PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “Remote Patient Monitoring”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 37 records · Page 2Linked to original sources
PubMed1988

Patient anesthesia and monitoring at a 1.5-T MRI installation.

This paper describes the facilities successfully used to provide patient monitoring and anesthesia support in a 1.5-T imaging installation. The requirements for the MRI site for anesthetic gases, shielded power, and radiofrequency ports are outlined. Specific modifications in anesthesia machines, anesthesia cart, laryngoscope, mercury sphygmomanometer, oximeter, and remote blood pressure devices are described. Additional aspects of patient monitoring and support, e.g., electrocardiogram and pressure infusion, are also discussed.

Anesthesiology↗
PubMed1986

Electrocardiographic monitoring after electrical injury: necessity or luxury.

It has been common practice to perform routine electrocardiographic (EKG) monitoring of electrically burned patients for the first 24 hours following injury. Is this monitoring necessary, or is it a luxury based on remote probabilities? The records of 48 consecutive patients admitted with high-voltage (greater than 1,000 volts) electrical injuries were reviewed with respect to history of a cardiac event in the field, EKG abnormalities on admission, and the presence of cardiac arrhythmias during the first postinjury day. No serious arrhythmias occurred in any patients who had a normal EKG on admission. It was concluded that routine cardiac monitoring after a high-voltage injury should be individualized based on history of loss of consciousness, documentation of an arrythmia, or an abnormal EKG.

Adolescent↗
PubMed1994

Monitored outpatient management of mild gestational hypertension remote from term.

OBJECTIVE: Our purpose was to test the hypothesis that monitored outpatient management of mild gestational hypertension remote from term reduces maternal hospitalization without adversely affecting maternal and perinatal outcome. STUDY DESIGN: Five hundred ninety-two patients at 24 to 36 weeks' gestation with mild gestational hypertension were monitored on an outpatient basis with four times daily automated blood pressure measurement and daily assessment of weight, proteinuria, and fetal movement. Maternal and perinatal outcomes were compared with previously published results from inpatient management of mild gestational hypertension. RESULTS: The mean gestational age at enrollment was 32.5 +/- 3.2 weeks with a mean gestational age at delivery of 36.7 +/- 3.6 weeks. The mean pregnancy prolongation was 27.4 +/- 3.3 days, which is similar to previously reported inpatient studies. The mean antepartum hospitalization for all patients during management was only 1.7 days. Three pregnancies were complicated by abruptio placentae, six by the syndrome of hemolysis, elevated liver enzymes, and low platelet count, and none by eclampsia. The mean birth weight was 2757 +/- 555 gm, with a birth weight of > or = 2000 gm achieved in 84% of managed patients. Eighty-seven percent of infants required a newborn hospitalization of < or = 7 days. Fifty-four percent of patients with significant proteinuria at enrollment were delivered at < 37.0 weeks' gestation, whereas only 29% of patients without proteinuria were delivered prematurely. The corrected perinatal mortality rate was 3.4 in 1000 total births. CONCLUSION: Properly monitored outpatient management of mild gestational hypertension remote from term reduces the number of days of maternal hospitalization with similar maternal and perinatal outcome compared with previously published results from inpatient management.

Abruptio Placentae↗
PubMed1992

Pulse oximetry in the postoperative care of cardiac surgical patients. A randomized controlled trail.

STUDY OBJECTIVE: To demonstrate the utility of pulse oximetry in detecting clinically unapparent episodes of arterial desaturation in postoperative cardiac surgical patients and to evaluate the effect of pulse oximetry on ordering arterial blood gas analyses. DESIGN: Prospective, randomized, partially blinded comparison. SETTING: Cardiothoracic surgical intensive care unit. PATIENTS: 35 patients following elective cardiac surgical procedures. INTERVENTIONS: All patients were monitored continuously with pulse oximetry throughout their ICU course. In group 1 patients, the SpO2 data were available at the bedside. In group 2 patients, the SpO2 data were masked at the bedside and monitored at a remote location. MEASUREMENTS AND RESULTS: Utilization of pulse oximetry allowed a significant reduction in arterial blood gas utilization in group 1 (group 1: 12.4 +/- 7.5 blood gas analyses per ICU admission vs group 2: 23.1 +/- 8.8; p = 0.0007) without adverse events. Clinically unapparent desaturations were detected in 7 of 15 patients in group 2. CONCLUSIONS: Pulse oximetry improves patient safety through the detection of clinically unapparent episodes of desaturation and can allow a reduction in the number of blood gas analyses utilized without adverse effects to the patient. This may allow a potential cost savings to the patient.

