Document Detail


Influence of pulse oximetry and capnography on time to diagnosis of critical incidents in anesthesia: a pilot study using a full-scale patient simulator.
MedLine Citation:
PMID:  9951756     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Many studies (outcome, epidemiological) have tested the hypothesis that pulse oximetry and capnography affect the outcome of anesthetic care. Uncontrollable variables in clinical studies make it difficult to generate statistically conclusive data. In the present study, we eliminated the variability among patients and operative procedures by using a full-scale patient simulator. We tested the hypothesis that pulse oximetry and capnography shorten the time to diagnosis of critical incidents. METHODS: A simulator was programmed to represent a patient undergoing medullary nailing of a fractured femur under general anesthesia and suffering either malignant hyperthermia, a pneumothorax, a pulmonary embolism or an anoxic oxygen supply. One hundred thirteen anesthesiologists were randomly assigned to one of two groups of equal size, one with access to pulse oximetry and capnography data and the other without. Each anesthesiologist was further randomized to one of the four critical incidents. Each anesthetic procedure was videotaped. The time to correct diagnosis was measured and analyzed. RESULTS: Based on analysis of 91 of the subjects, time to diagnosis was significantly shorter (median of 432 s vs. >480 s) for the anoxic oxygen supply scenario (p = 0.019) with pulse oximetry and capnography than without. No statistical difference in time to diagnosis was obtained between groups for the other three critical incidents. CONCLUSIONS: Simulation may offer new approaches to the study of monitoring technology. However, the limitations of current simulators and the resources required to perform simulator-based research are impediments to wide-spread use of this tool.
Authors:
S Lampotang; J S Gravenstein; T Y Euliano; W L van Meurs; M L Good; P Kubilis; R Westhorpe
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of clinical monitoring and computing     Volume:  14     ISSN:  1387-1307     ISO Abbreviation:  J Clin Monit Comput     Publication Date:  1998 Jul 
Date Detail:
Created Date:  1999-04-22     Completed Date:  1999-04-22     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  9806357     Medline TA:  J Clin Monit Comput     Country:  NETHERLANDS    
Other Details:
Languages:  eng     Pagination:  313-21     Citation Subset:  IM    
Affiliation:
Department of Anesthesiology, University of Florida College of Medicine, University of Florida Brain Institute, Gainesville 32610-0254, USA. sem@anest4.anest.ufl.edu
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MeSH Terms
Descriptor/Qualifier:
Anesthesia, General
Capnography*
Computer Simulation
Humans
Intraoperative Complications / diagnosis*,  epidemiology
Oximetry*
Pilot Projects
Random Allocation

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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