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PubMed1994

[Intraoperative monitoring of motor cranial nerves in operations of the neck and cranial base].

Intraoperative monitoring of cranial nerves is performed to minimize postoperative cranial nerve dysfunction. We performed electrophysiological monitoring of motor cranial nerves with a NIM 2 unit from Xomed Treace and a patient multiplexer developed in our clinic. This multiplexer allows simultaneous monitoring of 4 cranial nerves and is additionally equipped with a bipolar stimulation mode. This intraoperative monitoring was employed during 102 skull base operations. Of these 102 operations, 44 were acoustic neuroma removals by translabyrinthine approach and 36 by a middle fossa approach. Various operations including removal of tumours of the jugular foramen and the infratemporal fossa were performed in the remaining 22 patients. The facial nerve, being the most frequently monitored nerve, was evaluated both pre- and intraoperatively. Electrophysiologic data were evaluated with respect to their predictive value for postoperative facial nerve function. The relative per cent decrease in amplitude of the EMG after resection compared to that observed before resection seems to be of some predictive value for postoperative facial nerve function. A 50-60% decrease or more is associated with an increase in the House classification. Intraoperative monitoring is a useful tool in skull base surgery allowing for safer and faster identification of motor nerves in pathologic anatomic conditions. It allows the surgeon a degree of comfort by providing immediate information regarding the status of the nerve. It may also improve post-operative nerve function and shorten operating time. Additionally, neuromonitoring provides some information about expected postoperative facial nerve function.

Cranial Nerves↗

PubMed1975

Comparison of ventricular ectopic activity during 24-hour monitoring and exercise testing in patients with coronary heart disease.

The exposure of ventricular ectopic activity (VEA) by maximal exercise testing and 24-hour ambulatory monitoring was compared in 100 unselected patients with coronary heart disease. The arrhythmia was noted with exercise in 56 patients and with monitoring in 88. Repetitive forms such as couplets and ventricular tachycardia were found to be twice as frequent (40 vs. 20) with monitoring than with exercise. Patients with prior myocardial infarction had more frequent ventricular ectopic activity of a more advanced grade with both exercise and monitoring than patients with angina pectoris. Exercise exposed the grades of ectopic activity that recurred during two or more hours of the monitoring session. Of seven patients with ventricular tachycardia on exercise only four exhibited this grade with monitoring. It may be that these two methods divulge different information regarding the electrophysiologic state of the myocardium.

Adult↗

PubMed1978

Effect of fetal monitoring on neonatal death rates.

We analyzed data from 15,846 live-born infants to assess the effect of electronic fetal monitoring on neonatal death rates. The crude neonatal death rate was 1.7 times higher in unmonitored infants than in those monitored. Adjusting for inherent risk and changes in mortality rates and monitoring rates during the years of the study lowered the relative risk to 1.4 (95 per cent confidence interval, 0.85 to 2.45). The estimated yield from monitoring decreased as the inherent risk of the baby declined. Thus, in the highest-risk group 109 lives might be saved for every thousand babies monitored. In the lowest risk group (babies at term with no risk factors) the neonatal death rate is around one per thousand. The absolute benefit for this large group could therefore not exceed one life saved for every thousand babies monitored.

Female↗

PubMed1992

Induction of labor as compared with serial antenatal monitoring in post-term pregnancy. A randomized controlled trial. The Canadian Multicenter Post-term Pregnancy Trial Group.

BACKGROUND: The rates of perinatal mortality and neonatal morbidity are higher for post-term pregnancies than for term pregnancies. It is not known, however, whether the induction of labor results in better outcomes than does serial fetal monitoring while awaiting spontaneous labor. METHODS: We studied 3407 women with uncomplicated pregnancies of 41 or more weeks' duration. The women were randomly assigned to undergo induction of labor or to have serial antenatal monitoring and spontaneous labor unless there was evidence of fetal or maternal compromise, in which case labor was induced or cesarean section was performed. In the induction group, labor was induced by the intracervical application of prostaglandin E2. Serial antenatal monitoring consisted of counts of fetal kicks, nonstress tests, and assessments of amniotic-fluid volume. The outcomes we measured were the rates of perinatal mortality, neonatal morbidity, and delivery by cesarean section. RESULTS: Among the 1701 women in the induction group, 360 (21.2 percent) underwent cesarean section, as compared with 418 (24.5 percent) of the 1706 women in the monitoring group (P = 0.03). This difference resulted from a lower rate of cesarean section performed because of fetal distress among the women in the induction group (5.7 percent vs. 8.3 percent, P = 0.003). When two infants with lethal congenital anomalies were excluded, there were no perinatal deaths in the induction group and two stillbirths in the monitoring group (P not significant). The frequency of neonatal morbidity was similar in the two groups. CONCLUSIONS: In post-term pregnancy, the induction of labor results in a lower rate of cesarean section than serial antenatal monitoring; the rates of perinatal mortality and neonatal morbidity are similar with the two approaches to management.