Cardiac Surgical Procedures↗
PubMed1995

Remote telemetry: new twists for old technology.

Availability of telemetry beds was increased cost-effectively by providing telemetry on medical/surgical units with remote monitoring at designated critical care areas. Guidelines were developed for patient selection, education, clinical policy and procedure. A two-hour inservice was completed by all medical/surgical nurses and after a pilot study the system was implemented on three medical/surgical units.

Cost-Benefit Analysis↗
PubMed1995

Postinfarction ventricular arrhythmias in children.

Because limited information is available on significant arrhythmias after myocardial infarction in pediatric patients, this study was performed to determine the incidence and impact of ventricular tachycardia or fibrillation on the postinfarction course in patients aged 1 day to 16 years. Review of 96 such children showed a wide range of underlying heart disease (56 patients with congenital heart disease, 12 with cardiomyopathy, and 28 with acquired heart disease). Postinfarction ventricular tachycardia/fibrillation occurred commonly (28% of patients with acute myocardial infarction) and early (84% by 2 days after diagnosis). Postinfarction mortality was high in patients with acute myocardial infarction (61%) and appeared to be independent of type of associated heart disease. Ventricular tachycardia/fibrillation was associated with higher mortality rates (approximately 80%) in patients with acute or remote myocardial infarction. The 61 postinfarction survivors were monitored for an average of 4.9 years, and none had significant recurrent ventricular arrhythmias or late sudden death.

Adolescent↗
PubMed1988

Intraoperative interstitial radiation therapy for hepatic metastases from colorectal carcinomas.

Liver metastases from colorectal carcinomas occur frequently. While surgical resection offers the only hope for long-term cure, unsuspected bilobar metastases or extrahepatic metastatic disease may be found at laparotomy, precluding hepatic resection for cure. In this setting intraoperative interstitial hepatic irradiation using the Gamma Med II (Mick Radio-Nuclear Instruments, Bronx, New York) remote afterloading irradiator and an Iridium-192 source permits delivery of a tumoricidal dose to liver tumor(s) with a limited radiation dose to adjacent normal liver. Six patients underwent laparotomy for potential resection of hepatic metastases in a shielded operating room equipped with remote anesthesia monitoring capability and were found to be unresectable. An upper hand retractor facilitated liver exposure during the exploratory and subsequent radiation phases of the procedure. Intraoperative interstitial radiation therapy was performed in each patient. No significant complications occurred on follow-up from 2 to 9 months. Hepatic tumor regression or stabilization occurred on sonography and/or CT scan in each case with a median follow-up of 5 months. The technique offers the potential to ablate discrete tumor nodules within the liver. Ongoing clinical trials will determine the role of intraoperative interstitial radiation in the treatment of hepatic metastases.

Adenocarcinoma↗
PubMed1991

Remote frozen section service: a telepathology project in northern Norway.

We discuss the organization of a remote frozen section service in northern Norway. The service is operated by remote control of a motorized video-microscope located at Kirkenes Hospital, at a distance of more than 400 km from the workstation at the University Hospital in Tromsø. The video images of the frozen section are transmitted via a two-way telephone and video telenetwork with a 2 Mbit/s capacity. The images are displayed on monitors and diagnosed by pathologists in Tromsø. To date, 17 patients have been examined by remote frozen section. Correct benign versus malignant diagnoses have been given in all 17 cases compared with final diagnoses based on formalin-fixed and paraffin-embedded material. The average time taken for examining each frozen section was 15 minutes (range, 5 to 30 minutes). In none of the cases was the interpretation of the slides difficult due to deficient quality of the video images. For small hospitals with limited availability of local pathology services and for hospitals with a deficiency of specialists, telepathology may be a worthwhile substitute.

