Journal of clinical monitoring
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Review
Integration of monitoring for intelligent alarms in anesthesia: neural networks--can they help?
Although there has been a decrease in the number of anesthesia-related critical incidents, there are still opportunities for further improvement. We discuss the potential of integrated monitoring and artificial neural networks as a means of vigilantly watching for patterns in multiple variables to detect incidents and reduce false alarms. ⋯ We present artificial neural networks as an approach that is more suited to the type of multivariable monitoring and pattern recognition required. Along with rule-based artificial intelligence, these now have the potential to help develop innovative monitoring in the operating room.
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The Relaxometer is a computer-controlled system developed for reliable clinical experimental measurements on neuromuscular block. This system is based on an adapted personal computer (Atari 1040 ST) with a monochrome monitor (Atari SM 124), and a microcomputer-driven slave unit (stimulator). ⋯ The system is equipped with a temperature module for continuous monitoring of the skin/muscle temperature and a rechargeable battery to allow uninterrupted measurements if the apparatus is disconnected from the line power. All acquired data, computer-calculated parameters (onset time, duration time, recovery index, train-of-four ratio, tetanic fade, and posttetanic count), and the mechanomyogram are presented on screen continuously, are stored on floppy disk, and can be printed in a well-organized format.
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Although reduced waste of expensive anesthetic gases is a strong incentive to use closed-circuit anesthesia, manual methods of performing closed-circuit anesthesia are labor intensive and thus not widely used. Automation of closed-circuit anesthesia delivery may reduce the work. A pressure-based adaptive controller was designed and tested on mongrel dogs to evaluate the feasibility of automating closed-circuit anesthesia using an accessory to an existing clinical anesthesia machine and a gas analyzer. ⋯ This pressure controller differs from previously published closed-circuit anesthesia controllers that measure gas volume changes within a mechanical ventilator. A pressure-based controller is easily attached to a standard anesthesia machine and is compatible with modes of ventilation other than controlled mechanical ventilation. The controller used in this study is not designed for clinical use, but was developed to investigate the feasibility of pressure as a basis for gas volume control in closed-circuit anesthesia administration.