Journal of Clinical Monitoring and Computing

Mach, William; Thimmesch, Amanda; Orr, James; Slusser, Joyce; Pierce, Janet

doi: 10.1007/s10877-010-9242-4pmid: 20623376

Understanding the dif- ferences between FCM and LSCM can assist investigators in planning and design of their research or clinical testing. Researchers and clinicians optimize these technique capa- bilities with the cellular characteristics they wish to measure delineating molecular and cellular events occurring in health and disease. Discovery of mechanisms in cells using FCM and LSCM provide evidence needed to guide future treatment and interventions.

Eipe, Naveen; Doherty, Dermot

doi: 10.1007/s10877-010-9243-3pmid: 20635124

Capnography has been proven to be a useful non-invasive perioperative monitor of the physiology and safety of the child. This list of the clinical applications and interpretations of capnography could find use in teaching and simulation in pediatrics.

Salvarani, Francesco; Nichelatti, Michele; Montomoli, Cristina

doi: 10.1007/s10877-010-9244-2pmid: 20644986

The proposed strategy permits to forecast the incidence of the urinary tract nosocomial infections by using repeated measures of prevalence. It is hence possible to estimate the incidence from cross-sectional prevalence data with sufficient accuracy to monitor and estimate the time dynamics of these infections.

Umesh, Goneppanavar; Jasvinder, Kaur; Nanda, Shetty; Ranjan, Shetty

doi: 10.1007/s10877-010-9245-1pmid: 20635123

Monitoring the oxygenation status of patients with poor peripheral perfusion or ischemic peripheries is challenging in view of unreliable or unrecordable pulse oximeter data. In this article we describe a very simple and innovative technique of using the arterial line for reliable recording of arterial oxygen saturation (SpO2) in such patients. We conclude that the arterial line can be used as an extension of the artery and SpO2 may be reliably measured using the arterial line in such patients as long as the blood in the arterial tubing is pulsatile and a good contact is ensured between the arterial tubing and the sensor of the pulse oximeter.

Hrelec, Candace; Puente, Erika; Bergese, Sergio; Dzwonczyk, Roger

doi: 10.1007/s10877-010-9246-0pmid: 20652380

Although the SI and BIS both can assess a patient’s level of consciousness and are correlated, they are not in agreement with each other numerically and therefore are not interchangeable. It is difficult to assess each monitor’s true responsiveness to acute changes in consciousness level from our study design. The differences between the metrics we observed in this study are most likely due to differences in signal processing methodologies, EEG frequencies employed and signal filtering utilized in the monitors.

Nardi, Olivier; Gonzalez, Hélène; Fayssoil, Abdallah; Annane, Djillali

doi: 10.1007/s10877-010-9247-zpmid: 20652379

In patients with severe sepsis or septic shock, non invasive recording of Masseter-StO2 was significantly associated with ScvO2 Further studies are required to determine the usefulness of Masseter-StO2 guided management of severe sepsis or septic shock.

Walton, Zachary; Kyriacou, Panayiotis; Silverman, David; Shelley, Kirk

doi: 10.1007/s10877-010-9248-ypmid: 20644985

Objective. We investigate the hypothesis that the photoplethysmograph (PPG) waveform can be analyzed to infer regional venous oxygen saturation. Methods. Fundamental to the successful isolation of the venous saturation is the identification of PPG characteristics that are unique to the peripheral venous system. Two such characteristics have been identified. First, the peripheral venous waveform tends to reflect atrial contraction. Second, ventilation tends to move venous blood preferentially due to the low pressure and high compliance of the venous system. Red (660 nm) and IR (940 nm) PPG waveforms were collected from 10 cardiac surgery patients using an esophageal PPG probe. These waveforms were analyzed using algorithms written in Mathematica. Four time-domain saturation algorithms (ArtSat, VenSat, ArtInstSat, VenInstSat) and four frequency-domain saturation algorithms (RespDC, RespAC, Cardiac, and Harmonic) were applied to the data set. Results. Three of the algorithms for calculating venous saturation (VenSat, VenInstSat, and RespDC) demonstrate significant difference from ArtSat (the conventional time-domain algorithm for measuring arterial saturation) using the Wilcoxon signed-rank test with Bonferroni correction (p < 0.0071). Conclusions. This work introduces new algorithms for PPG analysis. Three algorithms (VenSat, VenInstSat, and RespDC) succeed in detecting lower saturation blood. The next step is to confirm the accuracy of the measurement by comparing them to a gold standard (i.e., venous blood gas).

Silvestri, L.; van Saene, H. K. F.; Tomasino, S.; Taylor, N.

doi: 10.1007/s10877-010-9249-xpmid: 20652378

Sleigh, James; Leslie, Kate; Voss, Logan

doi: 10.1007/s10877-010-9251-3pmid: 20680669

During anesthesia maintained with desflurane or propofol, surgical incision has modest effects on the EEG patterns. It does not cause an increase in high frequency power; the most consistent changes are a loss of EFA amplitude and burst suppression patterns. This effect is not strongly modified by the depth of anesthesia—as estimated by the BIS.

Zenker, Sven

doi: 10.1007/s10877-010-9252-2pmid: 20676923

Parallelized PF’s performance makes their application to complex mathematical models of physiology for the purpose of clinical data interpretation, prediction, and therapy optimization appear promising. JSPE in the described extremely underdetermined scenario nevertheless extracted information of potential clinical relevance from the data in this simulation setting. However, fully satisfactory resolution of this problem when minimal prior knowledge about parameter values is available will require further methodological improvements, which are discussed.