Adult↗

PubMed1995

Postprandial versus preprandial blood glucose monitoring in women with gestational diabetes mellitus requiring insulin therapy.

BACKGROUND: The fetuses of women with gestational diabetes mellitus are at risk for macrosomia and its attendant complications. The best method of achieving euglycemia in these women and reducing morbidity in their infants is not known. We compared the efficacy of postprandial and preprandial monitoring in achieving glycemic control in women with gestational diabetes. METHODS: We studied 66 women with gestational diabetes mellitus who required insulin therapy at 30 weeks of gestation or earlier. The women were randomly assigned to have their diabetes managed according to the results of preprandial monitoring or postprandial monitoring (one hour after meals) of blood glucose concentrations. Both groups were also monitored with fasting blood glucose measurements. The goal of insulin therapy was a preprandial value of 60 to 105 mg per deciliter (3.3 to 5.9 mmol per liter) or a postprandial value of less than 140 mg per deciliter (7.8 mmol per liter). Obstetrical data and information on neonatal outcomes were collected. RESULTS: The prepregnancy weight, weight gain during pregnancy, gestational age at the diagnosis of diabetes and at delivery, degree of compliance with therapy, and degree of achievement of target blood glucose concentrations were similar in the two groups. The mean (+/- SD) change in the glycosylated hemoglobin value was greater in the group in which postprandial measurements were used (-3.0 +/- 2.2 percent vs. 0.6 +/- 1.6 percent, P < 0.001) and the infants' birth weight was lower (3469 +/- 668 vs. 3848 +/- 434 g, P = 0.01). Similarly, the infants born to the women in the postprandial-monitoring group had a lower rate of neonatal hypoglycemia (3 percent vs. 21 percent, P = 0.05), were less often large for gestational age (12 percent vs. 42 percent, P = 0.01) and were less often delivered by cesarean section because of cephalopelvic disproportion (12 percent vs. 36 percent, P = 0.04) than those in the preprandial-monitoring group. CONCLUSIONS: Adjustment of insulin therapy in women with gestational diabetes according to the results of postprandial, rather than preprandial, blood glucose values improves glycemic control and decreases the risk of neonatal hypoglycemia, macrosomia, and cesarean delivery.

Adult↗

PubMed2002

Electroencephalogram monitoring facilitates sedation with propofol for routine ERCP: a randomized, controlled trial.

BACKGROUND: Endoscopy with the patient under sedation with propofol requires careful monitoring of patient consciousness and vital signs to achieve the desired hypnotic effect without overdosage. Because level of consciousness is difficult to judge by clinical observation alone, electroencephalogram monitoring has been used to guide general anesthesia. METHODS: Eighty consecutive patients (mean [SD] age 62 [14] years) undergoing ERCP for various indications were randomly allocated to 2 groups. In group A (n = 40), propofol sedation was guided by conventional monitoring (heart rate, blood pressure, oxygen saturation, electrocardiogram), whereas electroencephalogram monitoring was performed but not displayed to the physician who administered the drug. In group B (n = 40), electroencephalogram monitoring was displayed online and used to guide propofol administration to maintain a preselected sedation level. Procedure-related parameters, recovery time, and quality (postanesthesia recovery score), as well as patient cooperation and tolerance for the procedure (visual analog scale) were prospectively assessed. RESULTS: The groups were comparable with regard to demographic, clinical, and procedure-related parameters. Mean propofol dose was significantly lower in group B than in group A (respectively, 290 [158] mg vs. 374 [166] mg; p = 0.02). The mean decrease in arterial blood pressure was significantly lower in group B than in group A (respectively, 11 [6] mm Hg vs. 14 [7] mm Hg; p < 0.05). Clinically relevant changes in vital signs to below critical values were observed in both groups, albeit infrequently. Efficacy of sedation was also rated similar in both groups, whereas mean recovery time was significantly faster in group B than in group A (respectively, 16 [7] minutes vs. 20 [8] minutes; p = 0.02). Accordingly, the recovery score tended to be better in group B compared with group A (respectively, 8.4 [1.0] points vs. 8.0 [0.9] points; p = 0.06). The predefined target level of sedation was maintained during 75% of the procedure time in group B but in only 58% of the time in group A (p < 0.05), and deeper sedation levels were achieved significantly more often in group B patients compared with group A patients (p < 0.05). CONCLUSION: Electroencephalogram monitoring enables more effective titration of propofol dosage for sedation during endoscopy and is, therefore, associated with faster patient recovery.

