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Results for “Monitoring, Physiologic”

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At least 109 records · Page 6Linked to original sources
PubMed1988

Aggressive physiologic monitoring of pediatric head trauma patients with elevated intracranial pressure.

The management of pediatric patients with severe head trauma often requires aggressive physiologic monitoring and treatment. As intracranial pressure (ICP) increases, so does mortality. Yet attempts to decrease elevated ICP can cause physiologic and hemodynamic problems. In this retrospective analysis of 25 patients treated with ICP monitoring alone, ICP measurements plus mannitol, or ICP measurements plus pentobarbital (PB) induced coma/mannitol, survival rates were higher than predicted, particularly among the most severely injured. These results were apparently due to the intensive care and aggressive monitoring. Although barbiturates are known to decrease ICP, the adverse effects encountered, including hypotension, cardiovascular depression and arrhythmias, often outweigh the benefits. Hemodynamic abnormalities are unpredictable and monitoring with Swan-Ganz catheter is useful in managing patients with PB-induced comas. Many failures of PB therapy in pediatric patients may be related to undiagnosed decreases in cardiac output, resulting in decreased cerebral blood flow, even with well-controlled ICP.

Accidental Falls↗
PubMed2002

Physiological monitoring as an objective tool in virtual reality therapy.

The goals of this study were twofold: (1) to investigate nonphobics' and phobics' physiological response in virtual environments, and (2) to analyze the trend of phobics' physiology during virtual reality (VR) treatment. As a measure of physiology, heart rate, skin resistance, and skin temperature were acquired. The data for two groups of participants were analyzed: 22 nonphobic participants (mean = 32 +/- 9.4 years) and 36 subjects with fear of flying (mean = 40 +/- 12.1 years) who met the DSM-IV criteria for fear of flying. As a result, skin resistance showed significant differences between nonphobics and phobics, T(56) = 2.978 and p < 0.01, respectively. The physiological response of 33 phobic participants, who were able to fly without medicine after VR treatment, showed a gradual trend toward the nonphobics' physiological responses as therapy sessions progressed. In this study, physiological monitoring, in particular skin resistance, appeared to be useful both in understanding the physiological state of phobic individuals and in evaluating the results of treatment in VR psychotherapy.

Adult↗
PubMedDate not supplied

Sedation, anesthesia, and physiologic monitoring during MR imaging: evaluation of procedures and equipment.

The authors developed safe standard sedation and general anesthesia procedures for adults and children, including adequate physiologic monitoring, during magnetic resonance (MR) imaging. Six-year results are reported from one institution; 75% of the 600 patients per year who require sedation or anesthesia are children who require sedation only. Testing was done to determine MR compatibility of various types of equipment essential for monitoring and supporting sedated or anesthetized patients in 1.0- and 1.5-T MR imagers. Use of sedation procedures that include oral chloral hydrate after sleep deprivation resulted in a failure rate of 3.8% in sedating outpatient children. Every physiologic parameter that can be monitored under normal circumstances in the critical care unit or operating room can be monitored during MR imaging. Our experience indicates that with careful consideration of the unique MR environment and with rigorous testing of monitoring equipment, MR imaging can be performed safely in sedated or anesthetized patients.

Adult↗
PubMedDate not supplied

Continuous physiologic monitoring and the identification of sepsis: what is the evidence supporting current clinical practice?

Sepsis is a multifaceted and complex medical condition that consumes a vast array of critical care resources and creates an exceptionally difficult clinical challenge for critical care clinicians. As a result, many initiatives over the past decade have been set in motion with the goal of improving the clinical care of patients with sepsis. This article provides a review of the consensus definitions of sepsis and the status of current treatment initiatives for sepsis. The focus of this article is to review the evidence supporting the current clinical practice guidelines with regard to the continuous physiologic monitoring of temperature, blood pressure, heart rate, and respiratory rate. These parameters were chosen because they are recommended by both current consensus practice guidelines and early goal-directed therapy practice. In addition, they are continuously or frequently monitored in the setting of critical care, and though nonspecific for sepsis, as a group they may identify septic patients or those at risk for sepsis. Because critical care nurses are responsible for the continuous monitoring of patients at risk for developing sepsis, they may be able to observe the convergence of nonspecific diagnostic criteria and physical assessment cues early in the development of the condition and positively affect outcomes.

