International journal of clinical monitoring and computing最新文献

{"title":"Proposal of a computerized algorithm for continuous wave CO2 laser on-line control during orthopaedic surgery. Phase II: simplified algorithm version (LCA-s) and helmet-mounted data access device solution.","authors":"F Canestri","doi":"10.1007/BF03356594","DOIUrl":"https://doi.org/10.1007/BF03356594","url":null,"abstract":"<p><p>This paper is the continuation of the Phase I report published in 1992 by Canestri. It contains recent findings on how to speed-up the process of sublimated volume forecasting for a TEM11* CO2 laserbeam in CW mode following an original model proposed by the author--called LCA--here presented in a simplified version (LCA-s) on PMMA (polymethylmethacrilate) samples. Other interesting parameters, such as the time required to create the minimal injury vb along with its physical interpretations, are reported and explained. TEM11*, TEM01* and TEM00 beams profiles are also compared and discussed for LCA-s. The results of both Phase I and Phase II of this investigation can be integrated in one single solution package for the end-user, combining fast decisions making and operational features. The final part of this paper describes the 'helmet-mounted' data recall visor methodology which allows the surgeon to access to a data base for information retrieval during the course of an operation without interrupting the surgical case itself. This particularly interesting application allows the surgeon to consult a centrally-located data base which contains important information regarding similar clinical cases, choice of laserbeam profiles and focal lengths, simulation of beam behaviours, performances and other data. The on-line and direct access to the data base supports him in all those borderline situations in the O.R. in which the laser device type and configuration/calibration play a device role in the success of the operation. Also, the helmet-mounted display frees surgeon's hands in order to allow him to continue the operation while consulting the data base on-line, thus speeding up decision processes regarding changes of laser set-up, general calibration optimization and remote clinical consultancy.</p>","PeriodicalId":77181,"journal":{"name":"International journal of clinical monitoring and computing","volume":"14 3","pages":"199-206"},"PeriodicalIF":0.0,"publicationDate":"1997-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/BF03356594","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20315738","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A computing system for the clinical and experimental investigation of cerebrovascular reactivity.","authors":"P Smielewski,&nbsp;M Czosnyka,&nbsp;W Zabolotny,&nbsp;P Kirkpatrick,&nbsp;H Richards,&nbsp;J D Pickard","doi":"10.1007/BF03356593","DOIUrl":"https://doi.org/10.1007/BF03356593","url":null,"abstract":"<p><p>We present a computing system for the recording and on-line analysis of analogue signals derived from bedside cerebrovascular monitors in different pathophysiological conditions. These include arterial blood pressure and oxygen saturation, end-tidal carbon dioxide concentration, cerebral blood flow velocities using transcranial Doppler ultrasonography, and concentration changes in cerebral oxy- and deoxyhaemoglobin from near infrared spectroscopy. Configuration and analysis adopts arithmetic expressions of different signal processing functions, various statistical properties for each signal, frequency spectrum analysis using fast Fourier transformation, and correlation/cross-correlation. The software offers off-line analysis of non-invasive tests of cerebrovascular reactivity. Several examples of clinical assessment of cerebrovascular reactivity are presented, including cerebral haemodynamic stress tests which employ carbon dioxide, acetazolamide, the breath holding test, leg cuff inflation and deflation, and transient carotid artery compression. Application within the experimental setting with induced haemorrhagic hypotension can also be used.</p>","PeriodicalId":77181,"journal":{"name":"International journal of clinical monitoring and computing","volume":"14 3","pages":"185-98"},"PeriodicalIF":0.0,"publicationDate":"1997-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/BF03356593","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20315737","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Computerized ventilator data selection: artifact rejection and data reduction.","authors":"W H Young,&nbsp;R M Gardner,&nbsp;T D East,&nbsp;K Turner","doi":"10.1007/BF03356591","DOIUrl":"https://doi.org/10.1007/BF03356591","url":null,"abstract":"<p><strong>Objective: </strong>To determine acceptable strategies for automated data acquisition and artifact rejection from computerized ventilators using the Medical Information Bus.</p><p><strong>Design: </strong>Medical practitioners were surveyed to establish 'clinically important' ventilator events. A prospective study involving frequent data collection from ventilators was also conducted.</p><p><strong>Subjects: </strong>Data from 10 adult patients were collected every 10 seconds from a Puritan Bennett 7200A ventilator for a total of 617.1 hours.</p><p><strong>Interventions: </strong>Twelve different computerized data selection and artifact algorithms were tested and evaluated.</p><p><strong>Measurements and main results: </strong>Data derived from 12 data selection algorithms were compared with each other and with data manually charted by respiratory therapists into a computerized charting system. Ventilator setting data collected by the algorithms, such as FIO2, reduced the amount of data collected to about 25% compared to manually charted data. The amount of data collected for measured parameters, such as tidal volume, from the ventilator had large variability and many artifacts. Automated data capture and selection generally increased the amount of data collected compared to manual charting, for example for the 3 minute median the increase was a modest 1.2 times.