Journal of clinical monitoring and computing
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J Clin Monit Comput · Jan 2000
Evaluation of two new ecological interface approaches for the anesthesia workplace.
Currently, vital parameters are commonly displayed as trends along a timeline. However, clinical decisions are more often based upon concepts, such as the depth of anesthesia, that are derived by combining parameter relationships and additional context information. The current displays do not visualize such concepts and therefore do not optimally support the decision process. A new display should present an ecological interface (EI). The principle of EI design is to visualize all of the information necessary for decision making in one single display. ⋯ The results have shown that appropriately designed EIs may improve the anesthetist's decision making and focus attention on specific problems. Now, the findings have to be tested in future studies by widening the scope using other simulated scenarios and being closer to reality under real conditions in the OR. Eye tracking proved to be a useful method to analyze the anesthetists' decision making and appropriately re-design interfaces.
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J Clin Monit Comput · Jan 2000
The effect of single twitch and train-of-four stimulation on twitch forces during stable neuromuscular block.
We investigated whether the response to a single twitch (ST) stimulus or the first response (T1) to a train-of-four (TOF; 4 stimuli at 2 Hz) stimulus following a stimulus interval of 10 s (i.e., the time between two consecutive ST or TOF stimuli) is influenced by the preceding stimulus in the presence of a stable 50% neuromuscular block. In addition, we determined whether ST and TOF stimulation yield different results under these circumstances. ⋯ The ST or T1 force during stimulation with a stimulus interval of 10 s or more during a stable 50% neuromuscular block in the tibialis anterior muscle of the cat is not affected by the preceding stimulus. In addition, ST and T1 forces do not differ when employing a stimulus interval of 10 s or more under these circumstances. Our results thus indicate that the known differences between ST and T1 forces after a bolus injection of a muscle relaxant can not be explained by differences in acetylcholine release when the stimulus interval exceeds 10 s.
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J Clin Monit Comput · Jan 2000
Effects of digital filtering on the parameters of impulse-like eye movements.
Influence of two filtering modes were researched with electro-oculographically recorded impulse-like eye movements. Linear finite impulse response (FIR) and non-linear hybrid median filters were explored by considering gain and latency parameters that yield the most important information in the case of these eye movements. It is stated that carefully selected lowpass filtering can securely be run without considerable changes in parameter values in order to discard noise stemming from physiological or other reasons.
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J Clin Monit Comput · Jan 2000
Limits of corrected flow time to monitor hemodynamic status in children.
Doppler corrected flow time (i.e., corrected left ventricular ejection time) as a noninvasive tool for assessing hemodynamic changes has been previously reported for adult patients. Its use in paediatrics seems to be worthwhile but no data concerning its accuracy are presently available in this population. The purpose of this work was to study the relationships between corrected flow time (FT) and indices of systemic vascular resistance (SVR) and of myocardial contractility in healthy children. ⋯ These results show that the use of Bazett's formula correct FT could lead to hemodynamic misinterpretations, because it does not rule out all the heart rate effect. Moreover, in healthy children corrected FT appears as an inaccurate index to monitor physiological afterload alterations, because of the involvment of other hemodynamic factors such as contractility in its variation.
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J Clin Monit Comput · Jan 2000
Using an anesthesia information management system to prove a deficit in voluntary reporting of adverse events in a quality assurance program.
A deficit is suspected in the manual documentation of adverse events in quality assurance programs in anesthesiology. In order to verify and quantify this, we retrospectively compared the incidence of manually recorded perioperative adverse events with automatically detected events. ⋯ Using automatic detection, we were able to prove a considerable deficit in the documentation of adverse events according to the guidelines of the German quality assurance program in anesthesiology. Based on the data from manual recording, the results of the quality assurance of our department match those of other comparable German departments. Thus, we are of the opinion that manual incident reporting seriously underestimates the true occurrence rate of incidents. This brings into question the validity of quality assurance comparisons based on manually recorded data.