Blood Pressure↗
PubMed2005

Aortic atresia and type B interrupted aortic arch: diagnosis by physiologic cerebral monitoring.

Physiologic cerebral monitoring has become an important part of our cardiovascular surgical unit. We recently encountered an unusual variant of aortic atresia that was first suggested by physiologic cerebral monitoring and required modification of our operative technique. We describe and discuss the anatomy, its translation into cerebral monitor findings, and how we modified our operative technique.

Aorta, Thoracic↗
PubMed1996

Remote continuous physiological monitoring in the home.

As part of a larger study we established a remote physiological monitoring network to investigate cardiorespiratory function during sleep in 400 infants in their homes. The objective of the study was to link measurements made at three weeks and three months of age with detailed measurements of maternal and fetal nutrition during pregnancy and subsequent outcome (growth, development and cardiorespiratory diseases). Five infants per night were monitored anywhere within a radius of 10 miles (16 km) of the remote hub. Of 800 overnight studies on 64 (of 400) infants, 99 were completed. Options allowed downloading data from monitor memory as well as review (on- and off-line) from the infants' or nurses' homes, the hub and the Oxford telemonitoring centre. The reasons for these measurements being made at home were to ensure physiological accuracy and to reduce cost. The network was effectively run by local community nurses; with the exception of the size and cost of the monitors, it had all the elements of a remote primary-care clinical service.

Community Health Services↗
PubMed2006

Physiological monitoring and control in hemodialysis: state of the art and outlook.

Medical devices for monitoring and feedback control of physiological parameters of the dialysis patient were introduced in the early 1990s. They have a wide range of applications, aiming at increasing the safety and ensuring the efficiency of the treatment, and at an improved restoration of physiological conditions, leading to an overall reduction in morbidity and mortality. Such devices include sensors for the measurement of temperature, optical parameters and sound speed in blood, and electrical characteristics of the human body, and other parameters. Essential for the development of these devices is a detailed understanding of the pathophysiological background of a therapeutical problem. There is still a large potential to introduce new devices for further therapy improvement and automation. Also, the size of the hemodialysis market appears attractive; however, a new product has to meet several specific requirements in order to also become commercially successful. This review describes the therapeutic and technical principles of several available devices, reports on concepts for possible future devices, and presents a short overview on the market environment.

Blood Pressure↗
PubMed2005

Remote physiological monitoring: clinical, financial, and behavioral outcomes in a heart failure population.

This article reports on the outcomes associated with remote physiological monitoring (RPM) conducted as part of a heart failure disease management program. Claims data, medical records, data transmission records, and survey results for 91 individuals ages 50-92 (mean 74 years) successfully completing a heart failure RPM program were analyzed for time periods before, during, and after the monitoring intervention. The program was associated with significant reductions in per member per month costs and emergency room and hospital utilization. More detailed analyses were performed for specific gender and age subgroups. Participant surveys indicated high levels of satisfaction, and improvements in self-perceived health status, self-efficacy, and self-management behaviors. This study is the first to assess the impact of a RPM program following removal of the monitoring equipment. The results indicate that RPM, as a component of a traditional disease management program, has a sustained, beneficial effect on participants' lifestyles after the monitoring period has ended.

Aged↗
PubMed1993

Fundamentals of physiologic monitoring.