</p><p><strong>Conclusion: </strong>Computerized methods for collecting ventilator setting data were relatively straightforward and more-efficient than manual methods. However, the method for automated selection and presentation of observed measured parameters is much more difficult. Based on the findings and analysis presented here, the authors recommend recording ventilator setting data after they have existed for three minutes and measured parameters using a three minute median data selection strategy. Such an algorithm rejected most artifacts, required minimal computational time, had minimal time-delay, and provided clinically acceptable data acquisition. The results presented here are but a starting point in developing automated ventilator data selection strategies.</p>","PeriodicalId":77181,"journal":{"name":"International journal of clinical monitoring and computing","volume":"14 3","pages":"165-76"},"PeriodicalIF":0.0,"publicationDate":"1997-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/BF03356591","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20315735","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perspectives on development of IEEE 1073: the Medical Information Bus (MIB) standard.","authors":"R J Kennelly,&nbsp;R M Gardner","doi":"10.1007/BF03356588","DOIUrl":"https://doi.org/10.1007/BF03356588","url":null,"abstract":"<p><p>Automated data capture from bedside patient medical devices is now possible using a new Institute of Electrical and Electronic Engineering (IEEE) and American National Standards Institute (ANSI) Medical Information Bus (MIB) data communications standard (IEEE 1073). The first two standard documents, IEEE 1073.3.1 (Transportation Profile) and IEEE 1073.4.1 (Physical Layer), define the hardware protocol for bedside device communications. With the above noted IEEE MIB standards in place, hospitals can now start designing customized applications for acquiring data from bedside devices such as bedside monitors, i.v. pumps, ventilators, etc. for multiple purposes. The hardware 'plug and play' features of the MIB will enable nurses and physicians to establish communications with these devices simply and conveniently by plugging them into a bedside data connector. No other action will be necessary to establish identification of the device or communications with the device. Presently to connect bedside devices, technical help from hardware and software experts are required to establish such communications links. As a result of standardization of communications, it will be easy to establish a highly mobile network of bedside devices and more promptly and efficiently collect patient related data. Collection of data automatically should lead to the design of new medical computing applications that will tie in directly with the emerging mission and operations of hospitals. The MIB will permit acquisition of patient data more efficiently with greater accuracy, more completeness and more promptly. The above noted features are all essential to the development of computerized treatment protocols and should lead to improved quality of patient care. This manuscript provides the rational and historical overview of the development of the MIB standard.</p>","PeriodicalId":77181,"journal":{"name":"International journal of clinical monitoring and computing","volume":"14 3","pages":"143-9"},"PeriodicalIF":0.0,"publicationDate":"1997-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/BF03356588","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20318524","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Abstracts of the 17th Annual Symposium on Computing in Anesthesia and Intensive Care","authors":"M. Bloom, V. Lanza, T. Engel, Y. Iwase, H. Sakio, J. Feldman, Mehboob H. Ebrahim, T. E. Palmer, J. Philip, J. Mandel, C. Waterman, R. Whiting, F. O’Connor, W. Coleman, N. T. Smith, K. Starko, Lori A. Fernandes, C. Brandt, S. Powsner, K. Ruskin, P. Miller, Jin Liu, Harbhej Singh, D. Song, P. White, G. Kenny, H. Bennett, C. Mastropietro, K. Morita, M. Hastie, C. Scheib, Laszlo Gallfly, Raffi Dishakjian, D. Essin, V. deCiutiis, S. Steen, A. Scumlimbrene, K. Chan, D. Doyle","doi":"10.1007/BF03356586","DOIUrl":"https://doi.org/10.1007/BF03356586","url":null,"abstract":"","PeriodicalId":77181,"journal":{"name":"International journal of clinical monitoring and computing","volume":"14 1","pages":"113-142"},"PeriodicalIF":0.0,"publicationDate":"1997-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/BF03356586","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"52573673","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Feedback control in anaesthesia.","authors":"A J Asbury","doi":"10.1007/BF03356572","DOIUrl":"https://doi.org/10.1007/BF03356572","url":null,"abstract":"<p><p>This review considers the some of the methods of automatic control which are usable in medicine. The features of each type of control system are explained and the advantages and disadvantages summarised. The author has attempted to maintain a balance between what is possible with the excellence of modern engineering, and what is feasible in the clinical area, and practical when working with patients. The problem of lack of knowledge of an individual patient is emphasised, as is the potential of fuzzy logic methods in the future.