Equipment and Supplies, Hospital↗
PubMed1976

The epidemiology of 2056 remote site infections and 1966 surgical wound infections occurring in 1865 patients: a four year study of 40,923 operations at Rush-Presbyterian-St. Luke's Hospital, Chicago.

Over a 4-year period 40,923 operations and 44,716 surgical admissions were monitored for both community and hospital onset infections. One thousand eight hundred sixty-five patients had 1966 surgical wound infections and 2056 remote infections including 1652 hospital onset and 404 community onset infections. One thousand one hudnred forty-four patients with multiple infections averaged 40 days in the hospital contrasted with 24 days for 721 patients with a single wound infection. The total excess cost of hospitalization for these patients was $951,150. A statistically significant reduction occurred for urinary tract infections, lower respiratory infections and clean and contaminated surgical wound infections. It is suggested that these are all inter-related and a significant reduction in surgical wound infections can be achieved through control of infections at remote sites, particularly those associated with medical devices. The coagulase positive staphylococcus is still the most important single bacterial species in the primary etiology of surgical wound infections. When the gastrointestinal tract is entered or "supra" infecting organisms appear, gram negative bacteria and mixed gram negative and gram positive infections are dominant. Reduction in remote site infections occurring in surgical patients is necessary to reduce the incidence of surgical wound infections, suggest preventive and control measures, and document the effectiveness of such measures.

Adolescent↗
PubMed1992

Pediatric chest imaging.

The highlight of recent articles published on pediatric chest imaging is the potential advantage of digital imaging of the infant's chest. Digital chest imaging allows accurate determination of functional residual capacity as well as manipulation of the image to highlight specific anatomic features. Reusable photostimulable phosphor imaging systems provide wide imaging latitude and lower patient dose. In addition, digital radiology permits multiple remote-site viewing on monitor displays. Several excellent reviews of the imaging features of various thoracic abnormalities and the application of newer imaging modalities, such as ultrafast CT and MR imaging to the pediatric chest, are additional highlights.

Child↗
PubMed1976

ECG telephone transmission for monitoring pacemakers and cardiac arrhythmias.

A network of ECG telephone transmission has been established which uses simple and inexpensive equipment, and which is aimed particularly at arrhythmia monitoring. Hospitals in areas remote from major medical centers are able to transmit to the Toronto General Hospital for expert advice. 400 patients in their homes may transmit to any of these hospitals for monitoring of pacemaker function or intermittent cardiac arrhythmia. Any patients in the Toronto General Hospital not admitted for a cardiac problem may be monitored via telephone by the expert nurses in the coronary care unit if a cardiac arrhythmia should arise. Equipment for the system has been carefully designed to minimize cost and to make it simple to use, particularly for the old or infirm patients in their homes. Transmissions between hospitals meet American Heart Association specifications for ECG recording. Transmissions of arrhythmias from patients' homes are carried out with a reduced low-frequency response. Expert cardiologists find both transmissions acceptable for their particular purpose. Standards should be set for simple, economic transmission systems as well as for those meeting the most stringent criteria.

Amplifiers, Electronic↗
PubMed1991

Reduction in radiation exposure to nursing personnel with the use of remote afterloading brachytherapy devices.

The radiation exposure to nursing personnel from patients with brachytherapy implants on a large brachytherapy service were reviewed. Exposure to nurses, as determined by TLD monitors, indicates a 7-fold reduction in exposure after the implementation of the use of remote afterloading devices. Quarterly TLD monitor data for six quarters prior to the use of remote afterloading devices demonstrate an average projected annual dose equivalent to the nurses of 152 and 154 mrem (1.5 mSv). After the implementation of the remote afterloading devices, the quarterly TLD monitor data indicate an average dose equivalent per nurse of 23 and 19 mrem (0.2 mSv). This is an 87% reduction in exposure to nurses with the use of these devices (p less than 0.01).

Brachytherapy↗
PubMed1991

[Unstable stenocardia: prognostic significance of painless forms of myocardial ischemia during hospitalization and in the remote period].

Variants of unstable angina pectoris were compared upon examination of 366 relevant patients. 24-h ECG monitoring registered painless ST shifts in 75 of them. Treatment at hospital produced results independent of ischemia form (painful or painless). However, the analysis of long-term response for 10 patients demonstrating episodes of ischemia at discharge suggests that in spite of numerous adjustments of treatment in 70% of the patients the risk of unfavorable outcome seems great.