Adult↗

PubMed1993

Comparison of angioscopy and angiography for monitoring infrainguinal bypass vein grafts: results of a prospective randomized trial.

PURPOSE: This study was designed to determine whether, in primary infrainguinal bypass grafts in which only saphenous vein is used as the graft conduit, routine monitoring with intraoperative angioscopy can improve early graft patency as compared with standard monitoring with intraoperative completion angiography; and to delineate the advantages and disadvantages of these two modalities and their respective roles for the routine monitoring of the infrainguinal bypass graft. METHODS: A total of 293 patients undergoing primary saphenous vein infrainguinal bypass grafting were prospectively randomized and monitored with either completion angioscopy or completion angiography. Clinical parameters, indications for operation, graft anatomy, and configuration were evenly matched in both groups. Forty-three bypasses were excluded from the study after randomization, including 12 veins randomized to angiogram, deemed inferior, and prepared with angioscopy. RESULTS: In the 250 bypass grafts (angioscopy 128, angiography 122) there were 39 interventions (conduit, 29; anastomosis, 8; distal artery, 2), 32 with angioscopy and 7 with angiography (p < 0.0001). Twelve (4.8%) of the 250 grafts failed in less than 30 days, four (3.1%) of 128 in the angioscopy group and eight (6.6%) of 122 in the angiography group (p = 0.11 by one-sided hypothesis test). CONCLUSION: Although no statistical improvement in the proportions of failures in primary saphenous vein bypass grafts routinely monitored with completion angioscopy rather than the standard completion angiogram was demonstrated, the study delineates a trend that favors completion angioscopy for routine vein graft monitoring and demonstrates the advantages of angioscopy in preparing the optimal vein conduit.

Aged↗

PubMed2001

Home blood pressure monitoring. Current knowledge and directions for future research.

Home blood pressure (BP) monitoring has become popular in clinical practice and several automated devices for home BP measurement are now recommendable. Home BP is generally lower than clinic BP, and similar to daytime ambulatory BP. Home BP measurement eliminates the white coat effect and provides a high number of readings, and it is considered more accurate and reproducible than clinic BP. It can improve the sensitivity and statistical power of clinical drug trials and may have a higher prognostic value than clinic BP. Home monitoring may improve compliance and BP control, and reduce costs of hypertension management. Diagnostic thresholds and treatment target values for home BP remain to be established by longitudinal studies. Until then, home BP monitoring is to be considered a supplement. However, high home BP may support or confirm the diagnosis made in the doctor's office, and low home BP may warrant ambulatory BP monitoring. During long-term follow-up, home BP monitoring provides an opportunity for close attention to BP levels and variations. The first international guidelines have established a consensus document with recommendations, including a proposal of preliminary diagnostic thresholds, but further research is needed to define the precise role of home BP monitoring in clinical practice.

Blood Pressure Determination↗

PubMed2002

Preparing to measure the effects of the NOx SIP call--methods for ambient air monitoring of NO, NO2, NOy, and individual NOz species.

The capping of stationary source emissions of NOx in 22 states and the District of Columbia is federally mandated by the NOx SIP Call legislation with the intended purpose of reducing downwind O3 concentrations. Monitors for NO, NO2, and the reactive oxides of nitrogen into which these two compounds are converted will record data to evaluate air quality model (AQM) predictions. Guidelines for testing these models indicate the need for semicontinuous measurements as close to real time as possible but no less frequently than once per hour. The measurement uncertainty required for AQM testing must be less than +/-20% (+/-10% for NO2) at mixing ratios of 1 ppbv and higher for NO, individual NOz component compounds, and NOy. This article is a review and discussion of different monitoring methods, some currently used in research and others used for routine monitoring. The performance of these methods is compared with the monitoring guidelines. Recommendations for advancing speciated and total NOy monitoring technology and a listing of demonstrated monitoring approaches are also presented.

