pressure monitor
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2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Cathrine Tverdal ◽  
Mads Aarhus ◽  
Pål Rønning ◽  
Ola Skaansar ◽  
Karoline Skogen ◽  
...  

Abstract Background The rates of emergency neurosurgery in traumatic brain injury (TBI) patients vary between populations and trauma centers. In planning acute TBI treatment, knowledge about rates and incidence of emergency neurosurgery at the population level is of importance for organization and planning of specialized health care services. This study aimed to present incidence rates and patient characteristics for the most common TBI-related emergency neurosurgical procedures. Methods Oslo University Hospital is the only trauma center with neurosurgical services in Southeast Norway, which has a population of 3 million. We extracted prospectively collected registry data from the Oslo TBI Registry – Neurosurgery over a five-year period (2015–2019). Incidence was calculated in person-pears (crude) and age-adjusted for standard population. We conducted multivariate multivariable logistic regression models to assess variables associated with emergency neurosurgical procedures. Results A total of 2151 patients with pathological head CT scans were included. One or more emergency neurosurgical procedure was performed in 27% of patients. The crude incidence was 3.9/100,000 person-years. The age-adjusted incidences in the standard population for Europe and the world were 4.0/100,000 and 3.3/100,000, respectively. The most frequent emergency neurosurgical procedure was the insertion of an intracranial pressure monitor, followed by evacuation of the mass lesion. Male sex, road traffic accidents, severe injury (low Glasgow coma score) and CT characteristics such as midline shift and compressed/absent basal cisterns were significantly associated with an increased probability of emergency neurosurgery, while older age was associated with a decreased probability. Conclusions The incidence of emergency neurosurgery in the general population is low and reflects neurosurgery procedures performed in patients with severe injuries. Hence, emergency neurosurgery for TBIs should be centralized to major trauma centers.


2021 ◽  
pp. 000313482110562
Author(s):  
Malka H. Fox-Epstein ◽  
Sarah S. Baker ◽  
Brian C. Thurston ◽  
Charles E. Morrow ◽  
Caleb J. Mentzer ◽  
...  

Introduction The Brain Trauma Foundation advises intracranial pressure monitor placement (ICPM) following traumatic brain injury (TBI) with a Glasgow Coma Scale (GCS) score ≤8 and an abnormal head computed tomographic scan (CT) finding. Prior studies demonstrated that ICPMs could be placed by non-neurosurgeons. We hypothesized that ICPM placement by trauma critical care surgeons (TCCS) would increase appropriate utilization (AU), decrease time to placement (TTP), and have equivalent complications to those placed by neurosurgeons. Methods We retrospectively reviewed medical records of adult trauma patients admitted with a TBI in a historical control group (HCG) and practice change group (PCG). Demographics, Injury Severity Score (ISS), outcomes, ICPM placement by provider type, and time to placement were identified. Complications and appropriate utilization were recorded. Results 70 patients in the HCG and 84 patients in the PCG met criteria for inclusion. Demographics, arrival GCS, ICU GCS, ISS, and admission APACHE II scores were not statistically significant. AU was 7/70 for HCG vs 19/84 in the PCG ( P = .04036). Median TTP was 6.5 hours for HCG vs 5.25 for PCG ( P = .9308). Interquartile range showed the data clustered around an earlier placement time, 2.3-14.0 hours, in the PCG. Complications between the 2 groups were not statistically significant, 0/7 for HCG vs 5/19 for PCG ( P = .2782). Discussion This study confirms that ICPMs can be safely placed by TCCS. Our results demonstrate that placement of ICPMs by TCCS improves AU and possibly improves TTP.


2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 230-230
Author(s):  
Maurita Harris ◽  
Kenneth Blocker ◽  
Mimi Trinh ◽  
Tracy Mitzner

Abstract Appropriate instruction is critical for ensuring the MEDSReM-2 system (i.e., smartphone app, blood pressure monitor, online portal) will be easily and effectively used and will, therefore, be more likely to be adopted. We will present our iterative processes for developing instructional support for MEDSReM 2 using human factors design principles (e.g., task analyses, comparative analyses, expert evaluation of mock-ups with screen flows). The instructional supports include user manuals, videos, as well as instructions within the MEDSReM 2 app. We will also highlight design principles used to empower the user and the benefits of using an interdisciplinary approach (i.e., gerontology, cognitive psychology, educational psychology, design, community health) to develop instructional support for older adult users.