Adult↗
PubMed1992

How frequent is chronic lumbar arachnoiditis following intrathecal Myodil?

Chronic lumbar arachnoiditis has numerous causes, including the introduction of contrast media into the lumbar subarachnoid space. The oily contrast medium Myodil (iophendylate) is often cited but the true incidence of symptomatic lumbar arachnoiditis due solely to the presence of Myodil is unknown. A retrospective review of 98 patients in whom Myodil was introduced by ventriculography or cisternography, i.e. remote from the lumbar spine, revealed no cases of chronic lumbar arachnoiditis. All patients were monitored closely for periods ranging from 1 to 28 years. We conclude that, in these circumstances, it is rare for Myodil to produce symptomatic arachnoiditis.

Adult↗
PubMed1980

Silent ST segment deviations and extent of coronary artery disease.

Fifty patients who underwent coronary and left ventricular angiography for suspected coronary artery disease (CAD) had ambulatory ECG monitoring at a time remote from that of catheterization. After correcting for positional ST segment variation on ambulatory ECG, the amount of time that ST segments deviated more than 1 mm. from baseline without corresponding angina was determined, and these results were correlated with results of angiography. Silent ST segment deviations were seen in patients without significant CAD in 2.2% of observations, but increased significantly with extent of coronary artery disease (2.9%, 8.2%, and 10.1% of observations in the one-, two-, and three-vessel disease groups, respectively). This relationship was independent of ventricular function, resting ECG, and previous symptoms. It is concluded that silent ST segment deviations on ambulatory ECG reflect the presence and severity of coronary artery disease.

Adult↗
PubMed1995

Neurophysiologic assessment in the management of spinal dysraphism.

Neurophysiologic techniques provide a valuable addition to the armamentarium of tools for the evaluation of sensory and motor function in the pediatric spinal cord. These techniques include median, radial, and ulnar nerve evoked potentials from the upper extremity; common peroneal and tibial nerve evoked potentials from the lower extremity; dermatomal potentials; and compound muscle action potentials and compound nerve action potentials. The techniques that evaluate the sensory system have been used extensively and effectively as research tools, as adjuncts to diagnostic evaluation, and for intraoperative monitoring. There is a considerable literature that describes the properties of SEPs in the infant and young child. Techniques for assessing the descending pathways have been developed in the last 10 years. These techniques hold great promise as both diagnostic and intraoperative monitoring tools. Many questions, however, still exist concerning their value and use. The rapidly increasing capability available in computer systems is also providing enhanced capability in the acquisition, display, and analysis of neurophysiologic data. It is now common to acquire multiple responses simultaneously, e.g. tibial SEPs, pudendal SEPs, and motor potentials. It is also possible to apply computationally intensive numerical algorithms in real time to enhance signal quality and reduce the time required to produce an interpretable display. Finally, it is possible to monitor multiple cases simultaneously from remote locations. These enhanced computational capabilities are helping to optimize the contribution of neurophysiologic monitoring to patient care.

Child↗
PubMed1992

Frozen section service via the telenetwork in northern Norway.

We present preliminary results of remote frozen section service for two local hospitals in Northern Norway. The service is arranged by remote controlling microscopes with motorized X, Y and Z stage movements, magnification and illumination located at Kirkenes and Harstad Hospitals at a distance up to 400 km apart from the workstation at the University Hospital in Tromsø. The video-images of the frozen section are transmitted via a two-ways phone and video telenetwork with 2 Mbit/s capacity. The images are displayed on a monitor as both still and live images and diagnosed by pathologists in Tromsø. To data, 50 patients are examined by remote frozen section service. Correct benign versus malignant diagnoses are given in all cases compared with final diagnoses based on formalin fixed and paraffin embedded material except for two false negative malignant cases and two deferred diagnoses. The average time taken for examining each case of frozen section was 13 minutes. For hospitals with limited requirement of local pathology service and for hospitals with deficiency of specialists, remote frozen section service may be a worthwhile substitute.

Diagnosis, Differential↗