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Results for “Monitoring, Physiologic”

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At least 91 records · Page 5Linked to original sources

PubMed1987

Physiologic monitoring during civilian air medical transport.

We used a questionnaire to survey the physiologic monitoring practices of 106 civilian helicopter flight programs in the United States. Respondents indicated whether they used specified items of equipment "all the time," "only as needed," or "never." Properly completed questionnaires were received from 94 of the 106 programs. Although basic EKG and blood pressure monitoring were done routinely by all programs, temperature was not measured by over half the programs. Less than 20% of programs are able to monitor systemic or pulmonary arterial pressures invasively during flight. Routine monitoring of the fetus is done only rarely during transport of high-risk obstetrical patients. We conclude that monitoring during air medical transport can be improved by taking better advantage of available technology.

Adult↗

PubMed1978

Physiologic monitoring goals for the critically ill patient.

Definition of the appropriate therapeutic goals for physiologic monitoring of patients postoperatively was approached by analyzing more than 50,000 values of the 20 most commonly monitored variables in a series of 113 critically ill patients throughout their immediate postoperative course. In general, normal values were poor criteria for monitoring, since normal values were restored in an average of 75 per cent of the survivors and 76 per cent of the nonsurvivors for the five most frequently measured variables; that is, arterial pressure, heart rate, central venous pressure, wedge pressure and cardiac output. Moreover, an average of 56 per cent of the 20 most commonly monitored variables of nonsurvivors was restored to the normal range. Furthermore, 34 per cent of all the nonsurvivors' values were within the normal range; this was only 2.4 per cent less than the percentage of normal values for the survivors. The empirically determined median value of the survivors taken in the late stage during periods remote from therapy was found to be a better criterion for therapeutic goals for most variables, including blood flow, oxygen transport and most intravascular pressures. However, normal values were satisfactory for arterial pressure, peripheral resistance, pH, mixed venous oxygen tension and arterial carbon dioxide tension, largely because of the biphasic patterns of these variables.

Blood Chemical Analysis↗

PubMed2006

RTWPMS: a real-time wireless physiological monitoring system.

This paper demonstrates the design and implementation of a real-time wireless physiological monitoring system for nursing centers, whose function is to monitor online the physiological status of aged patients via wireless communication channel and wired local area network. The collected data, such as body temperature, blood pressure, and heart rate, can then be stored in the computer of a network management center to facilitate the medical staff in a nursing center to monitor in real time or analyze in batch mode the physiological changes of the patients under observation. Our proposed system is bidirectional, has low power consumption, is cost effective, is modular designed, has the capability of operating independently, and can be used to improve the service quality and reduce the workload of the staff in a nursing center.

Computer Systems↗

PubMed2004

Alarm-enhancement systems for ventilators: problems with physiologic monitoring interfaces.

In our January 2004 Guidance Article "Alarm-Enhancement Systems for Ventilators," we discussed several categories of ventilator alarm enhancements that communicate ventilator alarms to locations where they are more likely to be detected by caregivers. One of these options is interfacing ventilators with networked physiologic monitors. Presently, as part of an Evaluation we are conducting on physiologic monitoring systems, we are testing interfaces that allow ventilator alarm notification at a monitoring system's central station. While such interfaces can offer considerable advantages, our testing has also revealed some problems. These problems are not severe enough to rule out the monitoring-interface option, but they are significant, and hospitals need to be aware of them.

Equipment Design↗

PubMed1992

Physiological monitoring techniques for home health care.

Practical techniques of nonconstrained physiological monitoring which are acceptable in daily life have been attempted, and obtained preliminary results: Successive records of temperature profile on a bed provide information such as body movement, and sleep hours. ECG can be recorded automatically in a bathtub with electrodes on the inside wall of the tub. Heart rate can be measured by ECG taken at a toilet seat. Proposed techniques do not require any effort of measurement procedure to the subject, and thus it is expected that physiological data can be accumulated automatically even though subjects never aware the monitoring procedure.

Activities of Daily Living↗

PubMed1989

A method of remote physiological monitoring of a fully mobile primate in a single animal cage.

A system was designed to allow the physiological monitoring of a fully mobile, unstressed baboon (Papio anubis) in a single animal cage for the purpose of measuring the changes occurring in a hyperbaric environment. It was required to operate for at least three months, both inside a pressure chamber and outside, and to measure the following parameters: electroencephalogram (EEG, three channels), electrooculogram (EOG), electromyelogram (EMG, two channels), electrocardiogram (ECG), arterial blood pressure, respiration and body temperature. Also in the system were catheters through which blood samples could be taken and intravenous drugs given. The overall system consisted of a harness and jacket, an umbilical and back pack, a combined electrical and fluid transmission swivel and a monitoring implant and catheters.

Animal Welfare↗

PubMed1995

Fibre-optical sensor based on fluorescent indicator for monitoring physiological pH values.