Air Pollutants↗

PubMed2002

Evaluation of the RAMS continuous monitor for determination of PM2.5 mass including semi-volatile material in Philadelphia, PA.

The real-time ambient mass sampler (RAMS) is a continuous monitor based on particle concentrator, denuder, drier, and tapered element oscillating microbalance (TEOM) monitor technology. It is designed to measure PM2.5 mass, including the semi-volatile species NH4NO3 and semi-volatile organic material, but not to measure PM2.5 water content. The performance of the RAMS in an urban environment with high humidity was evaluated during the July 1999 NARSTO-Northeast Oxidant and Particles Study (NEOPS) intensive study at the Baxter water treatment plant in Philadelphia, PA. The results obtained with the RAMS were compared to mass measurements made with a TEOM monitor and to constructed mass obtained with a Particle Concentrator-Brigham Young University Organic Sampling System (PC-BOSS) sampler designed to determine the chemical composition of fine particles, including the semi-volatile species. An average of 28% of the fine particulate material present during the study was semi-volatile organic material lost from a filter during particle collection, and 1% was NH4NO3 that was also lost from the particles during sampling. The remaining mass was dominantly nonvolatile (NH4)2SO4 (31%) and organic material (37%), with minor amounts of soot, crustal material, and nonvolatile NH4NO3. Comparison of the RAMS and PC-BOSS results indicated that the RAMS correctly monitored for fine particulate mass, including the semivolatile material. In contrast, the heated filter of the TEOM monitor did not measure the semi-volatile material. The comparison of the RAMS and PC-BOSS data had a precision of +/-4.1 microg/m3 (+/-9.6%). The precision of the RAMS data was limited by the uncertainty in the blank correction for the reversible adsorption of water by the charcoal-impregnated cellulose sorbent filter of the RAMS monitor. The precision of the measurement of fine particulate components by the PC-BOSS was +/-6-8%.

Air Pollutants↗

PubMed2004

Development and application of protocols for the determination of response of real-time particle monitors to common indoor aerosols.

Protocols have been developed and applied for the generation of aerosols that are likely to be comparable to those encountered in field settings for the calibration of easily transportable/portable real-time particle monitors. Aerosols generated were simulated environmental tobacco smoke, cedar wood smoke, cooking oil fumes, and propane stove particles. The time-integrated responses of three nephelometers and a monitor for particle-bound polynuclear aromatic hydrocarbons (PAH) were compared with gravimetric respirable suspended particulate matter (RSP) in a controlled-atmosphere chamber. In general, the monitor responses increased linearly with increasing mass concentration. However, the two monitors that reported mass per volume concentrations tended to overreport the actual RSP concentrations by factors up to 4.4. The real-time PAH monitor did not respond to cooking oil fumes, indicative of little PAH being present in the aerosol. One of the monitors that has been used in a variety of studies reported in the literature (DustTrak) was collocated with gravimetric RSP samplers in several hospitality venues in the Louisville, KY, area. Field studies indicated that the units overreported actual RSP concentrations by factors of 2.6-3.1, depending on whether the sampling was conducted in the nonsmoking or smoking sections of the facilities.

Aerosols↗

PubMed2006

An inexpensive dual-chamber particle monitor: laboratory characterization.

In developing countries, high levels of particle pollution from the use of coal and biomass fuels for household cooking and heating are a major cause of ill health and premature mortality. The cost and complexity of existing monitoring equipment, combined with the need to sample many locations, make routine quantification of household particle pollution levels difficult. Recent advances in technology, however, have enabled the development of a small, portable, data-logging particle monitor modified from commercial smoke alarm technology that can meet the needs of surveys in the developing world at reasonable cost. Laboratory comparisons of a prototype particle monitor developed at the University of California at Berkeley (UCB) with gravimetric filters, a tapered element oscillating microbalance, and a TSI DustTrak to quantify the UCB particle monitor response as a function of both concentration and particle size and to examine sensor response in relation to changes in temperature, relative humidity, and elevation are presented here. UCB particle monitors showed good linearity in response to different concentrations of laboratory-generated oleic acid aerosols with a coarse (mass median diameter, 2.1 microm) and fine (mass median diameter, 0.27-0.42 microm) size distributions (average r2 = 0.997 +/- 0.005). The photoelectric and ionization chamber showed a wide range of responses based on particle size and, thus, require calibration with the aerosol of interest. The ionization chamber was five times more sensitive to fine rather than coarse particles, whereas the photoelectric chamber was five times more sensitive to coarse than fine. The ratio of the response between the two sensors has the potential for mass calibration of individual data points based on estimated parameters of the size distribution. The results demonstrate the significant potential of this monitor, which will facilitate the evaluation of interventions (improved fuels, stoves, and ventilation) on indoor air pollution levels and research on the impacts of indoor particle levels on health in developing countries.

