International journal of clinical monitoring and computing
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Int J Clin Monit Comput · May 1995
A bolus plus continuous infusion protocol for controlling neuromuscular blockade during anesthesia.
Neuromuscular blockade is controlled during anesthesia by administering either bolus doses or a continuous infusion of a blocking agent. To test whether a constant infusion technique requires less attention and provides better control we used a computer to simulate neuromuscular blockade. Using the model we maintained 95% blockade with mivacurium, atracurium, and vecuronium. ⋯ The infusion rate was adjusted only 1.12 +/- 0.79 times per hour. The desired level of muscle relaxation was easily controlled using the bolus plus continuous infusion protocol. The infusion scheme might be implemented in future drug infusion pumps.
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Int J Clin Monit Comput · Feb 1995
Comparative Study Clinical Trial Controlled Clinical TrialNoninvasive continuous blood pressure measurement during anaesthesia: a clinical evaluation of a method commonly used in measuring devices.
The objective of the study was assess the utility during anaesthesia of noninvasive continuous blood pressure measurement techniques which use intermittent oscillometric blood pressure measurement for their calibration. The assessment was performed by comparing noninvasive blood pressure with intra-arterial blood pressure. The noninvasive blood pressure measurement device used for evaluation was the NCAT N-500 which uses tonometry for its continuous measurements. ⋯ Correlation of dynamic behavior was lower for OTBP than for ITBP. A significant effect of site difference between calibration measurements and continuous measurements was not found. It is concluded that the approach of continuous noninvasive blood pressure measurement based on the combination of two different measurement methods, in which the continuous method is calibrated by the oscillometric method, lead to clinical unacceptable accuracy and agreement in the patient group studied.
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Information about the use of data processing systems in prehospital emergency medicine were collected, using a questionnaire sent to all German rescue helicopter bases. Twenty-seven of the 42 German rescue helicopter bases returned the questionnaire. At present, only 15 of them take advantage of electronic data processing. ⋯ Future developments may include automated data transfer and digitization of handwritten documents to decrease the workload of the staff. For the automation of data transfer, configuration and synchronisation a standardized interface in all medical devices is required. There is a clear need for the use of data processing systems in emergency medicine.
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Int J Clin Monit Comput · Feb 1995
Automated anaesthesia record systems, observations on future trends of development.
The introduction of electronic anaesthesia documentation systems was attempted as early as in 1979, although their efficient application has become reality only in the past few years. Today, documentation technology is offered by most of the monitor manufacturers and new systems are being developed by various working groups. The advantages of the electronic protocol are apparent: Continuous high quality documentation, comparability of data due to the availability of a anaesthesia data bank, reduction of the workload of the anaesthesia staff and availability of new additional information. ⋯ The advantages of accurate documentation and quality control in the presence of careful planning will outweight cost considerations. However, at this time, almost none of the commercially available systems have matured to a point where their purchase can be recommended without reservation. There is still a lack of standards for the subsequent exchange of data and a solution to a number of ergonomic problems still remains to be found.
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Int J Clin Monit Comput · Feb 1995
Clinical evaluation of the 'head-up' display of anesthesia data. Preliminary communication.
To solve the problem of monitoring the patient during administration of anesthesia, a commercially available head-up display (HUD) was evaluated during one day of surgery at the Ohio State University Hospitals. This monitor is mounted on a headband worn by the anesthesiologist. It projects a monochrome image of monitor data directly into one eye. ⋯ Nine of the testers expressed a desire to evaluate the monitor further. Their major complaints were that the connecting cable between the HUD and its computer was too short, the resolution of the monitor was inadequate, and the data on the screen were not organized in a familiar way. If these problems could be corrected, most users believed that this HUD could be a valuable tool to aid the anesthesiologist in the operating room.