Bio-electrical impedance analysis in critically ill patients: are we ready for prime time?
(Source: Journal of Clinical Monitoring and Computing)
Source: Journal of Clinical Monitoring and Computing - December 5, 2019 Category: Information Technology Source Type: research

Predictive value of the surgical pleth index for the hemodynamic responses to trachea intubation and skin incision
AbstractSurgical pleth index (SPI) has been widely investigated in assessing the nociceptive level. The aim of this study was to investigate the relationship between SPI level and patient responses to trachea intubation and skin incision. A total of 40 patients undergoing open abdominal general surgery were recruited for analyses. The patients were monitored with electrocardiogram, non-invasive blood pressure, SpO2, invasive blood pressure and SPI before anesthesia induction. Anesthesia was induced with midazolam, propofol, sufentanil and rocuronium and maintained with sufentanil and sevoflurane. Blood pressure, heart rate...
Source: Journal of Clinical Monitoring and Computing - December 5, 2019 Category: Information Technology Source Type: research

Optimized electrical bioimpedance measurements of abdominal wall on a porcine model for the continuous non-invasive assessment of intra-abdominal pressure
AbstractThis work describes the optimization of electrical bioimpedance measurements for indirect intra-abdominal pressure (IAP) assessment. The experimental run was performed on a femaleSus scrofa domesticus (domestic pig). Different values of IAP were induced by inflation of the abdominal cavity, using a trocar placed near the umbilicus over thelinea alba. The whole experiment was run within 1  h of the subject being sacrificed. The abdominal wall thickness was measured at an IAP of 5 mmHg. An exponential trend linking between the bioimpedance values at 99.8 kHz and the IAP was found. Non-optimized electro...
Source: Journal of Clinical Monitoring and Computing - December 4, 2019 Category: Information Technology Source Type: research

Multicenter comparison of three intraoperative hemoglobin trend monitoring methods
AbstractTransfusion decisions are guided by clinical factors and measured hemoglobin (Hb). Time required for blood sampling and analysis may cause Hb measurement to lag clinical conditions, thus continuous intraoperative Hb trend monitoring may provide useful information. This multicenter study was designed to compare three methods of determining intraoperative Hb changes (trend accuracy) to laboratory determined Hb changes. Adult surgical patients with planned arterial catheterization were studied. With each blood gas analysis performed, pulse cooximetry hemoglobin (SpHb) was recorded, and arterial blood Hb was measured b...
Source: Journal of Clinical Monitoring and Computing - December 3, 2019 Category: Information Technology Source Type: research

Oesophageal balloon calibration during pressure support ventilation: a proof of concept study
AbstractOesophageal balloon calibration improves the oesophageal pressure (Pes) assessment during invasive controlled mechanical ventilation. The primary aim of the present investigation was to ascertain the feasibility of oesophageal balloon calibration during pressure support ventilation (PSV). Secondarily, the calibrated Pes (Pescal) was compared to uncalibrated one acquired at 4  ml-filling volume (PesV4), as per manufacturer recommendation. After a naso-gastric tube equipped with oesophageal balloon was correctly positioned in 21 adult patients undergoing invasive volume-controlled ventilation (VCV) for acute hyp...
Source: Journal of Clinical Monitoring and Computing - December 2, 2019 Category: Information Technology Source Type: research

Estimation of respiratory rate using infrared video in an inpatient population: an observational study
This study utilized infrared thermography (IRT) to measure RR in a critically ill population in the Intensive Care Unit. This study was carried out in a Single Hospital Centre. Respiratory rate in 27 extubated ICU patients was counted by two observers and compared to ECG Bioimpedance and IRT-derived RR at distances of 0.4 –0.6 m and>  1 m respectively. IRT-derived RR using two separate computer vision algorithms outperformed ECG derived RR at distances of 0.4–0.6 m. Using an Autocorrelation estimator, mean bias was − 0.667 breaths/min. Using a Fast Fourier Transform estimat...
Source: Journal of Clinical Monitoring and Computing - December 2, 2019 Category: Information Technology Source Type: research

Preoperative cerebral and renal oxygen saturation and clinical outcomes in pediatric patients with congenital heart disease
We examined the predictability of preoperative cerebral and renal rSO2 values for outcomes in pediatric patients undergoing cardiac surgery under cardiopulmonary bypass (CPB). Patients who underwent pediatric cardiac surgery under CPB between September 2015 and September 2017 were enrolled in this study. Patients monitored with both cerebral and renal rSO2 at the beginning of surgery were included. The primary outcome was the prediction of outcomes after pediatric cardiac surgery. Outcome was defined as any of: (1) death within 30 days after surgery, or the need for (2) renal replacement therapy or (3) extracorporeal membr...
Source: Journal of Clinical Monitoring and Computing - November 1, 2019 Category: Information Technology Source Type: research

