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At least 19 recordsLinked to original sources
PubMed2000

Physiologic monitoring systems.

Physiologic monitoring systems monitor vital physiologic parameters so that clinicians can be informed of changes in a patient's condition. They typically consist of several distinct components, including a central station, bedside monitors, and ambulatory telemetry transmitters and receivers. We previously evaluated physiologic monitoring systems in our January-February 1999 issue (Health Devices 28[1-2]). For this update, we have tested systems from two additional suppliers, using the same criteria and test methods that we used for the eight systems in the original study. As in the earlier Evaluation, we have examined how each system functions as a whole, rather than focusing on the performance of individual components. We judged the systems primarily on adaptability, alarm implementation, and human factors design. In the Conclusions, we compare all 10 units evaluated to date. We also provide updated product information for the systems evaluated in our original study; in some cases, the changes that have been made to those systems have caused us to revise our ratings. We rated all the systems based on their capabilities for each of six applications: (1) critical care unit, (2) emergency department, (3) intermediate care unit and general medical/surgical floor, (4) operating room, (5) postanesthesia care unit, and (6) transport. As in our earlier study, we have determined that most of the evaluated systems have drawbacks for one or more of the evaluated applications. In our January-February 1999 Evaluation of physiologic monitoring systems (Health Devices 28[1-2]), we discussed the issues surrounding the purchase and use of these systems. In this introduction, we recap the most significant points from that discussion, provide some new information about ambulatory telemetry and wireless networks, and briefly describe the components of this Update Evaluation.

Equipment Design↗
PubMed2000

[A pilot study to establish a support system using SpO2 monitoring system and videoconference system for patients under home mechanical ventilation].

Development of portable ventilators has enabled patients suffering from respiratory failure to live outside hospitals. The number of patients with neuromuscular disorders receiving home mechanical ventilation (HMV) has been increasing year by year. However, Japanese social support services are not sufficient for these patients. Thus, we tried to establish a system to support patients under HMV using SpO2 monitoring system and videoconference system. Pulse oximeter was connected to a portable personal computer, which stores real-time data and send daily data to hospital. The computer in our hospital receives patient's data and prints out it as a trend-graph, which enables medical staffs to know patient's condition. When SpO2 deteriorates significantly, alarm system works automatically to warn patient's family. In case SpO2 worsens more severely, alarm also warns medical staffs in our hospital to call the patient to confirm patient's condition and to give advices. Videoconference system was also introduced to communicate quickly and correctly. Thirty-four patients with progressive muscular dystrophy attended this study after informed consents. They used these systems in the period between discharge and first visit to hospital. Videoconference system was utilized in only two patients, because it required a digital line. These systems were effective in decreasing anxieties of patients and their families about HMV. According to daily check, 16 of 34 patients showed temporary deterioration of respiratory condition, although all patients had been in good condition in hospital. Loosening of the belt of nasal mask, air leak from opened mouth were frequent causes for the deteriorations. These problems could be corrected smoothly after discussion and advices. Thus this system was very useful to establish good respiratory management in a short period. Monitoring system also detected troubles of ventilators. Two patients showed progressive worsening of SpO2 day by day, however we could not find any problems in their respiratory managements. When we checked the ventilator, there were lumps of dust at the upper-pressure limit valves, which caused air leak. It was revealed that 3 of 27 ventilators had the same troubles, which caused leaks more than 10% of the flow volume. This fact proved that this system was also effective to prevent severe troubles from unexpected problems about HMV. Videoconference system enabled us to communicate quickly and correctly. It was also convenient to give advices. It is quite difficult for ordinary people to explain and understand physical condition and methods to handle respirator with only oral communication. Visual communication solved these troubles almost completely. Although there are some problems about this system including high cost and quality of picture, it is undoubtedly powerful tool. It is natural for patients with respiratory failure to wish to stay their home, when they possessed portable respirators. So it is important to decrease the risk related to HMV. We verified that the combination of monitoring system and multimedia can produce effective support system. It is important to improve these systems and cut down the cost for popularization.

