced sedation.
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To describe and evaluate a new weaning and decision support system for mechanical ventilation. ⋯ A new weaning and decision support system for mechanical ventilation is presented. The recommendations made by the system were found to be in line with clinical determinations. Further refinements in the FLEX predictions can be easily made by including inputs which represent permissive hypercapnea or increased metabolic demand for selected patients.
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J Clin Monit Comput · Apr 2008
Comparative Study Clinical TrialComparison of Narcotrend Index, Bispectral Index, spectral and entropy parameters during induction of propofol-remifentanil anaesthesia.
This study investigated the suitability of various electroencephalogram (EEG) parameters to describe anaesthetic drug effects in propofol-remifentanil anaesthesia. The investigated parameters were the Narcotrend Index (NI), the Bispectral Index (BIS), and standard spectral and entropy parameters. Additionally, it was investigated whether the effect of a fixed dosage of propofol on the attained depth of hypnosis during induction of anaesthesia is different in male and female patients. ⋯ NI and BIS are superior to spectral and entropy parameters in describing changes of propofol concentration during induction of propofol-remifentanil anaesthesia.
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J Clin Monit Comput · Feb 2008
Comparative StudyThe impact of a clinical information system in an intensive care unit.
Although clinical information systems (CISs) have been available and implemented in many Intensive care Units (ICUs) for more than a decade, there is little objective evidence of their impact on the quality of care and staff perceptions. This study was performed to compare time spent charting with pen and paper patient data versus time spent with the new electronic CIS and to evaluate staff perceptions of a CIS in an ICU. ⋯ The implementation of a CIS was associated with a reduced time spent for daily activity and a positive medical and nursing staff perception.