Journal of clinical monitoring最新文献_第10页

Accuracy and utility of a new reflectance pulse oximeter for fetal monitoring during labor. 一种新型反射脉搏血氧仪在分娩过程中胎儿监测的准确性和实用性。

Journal of clinical monitoring Pub Date : 1997-03-01 DOI: 10.1023/a:1007370920986

A Izumi, H Minakami, I Sato

{"title":"Accuracy and utility of a new reflectance pulse oximeter for fetal monitoring during labor.","authors":"A Izumi, H Minakami, I Sato","doi":"10.1023/a:1007370920986","DOIUrl":"https://doi.org/10.1023/a:1007370920986","url":null,"abstract":"Objective: To evaluate the accuracy of a new pulse oximeter in estimating the oxyhemoglobin (O2Hb) concentration in fetal arterial blood (SaO2) with either a high concentration of hemoglobin F (HbF) or a low concentration of O2Hb during labor.Patients and methods: Fetal forehead arterial oxygenation was determined in 44 fetuses by reflectance pulse oximeter (SpO2) during labor and was compared with SaO2 determined immediately after birth. Because HbF has little or no known effect on pulse oximetry, but does affect the laboratory multiwavelength \"CO-oximeter\" type reading, the SaO2 was corrected by HbF concentration. SpO2 and SaO2 were simultaneously measured in five hypoxic adult volunteers achieved by inhaling 11% oxygen.Results: A gradual decline in HbF concentration was seen during weeks 37 to 40 of gestation. HbF concentration varied near term, ranging between 53 and 88% of the fetal hemoglobin concentration (mean +/- SD = 74.6 +/- 6.3%). This alteration produced a lower %O2Hb percent by 4% at the most. The corrected SaO2 in cord blood correlated with fetal SpO2 (y = 0.974, x -7.279, r = 0.90). In five adults, SpO2 reflected well SaO2 with a mean +/- SD of bias of -1.1 +/- 2.9%.Conclusions: SpO2 determined by a new reflectance pulse oximeter at the end of labor correlated with an immediate post-natal cord arterial blood sample before the first breath, with a mean and SD of bias of 8.5 +/- 6.2%. Reflectance pulse oximetry is a useful tool for continuous noninvasive monitoring of the fetal oxygen status during labor.","PeriodicalId":77199,"journal":{"name":"Journal of clinical monitoring","volume":"13 2","pages":"103-8"},"PeriodicalIF":0.0,"publicationDate":"1997-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1023/a:1007370920986","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20061360","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}

引用次数: 2

FIx controller: an instrument to automatically adjust inspired oxygen fraction using feedback control from a pulse oximeter. FIx控制器:一种使用脉搏血氧计反馈控制自动调节吸入氧分数的仪器。

Journal of clinical monitoring Pub Date : 1997-03-01 DOI: 10.1023/a:1007384122804

D B Raemer, X B Ji, G P Topulos

{"title":"FIx controller: an instrument to automatically adjust inspired oxygen fraction using feedback control from a pulse oximeter.","authors":"D B Raemer, X B Ji, G P Topulos","doi":"10.1023/a:1007384122804","DOIUrl":"https://doi.org/10.1023/a:1007384122804","url":null,"abstract":"Objective: To develop an instrument to help prevent pulmonary O2 toxicity, a syndrome that manifests itself in adult intensive care patients.Methods: We designed, built, and tested a device that controls FIO2 exposure using oxygen saturation measured with a pulse oximeter (SpO2) in a negative feedback control system. A target SpO2 is designated by the clinician and the system adjusts the FIO2 from a mechanical ventilator so as to minimize the difference between the measured SpO2 and the target. Important elements of the system include a conservative artifact rejection algorithm, a gainscheduled sampled-data proportional-integral-derivative (PID) controller, and a safety system to prevent inspired mixtures with undesirably low FIO2 due to device failure.Results: The control system was tuned in a series of animal experiments. Acceptable clinical response of the system was obtained using a gain-scheduled controller algorithm whereby the gain of the proportional term of a PID controller was adjusted based on the error signal and measured minute ventilation. Also, the artifact rejection algorithm and safety systems were successfully tested using simulation.Conclusions: Testing the effectiveness of this instrument will require comparison with manual control of FIO2 in an appropriately designed trial.","PeriodicalId":77199,"journal":{"name":"Journal of clinical monitoring","volume":"13 2","pages":"91-101"},"PeriodicalIF":0.0,"publicationDate":"1997-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1023/a:1007384122804","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20060273","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}

引用次数: 19

Resuscitation of passengers on two TWA flights. 两架环球航空航班上的乘客心肺复苏。

Journal of clinical monitoring Pub Date : 1997-03-01

S H Statman

引用次数: 0

Response to question of machine obsolescence. 对机器陈旧问题的回应。

Journal of clinical monitoring Pub Date : 1997-03-01

P J Schreiber

引用次数: 0

In vitro evaluation of intragastric PCO2 measurement by air tonometry. 体外评价气压法测定胃内PCO2的效果。

Journal of clinical monitoring Pub Date : 1997-03-01 DOI: 10.1023/a:1007335622132