2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 824-824
Author(s):  
Pan Liu ◽  
Yaxin Zhang ◽  
Shijie Li ◽  
Ying Li ◽  
Yumeng Chen ◽  
...  

Abstract Background Hypertension is one of the commonest chronic cardiovascular diseases in older adults. Frailty and hypertension often coexist in older people, but few studies have explored frailty in older hypertensive adults. We aimed to explore the correlation of frailty with quality of life in older hypertensive adults. Method: We enrolled 291 patients with hypertension aged ≥60 years. Ambulatory blood pressure monitor was performed. Physical frailty was assessed by Fried phenotype. Quality of life was assessed by SF-36. Results Forty-eight (16.5%) patients were frail. Compared with non-frail older hypertensive patients, frail patients were older, had lower education levels, a higher rate of living alone, and a longer duration of hypertension. Moreover, they had lower diastolic blood pressure (DBP) and mean arterial pressure (MAP), and higher pulse pressure, more chronic diseases, a higher proportion of calcium channel blockers (CCBs) usage, and worse quality of life. Frailty scores were positively correlated with pulse pressure, and negatively correlated with DBP and MAP. The SF-36 score was negatively correlated with frailty scores and positively correlated with grip strength and walking speed. After adjusting for age, the SF-36 score was negatively correlated with frailty and positively correlated with walking speed. Frailty, when adjusted for age, duration of hypertension, DBP and comorbidity, had a significant effect on the SF-36 score. Conclusion Frailty was associated with worse quality of life of older adults with hypertension. Frailty prevention and intervention may help improve the quality of life of older hypertensive adults. Keywords: frailty, older adults, hypertension, quality of life


Author(s):  
Masoud Farahmand ◽  
Hossein Mirinejad ◽  
Christopher G Scully

Abstract Objective: Advanced hemodynamic monitoring systems have provided less invasive methods for estimating pressure-derived measurements such as pressure-derived cardiac output (CO) measurements. These devices apply algorithms to arterial pressure waveforms recorded via pressure recording components that transmit the pressure signal to a pressure monitor. While standards have been developed for pressure monitoring equipment, it’s unclear how the equipment-induced error can affect secondary measurements from pressure waveforms. We propose an approach for modelling different components of a pressure monitoring system and use this model-based approach to investigate the effect of different pressure recording configurations on pressure-derived hemodynamic measurements. Approach: The proposed model-based approach is a three step process. 1) modelling the response of pressure recording components using bench tests; 2) verifying the identified models through nonparametric equivalence tests; and 3) assessing the effects of pressure recording components on pressure-derived measurements. To delineate the application of this approach, we performed a series of model-based analyses to quantify the combined effect of a wide range of tubing configurations with various damping ratios and natural frequencies and monitors with different bandwidths on pressure waveforms and CO measurements by six pulse contour algorithms. Results: Model-based results show the error in pressure-derived CO measurements because of tubing configurations with different natural frequencies and damping ratios. Tubing configurations with low natural frequencies (<23 Hz) altered characteristics of pressure waveforms in a way that affected the CO measurement, some by as much as 20%. Significance: Our method can serve as a tool to quantify the performance of pressure recording systems with different dynamic properties. This approach can be applied to investigate the effects of physiologic signal recording configurations on various pressure-derived hemodynamic measurements.


2021 ◽  
Author(s):  
Yuzhang Wu ◽  
Yan Zhao ◽  
Shengping Yu ◽  
Fan Li ◽  
Shifei Cai ◽  
...  