Adolescent↗
PubMed1987

Computerized monitoring systems.

Computerized monitoring systems facilitate the acquisition, storage, and retrieval of multiple vital parameters, which allow for rapid clinical decision making and more timely patient management. However, computerized monitoring systems can only augment, not replace, direct patient observations and care by nursing personnel. To provide the most effective care for patients, nurses must become proficient in the use of the advanced technology of computerized monitoring systems but also retain the humanistic "caring" quality.

Computer Systems↗
PubMed1992

Smoking, pregnancy, and source of prenatal care: results from the Pregnancy Risk Assessment Monitoring System. The Pregnancy Risk Assessment Monitoring System Working Group.

OBJECTIVE: To assess the impact of current smoking intervention efforts and to target future efforts by describing the relationships between maternal smoking, smoking cessation, and source of prenatal care. METHODS: We used population-based data from 6319 mothers who delivered live-born infants during 1988 and 1989 in Maine, Michigan, Oklahoma, and West Virginia. The number of women sampled per state ranged from 1490-2659; state-specific response rates ranged from 66-84%. Analysis weights adjusted for selection probability and non-response. RESULTS: The prevalences of maternal smoking before, during, and after pregnancy among women receiving publicly funded prenatal care were 2.3-3.4 times the comparable prevalences among privately insured women receiving prenatal care from private providers. Although many smokers reduced or quit smoking during pregnancy, most resumed or increased their smoking to nearly pre-pregnancy levels by 3-6 months postpartum. CONCLUSIONS: Interventions should target the very high levels of smoking among the 27% of women receiving publicly funded prenatal care. However, from a population perspective, the greatest potential for reduction in smoking is among patients of private providers, who care for 61% of pre-pregnancy smokers.

Female↗
PubMedDate not supplied

Physiologic monitoring systems.

Physiologic monitoring systems, which monitor vital physiologic parameters so that clinicians can be informed of changes in a patient's condition, typically consist of several distinct components, including a central station, bedside monitors, and ambulatory telemetry transmitters and receivers. For this study, rather than focusing on how each component performs individually, we evaluated how the entire system functions as a whole to better parallel the acquisition practices followed by most hospitals. We evaluated systems from eight suppliers, focusing primarily on adaptability, alarm implementation, and human factors design. We included only systems that offer (1) a central station that can concurrently receive information from bedside monitors and ambulatory telemetry transmitters, (2) one or more bedside monitors that can be used in critical care and intermediate care areas, as well as during transport, and (3) ambulatory telemetry monitoring. We rated the evaluated systems based on their capabilities for each of six applications: critical care unit, emergency department, intermediate care unit and general medical/surgical floor, operating room, postanesthesia care unit, and transport. We found that many of the systems are suitable for some applications, but are unable to meet the requirements for others.

Computer Systems↗
PubMed1988

Development of and clinical experience with a new TV monitoring system in electronic endoscopy. Bi-plane TV monitoring system.

We developed a bi-plane TV monitoring system using a TV endoscope (Electronic endoscope manufactured by Toshiba-Machida, Tokyo, Japan) that permits simultaneous display of real-time and prerecorded images. Various findings of the two examinations can be precisely compared using this system, and a detailed evaluation of the progress of peptic ulcers obtained. In addition, the effects of various endoscopic therapies can be accurately evaluated. In endoscopic injection sclerotherapy of esophageal varices, new varices (or recurrent varices) were differentiated. In laser therapy for early gastric cancer, precise delimitation of the lesion for radiation was possible, and the therapeutic effects were more accurately evaluated. These results show the diagnostic as well as therapeutic usefulness of this system. Furthermore, for the examination of the lower digestive tract, X-ray images were incorporated into this system. This is a useful modality for diagnostic and therapeutic procedures in colonic disease.

