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  • 1
    Electronic Resource
    Electronic Resource
    Noninvasive continuous blood pressure measurement from the finger: Optimal measurement conditions and factors affecting reliability (1987)
    Springer
    Journal of clinical monitoring and computing 3 (1987), S. 6-13 
    Details
    ISSN: 1573-2614
    Keywords: Monitoring ; Blood pressure ; Noninvasive monitoring
    Source: Springer Online Journal Archives 1860-2000
    Topics: Computer Science , Medicine
    Notes: Abstract We recorded finger arterial blood pressure (FINAP) in 50 male patients during various types of surgical operations. Three different types of cuffs were used on four fingers of each patient. Measurements were made by the arterial volume-clamp method of Penaz. The FINAP measurements were compared with pressure data obtained ipsilaterally from a radial artery catheter-transducer system (intraarterial pressure [IAP]) to find optimal recording conditions and to document factors affecting FINAP readings. The thumb, with a specially designed cuff, gave the most accurate results. The mean FINAP- IAP difference for the thumb was −4.8 mm Hg for systolic pressure, 1.49 mm Hg for diastolic pressure, and 0.29 mm Hg for mean pressure. The differences were statistically significant for systolic and diastolic pressure but not for mean pressure. The regression slope for thumb systolic FINAP/IAP was 0.979, that for thumb diastolic FINAP/IAP was 0.963, and that for mean thumb FINAP/IAP was 0.996, whereas the intercepts were 7.499 for systolic pressure, 0.802 for diastolic pressure, and 0.083 for mean pressure. The correlation coefficients were 0.945 (systolic), 0.884 (diastolic), and 0.949 (mean). The correlation coefficients with the other fingers ranged from 0.502 to 0.922 for systolic pressure, 0.757 to 0.932 for diastolic pressure, and 0.767 to 0.892 for mean pressure. The slopes for the various finger-cuff combinations ranged from 0.537 to 0.996, and the intercepts ranged from 0.083 to 32.387 from mean pressure. In 3 patients (6%) the FINAP measurement was not possible because of insufficient peripheral circulation. In 9 other patients (18%) the FINAP measurements were not accurate during some periods of time. In 5 of those 9 patients the difficulties were related to arterial cannulation and began immediately after cannulation. In 1 of those 5 patients the FINAP subsequently decreased dramatically after the onset of phenylephrine infusion because of peripheral vasoconstriction and diminished blood flow. In the 4 other patients the FINAP readings were accurate at the beginning of anesthesia but later decreased out of proportion to changes in IAP. These periods were associated with one-lung ventilation. The FINAP accurately reflects systemic arterial pressure. Measurements from the thumb fitted with a specially designed cuff approximate IAP best. Factors affecting peripheral circulation must be taken into consideration when this device is used in the monitoring of FINAP.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00770876
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    Paper (German National Licenses)
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  • 2
    Electronic Resource
    Electronic Resource
    The effect of muscle movement on the electroencephalogram during anesthesia with alfentanil (1986)
    Springer
    Journal of clinical monitoring and computing 2 (1986), S. 15-21 
    Details
    ISSN: 1573-2614
    Keywords: Brain ; electroencephalography ; Muscle ; pancuronium ; succinylcholine ; electromyography ; Anesthetics ; intravenous ; narcotic ; Analgestics ; alfentanil ; Neuromuscular relaxants ; pancuronium ; succinylcholine
    Source: Springer Online Journal Archives 1860-2000
    Topics: Computer Science , Medicine
    Notes: Abstract Using aperiodic analysis, we examined the impact on the electroencephalogram (EEG) of muscle activity from opiate-induced rigidity with alfentanil. We compared two groups of patients, one receiving alfentanil with neuromuscular blocking agents and the other group receiving no relaxants. The alfentanil-induced muscle rigidity exerted a noticeable effect on the EEG, with a moderate effect on total power at 1 Hz; a marked effect on the total number of waves, cumulative percent power at 3 Hz, and average power at 17 to 19 Hz; and a striking effect on F90, the frequency below which 90% of the power resides. The presence of electromyographic (EMG) noise in the EEG consistently altered the variables derived from the EEG, so that anesthetic depth appeared less than it actually was. This was true in spite of the fact that we gave slightly more alfentanil in the group not receiving a relaxant. Although the observed muscle activity was greater than that usually seen clinically, and may have differed qualitatively, the results do serve as a warning that muscle noise can interfere with the EEG. Currently, there is no computerized technique that will reject or account for this noise, and we must depend on observation to recognize the EMG patterns within the EEG, either with the raw recording or with a detailed analysis (such as aperiodic analysis), and to compensate for this noise if possible. Techniques that average the EEG or that present a single number have difficulty providing this information. These results do not detract from the usefulness of the EMG contained in EEG recordings as a supplementary or complementary indicator of anesthetic lightness.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01619173
    Library Location Call Number Volume/Issue/Year Availability
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    Paper (German National Licenses)
    Fulltext
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