A fibre-optical sensor has been developed based on the fluorescent indicator 8-hydroxyl-1,3,6-pyrene trisulphonic acid trisodium salt (HOPSA) for monitoring physiological pH values. Dowex-1 strongly basic anion exchange resin is used as the medium to immobilise the indicator on the end of an optical fibre. Polyurethane is coated on the sensor as the permeable membrane for H+. The properties of HOPSA in solution, as well as when immobilised on the sensor, are studied and found to have the potential for monitoring physiological pH values.

Biosensing Techniques↗

PubMed1989

Physiologic monitoring of combat casualties.

We discuss general concepts and organization of combat casualty care. We identify important issues regarding physiologic monitoring of combat casualties and examine inherent limitations of this monitoring. Effective and practical techniques for monitoring the cardiovascular, pulmonary, central nervous, renal, and coagulation systems are presented in detail.

Emergency Medical Services↗

PubMed1963

Physiologic monitoring of blood glucose.

The technique of continuous chemical analysis in vivo gives promise of real value in medicine. Applied to physiologic monitoring of blood glucose, it provides an invaluable tool for the study of labile diabetes and metabolic problems. Its use during surgical procedures and in post-operative management of such patients and in teaching is to be encouraged.

Appointments and Schedules↗

PubMed2005

A multiparameter wearable physiologic monitoring system for space and terrestrial applications.

A novel, unobtrusive and wearable, multiparameter ambulatory physiologic monitoring system for space and terrestrial applications, termed LifeGuard, is presented. The core element is a wearable monitor, the crew physiologic observation device (CPOD), that provides the capability to continuously record two standard electrocardiogram leads, respiration rate via impedance plethysmography, heart rate, hemoglobin oxygen saturation, ambient or body temperature, three axes of acceleration, and blood pressure. These parameters can be digitally recorded with high fidelity over a 9-h period with precise time stamps and user-defined event markers. Data can be continuously streamed to a base station using a built-in Bluetooth RF link or stored in 32 MB of on-board flash memory and downloaded to a personal computer using a serial port. The device is powered by two AAA batteries. The design, laboratory, and field testing of the wearable monitors are described.

Aerospace Medicine↗

PubMed2006

A randomised controlled trial of the effect of continuous electronic physiological monitoring on the adverse event rate in high risk medical and surgical patients.

We conducted a randomised controlled trial of mandated five-channel physiological monitoring vs standard care, in acute medical and surgical wards in a single UK teaching hospital. In all, 402 high-risk medical and surgical patients were studied. The primary outcome was the proportion of patients experiencing one or more major adverse events, including urgent staff calls, changes to higher care levels, cardiac arrests or death, in 96 h following randomisation. Secondary outcomes were the proportion of patients requiring acute treatment changes, and the 30-day and hospital mortality. In the 96 h following randomisation, 113 (56%) patients in the monitored arm and 116 (58%) in the control arm (OR 0.94, 95% CI 0.63-1.40, p = 0.76) had a major event. An acute change in treatment was necessary in 107 (53%) monitored patients and 101 (50%) control patients (OR 0.55, 95% CI 0.87-1.29). Thirty-four (17%) monitored patients and 35 (17%) control patients died within 30 days. Thirteen patients in the control group received full five-channel monitoring at the request of the ward staff. We conclude that mandated electronic vital signs monitoring in high risk medical and surgical patients has no effect on adverse events or mortality.

Adult↗

PubMed1990

What should be monitored? The past, present, and future of physiological monitoring.

The status of conventional monitoring by vital signs and present concepts of invasive monitoring with the balloon-tipped pulmonary artery (Swan-Ganz) catheter are reviewed. Survivors of high-risk general surgery were observed to have cardiac index (CI) values averaging 4.5 L/min.m2, oxygen delivery (DO2) greater than 600 mL/min.m2, and oxygen consumption (VO2) greater than 170 mL/min.m2. By contrast, those who subsequently died during their hospitalization maintained relatively normal CI, DO2, and VO2 values. However, in the immediate postoperative period, values for other hemodynamic variables were not greatly different for survivors and nonsurvivors or different from the normal range. A predictive index based on these observations predicted outcome correctly in 94% of the subjects in a subsequent prospective study. The use of survivor values as appropriate therapeutic goals was tested in prospective randomized clinical trials and was found to reduce mortality and morbidity significantly. Simultaneous invasive and noninvasive hemodynamic and oxygen-transport monitoring systems were evaluated in high-risk postoperative patients to describe unanticipated adverse circulatory events. Before the monitored event, about three-fourths of the patients exhibited normal function. At the nadir, cardiac functions decreased in about two-thirds, perfusion decreased in more than one-half, and paO2 fell in only one-fourth. Two-thirds recovered with increased cardiac function, more than one-half had improved perfusion, and paO2 increased in fewer than one-fifth of monitored events. These data provide an information base for criteria needed to develop therapeutic decision rules for noninvasive monitoring systems. When noninvasive data are continuously displayed early in the course of critical illness and high-risk conditions, therapy may be instituted early, while physiological deficits are still minimal and easily reversible.

Critical Care↗

PubMed1990

Multichannel physiological monitor plus simultaneous full-duplex speech channel using a dial-up telephone line.

