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Biomedical subjects

L C Rotello

Publications and source records attributed to L C Rotello.

4 recordsLinked to original sources
PubMed1996

Comparison of infrared ear thermometer derived and equilibrated rectal temperatures in estimating pulmonary artery temperatures.

OBJECTIVES: To investigate the clinical accuracy of infrared ear thermometer derived and equilibrated rectal temperatures in estimating core body temperature. The clinical bias (i.e., mean difference between body sites), and variability (SD of the differences) of simultaneous temperatures were compared with pulmonary artery temperatures. Clinical repeatability (pooled SD of triplicate reading differences) was also examined for three ear infrared thermometers. DESIGN: Prospective clinical study. SETTING: A multidisciplinary, adult intensive care unit. PATIENTS: Twenty patients with an existing pulmonary artery catheter were studied in a multidisciplinary, adult intensive care unit. INTERVENTIONS: A single operator using optimum ear infrared technique and masked to ear and rectal temperatures recorded triplicate measurements with each of three infrared ear thermometers, each over a 4-min period with each infrared thermometer, while an assistant recorded temperatures. Infrared and rectal temperatures were compared with a simultaneous pulmonary artery temperature. MEASUREMENTS AND MAIN RESULTS: Infrared ear thermometers and rectal thermometers were calibrated daily, and pulmonary artery catheters were calibrated on removal from the patient. Patients were grouped into afebrile and febrile groups, based on initial pulmonary artery temperature. Bias and variability were compared between thermometers using analysis of variance. Clinical bias, but not variability, was significantly different between three ear infrared thermometers (0.16 +/- 0.46 degrees C, 0.07 +/- 0.38 degrees C, and -0.22 +/- 0.47 degrees C). The repeatability was not different between ear infrared thermometers (range 0.13 degrees C to 0.14 degrees C). Rectal temperature had a significantly greater bias (average 0.3 degrees C), but less variability (average 0.2 degrees C). Bias was increased, and variability decreased for both rectal and infrared ear temperatures when pulmonary artery temperature was increased. CONCLUSIONS: The three infrared ear thermometers studied provided a closer estimate of core body temperature than equilibrated rectal temperature. Clinical bias was greatest in febrile vs. afebrile intensive care unit patients.

Adult↗
PubMed1994

MRI protocol for critically ill patients.

BACKGROUND Ventilators compatible with magnetic resonance imaging machines are not universally available. However, the lack of such equipment should not preclude magnetic resonance imaging. We have developed a method by which a critically ill patient requiring mechanical ventilation can safely undergo such imaging without compatible equipment. METHOD By using extended ventilator tubing and calculating volume lost due to tubing compliance, safe and reliable mechanical ventilation can be achieved from a distance without impairing scan quality. RESULTS We devised a method to calculate volume lost due to mechanical compliance of the tubing with ventilator circuits employing 20, 30, and 50 feet of tubing. We added the estimated loss of volume to the set tidal volume of 700 mL to give a delivered volume of 700 mL. Twenty breaths were evaluated for each length of tubing. The evaluation of the 20- and 30-foot lengths of tubing demonstrated 10- and 52-mL discrepancies, respectively, between predicted and measured volumes. The 50-foot length showed a 121-mL discrepancy between predicted and measured volumes. CONCLUSIONS Our method appears to be clinically accurate for predicting volume lost due to tubing compliance for lengths of ventilator tubing less than or equal to 30 feet. We have found this technique to be a safe and effective way to ensure patient safety and scan quality in patients requiring mechanical ventilation during magnetic resonance imaging.

Critical Care↗
PubMed1992

A nurse-directed protocol using pulse oximetry to wean mechanically ventilated patients from toxic oxygen concentrations.

The usual method of weaning mechanically ventilated patients from high FIO2 in our ICU, in which housestaff ordered all ventilator changes in an unstandardized manner (control group), was compared to a nurse-directed protocol that used a single arterial blood gas (ABG) analysis and multiple pulse oximetry measurements. The protocol required an ABG to be obtained upon the initiation of intubation/mechanical ventilation, followed by pulse oximetry measurements obtained in accordance with a standardized timetable. Decreases in FIO2 were guided by these results. It was concluded that a nurse-directed oxygen weaning protocol utilizing a combination of a single ABG and multiple pulse oximetry measurements was safe, reduced the need for ABGs, and decreased the duration of patient exposure to toxic oxygen concentrations.

Carbon Dioxide↗