Journal of clinical monitoring and computing
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J Clin Monit Comput · Feb 1998
The Diatek Arkive "Organizer" patient information management system: experience at a university hospital.
To install and successfully use early commercial automatic anesthesia recordkeepers, the Diatek Arkive "Organizer" units, in the operating rooms at a major university medical center. ⋯ Total resistance to the new devices on the part of a few vocal faculty members was a major factor in the ultimate downfall of the system. The method of introduction, and especially the lack of involvement of faculty, residents, surgeons, operating room personnel, hospital computer personnel, and the hospital administration in the installation also played a role in the failure of the system. Lack of a workable training mechanism for new residents prevented that user group from rapidly gaining comfort with the systems.
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J Clin Monit Comput · Feb 1998
Three years experience with a patient data management system at a neonatal intensive care unit.
We report about our experience with the patient data management system (PDMS) Hewlett Packard CareVue 9000 at two neonatal ICUs. We describe our PDMS configuration (hard- and software), local adjustments and enhancements such as knowledge based systems for calculating the parenteral nutrition of newborn infants (VIE-PNN), for advising medication (VIE-Nmed), and for managing mechanical ventilation (VIE-VENT), and the results of a structured interview with our staff members about the acceptance of the system. Despite some criticism nearly all collaborators liked the system, especially because of its time saving automated documentation of vital data and mechanical ventilation parameters. ⋯ Main points of critique were the system's therapy planning facilities (medication administration records), the restrictive facilities for documenting patient care and the yet unsolved problems of data evaluation and export. PDM systems have to be constantly adapted to the user's needs and to the changing clinical environment. Living with the system asks for an intensive dialog with the system and its functionalities, for creativity and well defined ideas about the future system development.
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J Clin Monit Comput · Feb 1998
A formula to calculate oxygen uptake during low flow anesthesia based on FIO2 measurement.
Monitoring of oxygen uptake during general anesthesia would have several benefits, but unfortunately, this is usually not available in the clinical routine situation. The herein proposed formula to calculate oxygen uptake (. VO2) necessitates only the accurate measurement of FIO2 as well as fresh gas flow and composition. ⋯ In order to obtain representative results, calculation of. VO2 should be performed only after achievement of respiratory steady state conditions. Due to its simplicity and wide availability, it has the potential to become a valuable extension in anesthesia monitoring during the performance of routine general anesthesia.
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J Clin Monit Comput · Feb 1998
Assessment of pulmonary mechanics in mechanical ventilation: effects of imprecise breath detection, phase shift and noise.
In mechanical ventilation, the assessment of pulmonary mechanics, mainly of total compliance (Crs), total resistance (Rrs), and intrinsic positive end-expiratory pressure (PEEPint), is clinically important. By using airway pressure (Paw) and flow (V'aw), the least squares fit (LSF) method allows the continuous calculation of these parameters. The objective of this work was to study the influence of imprecise breath detection, phase shift between airway pressure and flow signals, and noise on the determination of Crs, Rrs, and PEEPint. ⋯ We conclude that the LSF method allows the assessment of Crs, Rrs, and PEEPint even with high levels of noise in patients with normal lungs provided that Paw and V'aw signals are precisely synchronised and a reliable breath detection algorithm is used.