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Technologies for minimally-invasive cardiac output measurement in patients during surgery remain little used in routine practice. We tested a redeveloped system based on CO2 elimination (VCO2) by the lungs for use in ventilated patients, which can be seamlessly integrated into a modern anesthesia/monitoring platform, and provides automated, continuous breath-by-breath cardiac output monitoring. A prototype measurement system was constructed to measure VCO2 and end-tidal CO2 concentration with each breath. A baseline measurement of non-shunt cardiac output was made during a brief oscillating change in ventilator rate, according to the differential CO2 Fick approach and repeated at 5–10 min intervals. Continuous breath-by-breath monitoring of cardiac output was performed between these intervals from measurement of VCO2, using a derivation of the Fick equation applied to pulmonary CO2 elimination and cardiac output displayed in real time. Measurements were compared with simultaneous measurements by thermodilution in 50 patients undergoing cardiac surgery or liver transplantation. Overall mean bias [sd] for agreement in cardiac output measurement was ??0.3 [1.1] L/min, percentage error?±?38.7%, intraclass correlation coefficient?=?0.91. Concordance in measurement of changes of at least 15% in cardiac output was 81.4%, with a mean angular bias of ??1.7°, and radial limits of agreement of ±?76.2° on polar plot analysis. The accuracy and precision compared favourably to other clinical techniques. The method is relatively seamless and automated and has potential for continuous, cardiac output monitoring in ventilated patients during anesthesia and critical care. 相似文献
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Marthe M. de Jonge Dina Ruano Ronald van Eijk Nienke van der Stoep Maartje Nielsen Juul T. Wijnen Natalja T. ter Haar Astrid Baalbergen Monique E.M.M. Bos Marjolein J. Kagie Maaike P.G. Vreeswijk Katja N. Gaarenstroom Judith R. Kroep Vincent T.H.B.M. Smit Tjalling Bosse Tom van Wezel Christi J. van Asperen 《The Journal of molecular diagnostics : JMD》2018,20(5):600-611
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Temperature cycling during platelet cold storage improves in vivo recovery and survival in healthy volunteers 下载免费PDF全文
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Theresa Thoma-Lürken Michel H.C. Bleijlevens Monique A.S. Lexis Jan P.H. Hamers 《Geriatric nursing (New York, N.Y.)》2018,39(6):653-662
Detecting practical problems of persons with dementia (PwD) experience at home, and advising them on solutions to facilitate aging in place are complex and challenging tasks for nurses and case managers. In this two group randomized, controlled laboratory experiment, the efficacy of a decision support application aiming to increase nurses' and case managers' confidence in clinical judgment and decision-making was tested. The participants (N?=?67) assessed a case of a PwD within the problem domains: self-reliance, safety and informal care, and provided suggestions for possible solutions. Participants used either their regular procedure with (intervention group) or without the App (control group) to conduct these tasks. No statistically significant difference was found on the primary outcome measure, the overall level of confidence. However, nurses and case managers highly recommended use of the App in practice. To explain these results, more research on the potential added value of the App is needed. 相似文献
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Merel?de?JongEmail author Angela?G.?E.?M.?de?Boer Sietske?J.?Tamminga Monique?H.?W.?Frings-Dresen 《Journal of occupational rehabilitation》2015,25(1):182-196
Purpose To assess issues that contribute to the Quality of Working Life (QWL) of employees with a chronic physical disease. Methods A systematic literature search was conducted using the databases PubMed, PsycINFO and EMBASE. Experiences and perceptions during the working life of employees with a chronic physical disease were extracted and synthesized into issues that contributed to their QWL. We organized these synthesized QWL issues into higher order themes and categories with qualitative data analysis software. Results From a total of 4,044 articles identified by the search, 61 articles were included. Data extraction and data synthesis resulted in an overview of 73 QWL issues that were classified into 30 themes. The following five categories of themes were identified: (1) job characteristics with issues such as job flexibility and work-site access; (2) the social structure and environment containing issues about disclosure, discrimination, misunderstanding, and awareness by employers or colleagues; (3) organizational characteristics with issues such as requesting work accommodations; (4) individual work perceptions including issues about enjoyment and evaluating work or life priorities; and (5) effect of the disease and treatment including issues about cognitive and physical health and work ability. Conclusion This systematic review offers an extensive overview of issues that might contribute to the QWL of employees with a chronic physical disease. This overview may function as a starting point for occupational support, such as monitoring and evaluating the QWL of employees with a chronic physical disease during return-to-work and work continuation processes. 相似文献
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Monique Lhussier HND MSc PhD Simon Eaton BMedSci BMBS FRCP DM CertMEd Natalie Forster BA PGCert Mathew Thomas BA Sue Roberts MBBS MSc FRCP Susan M Carr BA MSc PhD 《Health expectations》2015,18(5):605-624