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  • Articles  (20)
  • Monitoring  (20)
  • Springer  (20)
  • Nature Publishing Group
  • 2020-2023
  • 2005-2009
  • 2000-2004  (1)
  • 1985-1989  (19)
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  • Computer Science  (20)
  • Architecture, Civil Engineering, Surveying
  • Electrical Engineering, Measurement and Control Technology
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  • Articles  (20)
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  • Springer  (20)
  • Nature Publishing Group
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  • 1
    Electronic Resource
    Electronic Resource
    Does Monitoring of Post-Tetanic Count Prevent Alarms of Airway Pressure or Visible Muscle Activity during Intratracheal Jet Ventilation? (2000)
    Springer
    Journal of clinical monitoring and computing 16 (2000), S. 523-528 
    Details
    ISSN: 1573-2614
    Keywords: Monitoring ; airway pressure ; neuromuscular block; Ventilation ; intratracheal jet ventilation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Computer Science , Medicine
    Notes: Abstract Objective.Profound neuromuscular block (NMB) quantifiedby post-tetanic count (PTC) may prevent all muscle activity during anesthesia. We studied whether monitoring of PTC prevents airway pressure alarms or visible movements of the vocal cords and the abdomen during endo-laryngeal procedures (ELPs). Methods.In this prospective, double blind, study 50 healthy (ASA 1–3) patients scheduled for ELPs were randomized into five groups: atracurium, mivacurium, rocuronium, vecuronium and succinylcholine. During alfentanil-propofol anaesthesia, profound NMB was controlled by monitoring the PTC (target level PTC 0–2, 50 Hz titanic stimulation) of the adductor pollicis muscle. The muscle relaxants were administered using bolus dosing in all groups but in the succinylcholine group. The early signs of recovery of NMB to be observed were: 1) airway pressure alarms, 2) movements of vocal cords on the laryngeal video monitor and 3) movements of the abdomen. The inference was based on90% confidence interval tests. Results.During 50 ELP:s following signs of early recovery of NMB were recognized: 2 alarms of airway pressure, 16 laryngeal movements and 11 movements of the abdomen. The proportion of airway pressure alarms was significantly lower than proportion of all detectable movements (95% confidence interval analysis). Twelve of the movements were recorded at PTC zero level. The signs of early recovery of NMB were detected in all groups.Conclusions.PTC-monitoring following 50 Hz stimulation does not ensure total inactivity of muscles during alfentanil-propofol anesthesia, regardless which relaxant has been chosen. During ELPs, simultaneous observation of the vocal cords and the abdomen is more sensitive in detecting early recovery of NMB compared to our method of airway pressure monitoring.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1011431723515
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  • 2
    Electronic Resource
    Electronic Resource
    Essential monitoring examined through different lenses (1986)
    Springer
    Journal of clinical monitoring and computing 2 (1986), S. 22-29 
    Details
    ISSN: 1573-2614
    Keywords: Equipment ; computers ; monitors ; Measurement techniques ; Monitoring ; Records ; anesthesia
    Source: Springer Online Journal Archives 1860-2000
    Topics: Computer Science , Medicine
    Notes: Abstract When we ask, what renders essential a particular monitoring approach during routine anesthesia for a healthy patient, perplexing questions, rather than satisfying answers, are raised. I have examined these questions with the help of three lenses that focus on the relationship between the outcome of anesthesia and the detection, and thus correction, of abnormalities during anesthesia. The first lens looks at whether the monitoring modalities accepted by anesthesiologists as “minimal” and “essential” have been scientifically proven to affect outcome from routine anesthesia. A second lens views how well monitors reveal the integrity of the organism and its components. Currently available monitors describe the output of cells or organs but relay little information about the viability of cells. Thus, they describe the symptoms rather than the causes of the pathophysiology related to anesthesia. Today's monitors also measure input, for example, the supply of oxygen, perhaps the most routinely measured of all the variables. The third lens looks at whether there are nonclinical influences on monitoring practice. This lens views the gap between recognizing monitoring possibilities and adopting them clinically; it also views geographic differences in monitoring, as well as social pressures exerted through legal proceedings. Finally, currently recognized essential monitors such as blood pressure measurement, electrocardiography, and oxygen analysis are mentioned, and candidates for inclusion in the list of essential monitors, such as oximeters, capnographs, and the automated record, are discussed.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01619174
