Articles from Anesthesiology

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Patel, Santosh I. ; Souter, Michael J.
Equipment-related Electrocardiographic Artifacts: Causes, Characteristics, Consequences, and Correction [Review]
Anesthesiology. 108(1):138-148, January 2008.
Abstract
Interference of the monitored or recorded electrocardiogram is common within operating room and intensive care unit environments. Artifactual signals, which corrupt the normal cardiac signal, may arise from internal or external sources. Electrical devices used in the clinical setting can induce artifacts by various different mechanisms. Newer diagnostic and therapeutic modalities may generate artifactual changes. These artifacts may be nonspecific or may resemble serious arrhythmia. Clinical signs, along with monitored waveforms from other simultaneously monitored parameters, may provide the clues to differentiate artifacts from true changes on the electrocardiogram. Simple measures, such as proper attention to basic principles of electrocardiographic measurement, can eliminate some artifacts. However, in persistent cases, expert help may be required to identify the precise source and minimize interference on the electrocardiogram. Technological advancements in processing the electrocardiographic signal may be useful to detect and eliminate artifacts. Ultimately, an improved understanding of the artifacts generated by equipment, and their identifying characteristics, is important to avoid misinterpretation, misdiagnosis, and iatrogenic complication.

Kroner, Anke ; Binnekade, Jan M. ; Graat, Marleen E. ; Vroom, Margreeth B. ; Stoker, Jaap
On-demand Rather than Daily-routine Chest Radiography Prescription May Change Neither the Number Nor the Impact of Chest Computed Tomography and Ultrasound Studies in a Multidisciplinary Intensive Care Unit
Anesthesiology. 108(1):40-45, January 2008.
Abstract
Background: Elimination of daily-routine chest radiographs (CXRs) may influence chest computed tomography (CT) and ultrasound practice in critically ill patients.Methods: This was a retrospective cohort study including all patients admitted to a university-affiliated intensive care unit during two consecutive periods of 5 months, one before and one after elimination of daily-routine CXR. Chest CT and ultrasound studies were identified retrospectively by using the radiology department information system. Indications for and the diagnostic/therapeutic yield of chest CT and ultrasound studies were collected.Results: Elimination of daily-routine CXR resulted in a decrease of CXRs per patient day from 1.1 +/- 0.3 to 0.6 +/- 0.4 (P <>