International journal of clinical monitoring and computing
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Int J Clin Monit Comput · Nov 1993
A clinical computer database entry form for an intraoperative anesthesiology-based transesophageal echocardiography monitoring service.
Transesophageal echocardiography (TEE) has been increasingly applied to supplement and, in instances, to supplant conventional intraoperative cardiac monitoring. Our body of experience (> 1600 intraoperative TEE procedures), combined with insights gleaned from an intramural quality assurance study, and clinical implications of certain recent advances in the field, led us to develop the following TEE computer database entry form. ⋯ The two-dimensional echocardiographic, saline-contrast, color flow and pulsed Doppler data represent both right and left ventricular performance, valvular function and specific lesions. This database entry form is intended to serve as a guide for performance of a nominally complete intraoperative study and facilitate maintenance of a TEE archive consistent with current advances.
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For almost 100 years, the anaesthesia record has been the sole information tool trying to fulfill an ample catalogue of functions related to the anaesthesia information processes. Automated anaesthetic record systems have evolved around data being available online, as an imitation of the handwritten record. None has developed an information tool capable of an efficient utilization of the wide range of resources provided by modern technology to fulfill the information requirements of the anaesthetic environment. ⋯ The internal functions of a CIPU are treatment control and medicolegal documentation. The external functions are fulfilled by transferring required sets of D&I for subsequent treatment control (next CIPU), audit, quality control, cost calculation, etc. Using such an approach, an Anaesthesia Information Concept (AIC) can be realized by a wide range of modular and hybrid systems (combination of different tools such as paper records, computers, etc), as opposed to universal and single automated documentation systems, which up to now have failed to fulfill the information demands of the anaesthetic environment.
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Int J Clin Monit Comput · Oct 1993
Assessment of the value and pattern of use of a target controlled propofol infusion system.
Thirty one anaesthetists were supplied with a pharmacokinetic based target controlled propofol infusion system for evaluation. Twenty seven of 30 replies to a questionnaire sent to them indicated that the system had changed their use of propofol for maintenance of anaesthesia. The main reasons were greater ease of use and more confidence regarding the predictability of anaesthetic effects compared with manually controlled infusion. ⋯ The mean time during which the system was in maintenance mode, when the predicted blood concentration of propofol was held constant for at least one minute, was 26.1 minutes. The median number of alterations in propofol concentration was 6. The target controlled infusion system provided an inexpensive and acceptable method of delivering intravenous anaesthesia.
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Int J Clin Monit Comput · May 1993
A knowledge-based alarm system for monitoring cardiac operated patients--technical construction and evaluation.
A knowledge-based alarm system for intensive care monitoring was designed, built, tested on-line, and evaluated. The system is a functional prototype of a highly specific patient monitor providing alarms on hypovolemia, hyperdynamic state, left ventricular failure and hypoventilation. ⋯ The alarm system has an electronic access to data available in a multichannel patient monitor and the patient data management system of the intensive care unit. Median filtering, trend estimation, and rule-based reasoning are applied when processing the measured variables and estimating the patient's state.