Aerosols↗

PubMed2003

Viability of interceptor trenches for monitoring groundwater quality near landfills.

Computer models were used to quantify the detection capability of four alternative groundwater monitoring systems in a shallow aquifer near a 50-m by 75-m landfill oriented oblique to groundwater flow. The monitoring systems included a network of five wells, and 1-m, 3-m, and 5-m wide gravel interceptor trenches. Each trench was 42-m long. Wells and trenches were positioned on a monitoring locus located 15-m, in the direction parallel to groundwater flow, from the landfill's downgradient boundary. There was an equal spacing, in the direction perpendicular to groundwater flow, between monitoring wells, and the trenches were positioned near the middle of the monitoring transect. The five-well network detected 81% of contaminant plumes originating within the landfill's footprint before they reached a buffer zone boundary located 50-m from the landfill's downgradient corner. By comparison, the 1-m, 3-m, and 5-m wide trenches detected 77, 84, and 88% of the contaminant plumes, respectively. Convergent flow induced by wider trenches yielded slightly higher detection efficiencies. Although the well and trench monitoring systems registered similar detection capability, estimated costs for installing the trench systems were more than 10 times those of constructing the wells. Overall, results of this study suggest that, even for shallow aquifers, gravel interceptor trenches are not a cost effective method for detecting leaks from landfills.

Computer Simulation↗

PubMed1996

Gram-negative bacteremia in open-heart-surgery patients traced to probable tap-water contamination of pressure-monitoring equipment.

OBJECTIVE: To determine the cause(s) of an outbreak of gram-negative bacteremia (GNB) in open-heart-surgery (OHS) patients at hospital A. DESIGN: Case-control and cohort studies and an environmental survey. RESULTS: Nine patients developed GNB with Enterobacter cloacae (6), Pseudomonas aeruginosa (5), Klebsiella pneumoniae (3), Serratia marcescens (2), or Klebsiella oxytoca (1) following OHS; five of nine patients had polymicrobial bacteremia. When the GNB patients were compared with randomly selected OHS patients, having had the first procedure of the day (8 of 9 versus 12 of 27, P = .02), longer cardiopulmonary bypass (median, 122 versus 83 minutes, P = .01) or cross-clamp times (median, 75 versus 42 minutes, P = .008), intraoperative dopamine infusion (9 of 9 versus 15 of 27, P = .01), or exposure to scrub nurse 6 (6 of 9 versus 4 of 27, P = .001) were identified as risk factors. When stratified by length of the procedure, only being the first procedure of the day and exposure to scrub nurse 6 remained significant. First procedures used pressure-monitoring equipment that was assembled before surgery and left open and uncovered overnight in the operating room, whereas other procedures used pressure-monitoring equipment assembled immediately before the procedure. At night, operating rooms were cleaned by maintenance personnel who used a disinfectant-water solution sprayed through a hose connected to an automatic diluting system. Observation of the use of this hose documented that this solution could have contacted and entered uncovered pressure-monitoring equipment left in the operating room. Water samples from the hose revealed no disinfectant, but grew P aeruginosa. The outbreak was terminated by setting up pressure-monitoring equipment immediately before the procedure and discontinuing use of the hose-disinfectant system. CONCLUSIONS: This outbreak most likely resulted from contamination of uncovered preassembled pressure-monitoring equipment by water from a malfunctioning spray disinfectant device. Pressure-monitoring equipment should be assembled immediately before use and protected from possible environmental contamination.

Adult↗

PubMed1999

Inductive plethysmography components analysis and improved non-invasive postoperative apnoea monitoring.

