Abstract
A computer system has been designed for documentation and data acquisition during open heart surgery. This computer system (called ‘Carola’) processes all patient data during cardiac surgery. More than 50 analogue or digital signals are scanned. These are derived from a monitoring rack, a Siemens Servo 900B ventilator with its accessory devices and a heart lung machine. All these values are plotted as well as off line data, such as medications, fluids, laboratory results and user comments, on an A3 format anesthetic record using an eight pen flat bed plotter. Simultaneously all data is written onto a cassette tape. These tapes are then transferred to a database for storage and statistical processing. The sampling frequency is every 10 seconds, averages being calculated over one minute periods. The chart is updated once a minute normally or every 15 minutes for slowly changing signals e.g. temperatures.
Hardware and software of the computer have modular design. The hardware consists of two Motorola 6809 based microprocessor systems. The software is entirely written in Pascal. The user interface is implemented on a menu driven basis. A terminal with a keyboard is used for the communication with the users, namely anesthetic nurses and anesthesiologists. The system was readily accepted by the users. The menu structure proved to be easy to learn and allowed fast entries, even when the users were not previously accustomed to the use of a keyboard. The clear and detailed presentation of the data on the plotted chart helped to detect trends early and facilitated therapeutic decisions. From december 1983 the first prototype was used on a routine basis, followed by a second unit in June 1984 and a third in December 1985. Up to now more than 12.500 anesthetic hours have been recorded. Since then almost 100% of all anesthetics performed in our cardiothoracic unit have been documented by the computers, including all short procedures without invasive monitoring and all emergencies.
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Beneken JEW, Blom JA, Meijler AP et al.: Computerized data acquisition and display in anesthesia. In: Prakash O (ed.) Computing in Anaesthesia and Intensive Care. Boston: Martinus Nijhoff, 1984, 25–43.
Block FE, Burton LW, Rafal MD, Burton K, Newwy C, Dawell L, Klein F, Davis DA, Harmel H: Two computerbased anesthetic monitors: The duke automatic monitoring equipment (dame) system and the microdame. J Clin Monitoring 1: 30–48, 1985.
Dijkstra EW: Cooperating sequential processes, Technical University, Eindhoven, the Netherlands, 1965. (Reprinted in Programming Languages, S. Genuys (ed.) Academic Press, 1968, New York).
Hartung HJ, Bender HJ, Osswald PM, Lutz H, Olsson SG: Entwicklung und Einsatz eines Computergestutzt erstellten Anaesthesie-protokolls. Anaesthesist 32: 205–213 1983.
Meijler AD: ‘Automatisation in Anaesthesia’, a Relief? Ealuation of a Data Acquisition and Display System. Thesis, Technical University of Eindhoven, Eindhoven, the Netherlands, 1986.
Paulsen AW, Frazier WT, Harbort RA: Computer aided monitoring for the anesthetist. Presented at the 2. Internat. Symposium: Computers in Critical Care and Pulmonary Medicine. Lund/Sweden, 1980.
Prakash O, van der Borden SG, Meij SH, Rulf ENR, Hugenholtz PG: A microcomputer based charting system for documentation of circulatory respiratory and pharmacological data during anesthesia. J Clin Monit 1: 155–160, 1984.
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Karliczek, G.F., de Geus, A.F., Wiersma, G. et al. Carola, a computer system for automatic documentation in anesthesia. J Clin Monit Comput 4, 211–221 (1987). https://doi.org/10.1007/BF02915861
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DOI: https://doi.org/10.1007/BF02915861