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  • 3
    Electronic Resource
    Electronic Resource
    Noninvasive continuous blood pressure measurement from the finger: Optimal measurement conditions and factors affecting reliability (1987)
    Springer
    Journal of clinical monitoring and computing 3 (1987), S. 6-13 
    Details
    ISSN: 1573-2614
    Keywords: Monitoring ; Blood pressure ; Noninvasive monitoring
    Source: Springer Online Journal Archives 1860-2000
    Topics: Computer Science , Medicine
    Notes: Abstract We recorded finger arterial blood pressure (FINAP) in 50 male patients during various types of surgical operations. Three different types of cuffs were used on four fingers of each patient. Measurements were made by the arterial volume-clamp method of Penaz. The FINAP measurements were compared with pressure data obtained ipsilaterally from a radial artery catheter-transducer system (intraarterial pressure [IAP]) to find optimal recording conditions and to document factors affecting FINAP readings. The thumb, with a specially designed cuff, gave the most accurate results. The mean FINAP- IAP difference for the thumb was −4.8 mm Hg for systolic pressure, 1.49 mm Hg for diastolic pressure, and 0.29 mm Hg for mean pressure. The differences were statistically significant for systolic and diastolic pressure but not for mean pressure. The regression slope for thumb systolic FINAP/IAP was 0.979, that for thumb diastolic FINAP/IAP was 0.963, and that for mean thumb FINAP/IAP was 0.996, whereas the intercepts were 7.499 for systolic pressure, 0.802 for diastolic pressure, and 0.083 for mean pressure. The correlation coefficients were 0.945 (systolic), 0.884 (diastolic), and 0.949 (mean). The correlation coefficients with the other fingers ranged from 0.502 to 0.922 for systolic pressure, 0.757 to 0.932 for diastolic pressure, and 0.767 to 0.892 for mean pressure. The slopes for the various finger-cuff combinations ranged from 0.537 to 0.996, and the intercepts ranged from 0.083 to 32.387 from mean pressure. In 3 patients (6%) the FINAP measurement was not possible because of insufficient peripheral circulation. In 9 other patients (18%) the FINAP measurements were not accurate during some periods of time. In 5 of those 9 patients the difficulties were related to arterial cannulation and began immediately after cannulation. In 1 of those 5 patients the FINAP subsequently decreased dramatically after the onset of phenylephrine infusion because of peripheral vasoconstriction and diminished blood flow. In the 4 other patients the FINAP readings were accurate at the beginning of anesthesia but later decreased out of proportion to changes in IAP. These periods were associated with one-lung ventilation. The FINAP accurately reflects systemic arterial pressure. Measurements from the thumb fitted with a specially designed cuff approximate IAP best. Factors affecting peripheral circulation must be taken into consideration when this device is used in the monitoring of FINAP.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00770876
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  • 4
    Electronic Resource
    Electronic Resource
    Anesthetic mishaps and the cost of monitoring: A proposed standard for monitoring equipment (1988)
    Springer
    Journal of clinical monitoring and computing 4 (1988), S. 5-15 
    Details
    ISSN: 1573-2614
    Keywords: Monitoring ; standards ; Injury ; Risk ; Anesthetic mishaps
    Source: Springer Online Journal Archives 1860-2000
    Topics: Computer Science , Medicine
    Notes: Abstract Review of insurance data indicates that approximately 1.5 claims are paid per 10,000 anesthetic procedures, a conservative estimate of the incidence of preventable serious injury associated with anesthesia. Insurance data permit estimation of the premium cost for the anesthesiologist and hospital, per operating room per year, of $69,429.00. We propose the use of an enhanced monitoring standard requiring a pulse oximeter, capnograph, spirometer, halometer, automatic sphygmomanometer, breathing circuit oxygen analyzer, stethoscope, electrocardiographic monitor, and temperature monitor. We suggest that this premium cost, together with the estimate that 50% of incidents would be avoided, predicts a resultant saving of over $27,000/operating room/year, a savings equal to the entire cost of the enhanced monitoring system in approximately 8 months, or a yearly savings of over five times the annualized expense of the monitoring system. Thus, in addition to the moral imperative to monitor a patient during anesthesia to avoid injury and death, there is an economic incentive to monitor effectively.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01618101
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  • 5
