Journal of clinical monitoring and computing
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J Clin Monit Comput · May 1998
Transcutaneous renal function monitor: precision during unsteady hemodynamics.
Hospital acquired renal dysfunction, most commonly caused by renal hypoperfusion, dramatically increases mortality in intensive care patients. Glomerular filtration rate (GFR) is rapidly altered during renal hypoperfusion, and a more rapid means of GFR measurement may prompt institution of renal-specific therapy. We hypothesized that a transcutaneous renal function monitor can rapidly and accurately assess acute changes in GFR within a time frame much shorter than the 2-4 hours currently available. ⋯ TC monitoring provides prompt indication of directional changes in GFR and may provide the clinician warning of inadequate resuscitation. Prospective analysis of the specificity, sensitivity, and TC guided renal-specific resuscitation is needed.
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J Clin Monit Comput · May 1998
Adaptive lung ventilation (ALV) during anesthesia for pulmonary surgery: automatic response to transitions to and from one-lung ventilation.
Adaptive lung ventilation is a novel closed-loop-controlled ventilation system. Based upon instantaneous breath-to-breath analyses, the ALV controller adjusts ventilation patterns automatically to momentary respiratory mechanics. Its goal is to provide a preset alveolar ventilation (V'A) and, at the same time, minimize the work of breathing. Aims of our study were (1) to investigate changes in respiratory mechanics during transition to and from one-lung ventilation (OLV), (2) to describe the automated adaptation of the ventilatory pattern. ⋯ Respiratory mechanics during transition to and from OLV are characterized by marked changes in R and C into opposite directions, leaving TC unaffected. The ALV controller manages these transitions successfully, and maintains V'A reliably without intervention by the anesthesiologist. VT during OLV was found to be consistently lower than recommended in the literature.
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J Clin Monit Comput · May 1998
Use of a neonatal blood pressure cuff to monitor blood pressure in the adult finger--comparison with a standard adult arm cuff.
There are few suitable methods for monitoring blood pressure continuously (or intermittently) for research in adult stroke patients, who are ill but do not justify invasive intensive care monitoring. ⋯ The reproducibility of sequential blood pressure measurements made with the finger cuff was better than with the arm cuff. The performance of the finger cuff compared with that of the arm cuff was sufficiently good to encourage use of the finger cuff in research involving automatic intermittent monitoring to observe sequential blood pressures over time in stroke patients. However, measurements of systolic and diastolic pressure were not the same with the two cuffs and further work on calibration of the finger cuff would be useful.
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J Clin Monit Comput · May 1998
A cross-validated multifactorial index of perioperative risks in adults undergoing anaesthesia for non-cardiac surgery. Analysis of perioperative events in 26907 anaesthetic procedures.
To develop a severity index of anaesthetic risk that predicts relevant perioperative adverse events in adults. ⋯ The index seems to reflect the risk of relevant perioperative incidents. It can be used for audit purposes. In daily routine, the index could focus our attention on patients with increased perioperative risk. However, it is limited in detecting particular constellations of factors which interact on each other with regard to perioperative risk.
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J Clin Monit Comput · May 1998
Applying human factors to the design of medical equipment: patient-controlled analgesia.
Medical instruments commonly have poorly designed user interfaces that promote human errors with life-threatening consequences. The primary hypothesis of this study was that a specific user interface could be made safer and more efficient if redesigned using human factors techniques and principles. ⋯ Adopting a human factors approach to redesigning the PCA interface led to significantly faster, easier, and more reliable performance. These findings have important implications for improving the design of other computer-based medical equipment.