Predicting postoperative delirium and postoperative cognitive decline with combined intraoperative electroencephalogram monitoring and cerebral near-infrared spectroscopy in patients undergoing cardiac interventions
AbstractStudies have associated electroencephalogram (EEG) suppression with postoperative delirium (POD) and postoperative cognitive decline (POCD). Otherwise, improving cerebral tissue oxygen saturation (rScO2) seems beneficial. No study has evaluated the impact of EEG suppression and decreased rScO2 on the incidence of POD and POCD when the intraoperative management of patients is performed with a depth-of-anesthesia (DOA) monitor and a cerebral oximetry. In this prospective study patients undergoing cardiac interventions were monitored with the NeuroSENSE® DOA monitor and bilateral cerebral oximetry. An algorithm wa...
Source: Journal of Clinical Monitoring and Computing - November 1, 2019 Category: Information Technology Source Type: research

Synchronized mandibular movement and capnography: a novel approach to obstructive airway detection during procedural sedation —a post hoc analysis of a prospective study
AbstractPerioperative complications related to obstructive sleep apnea still occur despite the use of partial pressure end-tidal CO2\(\left( {{{\text{P}}_{{\text{ETC}}{{\text{O}}_2}}}} \right)\) and pulse oximetry. Airway obstruction can complicate propofol sedation and a novel monitor combining mandibular movement analysis with capnography may facilitate its detection. Patients scheduled for sleep endoscopy were recruited and monitored with standard monitoring,\({{\text{P}}_{{\text{ETC}}{{\text{O}}_2}}},\) and Jaw Activity (JAWAC) mandibular movement sensors. A post hoc analysis investigated airway obstruction prediction ...
Source: Journal of Clinical Monitoring and Computing - November 1, 2019 Category: Information Technology Source Type: research

In vitro efficiency of 16 different Ca(OH) 2 based CO 2 absorbent brands
AbstractData directly comparing CO2 absorbents tested in identical and clinically relevant conditions are scarce or non-existent. We therefore tested and compared the efficiency of 16 different brands of Ca(OH)2 based CO2 absorbents used as loose fill or a cartridge in a refillable canister under identical low flow conditions. CO2 absorbents efficiency was tested by flowing 160  mL/min CO2 into the tip of a 2  L balloon that was ventilated with an ADU anesthesia machine (GE, Madison, WI, USA) with a tidal volume of 500 mL and a respiratory rate of 10/min while running an O2/air FGF of 300  mL/min. After...
Source: Journal of Clinical Monitoring and Computing - November 1, 2019 Category: Information Technology Source Type: research

Pulmonary lung Doppler signals: normative data in a pediatric population compared with adults
AbstractLung Doppler signals (LDS) acquired via transthoracic echocardiography is a novel technology previously reported in adults for use in detecting pulmonary hypertension. The aim of this study was to characterize LDS in healthy children to establish normative pediatric LDS data, and compare the pediatric data to the previously published healthy adult LDS. In this prospective, two-center study, LDS were acquired in children without cardiopulmonary disease using a 2  MHz transthoracic pulsed Doppler transducer. The data were processed to obtain Doppler velocity patterns corresponding to phases of the cardiac cycle....
Source: Journal of Clinical Monitoring and Computing - November 1, 2019 Category: Information Technology Source Type: research

Economic and operational impact of an improved pathway using rapid molecular diagnostic testing for patients with influenza-like illness in a German emergency department
AbstractTo evaluate the economic and operational effects of implementing a shorted diagnostic pathway during influenza epidemics. This retrospective study used emergency department (ED) data from the 2014/2015 influenza season. Alere i influenza A& B rapid molecular diagnostic test (RDT) was compared with the polymerase chain reaction (PCR) pathway. Differences in room occupancy time in the ED and inpatient ward and cost differences were calculated for the 14-week influenza season. The process flow was more streamlined with the RDT pathway, and the necessary isolation time in the ED was 9  h lower than for PCR. Th...
Source: Journal of Clinical Monitoring and Computing - November 1, 2019 Category: Information Technology Source Type: research