    Electronic Resource
    Electronic Resource
    Monitoring instruments are no substitute for careful clinical observation (1988)
    Springer
    Journal of clinical monitoring and computing 4 (1988), S. 107-111 
    Details
    ISSN: 1573-2614
    Keywords: Monitoring ; Equipment: monitors
    Source: Springer Online Journal Archives 1860-2000
    Topics: Computer Science , Medicine
    Notes: Abstract Two clinicians present their views on contemporary patient monitoring equipment and methods. The first suggests that, although monitoring instruments and currently used gadgetry have improved his daily practice of anesthesiology, they are no substitute for careful and scrupulous clinical observations and are only as good as those who use them. He decries the “prescription” of monitoring instruments by those who do not administer anesthetics, such as insurance companies. The second clinician is impressed with the benefits of current monitoring equipment, but agrees that the instruments are no substitute for careful clinical observation. He contends that lower insurance premiums reflect the real improvements that have resulted from the use of sophisticated monitoring equipment.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01641811
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  • 6
    Electronic Resource
    Electronic Resource
    Pulse oximetry for monitoring during ward analgesia: Epidural morphine versus parenteral narcotics (1989)
    Springer
    Journal of clinical monitoring and computing 5 (1989), S. 87-89 
    Details
    ISSN: 1573-2614
    Keywords: Epidural morphine ; Hypoxia ; Monitoring ; Pulse oximetry
    Source: Springer Online Journal Archives 1860-2000
    Topics: Computer Science , Medicine
    Notes: Abstract A pulse oximeter was used to monitor oxygen saturation in 20 women following cesarean delivery. The patients were randomly assigned to one of two groups. Group A received conventional parenteral narcotics for relief of post-operative pain and group B received epidural morphine. All patients were monitored overnight, and data were stored continuously. There were no statistically significant differences in the low saturation values between the two groups. However, the group A desaturation episodes occurred an average of 2.7±1.9 hours after the parenteral narcotics were administered, and the group B desaturation episodes occurred an average of 13.7±5.9 hours after the epidural morphine was administered.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01617880
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  • 7
    Electronic Resource
    Electronic Resource
    An electronic stethoscope is judged better than conventional stethoscopes for anesthesia monitoring (1986)
    Springer
    Journal of clinical monitoring and computing 2 (1986), S. 151-154 
    Details
    ISSN: 1573-2614
    Keywords: Monitoring ; auscultation ; Equipment ; stethoscope ; monitoring ; electronic
    Source: Springer Online Journal Archives 1860-2000
    Topics: Computer Science , Medicine
    Notes: Abstract A prototype electronic monitoring stethoscope was constructed from readily available, high-quality components. It consisted of a conventional precordial or esophageal probe connected to a microphone by a rubber adapter. The microphone was connected by lightweight wire to an amplifier and headphones. Twenty-one anesthesia clinicians evaluated the stethoscope and responded to a multiple-choice preference questionnaire. The electronic stethoscope was judged to perform better than the conventional stethoscope in most categories evaluated. The electronic device was perceived to be louder, clearer in sound reproduction, more efficacious for monitoring, and easier to use continuously, and its head-phones were considered more comfortable than the conventional carpiece. Based on our results, we conclude that amplified stethoscopes have the potential to improve monitoring. Further development of electronic stethoscope monitoring seems warranted and is continuing.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01620547
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  • 8
    Electronic Resource
    Electronic Resource
    An electroencephalographic processing algorithm specifically intended for analysis of cerebral electrical activity (1986)
    Springer
    Journal of clinical monitoring and computing 2 (1986), S. 190-197 
    Details
    ISSN: 1573-2614
    Keywords: Monitoring ; physiologic ; electroencephalography ; Brain ; electroencephalography ; Algorithm ; aperiodic analysis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Computer Science , Medicine