For centuries, medical practitioners had no electronic medical instruments and had to rely on their senses of sight, hearing, smell, taste, and touch to obtain physiologic measurements. Although it is possible to estimate blood pressure by palpating the pulse at the radial or brachial artery, such estimates are not accurate. Determining arterial oxygen saturation of hemoglobin is more complex: how "blue" a patient appears depends on skin coloration, lighting, and the examiner's sense of color. Finally, using radiographic images to validate pulmonary edema when clinicians suspect that there is an elevated left atrial or pulmonary artery wedge pressure also challenges human senses. However, today's medical instruments use transducers and signal processors to convert patient information into a form that clinicians can easily perceive and understand. This article defines terms used with biomedical instrumentation and discusses the components of ideal physiologic patient monitoring systems.

Blood Pressure Monitors↗
PubMed1991

An instrument to monitor physiological and environmental parameters associated with heat stress on an ambulatory subject.

This paper outlines the development and construction of an instrument for use on an ambulatory subject which monitors selected physiological and environmental parameters that are a reflection of the degree of physiological strain associated with heat stress. The resulting instrument is rugged, reliable, and uses existing practical technology for in-the-field ambulatory monitoring, and provides minimal restriction to subject movement. The physiological parameters monitored (heart rate and skin temperature) were selected following examination of systemic, skin, and psychoneurotic heat disorders, with the environmental parameters (wind velocity, ambient temperature and relative humidity) based on existing heat stress indices' correlation with physiological parameters. A microprocessor is utilized for data acquisition, mathematical computation and long term storage, and software for downloading the data to a large mainframe computer is provided. Following calibration of the transduction circuits, the instrument was assembled and tested. Improvements are required to obtain the reliability originally envisaged. Additional field trials would see the collection of data to establish criteria to determine the values of the parameters monitored enabling prediction of the onset of heat stress in hot, humid environments.

Ambulatory Care↗
PubMed2005

An evaluation of a vibro-tactile display prototype for physiological monitoring.

Visual displays and auditory alarms are used to convey information on physiological variables in an operating room. However, the exponential growth in the number of physiological variables and the high probability of false alarms has amplified demands on the clinician's attention. We have extended existing tactile technology to improve situational awareness and produce a practical clinical advisory device. A vibro-tactile display, using two vibrating motors applied to the volar surface of the forearm, was compared to an auditory alarm in a simulated clinical environment. Compared with auditory alarms, the vibro-tactile alarm was as easy to learn and had a better identification rate when used alone or combined with the auditory alarm. Most users preferred the vibro-tactile alarm although the prototype caused some discomfort. Furthermore, a combined vibro-tactile and auditory alarm had reduced accuracy when compared with the vibro-tactile alarm alone. The vibro-tactile modality shows considerable promise for clinical practice but will require further clinical testing and refinement, especially with regard to user comfort.

Anesthesiology↗
PubMed1980

Use of physiological monitoring in crisis interviewing: intervention in suicidal states.

Use of physiological data displayed on Intensive Care Unit (ICU) monitors can be a valuable adjunct for the consulting psychiatrist interviewing a resistant post ingestion patient. Directing the patient's awareness to his own physiological responses at moments of repressed affect can aid in penetrating dense denial of depression and lead to better empathic contact between interviewer and patient. The equipment is unintrusive because it is part of the ICU environment, attached as standard procedure for management of such patients.

Adult↗
PubMed2004

Monitoring physiological status of GFP-tagged Pseudomonas fluorescens SBW25 under different nutrient conditions and in soil by flow cytometry.

