Journal of clinical monitoring and computing
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J Clin Monit Comput · Feb 1999
A strategy for developing practice guidelines for the ICU using automated knowledge acquisition techniques.
To implement practice guideline entry tools in a reminder system in order to provide decision support to health care workers in clinical care and emergency care environments. To design a knowledge acquisition environment that enables physicians to formulate, update, and verify guidelines without the assistance of a knowledge engineer. ⋯ These first results demonstrate that this bottom-up knowledge acquisition strategy, implemented by the automated knowledge acquisition tools, enables medical specialists to improve the quality of computer support in an ICU without assistance of a knowledge engineer.
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J Clin Monit Comput · Jan 1999
A graphical object display improves anesthesiologists' performance on a simulated diagnostic task.
This study tests the hypothesis that a graphical object display (a data display consisting of meaningful shapes) will affect the ability of anesthesiologists to perform a diagnostic task rapidly and correctly. The diagnostic tasks studied were recognition and differentiation of five etiologies of shock--anaphylaxis, bradycardia, myocardial ischemia, hypovolemia, pulmonary embolus. ⋯ The primary finding of this study was that anesthesiologists using the object display format committed significantly fewer diagnostic errors when interpreting physiologic data. In addition, both the recognition of no-shock and the diagnosis of shock etiology were completed more rapidly when the object display was used. The major limitation of this initial trial is the simplicity of the test. Future investigation of the impact of the display on clinical decision making will require more realistic clinical scenarios with partial or full simulation to better understand the potential clinical impact.
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J Clin Monit Comput · Jan 1999
A single computer-controlled mechanical insufflation allows determination of the pressure-volume relationship of the respiratory system.
To evaluate and further develop a method for determination and mathematical characterisation of the elastic pressure-volume (Pel-V) relationship in mechanically ventilated human subjects during one single modified insufflation with simultaneous determination of resistance of the respiratory system. ⋯ Using one single modified insufflation allows a fast and accurate determination of respiratory mechanics. The Pel-V curves were determined with high reproducibility and were adequately described by a three-segment model of the curve incorporating a linear segment between two asymmetrical non-linear segments.
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J Clin Monit Comput · Jan 1999
Clinical investigation of a new combined pulse oximetry and carbon dioxide tension sensor in adult anaesthesia.
To test the accuracy of a new combined oxygen saturation and cutaneous carbon dioxide tension (SPO2-PCO2) sensor in a routine adult clinical environment. This probe provides a non-invasive and continuous monitoring of the arterial oxyhaemoglobin saturation, arterial carbon dioxide tension and pulse rate at the ear lobe. The sensor is intended to measure both relevant respiration/ventilation parameters in one single probe. ⋯ During general anaesthesia, postoperative recovery and critical care treatment, both monitoring of oxygenation and ventilation is important. Since pulse oximetry estimates only arterial oxygen saturation, periodic blood sampling is still necessary to determine the patient's arterial carbon dioxide status. We could demonstrate that the difference between cutaneous and arterial PCO2 was clinically unimportant, and therefore we conclude that the two methods of estimating the patient's carbon dioxide status may be used interchangeably. Our results demonstrated that 3 min after sensor placement, the new SpO2-PCO2 sensor prototype proved to be a reliable tool for continuous non-invasive monitoring of oxygenation and ventilation.
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J Clin Monit Comput · Jan 1999
Computerized monitoring of physical activity and sleep in postoperative abdominal surgery patients.
Assessment of early postoperative activity is important in the documentation of improvements of peri-operative care. This study was designed to validate computerized activity-based monitoring of physical activity and sleep (actigraphy) in patients after abdominal surgery. ⋯ Computerized activity monitoring by actigraphy is a reliable and easy method for monitoring physical activity and sleep-wake cycles after major abdominal surgery.