    Notes: Abstract This article describes a computer procedure for the examination and analysis of cerebral electrical activity (CEA). Changes in CEA generate random electrical activity and may include transitory events, such as burst episodes. As yet, there are no standard techniques for evaluating the statistical process of the CEA. This article proposes a computerized method of analyzing the stochastic character of CEA using a computer algorithm. Using a real-time wave-by-wave technique, the algorithm characterizes CEA by the frequency and amplitude of each CEA waveform. This algorithm produces digital packets of information that describe individual CEA waveforms.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01620551
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  • 9
    Electronic Resource
    Electronic Resource
    Noninvasive monitoring of carbon dioxide: A comparison of the partial pressure of transcutaneous and end-tidal carbon dioxide with the partial pressure of arterial carbon dioxide (1987)
    Springer
    Journal of clinical monitoring and computing 3 (1987), S. 149-154 
    Details
    ISSN: 1573-2614
    Keywords: Monitoring ; carbon dioxide: end-tidal ; transcutaneous ; Measurement techniques: capnography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Computer Science , Medicine
    Notes: Abstract This study compares two noninvasive techniques for monitoring the partial pressure of carbon dioxide (Pco2) in 24 anesthetized adult patients. End-tidal PCO2 (PETCO2) and transcutaneous Pco2 (PtcCO2) were simultaneously monitored and compared with arterial Pco2 (PaCO2) determined by intermittent analysis of arterial blood samples. PETCO2 and PtcCO2 values were compared with PaCO2 values corrected to patient body temperature (PaC02T) and PaCO2 values determined at a temperature of 37°C (PaCO2). Linear regression was performed along with calculations of the correlation coefficient (r), bias, and precision of the four paired variables:PETCO2 versus PaCO2 and PaCO2T (n = 211), and PtcCO2 versus PaCO2 and PaCO2T (n = 233). Bias is defined as the mean difference between paired values, whereas precision is the standard deviation of the difference. The following values were found forr, bias, and ± precision, respectively.PetCO2 versus PaCO2: 0.67, −7.8 mm Hg, ±6.1 mm Hg;PETCO2 versus PaCO2T: 0.73, −5.8 mm Hg, ±5.9 mm Hg;PETCO2 versus PaCO2: 0.87, −1.6 mm Hg, ±4.3 mm Hg; PtcCO2 versus PaC02T: 0.84, +0.7 mm Hg, ±4.8 mm Hg. Although each of thesePCO 2 variables is physiologically different, there is a significant correlation (P 〈 0.001) between the noninvasively monitored values and the blood gas values. Temperature correction of the arterial values (PaCO2T) slightly improved the correlation, with respect toPETCO2, but it had the opposite effect for PtcCO2. In this study, the chief distinction between these two noninvasive monitors was thatPETCO2 had a large negative bias, whereas PtcCO2 had a small bias. We conclude from these data that PtcCO2 may be used to estimate PaCO2 with an accuracy similar to that ofPetCO2 in anesthetized patients.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01695936
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  • 10
    Electronic Resource
    Electronic Resource
    Monitoring of the inspired and end-tidal oxygen, carbon dioxide, and nitrous oxide concentrations: Clinical applications during anesthesia and recovery (1989)
    Springer
    Journal of clinical monitoring and computing 5 (1989), S. 149-156 
    Details
    ISSN: 1573-2614
    Keywords: Monitoring ; ventilation ; Oxygen ; concentration ; Carbon dioxide ; concentration ; Nitrous oxide ; concentration
    Source: Springer Online Journal Archives 1860-2000
    Topics: Computer Science , Medicine
    Notes: Abstract Respiratory oxygen, carbon dioxide, and nitrous oxide concentrations were recorded in 20 patients breath-by-breath during general anesthesia and early recovery, using the Cardiocap multiparameter monitor. Several approved maneuvers were performed to demonstrate the usefulness of endtidal oxygen measurement. “Oxygrams” provided by the fast paramagnetic oxygen sensor confirmed the capnometric information in the diagnosis of hypoventilation, apnea, and disconnections. In one patient, the alarm for inspiratory oxygen concentration, set at 18%, appeared to prevent alveolar hypoxia and low arterial saturation from occurring when oxygen instead of nitrous oxide was turned off. Low end-tidal oxygen levels revealed inadequate fresh gas oxygen supplementation while low flow circuits were closed. During manual hypoventilation at the end of anesthesia, the inspiratory-expiratory oxygen difference increased almost twofold while end-tidal carbon dioxide increased by only 30%. Changes in nitrous oxide concentration often complemented oxygen-related information obtained in our observations. In the recovery room, a decrease in end-tidal oxygen concentration preceded low pulse oximetry readings. Therefore, it is suggested that all three gases should be monitored continuously to prevent mishaps related to insufficient ventilation and inappropriate gas concentrations during anesthesia and immediate recovery.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01627446
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