Pseudomonas fluorescens SBW25, a plant growth promoting bacterium, has been widely studied due to its potential as an inoculum for improving crop yields. Environmental inoculants are usually applied on seeds or directly to soil and to effectively promote plant growth they need to be viable and active. However, it is difficult to study the physiological status of specific microorganisms in complex environments, such as soil. In this study, our aim was to use molecular tools to specifically monitor the physiological status of P. fluorescens SBW25 in soil and in pure cultures incubated under different nutritional conditions. The cells were previously tagged with marker genes (encoding green fluorescent protein and bacterial luciferase) to specifically track the cells in environmental samples. The physiological status of the cells was determined using the viability stains 5-cyano-2,3-ditolyl-tetrazolium chloride (CTC) and propidium iodide (PI), which stain active and dead cells, respectively. Luciferase activity was used to monitor the metabolic activity of the population. Most of the cells died after incubation for nine days in nutrient rich medium. By contrast when incubated under starvation conditions, most of the population was not stained with CTC or PI (i.e. intact but inactive cells), indicating that most of the cells were presumably dormant. In soil, a large fraction of the SBW25 cell population became inactive and died, as determined by a decline in luciferase activity and CTC-stained cells, an increase in PI-stained cells, and an inability of the cells to be cultured on agar medium. However, approximately 60% of the population was unstained, presumably indicating that the cells entered a state of dormancy in soil similar to that observed under starvation conditions in pure cultures. These results demonstrate the applicability of this approach for monitoring the physiological status of specific cells under stress conditions, such as those experienced by environmental inoculants in soil.

Biomarkers↗
PubMed1993

Physiologic monitoring of infants and children.

Accurate and safe monitoring of infants and children requires knowledge of their unique physiology, especially cardiovascular function, pulmonary physiology, and metabolic function. These individual features influence the equipment selection, as well as data interpretation. Although some adult equipment is adaptable for pediatric use, many specifications must be tailored to pediatric needs. Vascular monitoring in pediatric patients requires specific knowledge of insertion procedures and complications, fluid maintenance, and hemodynamic norms, indexed to body surface area. Valid data interpretation requires an understanding of the distinctive clinical responses intrinsic to the pediatric patient. Likewise, maintenance care for pediatric patients always includes attention to precise fluid balance, thermoregulation, and metabolic needs. Finally, all pediatric patients require constant vigilance to protect the integrity of their monitoring systems and, ultimately, the safety of these patients. Failure to address these concerns may result in complications or invalid data.

Adolescent↗
PubMed2005

Physiological monitoring of small animals during magnetic resonance imaging.

Maintaining a stable physiologic state is essential when studying animal models of epilepsy with simultaneous electroencephalograph (EEG) and functional magnetic resonance imaging (fMRI) or EEG and magnetic resonance spectroscopy (MRS). To achieve and maintain such stability in rats in the MRI environment, a minimally invasive but comprehensive system was developed to monitor body temperature, heart rate, blood pressure, blood oxygen saturation and end-tidal CO2 (ETCO2) of expired gas. All physiologic parameters were successfully monitored in Sprague-Dawley rats without interfering with EEG recordings during simultaneous fMRI and MRS studies. Body temperature, heart rate, blood pressure, blood oxygen saturation, and ETCO2, were maintained between 36.5 and 37.5 degrees C, 250-450 beats/min, 136+/-17 mmHg, >90%, and 20-35 mmHg, respectively for 6-8 h under inhalational anesthesia. This set-up could be extended to study in vivo applications in other laboratory animals with only minor modifications.

Anesthetics, Inhalation↗
PubMed1979

The use of Doppler shift radar to monitor physiological and drug induced activity patterns in the rat.

Doppler shift radar was used to monitor circadian activity patterns in the rat and to study the behavioural effects of p-chloroamphetamine and d-amphetamine. Activity was classified in two ways:-(a) slow (non-locomotory) and high (locomotory) speed movements. (b) the number of starts of activity, within either the slow or high speed zones of activity during a pre-set time. p-Choloramphetamine (5 mg/kg) produced a biphasic activity response; an initial increase in continuous non-locomotory activity followed by a longer lasting increase in exploratory locomotion containing regular starts of activity. d-Amphetamine (2.5 mg/kg) produced an increase in both non-locomotory and locomotory movements but a marked reduction in starts of activity (i.e. continuous non-exploratory activity). The combination of information on the amount and pattern (starts) of activity allows a more detailed analysis of the effects of drugs on activity to be made than with existing automated methods.

Animals↗