Because of bandwidth limitations, the Public Switched Telephone Network (PSTN) cannot normally accommodate simultaneous multichannel physiological signaling with speech. This communication describes work carried out to build a physiological monitoring system which can transmit up to six low-frequency data channels in the presence of a full-duplex speech channel using one telephone line.

Electrocardiography↗

PubMed1986

[Focal cerebral infarction in the rat: I. Operative technique and physiological monitorings for chronic model].

The purpose of this paper is to develop a new chronic model of focal cerebral infarction by occluding the middle cerebral artery (MCA) in the rat. The operative method and results of physiological monitoring before, during, and after operation are shown. In adult male Sprague-Dawley rats, the left MCA was occluded via trans-retro-orbital approach simply by retracting the temporalis muscle. This method was slightly modified from our original method for chronic experiments. In a group of rats, systemic arterial pressure and blood gases were monitored using a femoral arterial catheter before, during, and after the operation. In the other group, blood pressure by tail-cuff method, neurological findings, and body weight were examined for one week after the MCA occlusion. During the operation under the halothane anesthesia, systemic arterial pressure decreased about 30% comparing with preanesthetic normal value and then quickly returned to normal within 30 minutes after the operation. Body weight progressively decreased in the occluded group during the observation period of one week, although body weight in the sham-operated group decreased only for initial few days and recovered. No animal died during first one week. Slight right hemiparesis was observed only in the MCA occluded group for few days.

Animals↗

PubMed2000

Computer assisted physiologic monitoring and stability assessment in vascular surgical patients undergoing general anesthesia--preliminary data.

BACKGROUND: Physiologic monitors present an influx of numerical data that can be overwhelming to the clinician. We combined several parameters in an effort to reduce the amount of information that must be continuously monitored including oxyhemoglobin saturation by pulse oximetry, end-tidal CO2 concentration, arterial blood pressure, and heart rate into an integrated measure--the health stability magnitude (HSM). The HSM is computed for a predetermined basal period, the reference HSM (RHSM), and recalculated continuously for comparison with the baseline value. In this study we present the HSM concept and examine changes in the HSM during abdominal aortic aneurysm surgery. MATERIALS AND METHODS: After IRB approval, nine patients were studied. The anesthesiologist recorded all significant intra-operative events. Within a defined time interval, data were recorded and used to calculate a combined parameter, the HSM. The baseline or reference value of this index (RHSM) was calculated after the induction of anesthesia. Individual HSM values were repeatedly calculated for ten second periods after the RHSM value was established. A > 30% deviation of the HSM from the RHSM was considered significant. Deviations in the HSM were compared with events recorded by the anesthesiologist on a paper record and with the record from an electronic record-keeping system. The deviation observed between two consecutive HSMs, called dHSM, was plotted against HSM to construct a contour diagram of data from all patients to which individual cases could be compared. RESULTS: The plot showed that dHSM vs. HSM values were tightly clustered. The inner contour on the distribution plot contained 90% of values. Individual patient's time course, projected on this diagram, revealed deviations form "normal" physiology. Fifty-nine events led to > 30% deviations in the HSM; 27 were anticipated events and 32 were unanticipated. CONCLUSION: The correlation between HSM and dHSM depicts changes in multiple monitored parameters that can be viewed using a single graphical representation. Projection of individual cases on the contour diagram may help the clinician to distinguish relative intraoperative stability from important events. Data reduction in this manner may guide clinical decision-making in response to unanticipated or unrecognized events.

Aged↗

PubMed2000

Improving safety of dental procedures with physiological monitoring.

Because of changing demography and greater use of effective but complex medical treatment, increasing numbers of aged or medically compromised patients need dental treatment requiring intervention and local anaesthesia and sometimes parenterally administered sedation. Safety of dental treatment for these patients can be improved with physiological monitoring.

Aged↗

PubMed2004

Physiologic monitoring and anesthesia considerations in acute ischemic stroke.

Acute ischemic stroke is considered a neurologic emergency. The perioperative anesthesia management of acute ischemic stroke is challenging owing to the dynamic pathophysiology of the disease itself and the patients' comorbid factors and conditions. Herein, the authors review preoperative assessment, intraoperative and postoperative physiologic monitoring, and anesthesia management, with a focus on the control of the cerebrovascular and cardiovascular circulations. Issues specific to anesthesia monitoring and management in the radiology suite are emphasized.

Acute Disease↗

PubMed2005

Real-time magnetic resonance with physiologic monitoring for improved scan localization.

Imaging of the coronary arteries at diagnostic resolutions is made difficult due to cardiac and respiratory motion during data acquisition. Cardiac gating and respiratory gating or breath holding are effective ways to reduce the effects of motion. The optimal cardiac and respiratory timings vary widely across individuals. This work presents a real-time magnetic resonance imaging approach with physiologic monitoring that can be used to predict the optimal timings on a subject-by-subject basis during a brief real-time prescan. The feasibility of this approach at determining the optimal cardiac trigger delay and respiratory phase is demonstrated.

Adult↗