Journal of clinical monitoring and computing
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J Clin Monit Comput · Jul 2002
Bispectral Index in ICU: correlation with Ramsay Score on assessment of sedation level.
The assessment of sedation level in critically ill patient remains a challenge for the intensivists in order to avoid over- or under-sedation phenomena. Scoring systems commonly used still show some limitation; the introduction of Bispectral Index (an EEG parameter) could bring potential advantages in monitoring sedation. According to the reports, Bispectral Index correlates with levels of sedation on the Ramsay Scale. We report our personal experience in this topic. ⋯ The results of the study are consistent with those found in the literature on this topic of study. In fact, this study demonstrates the utility of BIS to track levels of consciousness in ICU patients while still maintaining the use of the score systems to care for ICU patients.
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J Clin Monit Comput · Jul 2002
Pulmonary blood flow (cardiac output) and the effective lung volume determined from a short breath hold using the differential Fick method.
This work attempts to show how pulmonary blood flow (Qp), cardiac output (CO(Fick)) and the lung volume of effective gas exchange (ELV) can be determined from breath-by-breath measurements of the tidal exhaled CO2 elimination V (litre/min) and the end tidal CO2 concentration P (%) using the differential Fick method. The measurements are made during steady state ventilation and when the CO2 balance in the lungs changes subsequent to a perturbation of the gas exchange conditions. ⋯ With a single breath perturbation, the differential Fick method can yield cardiopulmonary information using 2-3 breaths only and with a minimum of interference with the patient. Complete data analysis results in multiple determinations of the Qp and ELV values which improve the attainable precision. Our investigation points to the possibility to determine Qp, CO(Fick) and ELV also during spontaneous breathing, by using the natural tidal variations of V and P.
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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.
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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.
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J Clin Monit Comput · Apr 2002
Mycardial ischemia and determined chaos in integral homeostatic regulation.
This study was devoted to the problem of homeostatic stability loss caused by myocardial ischemia, induced by stress testing. It involved 55 patients with different variants of coronary heart disease and 15 practically healthy volunteers as controls. Routine bicycle ergometry and nonstop monitoring of the cardiac-interval duration were conducted simultaneously. ⋯ Determined chaos was shown to be the main property of these dynamics in all cases. The original method of measuring the cardiac rhythm entropy chaotisity level is presented. It is suggested that the newly revealed phenomenon of a sharp rise in the cardiac entropy trajectory chaotisity level and followed by a decrease, which happens in the multidimensional phase space, may be used as an additional criterion of myocardial ischemia development for the verification of dubious stress-testing results.