Name: a detailed protocol for physiological parameters acquisition and analysis in neurosurgical critical patients
Uploaded: 2017-10-17T13:00:00
Description: Watch this Scientific Journal Video about A Detailed Protocol for Physiological Parameters Acquisition and Analysis in Neurosurgical Critical Patients at JoVE.com

我们要感谢所有在新生儿监护病房工作的同事。

本议定书经上海交通大学医学院济医院机构审查委员会批准. 
 1. 病人的准备 注意: ICP 传感器由手术操作 ( 图 1 ) 放置在患者中。该传感器被放置在硬膜外间隙, 硬膜下间隙, 薄壁, 或心室系统. 
<ol> <li> 通过特定的通信电缆将 ICP 监视设备与床边显示器连接. </li>
	<li> 调整病人和 #39 的床边监控器的参考, 使床边监测器的数据与 ICP 监...

<ol>
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本文的目的是介绍一种新型的神经外科危重患者综合监测分析系统, 用于监测生理参数, 分析当前临床状况, 希望预测预后神经外科危重患者。目前, icp 监测的重点主要是平均 icp 值, 而忽略其他参数, 这可能会带来不准确或延迟的风险4,5,21。另一方面, icp 波形、放大器、RAP、PRx 和审咨委等衍生参数在预测预后和指导正确治疗方?...

ICP 监测被广泛用于评价神经外科的颅内状态, 尤其是神经外科危重患者1,2,3。除了平均 icp 值外, icp 波形、放大器、RAP、PRx、审咨委等等参数均可反映脑循环状态、脑脊液代偿性储备和大脑顺应4、5、6,7,8,9,10,11,12,13. 他们可以预示着即将到来的神经恶化, 甚至病人的结果14,15,16,17,18。它们也可以作为正确处理19的指导。然而, 大多数临床医生只关注的平均 ICP 值, 而忽略这些参数。这部分是因为在日常临床工作中, 很少有适合临床医生使用的特定设备。
为了解决这些弊端, 我们最近开发了一个多模监控系统。我们使用自动数据收集和存储设备, 以不断获取病人的生理信息, 如血压, ICP, 和氧饱和度, 并分析这些生理参数, 以揭示目前的临床状况,希望能预测神经外科危重患者的预后。该多模态监测系统具有以下几个优点: (1) 能在高频采集 real-time 数据, (2) 可记录多个参数,即、ICP 波形、PRx、RAP 和审咨委, (3) 可实现长期连续监测, (4)它是便携的, 易于学习。
因此, 本文的目的是显示一个详细的方法如何使用多学科监测系统记录各种生理参数的神经外科危重患者。

<table style="border-collapse:collapse;width:639pt" width="852">
	<colgroup>
		<col style="width:136pt" width="181" />
		<col style="width:171pt" width="228" />
		<col style="width:134pt" width="179" />
		<col style="width:198pt" width="264" />
	</colgroup>
	<tbody>
		<tr height="21" style="height:15.75pt">
			<td height="21" style="width:136pt;height:15.75pt" width="181">Bedside monitor</td>
			<td style="width:171pt" width="228">Philips</td>
			<td style="width:134pt" width="179">IntelliVue MP40 M8003A</td>
			<td style="width:198pt" width="264">With interfacing module</td>
		</tr>
		<tr height="21" style="height:15.75pt">
			<td height="21" style="height:15.75pt">ICP monitoring machine</td>
			<td>&#160;Johnson &#38; Johnson or Sophysa</td>
			<td></td>
			<td></td>
		</tr>
		<tr height="21" style="height:15.75pt">
			<td height="21" style="height:15.75pt">Arterial cannula</td>
			<td>BD</td>
			<td>REF682245</td>
			<td></td>
		</tr>
		<tr height="21" style="height:15.75pt">
			<td height="21" style="height:15.75pt">Pressure transducer</td>
			<td>Haisheng Medical</td>
			<td>DBPT-0103</td>
			<td></td>
		</tr>
		<tr height="21" style="height:15.75pt">
			<td height="21" style="height:15.75pt">Data collection device</td>
			<td>Shanghai Haoju</td>
			<td>Neumatic</td>
			<td></td>
		</tr>
		<tr height="21" style="height:15.75pt">
			<td height="21" style="height:15.75pt">Computer</td>
			<td></td>
			<td></td>
			<td>Requires Windows operating system</td>
		</tr>
	</tbody>
</table>

a detailed protocol for physiological parameters acquisition and analysis in neurosurgical critical patients

颅内压力 (ICP) 监测是目前广泛应用于神经外科危重患者。除了平均 icp 值外, icp 波形、脉冲振幅、icp 振幅与 icp 平均值 (RAP)、压力反应性指数 (PRx)、icp 和动脉血压 (基地) 波幅相关 (审咨委) 等相关参数上, 可以反映颅内状态, 预测预后, 也可作为正确治疗的指导。然而, 大多数临床医生只关注的平均 ICP 值, 而忽略这些参数, 因为目前的设备的局限性。我们最近开发了一个综合的监控系统来解决这些弊端。这种便携式的 user-friendly 系统将使用数据采集和存储装置, 以持续地获取患者的生理参数,即: 即、基地、ICP 和氧饱和度, 然后分析这些生理参数。希望将多学科监护系统作为监测生理参数的关键措施, 分析当前临床状况, 预测神经外科危重患者的预后。

这一新的多学科监测系统应用于22神经外科危重患者 (15 男性)。其中12人 (54.55%) 患有外伤性脑损伤, 其中 9 (40.91%) 有颅内出血, 1 (4.55%) 有严重脑梗塞。总监测时间超过1900小时 (约88小时每名患者)。手术成功后, 我们不断监测和分析他们的 ICP、BP、CPP、PRx、说唱和审咨委。图 3显示了来自该监视系统的代表性数据。我们可以调整时间线以查看更详细的信?...

Watch this Scientific Journal Video about A Detailed Protocol for Physiological Parameters Acquisition and Analysis in Neurosurgical Critical Patients at JoVE.com

A Detailed Protocol for Physiological Parameters Acquisition and Analysis in Neurosurgical Critical Patients

最近, 我们开发了一个便携式多学科监测系统, 监测各种生理参数的神经外科危重患者。介绍了如何使用这种多模态监控系统的详细协议。

神经外科危重患者生理参数采集与分析的详细方案

Intracranial pressure (ICP) monitoring is now widely used in neurosurgical critical patients. Besides mean ICP value, the ICP derived parameters such as ...

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