Electronics, Medical↗
PubMed2003

Calibration and evaluation of a transportable in vivo monitoring system for accident monitoring of internal contamination.

A transportable in vivo monitoring system has been constructed and calibrated. The system uses two hyper pure germanium detectors--one for measuring whole body activities, by measuring activity in the torso, and the second for determining activities of radioiodine in the thyroid. The optimum counting geometries have been determined and the system has been calibrated for subjects of different ages and builds. The complete system is transported in two trailers which are pulled by ordinary motor vehicles. The minimum detectable activity (MDA) for 137Cs in whole body for a 10 min counting interval at the 95% confidence level is 200 Bq. The MDA for a count of 131I in thyroid is 20 Bq. The system is capable of detecting activities that are equivalent to a dose of 1 mSv for a wide range of radionuclides.

Body Burden↗
PubMed1989

The C23A: first step to a monitoring system of CELSS in flight.

Studies for every level of CELSS: Waste processing, food production, photosynthesis system, and so on ..., imply an automatic system to control, command and quantify gases, water and chemical compounds. Used for many years in plant physiology studies, the C23A system monitors the analysis and quantifies gases (O2, CO2. N2, ...), physical parameters (temperature, humidity, ...) and chemical compounds (NH4+, N03-, ...) on numerous experiments. In the new version, the architecture of the computing system is near of the space requirements. We have chosen a structure with three independent levels: acquisition, monitoring and supervision. Moreover, we use multiplexed analysers: IRGA, mass spectrometer and cheminal analyser. The multiplexing increases the accuracy of the measurements and could facilitate the spatialization. Thus the whole structure anticipates the entire separation between automation in space and control-command on ground.

Automation↗
PubMed2000

Pregnancy intendedness and physical abuse around the time of pregnancy: findings from the pregnancy risk assessment monitoring system, 1996-1997. PRAMS Working Group. Pregnancy Risk Assessment Monitoring System.

OBJECTIVE: This study examines whether unintended pregnancy is associated with physical abuse of women occurring around the time of pregnancy, independent of other factors. METHODS: In 1996-1997, state-specific population-based data were obtained from the Pregnancy Risk Assessment Monitoring System (PRAMS) from 39,348 women in 14 states who had delivered a live-born infant within the previous 2-6 months. The study questionnaire asked about maternal behaviors and characteristics around the time of pregnancy. RESULTS: Women who had mistimed or unwanted pregnancies reported significantly higher levels of abuse at any time during the 12 months before conception or during pregnancy (12.6% and 15.3%, respectively) compared with those with intended pregnancies (5.3%). Higher rates of abuse were reported by women who were younger, Black, unmarried, less educated, on Medicaid, living in crowded conditions, entering prenatal care late, or smoking during the third trimester. Overall, women with unintended pregnancies had 2.5 times the risk of experiencing physical abuse compared with those whose pregnancies were intended. This association was modified by maternal characteristics, the association was strongest among women who were older, more educated, White, married, not on Medicaid, not living in crowded conditions, receiving first trimester prenatal care, or nonsmoking during the third trimester. CONCLUSIONS: Women with unintended pregnancies are at increased risk of physical abuse around the time of pregnancy compared with women whose pregnancies are intended. Prenatal care can provide an important point of contact where women can be screened for violence and referred to services that can assist them.

Adult↗
PubMedDate not supplied

[Problems of medical monitoring of patients and requirements for computer monitoring systems].

Medical monitoring of patients is intended for controlling their physiological parameters, providing information to the medical staff as of critical, precritical physiological values, as well as for accumulating information on the patients' condition in time (trends). The existing monitoring systems require further improvement by expanding the types of measuring channels connected to them, providing a definite service, adaptability to a concrete medical institution. The basic orders to develop and produce such systems were got from the leading medical institutions of the Republic of Udmurt. A list of physiological parameters requiring monitoring, specifications of transducer systems and measuring channels (as a table), as well as demands by for channels, as required, records written down into the trend, as results is given. Possible variants of the design and use of computer monitors are provided.