J J Kolkman, L J Zwaarekant, K Boshuizen, A B Groeneveld, S G Meuwissen

引用次数: 10

The implementation and acceptance of an intra-operative anesthesia information management system. 术中麻醉信息管理系统的实施与验收。

Journal of clinical monitoring Pub Date : 1997-03-01 DOI: 10.1023/a:1007333411788

R L Coleman, T Stanley, W C Gilbert, I C Sanderson, G A Moyer, K S Sibert, J G Reves

引用次数: 14

Evaluation of electrochemical nitric oxide and nitrogen dioxide analyzers suitable for use during mechanical ventilation. 电化学一氧化氮和二氧化氮分析仪在机械通气过程中适用性的评价。

Journal of clinical monitoring Pub Date : 1997-01-01 DOI: 10.1023/a:1007301912697

E P Purtz, D Hess, R M Kacmarek

{"title":"Evaluation of electrochemical nitric oxide and nitrogen dioxide analyzers suitable for use during mechanical ventilation.","authors":"E P Purtz, D Hess, R M Kacmarek","doi":"10.1023/a:1007301912697","DOIUrl":"https://doi.org/10.1023/a:1007301912697","url":null,"abstract":"Objective: Inhaled nitric oxide (NO) is increasingly being used in the treatment of diseases characterized by hypoxemia and pulmonary hypertension. To avoid complications, accurate quantitative analysis of NO and NO2 is necessary during this therapy. We evaluated the accuracy of electrochemical NO and nitrogen dioxide (NO2) analyzers suitable for use during mechanical ventilation.Methods: We evaluated six electrochemical NO analyzer brands (Bedfont, B & W, Dräger, EIT, Pulmonox, Saan). All were calibrated and used per manufacturer's specifications. An adult mechanical ventilator was used to produce serial dilutions of NO with O2 for [NO] of 0-80 ppm. F1O2 settings of 0.90, 0.70, 0.50, 0.30, and 0.21 were used. Settings of low, moderate, and high ventilation pressures were evaluated. Gas was sampled from the inspiratory limb of the ventilator circuit using either a sidestream or mainstream technique. [NO] was also measured using a calibrated chemiluminescence analyzer. For the analyzers that measured NO2, serial dilutions of 8.5 ppm NO2 with O2 were analyzed using chemiluminescence and the electrochemical analyzers.Results: Bias +/- precision for [NO] by individual devices ranged from 1.8 +/- 1.9 ppm to -1.0 +/- 0.7 ppm. There were significant differences in the bias between analyzers (P < 0.001), pressure settings (P < 0.001), and NO level (P < 0.017). The difference in bias between levels of F1O2 was not significant (P = 0.062). Bias +/- precision for NO2 ranged from 0.18 +/- 0.12 ppm to -0.14 +/- 0.13 ppm, with a significant difference between analyzers (P < 0.001).Conclusions: The bias and precision of these analyzers was acceptable for clinical use. The devices tended to be most accurate at [NO] < or = 20 ppm-the clinical conditions at which NO is most commonly used.","PeriodicalId":77199,"journal":{"name":"Journal of clinical monitoring","volume":"13 1","pages":"25-34"},"PeriodicalIF":0.0,"publicationDate":"1997-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1023/a:1007301912697","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20013484","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}

引用次数: 2

Computerized pre-anesthetic evaluation results in additional abstracted comorbidity diagnoses. 计算机化的麻醉前评估结果是附加的抽象的合并症诊断。

Journal of clinical monitoring Pub Date : 1997-01-01 DOI: 10.1023/a:1007320404788

G L Gibby, D A Paulus, D J Sirota, R W Treloar, K I Jackson, J S Gravenstein, J J van der Aa

{"title":"Computerized pre-anesthetic evaluation results in additional abstracted comorbidity diagnoses.","authors":"G L Gibby, D A Paulus, D J Sirota, R W Treloar, K I Jackson, J S Gravenstein, J J van der Aa","doi":"10.1023/a:1007320404788","DOIUrl":"https://doi.org/10.1023/a:1007320404788","url":null,"abstract":"Objective: To study the impact of information from a physician-entry computerized preanesthetic evaluation system on the coding of International Classification of Diseases (ICD-9-CM) diagnoses and on hospital reimbursement due to alterations in diagnosis-related group (DRG) codes.Methods: Nonrandomized, unblinded trial conducted at a 570-bed university tertiary care hospital. First without and then with reference to information contained on computer-based preanesthetic evaluation reports, medical charts were coded by the study institution's usual professional codes for ICD-9-CM discharge diagnoses and DRG assignment.Results: For 22 of 180 charts studied (12%, 95% confidence limits 7.4% to 16.7%), at least one ICD-9-CM diagnosis was added. Three of 84 DRG-based reimbursements were altered, increasing hospital reimbursement by 1.5%.Conclusions: Supplemental information from a physician-entered, problem-oriented, computerized preanesthetic evaluation system improved discovery of diagnoses in the population studied.","PeriodicalId":77199,"journal":{"name":"Journal of clinical monitoring","volume":"13 1","pages":"35-41"},"PeriodicalIF":0.0,"publicationDate":"1997-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1023/a:1007320404788","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20013485","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}