Twenty-nine patients were monitored overnight for breathing distress patterns during postoperative analgesia. Nasal flow apnoea monitoring and pulse oximetry data were recorded at 50 Hz. Respiratory inductive plethysmography (RIP) tracked tidal volume (TV) thoracoabdominal motion, and supplemented the flow monitoring by identifying detected apnoea type. TVs were computed from linear combinations of the RIP signals, but calibrations showed that multiple regression approaches with fitting errors <1% had highly variable coefficients and estimate precisions. Simple least squares theory showed that unstable parameter calculation and coefficient variation with signal conditions were inherent in RIP calibration models. Principal components (PC) methods were well suited to mitigating these problems because the RIP signals were highly correlated. The two PCs tracked the relative changes in TVs and indicated the degree of signal asynchrony, enabling improved uncalibrated monitoring. For accurately measuring RIP phase differences, the cross-correlation function was calculated. A simple version of PC analysis is developed, avoiding matrices, to help clarify how RIP calibration problems can be addressed. The methods are illustrated for calibration in normal breathing, and for postoperative monitoring during Cheyne-Stokes breathing. Sum and difference combinations of the RIP signals could discriminate central from obstructive apnoeas to help improve flow monitoring efficacy on-line.

Analgesia↗

PubMed2001

Progress in non-invasive respiratory monitoring using uncalibrated breathing movement components.

The theory for optimal linear combination of uncalibrated breathing movements was developed and applied in non-invasive respiratory monitoring situations for assessment. 16 patients were monitored overnight for respiratory depression during postoperative pain treatment. Intranasal/extra-oral airway pressure monitoring and pulse oximetry signals were recorded at 50 Hz. Respiratory inductive plethysmography (RIP) provided guidance to nurses regarding sensitivity settings of the pressure device during slow, shallow breathing, and vital information about breathing movements to help distinguish central from obstructive apnoeas. Subsequent analysis showed that the principal components of the standardized RIP signals would be helpful in any automated identification of pressure indicator false alarms and could provide a simple means for supplementary breath classification. The sum and difference of the scaled RIP values tracked changes in tidal volume and indicated any breathing movement asynchrony or paradox associated with obstructions. A construction was developed for emulating RIP calibration predictions of relative changes in tidal volume to within about 1%, so that invasive or demanding monitoring preparations could be by-passed altogether. The necessary signal combination and linearcalibration model background is reviewed for this simple formulation, which arises from component analysis and least squares regression. The methods are illustrated for definitive non-invasive postoperative monitoring and calibration situations. Theoretical and physiological reasons for preferring the use of balanced ribcage and abdomen contributions to overall tidal volume are presented that also help clarify the greater limitations of traditional RIP monitoring practices.

Analgesics, Opioid↗

PubMedDate not supplied

The Brain Trauma Foundation. The American Association of Neurological Surgeons. The Joint Section on Neurotrauma and Critical Care. Indications for intracranial pressure monitoring.

ICP monitoring per se has never been subjected to a prospective randomized clinical trial (PRCT) to establish its efficacy (or lack thereof) in improving outcome from severe head injury. Hence, there are insufficient data to support its use as a standard. However, there is a large body of published clinical experience that indicates that ICP monitoring (1) helps in the earlier detection of intracranial mass lesions, (2) can limit the indiscriminate use of therapies to control ICP which themselves can be potentially harmful, (3) can reduce ICP by CSF drainage and thus improve cerebral perfusion, (4) helps in determining prognosis, and (5) may improve outcome. ICP monitoring is therefore used by most head injury experts in the United States and is accepted as a relatively low-risk high-yield, modest cost intervention. Comatose head injury patients (GCS 3-8) with abnormal CT scans should undergo ICP monitoring. Comatose patients with normal CT scans have a much lower incidence of intracranial hypertension unless they have two or more of the following features at admission: age over 40, unilateral or bilateral motor posturing, or a systolic blood pressure of less than 90 mm Hg. ICP monitoring in patients with a normal CT scan with two or more of these risk factors is suggested as a guideline. Routine ICP monitoring is not indicated in patients with mild or moderate head injury. However, it may be undertaken in certain conscious patients with traumatic mass lesions at the discretion of the treating physician.

Brain Injuries↗

PubMed1998

Automated acquisition system for routine, noninvasive monitoring of physiological data.

A fully automated, noninvasive data-acquisition system was developed to permit long-term measurement of physiological functions at home, without disturbing subjects' normal routines. The system consists of unconstrained monitors built into furnishings and structures in a home environment. An electrocardiographic (ECG) monitor in the bathtub measures heart function during bathing, a temperature monitor in the bed measures body temperature, and a weight monitor built into the toilet serves as a scale to record weight. All three monitors are connected to one computer and function with data-acquisition programs and a data format rule. The unconstrained physiological parameter monitors and fully automated measurement procedures collect data noninvasively without the subject's awareness. The system was tested for 1 week by a healthy male subject, aged 28, in laboratory-based facilities.

Activities of Daily Living↗