Humans↗
PubMed1995

Accuracy and reproducibility of the measurement of actively circulating blood volume with an integrated fiberoptic monitoring system.

OBJECTIVE: Bedside monitoring of circulating blood volume has become possible with the introduction of an integrated fiberoptic monitoring system that calculates blood volume from the changes in blood concentration of indocyanine green dye 4 mins after injection. The aim of this investigation was to compare the blood volume estimate of the integrated fiberoptic monitoring system (group 1) with the standard methods of blood volume measurement using Evans blue (group 2), and indocyanine green measured photometrically (group 3). DESIGN: Prospective laboratory study. SETTING: Animal laboratory of a University's institute for experimental surgery. SUBJECTS: Eleven anesthetized, paralyzed, and mechanically ventilated piglets. INTERVENTIONS: A central venous catheter was used for the injection of the indicator dyes (Evans blue and indocyanine green). A fiberoptic thermistor catheter was advanced into the thoracic aorta. The fiberoptic catheter detects indocyanine green by reflection densitometry for the estimation of blood volume of the integrated fiberoptic monitoring system. Samples for the determination of Evans blue and indocyanine green concentrations were drawn from an arterial catheter in the femoral artery over a period of 17 mins after injection. MEASUREMENTS AND MAIN RESULTS: Measurements were performed during normovolemia, hypovolemia (blood withdrawal of < or = 30 mL/kg), and hypervolemia (retransfusion of the withdrawn blood plus an infusion of 10% hydroxyethyl starch [45 mL/kg]). Linear regression, correlation, and bias were calculated for the comparison of the blood volume estimates by the fiberoptic monitoring system (group 1) vs. the total blood volume estimates using Evans blue (group 2) and indocyanine green (group 3): group 1 = 0.82.group 2-26 mL; r2 = 82.71%; r = .91; n = 40; group 1-group 2 +/- 1 SD = -435 +/- 368 mL; group 1 = 0.79.group 3 + 50 mL; r2 = 74.81%; r = .87; n = 28; group 1-group 3 +/- 1 SD = -506 +/- 374 mL. CONCLUSIONS: The results demonstrate that the blood volume estimate of the fiberoptic monitoring system (group 1) correlates closely with the total blood volume measurement using Evans blue (group 2) and indocyanine green (group 3). Trapped indicator in the packed red cell column after centrifugation of the blood samples may account for an overestimation of group 2 and group 3 of approximately 10% to 14%, but there still remains a proportional difference of 10% between group 1 vs. group 2 and vs. group 3. This difference is due to the longer mixing times of group 3 (16 mins) and group 2 (17 mins), during which they are distributed in slowly exchanging blood pools. It seems that the blood volume estimate of the fiberoptic monitoring system (group 1) represents the actively circulating blood volume and may be useful for bedside monitoring.

Animals↗
PubMed2000

False alarms in very low birthweight infants: comparison between three intensive care monitoring systems.

UNLABELLED: Monitor alarms are a major burden on both patients and staff in intensive care units. We compared alarm rates from three different monitor systems (Hewlett Packard (HP), Kontron Instruments (KI), Marquette-Hellige (MH)) in a tertiary neonatal intensive care unit. Monitors were used in random order on three consecutive days over 8 h each in 16 preterm infants (median gestational age at birth 29 wk (range 24-34), age at study 18 d (8-53), weight at study 1,160g (595-1,430)). Alarms were classified as true or false using flow sheets based on continuous observation of both the patient and related parameters. There was one alarm every 9 min of monitoring. The median number of true alarms did not differ significantly between systems, being 28 per 8 h (range 9-87) for HP, 26 (3-81) for KI, and 30 (5-135) for MH. The median number of false alarms differed widely, with the HP system generating 32 (7-77) such alarms per 8 h, compared to 8 (0-19) for KI and 15 (2-32) for MH (p < 0.01 HP vs KI and MH, p < 0.05 KI vs MH). These differences between systems were mainly due to differences in pulse oximeter and transcutaneous PO2 monitor alarm rates. CONCLUSIONS: In conclusion, this study shows marked differences between both parameters and manufacturers in the frequency with which false alarms occur. It may provide a basis from which reductions in alarm rates can be sought.