Abstract Background Intracranial aneurysm(IA) is a serious disease.Analyze and review the cases of anterior circulation ruptured IA by supraorbital lateral keyhole approach, and summarize the experiences of this approach. Methods Retrospective analysis of 16 cases of ruptured anterior circulation IA in our department from January 2019 to June 2020, CT angiography (CTA) was performed before operation. Analyzing the IA’s parameters by 3D-CT reconstruction. The IA was clipped by supraorbital lateral keyhole approach combined with the 3D-skull reconstruction. Extraventricular drainage were performed before craniotomy. Intraoperative neurophysiological monitoring was performed during the operation. After operation, fluorescein angiography and vascular ultrasound were performed to check the clipping effect. Intracranial pressure monitor was performed postoperatively. CTA was reexamined one week after operation. The modified Rankin Scale (MRS) was performed 6 months after operation. Results There were 7 males (43.8%) and 9 females (56.2%) ,the average age is 52.3 years. Among them, 11 patients(68.8%) were anterior communicating artery aneurysms and 5 (31.2%) were middle cerebral artery aneurysms. All patients were out of hospital within 10 days without any death, without cerebral infarction, cerebrospinal fluid leakage and neurological impairments. About mRS score, after 6 months follow-up, 8 cases(50%) had 0 point, 4 cases (25%) had 1 point, 4 cases (25%) had 2 points. Conclusions For ruptured anterior circulation IA, the supraorbital lateral keyhole approach combined with ventricular drainage, intraoperative electrophysiological monitoring and intraoperative vascular ultrasound is a safe and minimally invasive treatment. The application of reconstruction clipping can reconstruct the diameter of parent vessel and reduce the recurrence rate of IA.


QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Ahmed Mohamed Saafan ◽  
Mohamed Ismail Shabayek ◽  
Marwa Mamdouh Mohamed ◽  
Mostafa Mabrouk Bayomi Ali

Abstract Background Semi-rigid uretroscopy (URS) is a common intervention approach for lower ureteric stones. Ureteral dilatation is frequently needed before URS to enable ureter accessing. Aminophylline is known by its muscle relaxant effect and has been suggested to be effective in ureteral dilation. Objectives To evaluate the effect of intravesical administration of aminophylline on ureteroscopy and to measure intraureteral pressure Methods This prospective randomized controlled study included 50 before and after aminophylline injection. patients with lower ureteral calculi. In group A, the ureter was dilated by intravesical aminophylline whereas in group B balloon dilator was used. Intraureteral pressure was measured using pressure transducer connected to invasive pressure monitor. Results No statistically significant difference was noticed between both groups in operative time, intra operative complication, need for ureteral stenting or stone free rate. However, post-operative pain and haematuria were statistically significantly higher among balloon group compared to aminophylline group. In group A, there was statistically significant decrease in intraureteral pressure after injection of aminophylline (7.80 ± 1.71) compared to before injection (12.2 ± 1.85) with p-value &lt; 0.001. Conclusion Aminophylline is effective in ureteral dilatation when intravesically injected with less frequent post-operative pain and hematuria.


2021 ◽  
Vol 2071 (1) ◽  
pp. 012024
Author(s):  
J R Sta. Agueda ◽  
J Lim ◽  
J M Mondragon ◽  
J Madrid ◽  
M G Belen ◽  
...  

Abstract Pressure ulcer is a result of relieving pressure from skin or underlying tissues, causing localized injuries. In this study, a prototype of an electronic monitoring layer that can be placed on top of the wound patch is designed. The electronic layer is comprised of four force-sensitive pressure sensors, and an integrated temperature and humidity sensor to monitor the activities surrounding the wound site. In the simulated wound bed experiments, the results indicated that the utilization of the Bosch BME280 I2C module, when placed on top of a gauze pad, can deliver accurate and real-time monitoring of the temperature and humidity values. Furthermore, the force-sensitive resistors (FSR) installed can be utilized to detect external pressure beyond the set allowable force applied of 32 mmHg or 700g. Therefore, the electronic layer assembled from commercially available sensors can be used to monitor temperature and humidity while being able to detect externally applied pressure in real-time. However, improvements in the size and flexibility of the electronic layer are necessary to reduce the discomfort that patients suffering from pressure ulcers will experience.


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