Journal of clinical monitoring
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The accuracy and precision of the new IRMA (Immediate Response Mobile Analysis System, Diametrics, Inc., St. Paul, MN) handheld blood gas analyzer was compared with that of two benchtop blood gas analyzers. The IRMA consists of a notebook-sized machine and disposable cartridges, each containing a pH, a CO2 and an O2 electrode, and provides bedside (point-of-care) blood gas analysis. ⋯ The new technology incorporated in the IRMA blood gas analyzer provides results with an accuracy that is similar to that of benchtop analyzers, but with all of the advantages of point-of-care analysis.
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Monitoring jugular venous oxygen saturation (SjvO2) has been useful for the early identification and treatment of cerebral ischemia in patients with severe head injury. However, the catheters that have been used for this purpose have not performed optimally. The purpose of this study was to evaluate the performance of a new regional oxygen saturation catheter for monitoring SjvO2. ⋯ The new regional oxygen saturation catheter provided reliable measurement of SjvO2 83% of the time when the signal quality index was < or = 3, and may be useful for continuous monitoring of SjvO2.
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To evaluate the utility of the iSTAT blood analyzer, a bedside device for hematocrit, sodium, potassium, and glucose measurement during cardiopulmonary bypass (CPB). ⋯ In summary, we found that in patients undergoing CPB, the iSTAT values agreed sufficiently well with standard laboratory values and that the iSTAT instrument can be relied upon for bedside measurements.
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Resistance to fluid infusion can be derived from measurements of pressure at two or more flow rates. We measured resistance in 31 patients using a pressure-monitoring infusion pump (Model 560, IVAC) by recording pressure at five flow rates (0, 50, 100, 200, and 300 mL/hr), and computing resistance as the slope of the pressure versus flow curve. Resistance was measured subcutaneously (Rtissue) and intravenously (Rvein) immediately after unsuccessful or successful IV catheter placement. ⋯ The median value for Rvein was 62 RU (range -13.6 to 420 RU), and for Rtissue, 544 RU (range 65.7 to 4170 RU). Receiver operating characteristic (ROC) analysis revealed that a 200-RU threshold detected infiltration with 0.90 sensitivity and 0.91 specificity. We conclude that elevated resistance during fluid infusion is an important early and easily measurable finding in fluid extravasation.