Journal of clinical monitoring and computing
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J Clin Monit Comput · Jan 2000
A proposed method for the measurement of anesthetist care variability.
Some critical events in anesthesiology occur as seemingly preventable misadventures, their exact origins indeterminable. Inexperienced anesthetists, anesthesia machine malfunctions, lack of vigilance and human error inevitably initiate some incidents. Anesthesia training improves recognition and decision-making. Avoiding crisis initiation and amelioration of those that do occur is one role of the consultant anesthesiologist. Safe patient care requires medical and procedural knowledge, technical expertise, and control of resources in a complex milieu. Anesthesia simulators are clinical laboratories where anesthetists can sharpen both cognitive and manual skills. Dynamic scenarios allow opportunities for anesthetists to explore and experience crises as they develop and apply their knowledge while attempting to manage these events. Simulator-based scenarios are reproducible and large amounts of useful data can be collected and saved. The authors hypothesize these data can be utilized to compare performance of anesthetists and to measure improvement of individual anesthetists over time. ⋯ It is suggested that the use of the techniques mentioned here may be of value in the development of a standardized testing protocol for anesthetists.
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To develop and test a method for standardized calibration of pulse oximeters. ⋯ The tests have shown the capabilities of a spectral light modulator for use as a possible calibration standard for pulse oximeters. If some improvements of the current prototype can be achieved we conclude from the experience with the device that this novel concept for the calibration of pulse oximeters is feasible and that it could become an important tool for assessing the performance of pulse oximeters.
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J Clin Monit Comput · Jan 2000
Accuracy of deadspace free ventilatory measurements for lung function testing in ventilated newborns: a simulation study.
A deadspace free method based on simultaneous ventilatory measurements in the inspiratory and expiratory limb of the ventilator circuit was compared to the conventional endotracheal method where the flow is measured between ETT and Y-Piece. The aim of our study was to find out how the arrangement of this setup affects the measuring accuracy of 1) the ventilatory and 2) the lung mechanical parameters by means of a computer simulation. ⋯ The dead space free method can be used for accurate ventilatory measurements during mechanical ventilation. However, for lung mechanic measurements in very low birth weight infants the position of the PNTs must be as short as possible.
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J Clin Monit Comput · Jan 2000
Comparative Study Clinical TrialNon-invasive estimation of cardiac output in critical care patients.
This study was carried out to compare cardiac output measurements determined by thermodilution and by Portapres, a non-invasive system. ⋯ To date, Portapres measurements cannot replace thermodilution cardiac output estimations. Fluctuations of finger arterial perfusion due to hemodynamic instability, hypothermia and catecholamines may be responsible for problems of Portapres use in critically ill patients.
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To describe a new pulse oximetry technology and measurement paradigm developed by Masimo Corporation. ⋯ The technological strategies implemented in Masimo SET pulse oximetry effectively permit continuous monitoring of SpO2 during challenging clinical conditions of motion and poor tissue perfusion.