Journal of clinical monitoring and computing
-
J Clin Monit Comput · Jul 2002
Diagnosis of anesthetic-induced upper airway obstruction in children using respiratory inductance plethysmography.
Upper airway obstruction is the most rapid and clinically relevant cause of hypoxia during sedation and anesthesia. This study was designed to determine if respiratory inductance plethysmography (RIP) could quantify the degree of upper airway obstruction caused by induction of general anesthesia. ⋯ We investigated two methods for analyzing RIP tracings during varying degrees of upper airway obstruction in anesthetized children. We found that neither technique was sufficiently accurate for predicting the severity of upper airway obstruction and would not be useful as a predictor of upper airway obstruction in the clinical or research settings.
-
J Clin Monit Comput · Jul 2002
Learning about new anesthetics using a model driven, full human simulator.
New pharmacological agents are introduced into medical practice at an ever-increasing pace. Teaching how to use new medications in the clinical setting presents educational challenges and puts patients at risk. ⋯ Patient simulation is a novel method of introducing new drugs to the medical community and is perceived by anesthesia providers as a valuable addition to available teaching methods.
-
J Clin Monit Comput · Jul 2002
Subcutaneous microdialysis for metabolic monitoring in abdominal aortic surgery.
Microdialysis, that is the sampling of interstitial fluid via semi-permeable tubes, has been shown to be suitable for detecting ischemic changes e.g. in brain and heart tissue. The purpose of the present study was to investigate the possibility of monitoring with subcutaneous microdialysis peri-operative metabolic sequelac of elective abdominal aortic surgery. In 22 patients microdialysis catheters were inserted subcutaneously in the lower leg as well as the shoulder serving as a reference topographic region. Lactate, pyruvate and glycerol, which indicate ischemia or reperfusion, were measured. We observed severe metabolic changes within the interstitial fluid of the lower extremity during ischemia followed by normalization during reperfusion. Despite high interstitial concentrations of lactate and glycerol indicating severe ischemia during clamping of the abdominal aorta these parameters returned to pre-operative values within 2 hrs after declamping and all patients recovered completely. ⋯ Subcutaneous microdialysis was able to detect metabolic changes due to ischemia during clamping of the abdominal aorta as well as reperfusion there after. It is a suitable technique to monitor the peri-operative course of the dependent tissue after abdominal aortic vascular surgery.
-
J Clin Monit Comput · Jul 2002
Case ReportsMonitoring of motor evoked potentials with high intensity repetitive transcranial electrical stimulation during spinal surgery.
Clinical utility of high voltage repetitive transcranial electrical stimulation (TES) was investigated in 46 patients undergoing spine surgery. ⋯ The findings suggest that intraoperative MEP monitoring is feasible method, however, its immediate prognostic value for adequacy of neuronal decompression and improvement requires further studies with larger patient population.
-
J Clin Monit Comput · Apr 2002
Xenon washout during in-vitro extracorporeal circulation using different oxygenators.
Xenon anesthesia is known to have no adverse influence on myocardial contractility and cardiocirculatory function even in cardiac compromised patients. To make use of this advantages for cardiac surgery patients undergoing extracorporeal circulation (ECC) it must be known if oxygenators are diffusible for xenon in order to avoid losses of the very expensive noble gas. ⋯ Using common oxygenators xenon is eliminated during ECC and lost into the atmosphere. To maintain anesthesia during ECC continuous xenon application would be necessary to compensate these losses. Due to its high price it would be too expensive to continue xenon anesthesia during ECC. Therefore it is not practicable to use the today's oxygenators and ECC equipment in xenon anesthesia.