Journal of clinical monitoring and computing
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J Clin Monit Comput · Dec 1999
Comparative Study Clinical TrialA comparison of lithium dilution cardiac output measurements made using central and antecubital venous injection of lithium chloride.
We have previously described an indicator dilution technique of measuring cardiac output in which lithium chloride is injected as a bolus via a central venous catheter and cardiac output derived from the arterial lithium dilution curve recorded from a lithium-selective electrode, which we have developed for this purpose. It would be an advantage if the lithium could be injected via the basilic vein (in the antecubital fossa) in those patients who do not need central venous catheterisation for other reasons. We have therefore compared cardiac output measurements made using these two routes of lithium chloride administration. ⋯ Injection of lithium chloride via the basilic vein in the antecubital fossa allows accurate lithium dilution cardiac output measurements to be made in patients who do not have central venous catheters in place.
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J Clin Monit Comput · Dec 1999
Patient's perceptions of an anesthesia preoperative computerized patient interview.
Our desire to elicit a more complete medical history from our patients led to the implementation of a preoperative computerized interview. We previously demonstrated the effectiveness of the interview by computing its mean completion time for the overall patient population (n = 120), and further examined the effects of age, gender, and educational level. In this study, we investigated patient perception of the interview itself. ⋯ The Stuart-Maxwell test was used to determine statistically significant differences in answers before and after the interview. Initial questionnaire responses reflected a positive attitude toward computer usage which became even stronger after the interview. The only negative responses elicited were really more "doctor positive" than "computer negative." We conclude that patients looked favorably upon participating in a computerized medical interview provided that physician-patient contact is maintained.
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J Clin Monit Comput · Dec 1999
Ergonomic evaluation of an ecological interface and a profilogram display for hemodynamic monitoring.
Comprehensive monitoring of the patient state and subsequent decision making is an essential part of the task of an anaesthetist. The physicians' decision making process is based upon a concept of partly abstract physiologic parameters such as depth of anaesthesia or contractility. This concept is derived from the measured parameters given on todays' trend displays in addition to context information available for the anaesthetist. We investigated two alternative approaches of display design for hemodynamic monitoring: 1) integrated displays based on ecological interface design, and 2) profilogram displays based on intelligent alarms. ⋯ Our results have shown that subjects came to more effective solutions with the traditional trend display. The main reason for this result may be their years of experience with this kind of display type. Regarding safe and goal-intended decision finding, the results are encouraging for further experiments with redesigned ecological displays. But these displays ought to have smoother changes with respect to the traditional trend displays. Furthermore, new experiments have to be performed under real or fairly real (e.g. together with an anaesthesia simulator) conditions to underline the positive results for ecological interfaces.