引用次数: 11

Simple and cost effective clinical methods for measuring neuromuscular fade responses with emphasis on "train of four" fade. 测量神经肌肉衰退反应的简单和成本有效的临床方法，重点是“四列”衰退。

Journal of clinical monitoring Pub Date : 1997-01-01 DOI: 10.1023/b:jocm.0000012480.32738.8e

L Gyermek

{"title":"Simple and cost effective clinical methods for measuring neuromuscular fade responses with emphasis on \"train of four\" fade.","authors":"L Gyermek","doi":"10.1023/b:jocm.0000012480.32738.8e","DOIUrl":"https://doi.org/10.1023/b:jocm.0000012480.32738.8e","url":null,"abstract":"Objective: To evaluate different pressure transducers, available in the operating room for pressure measurements, interfaced with common monitoring equipment, for quantitation of the train of four (TOF) fade during clinical neuromuscular block (NMB).Method: We determined evoked pressure changes produced by the thumb in response to TOF stimuli. We studied the responses of: a) a membrane disc device, and b) modified pressure transducers which were placed directly under the distal phalanx of the thumb of the clenched hand. The responses were displayed/recorded on OR monitors. The optimal positioning of these thumb pressure sensing (TPS) devices and their sensitivity and accuracy during onset, spontaneous (partial) recovery and pharmacologic reversal of NMB, were determined in anesthetized patients during muscle relaxation (Vecuronium) and reversal (Neostigmine). Simultaneous comparisons were made on twenty eight patients between the TOF fade responses obtained by the TPS devices and by conventional electromyographic and/or mechanomyographic methods. Comparisons were made either between pairs of data (e.g. \"t\" test, correlation coefficients, measuring agreement) or between several \"treatment\" groups (ANOVA of repeated measures).Results: Correlations between the results of the TPS devices and the other methods were the closest (r- > 0.8) at higher TOF (T4/T1) ratios (e.g. during reversal. Measuring agreement was satisfactory and no significant differences were detected between the regression data (e.g. slope, residuals, x-axis of the regression lines) of the T4/T1 ratios vs. time when comparing EMG and TPS data during reversal of NMB.Conclusion: Measuring quantitatively the TOF fade by TPS devices is an economically feasible method for determining the adequacy of recovery from clinical non-depolarizing NMB.","PeriodicalId":77199,"journal":{"name":"Journal of clinical monitoring","volume":"13 1","pages":"11-7"},"PeriodicalIF":0.0,"publicationDate":"1997-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1023/b:jocm.0000012480.32738.8e","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20014196","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}

引用次数: 0

Validation of reflectance pulse oximetry: an evaluation of a new sensor in piglets. 反射式脉搏血氧仪的验证:一种新型传感器在仔猪中的评价。

Journal of clinical monitoring Pub Date : 1997-01-01 DOI: 10.1023/a:1007332105965

R Nijland, S Nierlich, H W Jongsma, J G Nijhuis, B Oeseburg, K Springer, P Mannheimer

{"title":"Validation of reflectance pulse oximetry: an evaluation of a new sensor in piglets.","authors":"R Nijland, S Nierlich, H W Jongsma, J G Nijhuis, B Oeseburg, K Springer, P Mannheimer","doi":"10.1023/a:1007332105965","DOIUrl":"https://doi.org/10.1023/a:1007332105965","url":null,"abstract":"Objective: A new reflectance pulse oximetry sensor, developed for intrapartum estimation of arterial oxygen saturation (SaO2), was calibrated and evaluated. The sensor contains two light emitting diodes of 735 and 890 nm, and a photodetector at a distance of 14 mm from both light emitting diodes.Methods: In seven Yorkshire/Hampshire piglets, the reflectance sensor (Nellcor Puritan Bennett Inc.) was calibrated using blood sample SaO2 values. The resulting calibration line was evaluated in four Dutch piglets, by comparing pulse oximetry saturation readings (SpO2) with blood sample and intravascular fiberoptic oximetry SaO2 values. Several reflectance sensors were fixed on each animal. Desaturation levels were obtained by changing the gas mixture of oxygen/ nitrous oxide via a tracheal catheter.Results: In the Yorkshire/ Hampshire piglets, the standard deviation of difference (SpO2-SaO2) was 4.7% (n = 364), over an SaO2 range of 17% to 100%. In the Dutch piglets, the mean difference (SpO2-SaO2) was -1.6% and the standard deviation of difference was 5.4%, over the same SaO2 range (n = 254). Comparisons of continuous recordings of reflectance SpO2 and fiberoptic SaO2 revealed variation in individual regression lines.Conclusions: This new 735/890 nm reflectance sensor demonstrates acceptable accuracy in piglets. A further evaluation during labor should assess its feasibility for fetal surveillance.","PeriodicalId":77199,"journal":{"name":"Journal of clinical monitoring","volume":"13 1","pages":"43-9"},"PeriodicalIF":0.0,"publicationDate":"1997-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1023/a:1007332105965","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20013486","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}

引用次数: 10