Criticare

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The secular weight increase in European and US adolescents and the increasing use of oscillometric devices pose a problem to decide on normative blood pressure levels. We studied how biological and statistical aspects influence standards, and suggest new Northern Europe reference tables. All adolescents of Nord-Trøndelag county, Norway, aged 13-18 years were invited to the Nord-Trøndelag Health Study II (1995-1997), and the participation rate was 90% (n = 7682 after excluding 278 chronically ill patients)...

PURPOSE: The purpose of this study was to evaluate the cardiopulmonary effects of 2 sedation regimens during treatment: (1) oral meperidine and hydroxyzine with nitrous oxide (N2O); and (2) oral diazepam and hydroxyzine, submucosal meperidine, and N2O. Nitrous oxide was tapered to oxygen (O2) only 10 minutes following submucosal meperidine administration. METHODS: Sixty-two children were evaluated who met the following criteria: (1) history of uncooperative behavior; (2) ASA I or II; (3) nothing to eat or drink after midnight the night before the appointment; (4) an initial/recall exam prior to the sedation appointment; and (4) patients who met the American Academy of Pediatric Dentistry guidelines for sedation...

OBJECTIVE: To determine the influence of digital clubbing on oxygen saturation by pulse oximetry measurements (SpO2) in Cystic Fibrosis patients. BACKGROUND: Measuring the arterial oxygen saturation at the fingertip by pulse-oximetry is commonly used in the management of CF patients. In these patients, clinical signs of hyperoxia are often observed with oxygen supplies based on digital oximetry readings. This suggests inaccuracies in the digital measurement method, which in its turn may be caused by digital clubbing...

AIM: To compare blood pressure in neonates obtained from three different oscillometer blood pressure monitors (Dinamap, Criticare, Hewlett-Packard) with arterial blood pressure (Hewlett-Packard' invasive unit). STUDY DESIGN: A total of 32 randomized, non-invasive blood pressure series, each consisting of three measurements from each monitor, were obtained from 20 neonates (birthweight 531-4660 g). Each measurement was compared with the invasive pressure. RESULTS: Two factors appear to have a systematic effect on the difference between oscillometric and invasive pressure (the measurement deviance): the size of the infant, e...

UNLABELLED: The testing of pulse oximeter probes is generally limited to the integrity of the electrical circuit and does not include the optical properties of the probes. Few pulse oximeter testers evaluate the accuracy of both the monitor and the probe. We designed a study to compare the accuracy of nonproprietary probes (OSS Medical) designed for use with Nellcor, Datex-Ohmeda, and Criticare pulse oximeter monitors with that of their corresponding proprietary probes by using a commercial off-the-shelf pulse oximeter tester (Index)...

OBJECTIVE: Pulse oximetry (SpO2) is the non-invasive standard for monitoring arterial oxygen saturation in patients undergoing anesthesia, but is subject to external interference by motion artifact, peripheral vasoconstriction, and low cardiac output. We hypothesized that oximetry signals could be acquired from the esophagus when peripheral pulse oximetry is unobtainable. Therefore, we tested an esophageal stethoscope which incorporates transverse oximetry photodetectors and emitters in patients undergoing coronary bypass surgery...

Several pulse oximeter manufacturers have recently developed instruments that are claimed to be resistant to the effects of patient motion. We performed a laboratory volunteer experiment to compare the performances of several of these instruments, as well as some older models, during combinations of motion and hypoxemia. Twenty oximeters were studied. A motorized table produced different hand motions, and each motion was studied during both room air breathing and hypoxemia. Pulse oximeters on the nonmoving hand were used to provide control measurements for comparison...

Respiratory monitoring is an important aspect of critical care, especially in neurosurgery and neuro-intensive care. Fixed capnographs are too cumbersome to allow monitoring during patient transport. Recently several portable expired fraction carbon dioxide devices have been developed, but no evaluation of their clinical peformance has been reported. We compared the Criticare POET LT Handheld expired fraction carbon dioxide monitor, in three different settings, to fixed capnographs and arterial blood gas analysis...

BACKGROUND: Oscillometric pressure is measured by analysing, in relation to the cuff pressure, low-amplitude cuff-pressure pulsations generated by each arterial pulse. The cuff pressure is sampled at the pulse rate, introducing measurement variations, which are compounded by artefactual pulses. OBJECTIVE: To study the consistency of measurements with and without artefacts using simulated waveforms. METHODS: The Propaq Smartcuf (with and without electrocardiographic synchronization), the Welch Allyn 52 000 (before and after its software had been upgraded), the Critikon DINAMAP 8100 and Compact TS and the Criticare 507 NJC were evaluated...