Child Health Services↗
PubMed1989

Development and clinical application of an external fixator monitoring system.

A monitoring system for measuring movement occurring in a dynamic external fixator used to treat fractures is described. The system measures shortening during fracture healing, micromovement at the fracture site on weight bearing and detects pin loosening. The method of calibration including cadaver experiments is presented. The clinical application is described and the reasons for measuring movement are discussed.

Bone Nails↗
PubMed1998

Multicenter study of noninvasive monitoring systems as alternatives to invasive monitoring of acutely ill emergency patients.

BACKGROUND: Recent reports showed lack of effectiveness of pulmonary artery catheterization in critically ill medical patients and relatively late-stage surgical patients with organ failure. Since invasive monitoring requires critical care environments, the early hemodynamic patterns may have been missed. Ideally, early noninvasive hemodynamic monitoring systems, if reliable, could be used as the "front end" of invasive monitoring to supply more complete descriptions of circulatory pathophysiology. OBJECTIVES: To evaluate the accuracy and reliability of noninvasive hemodynamic monitoring consisting of a new bioimpedance method for estimating cardiac output combined with arterial BP, pulse oximetry, and transcutaneous PO2 and PCO2; we compared this system of noninvasive monitoring with simultaneous invasive measurements to evaluate circulatory deficiencies in acutely ill patients shortly after hospital admission where invasive monitoring was not readily available. We also preliminarily explored early differences in temporal hemodynamic patterns of survivors and nonsurvivors. DESIGN AND SETTING: Prospective comparison of simultaneous invasive and noninvasive measurements of circulatory function with retrospective analysis of data in university-run county hospitals, university hospitals and affiliated teaching hospitals, and a community private hospital. PATIENTS: We studied 680 patients, including 139 severely injured or hemorrhaging patients in the emergency department (ED), 129 medical (nontrauma) patients on admission to the ED, 274 high-risk surgical patients intraoperatively, and 138 patients recently admitted to the ICU. RESULTS: A new noninvasive impedance device provided cardiac output estimations under conditions in which invasive thermodilution measurements were not usually applied. There were 2,192 simultaneous bioimpedance and thermodilution cardiac index measurements; the correlation coefficient, r = 0.85, r2 = 0.73, p < 0.001. The precision and bias was -0.124+/-0.75 L/min/m2. Both invasive and noninvasive monitoring systems provide similar information and identified episodes of hypotension, low cardiac index, arterial hemoglobin desaturation, low transcutaneous O2, high transcutaneous CO2, and low oxygen consumption before and during initial resuscitation. The limitations of noninvasive systems were described. CONCLUSIONS: Noninvasive monitoring systems gave continuous displays of physiologic data that provided information allowing early recognition of low flow and poor tissue perfusion that were more pronounced in the nonsurvivors. Noninvasive systems may be acceptable alternatives where invasive monitoring is not available.

Adult↗
PubMed1984

[Digital radiation monitoring system with a personal computer].

This paper describes a data processing system of monitors with a personal computer for a radioisotope laboratory. A monitoring system includes 6 area, 6 dust, and 3 gas monitors. Monitor signals through a multiplexer were fed to the personal computer which has analogue ports. Processed data were displayed on a color CRT, stored on a 5 inch mini floppy disk, and printed out as a report. We developed a data processing program with BASIC language. This system largely reduced manpower required to estimate radiation levels in the laboratory. The personal computer has sufficiently enough ability to construct a digital monitoring system for a small radioisotope laboratory.

Computers↗