Journal of clinical monitoring and computing
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J Clin Monit Comput · Aug 2006
Controlled Clinical TrialMorbidly obese patients are hemodynamically stable during laparoscopic surgery: a thoracic bioimpedance study.
Morbid obesity caries an increased risk of cardiovascular morbidity and might be associated with intraoperative hemodynamic instability. Based on clinical observation, we hypothesized that during laparoscopic surgery, morbidly obese patients behave hemodynamically similar to the nonobese patients and remain hemodynamically stable. ⋯ Our study confirmed our hypothesis that for the most periods of laparoscopic surgery, obese patients are hemodynamically as stable as their nonobese counterparts.
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J Clin Monit Comput · Aug 2006
Clinical TrialEffects of a sigh on the respiratory mechanical properties in ali patients.
The application of sighs during baseline ventilation was found to improve alveolar recruitment and oxygenation in patients with acute respiratory distress syndrome (ARDS). The present investigation evaluates if respiratory mechanics can be modified by a sigh. ⋯ The sigh is useful to diminish viscoelastic impedance in ALI patients, thus allowing a smaller inflation pressure. Under the present experimental conditions it seems that viscoelastic mechanical alterations precede their elastic and resistive counterparts.
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J Clin Monit Comput · Jun 2006
Real-time computation of a patient's respiratory effort during ventilation.
In this paper, a new algorithm is proposed to compute the spontaneously generated respiratory effort during ventilation. ⋯ The respiratory effort increases over time until the patient is disconnected from the ventilator. We hope the maximum amplitude can be used as an indicator of the pressure the muscles of the patient are able to produce. This amplitude of the (mus)-signal in combination with the standard deviation (SD) may eventually lead to a new indicator to determine the moment that the patient can be weaned from the ventilator. This will have to be examined in the future.
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J Clin Monit Comput · Jun 2006
Comparative Study Controlled Clinical TrialThe effect of addition of nitrous oxide to a sevoflurane anesthetic on BIS, PSI, and entropy.
N(2)O is a commonly used anesthetic that has amnestic and analgesic properties. Recently, devices that estimate depth of consciousness have been introduced in an attempt to better titrate anesthesia, however the effect of N(2)O on these monitors is unclear. ⋯ Supplementing sevoflurane with > 65% N(2)O did not result in a significant change in either BIS or PSI when sevoflurane concentration was kept constant. Entropy, however, significantly decreased as anesthetic depth increased. When sevoflurane concentration was reduced during N(2)O administration, both BIS and Entropy rose despite maintenance of anesthetic depth, indicating a variable concentration effect between volatiles and N(2)O.
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For years researchers have been attempting to understand the relationship between central hemodynamics and the resulting peripheral waveforms. This study is designed to further understanding of the relationship between ear pulse oximeter waveforms, finger pulse oximeter waveforms and cardiac output (CO). It is hoped that with appropriate analysis of the peripheral waveforms, clues can be gained to help to optimize cardiac performance. ⋯ The ear is relatively immune to vasoconstrictive challenges which make ear plethysmographic waveforms a suitable monitor for central hemodynamic changes. The ear plethysmographic width has a good correlation with CO.