The now commonplace wearing of external nasal splints by sportsmen and athletes has never been scientifically evaluated. The present study looks into the effect of both isometric and isotonic exercise on nasal resistance and examines if this is altered by the wearing of an external nasal splint. Twenty subjects who did not suffer from rhinitis were tested. Nasal resistance measurements were recorded using an anterior rhinomanometer before and after exercise, with and without an external nasal splint. Pulse and blood pressure were measured using a Criticare Inc...

STUDY OBJECTIVE: To determine the effect of a new pulse oximeter (Nellcor Symphony N-3000, Pleasanton, CA) with signal processing technique (Oxismart) on the incidence of false alarms in the postanesthesia care unit (PACU). DESIGN: Prospective study. SETTING: Nonuniversity hospital. PATIENTS: 603 consecutive ASA physical status I, II, and III patients recovering from general or regional anesthesia in the PACU. INTERVENTIONS: We compared the number of alarms produced by a recently developed "third"-generation pulse oximeter (Nellcor Symphony N-3000) with Oxismart signal processing technique and a conventional pulse oximeter (Criticare 504, Waukesha, WI)...

STUDY OBJECTIVE: To determine the effect of a new signal processing technique (Oxismart, Nellcor, Inc., Pleasanton, CA) on the incidence of false pulse oximeter alarms in the operating room (OR). DESIGN: Prospective observational study. SETTING: Nonuniversity hospital. PATIENTS: 53 ASA physical status I, II, and III consecutive patients undergoing general anesthesia with tracheal intubation. MEASUREMENTS AND MAIN RESULTS: In the OR we compared the number of alarms produced by a recently developed third generation pulse oximeter (Nellcor Symphony N-3000) with Oxismart signal processing technique and a conventional pulse oximeter (Criticare 504)...

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The accuracy of pulse oximeters in measuring transient changes in oxygen saturation (SaO2) may be affected by the oximeter time response. The aim of this study was to assess the effect of modifying the pulse oximeter averaging time (T) on the measurement of SaO2 in patients with the sleep apnea-hypopnea syndrome (SAHS). Twelve patients with severe SAHS were studied during a nap with conventional oximeters: Ohmeda 3740 and Criticare 501. We compared the readings of each patient's oxygen desaturation measured simultaneously with two identical pulse oximeters...

This study compared the measurement of oxygen saturation of haemoglobin (SaO2) by two pulse oximeters (Ohmeda Biox 3700e and Criticare 504 USP) with the measurement of SaO2 in arterial blood samples by CO-oximetry. Unlike many previous validation studies, arterial blood was sampled in ground glass rather than plastic syringes. Twenty men, 11 well-trained cyclists (mean +/- SE, age = 23.3 +/- 1.5 years, mass = 71.4 +/- 1.1 kg VO2max = 77 +/- 1 ml.kg1.min-1) and 9 relatively untrained subjects (age = 27.1 +/- 2...

STUDY OBJECTIVE: To compare the performance of five pulse oximeters during hypoperfusion, probe motion, and exposure to ambient light interference. DESIGN: Prospective study. SETTING: Laboratory facility at a university medical center. PATIENTS: 8 unanesthetized, ASA physical status I volunteers. INTERVENTIONS: We evaluated five common pulse oximeters with respect to three scenarios: (1) an operating room light was shone on oximeter probes, (2) a motion generator was used to generate 2 Hz and 4 Hz hand motion, and (3) a pneumatic compression device overlying the brachial artery was used to simulate hypoperfusion...

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STUDY OBJECTIVE: Hemoglobin-based oxygen carrier 201 (HBOC-201) is a polymerized hemoglobin of bovine origin being developed for use in hemorrhage during surgery or trauma. Pulse oximetry is commonly used in clinical practice to assess percent saturation of hemoglobin (Spo2). The ability to measure Spo2 in the presence of HBOC-201 will be important for the use of this compound in patient care. METHODS: We carried out a randomized, single-blind, placebo-controlled study at the Upjohn Research Clinics in Kalamazoo, Michigan, with normal, healthy adult men and women as subjects...

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