Three years' experience with computer-based intensive care of patients following open heart and major vascular surgery.
The authors present their experiences with the Roche-5000 Computer-Based Intensive Care System in the management of 100 consecutive patients who have undergone open heart or major vascular surgery. The system performs the following junctions: (1) numerical and graphic display, out-of-limits alarms, storage and printout of 12 biological and surgical parameters, including chest drainage and urine output, by on-line direct monitoring; (2) display, storage, and printout of all additional laboratory and clinical data by manual input; (3) automatic demand-regulated transfusion and infusion program; (4) a program of medical logic, which includes situation analysis based on the above, two way dialogue with the computer, treatment recommendations to the physician, selective nursing and laboratory orders, acid-base analysis, and instructions for respirator setting. It was found that the computer-monitored patients recovered faster and smoother, with fewer fluctuations in the measured parameters and fewer postoperative complications than did those treated by conventional methods. One additional important effect of the system was that the nurse, relieved of the mechanical tasks of measuring, charting, and recording, was left with a greater amount of time for the care of the patient's personal needs. It seems ironic that such a technical advancement in electronics not only made the recovery faster and safer but also created a more humanistic approach in patient care, through better application of basic nursing techniques.
Robicsek
F
F
Department of Thoracic and Cardiovascular Surgery, Charlotte Memorial Hospital, the Heineman Medical Research Center, Charlotte, NC 28201, USA.
Masters
T N
TN
Reichertz
P L
PL
Daugherty
H K
HK
Cook
J W
JW
D006348:Cardiac Surgical Procedures; D003422:Critical Care / Q000379:methods*; D006801:Humans; D008991:Monitoring, Physiologic; D012984:Software; D014656:Vascular Surgical Procedures