Journal of clinical monitoring
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Retrospective clinical experience with our first 46 patients monitored with a fiberoptic intracranial pressure device is described. In 43 of 46 patients, the transducer was introduced into brain parenchyma. A ventriculostomy system was used in 3 of 46 patients. ⋯ Several problems were encountered, including breakage of system components (12%), erroneous readings requiring transducer repositioning (8.6%), epidural hematoma (3.4%), and infection (1.7%). No infections or hematomas occurred in the 3 cases in which the ventriculostomy system was used. Overall, our experience with the Camino intracranial pressure fiberoptic monitoring system confirms previous reports of its favorable features.
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The purpose of this study was to determine the accuracy of five rotating vane or turbine-type respirometers--fdE Magtrak Respiratory Monitor, fdE Haloscale Standard Wright Respirometer, Micro-Medical Pocket Monitor II, and Ohmeda 5400 and 5410 Volume Monitors--which are marketed as suitable for measuring expired gas volume in anesthetized adult patients. ⋯ All monitors showed reasonable clinical accuracy in the usual adult minute ventilation range during general anesthesia with intermittent positive-pressure ventilation (> 5 L/min) when used to measure air, water vapor-saturated air, or N2O/O2 mixtures.
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Near-infrared spectroscopy is a noninvasive bedside technique for monitoring hemoglobin saturation (HbO2%) in brain vasculature. The method linearly relates the optical signal detected from the surface of the head to HbO2%. To do so, the method relies on constant transcranial optical pathlength and light scattering as well as minimal interference by tissues overlying the brain. ⋯ Almost identical linear expressions were observed whether scalp and skull were ischemic or perfused. Transcranial optical pathlength was constant in each animal, but ranged from 10 to 18 cm among animals. The data indicate that the assumptions underlying near infrared spectroscopy are reasonably accurate in a given animal, but that the constants for transcranial optical pathlength and light scattering are not the same in all animals.(ABSTRACT TRUNCATED AT 250 WORDS)
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Our objective was to study the effect of the temperature of the anesthetic gas mixture (AGM) on esophageal temperature measurements made in children whose tracheas had been intubated for anesthesia. We also sought to establish the optimal site for the temperature sensor in the esophagus and to find a way to accurately place the sensor. ⋯ We conclude that best results are obtained when care is taken to place the thermistor in the lower quarter of the esophagus. (We provide a simple formula for calculating this placement in pediatric patients of varying ages.) Placing the probe by acoustic criteria cannot consistently be relied on to provide good thermometry.