</p>","PeriodicalId":77181,"journal":{"name":"International journal of clinical monitoring and computing","volume":"14 1","pages":"1-10"},"PeriodicalIF":0.0,"publicationDate":"1997-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/BF03356572","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20075410","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Delirium and cognitive disorders after cardiac operations: relationship to pre- and intraoperative quantitative electroencephalogram.","authors":"W J Hofsté,&nbsp;C A Linssen,&nbsp;E H Boezeman,&nbsp;J S Hengeveld,&nbsp;J A Leusink,&nbsp;A de-Boer","doi":"10.1007/BF03356576","DOIUrl":"https://doi.org/10.1007/BF03356576","url":null,"abstract":"<p><p>We examined the incidence of delirium and cognitive disorders after cardiac operations and the related risk factors. The value of pre- and intraoperative QEEG was determined. Using the Mini-Mental State Examination and the Saskatoon Delirium Checklist, 321 patients were tested during the immediate postoperative period. Forty-four patients (14%) showed delirium, 68 (23%) cognitive disorders and 26 (9%) both. Significant risk factors for the development of cognitive disorders were age > or = 70 yr, female gender, duration of cardiopulmonary bypass > or = 2.5 h and aorta-cross-clamping > 70 min. Risk factors for delirium were age > or = 70 yr, female gender and Hb < 5 mmol 1(-1) intraoperatively. The preoperative QEEG showed significant differences between the groups with and without a cognitive disorder, while the intraoperative QEEG showed significant differences between the groups with and without delirium. Different risk factors for delirium and cognitive disorders are a possible explanation for the controversies in the literature, where neuropsychologic complications were grouped together. A low intraoperative Hb is an important risk factor for the development of delirium and can be treated. The preoperative QEEG may have prognostic significance in the occurrence of cognitive disorders, while the intraoperative QEEG may have prognostic significance in the occurrence of delirium.</p>","PeriodicalId":77181,"journal":{"name":"International journal of clinical monitoring and computing","volume":"14 1","pages":"29-36"},"PeriodicalIF":0.0,"publicationDate":"1997-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/BF03356576","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20075990","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Computer aided analysis of heart rate variability in brain death.","authors":"D Knüttgen,&nbsp;K zur Nieden,&nbsp;M R Müller-Gorges,&nbsp;M Jahn,&nbsp;M Doehn","doi":"10.1007/BF03356577","DOIUrl":"https://doi.org/10.1007/BF03356577","url":null,"abstract":"<p><p>Forty neurosurgical, artificially ventilated patients were examined. Twenty of them had been diagnosed as brain dead, while twenty non-brain-dead patients served as a control group. From a surface ECG taken over a period of five minutes the mean heart rate and various indices of heart rate variability (HRV) were determined with the help of a special computer program (ProSciCard, Medisyt, Germany). The heart rate of the brain dead was significantly higher than that of the control patients. By contrast, all parameters of HRV were drastically reduced in the brain dead individuals compared to the controls. The results show that a significant change in the course of heart rate occurs after manifestation of brain death. This would appear to be the result of the elimination of all vegetative impulses derived from the brainstem. Computer-aided, the changes can be quantified in a simple way. The method could therefore be useful in brain death diagnosis.</p>","PeriodicalId":77181,"journal":{"name":"International journal of clinical monitoring and computing","volume":"14 1","pages":"37-42"},"PeriodicalIF":0.0,"publicationDate":"1997-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/BF03356577","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20075991","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"1st International Symposium on Decision Support in Anaesthesia and Intensive Care. Mainz, Germany, September 25-28, 1996. Abstracts.","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":77181,"journal":{"name":"International journal of clinical monitoring and computing","volume":"14 1","pages":"49-68"},"PeriodicalIF":0.0,"publicationDate":"1997-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20221391","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Technology evaluation report: obtaining pulse oximeter signals when the usual probe cannot be used.","authors":"F E Block,&nbsp;T M Fuhrman,&nbsp;L Cordero,&nbsp;C Schaaf,&nbsp;M Grönstrand,&nbsp;T Kajaste,&nbsp;K Nourijelyani,&nbsp;J Hsu","doi":"10.1007/BF03356575","DOIUrl":"https://doi.org/10.1007/BF03356575","url":null,"abstract":"<p><p>We studied the function of four different monitoring probes used with the Satlite pulse oximeter (Datex, Helsinki). The aim was to evaluate ease of use and compare the function of the probes and their attachment methods in different locations (finger, toe, ear, thumb web, instep, wrist, and ankle). Two similar pulse wave oximeters were used in the study. To select the best signal we determined the absolute height of the plethysmographic waveform for each probe. Probes were compared on awake normal adult volunteers (N = 13), in anesthetized adult patients (N = 12), and in neonates weighting 500-1000 g (N = 8). In all the adult trials, the clip-on finger probe was used as a reference, and probes taped or clipped onto the finger provided adequate signal from the ear or from the thumb web, however. In the neonates, taped-on probes were most satisfactory.</p>","PeriodicalId":77181,"journal":{"name":"International journal of clinical monitoring and computing","volume":"14 1","pages":"23-8"},"PeriodicalIF":0.0,"publicationDate":"1997-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/BF03356575","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20075989","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}