Journal of clinical monitoring
-
To test whether a neural network-based method could differentiate between tracheal and esophageal intubation in anesthetized patients by recognizing breathing circuit pressure and flow waveform patterns. ⋯ A neural network differentiated consistently tracheal from esophageal intubation when the ventilation test mode was used. The ventilation mode employed is feasible in most adult patients undergoing elective procedures under general anesthesia. Further research is required to train neural networks to recognize esophageal intubation in different age groups and when different ventilation modes are applied.
-
Comparative Study
Equivalence of fast flush and square wave testing of blood pressure monitoring systems.
The accurate recording of intraarterial pressure depends upon an appropriate dynamic response of the monitoring system. Generation of a square wave (SW) at the catheter tip is the engineering and in vitro laboratory gold standard. Fast flush (FF) testing is the clinical test of choice. Results from these two test methods have been assumed equal but have not been empirically confirmed. ⋯ For the characterization of dynamic response of invasive blood pressure monitoring systems, the FF test and SW test yield identical results. However, under certain conditions-air, R.O.S.E device-dynamic response as measured by FF testing was not equivalent to dynamic response as measured by the gold standard-the SW test. Specifically, small amounts of air in fluid-filled invasive blood pressure monitoring systems cause a slightly worse dynamic response as measured by FF testing versus the laboratory gold standard-the SW test.
-
To assess the correlation and accuracy of end-tidal PCO2 (PetCO2) sampled via nasal cannulae in pediatric patients by comparison to the criterion standard PaCO2, and to identify sources of error during PetCO2 monitoring via nasal cannulae. ⋯ Several factors-some controllable and all recognizable-affect the accuracy of PetCO2 monitored via nasal cannulae in pediatric patients. When these factors are not present, PetCO2 correlates well with PaCO2 and appears to be a useful monitor of ventilatory status during conscious or deep sedation.
-
This study monitored somatosensory evoked potentials (SSEP) at the median and ulnar nerves in awake volunteers placed in a simulated position for prone surgery. Neurologic symptoms were used as a surrogate endpoint for position related peripheral nerve injury; the occurrence of these symptoms was correlated with the presence or absence of SSEP changes in median and ulnar nerves. ⋯ While all SSEP changes were associated with symptoms, the development of symptoms in 3 of 7 patients without SSEP changes suggests that SSEPs may be an imperfect monitor for the detection of positioning injury. The limited sensitivity of SSEPs in this study may be due to the duration of the monitoring, sample size, or the validity of symptoms as a surrogate for nerve injury.