Level of agreement of point-of-care and laboratory HbA1c measurements in the preoperative outpatient clinic in non-diabetic patients who are overweight or obese
AbstractImplementation of point-of-care HbA1c devices in the preoperative outpatient clinic might facilitate the early diagnosis of glycemic disturbances in overweight or obese patients undergoing surgery, but validation studies in this setting do not exist. We determined the level of agreement between a point-of-care and laboratory HbA1c test in non-diabetic patients visiting the outpatient clinic for preoperative risk profiling. Point-of-care HbA1c levels were measured in whole blood obtained by a finger prick (Siemens DCA Vantage HbA1c analyzer) and in hemolysed EDTA blood in the central laboratory (LAB). Bland Altman a...
Source: Journal of Clinical Monitoring and Computing - November 1, 2019 Category: Information Technology Source Type: research

Determining the accuracy of zero-flux and ingestible thermometers in the peri-operative setting
This study compared the accuracy of two core temperature thermometers that can be used for this purpose: the 3M Bair Hugger ™ Temperature Monitoring System Zero Flux Thermometer and the CorTempR™ Wireless Ingestible Temperature Sensor. Readings were compared with the oesophageal probe, the current intraoperative standard. Thirty patients undergoing elective surgical procedures under general anaesthesia were recruited . The ingestible sensor was ingested prior to induction of anaethesia, and post induction, the zero-flux electrode attached above the right eyebrow and oesophageal probe inserted. During surgery, t...
Source: Journal of Clinical Monitoring and Computing - November 1, 2019 Category: Information Technology Source Type: research

Using the capnogram to assess pulmonary perfusion during a lobectomy: case studies
AbstractCapnography is an effective and non-invasive method for monitoring patients during general anesthesia and can reflect the changes in both the respiratory function as well as the circulatory function. In this paper, we present four cases of lobectomy in which we observed a “chair-like” waveform on performing capnography after the surgery. In all the cases, the appearance of this “chair-like” waveform led to the suspicion of a blockage in the pulmonary artery perfusion, which was then confirmed to be an obstruction in the pulmonary artery on further investigati on. This suggests that during lo...
Source: Journal of Clinical Monitoring and Computing - November 1, 2019 Category: Information Technology Source Type: research

Bilateral erector spinae plane block with single injection
(Source: Journal of Clinical Monitoring and Computing)
Source: Journal of Clinical Monitoring and Computing - November 1, 2019 Category: Information Technology Source Type: research

Breathing variability predicts the suggested need for corrective intervention due to the perceived severity of patient-ventilator asynchrony during NIV
AbstractPatient-ventilator asynchrony is associated with intolerance to noninvasive ventilation (NIV) and worsened outcomes. Our goal was to develop a tool to determine a patient needs  for  intervention by a practitioner due to the presence of patient-ventilator asynchrony. We postulated that a clinician can determine when a patient needs corrective intervention due to the perceived severity of patient-ventilator asynchrony. We hypothesized a new measure, patient breathing vari ability, would indicate when corrective intervention is suggested by a bedside practitioner due to the perceived severity of patient-ven...
Source: Journal of Clinical Monitoring and Computing - October 29, 2019 Category: Information Technology Source Type: research

May near infra-red spectroscopy and rapid perfusion pressure recovering be enough to rule out post-operative spinal cord injury? Two compared case-reports
(Source: Journal of Clinical Monitoring and Computing)
Source: Journal of Clinical Monitoring and Computing - October 28, 2019 Category: Information Technology Source Type: research

Multimodal non-invasive monitoring to apply an open lung approach strategy in morbidly obese patients during bariatric surgery
AbstractTo evaluate the use of non-invasive variables for monitoring an open-lung approach (OLA) strategy in bariatric surgery. Twelve morbidly obese patients undergoing bariatric surgery received a baseline protective ventilation with 8 cmH2O of positive-end expiratory pressure (PEEP). Then, the OLA strategy was applied consisting in lung recruitment followed by a decremental PEEP trial, from 20 to 8 cmH2O, in steps of 2 cmH2O to find the lung ’s closing pressure. Baseline ventilation was then resumed setting open lung PEEP (OL-PEEP) at 2 cmH2O above this pressure. The multimodal non-invasive variables used for moni...
Source: Journal of Clinical Monitoring and Computing - October 25, 2019 Category: Information Technology Source Type: research

Alterations of retinal vessels in patients with sepsis
AbstractTo compare the retinal vasculature of septic patients with age-matched healthy volunteers. This is a single-centre prospective observational study from January 2018 to May 2019 in a third-level ICU. We performed a single fundus imaging using a hand-held digital fundus camera in patients with sepsis or septic shock (n  = 40) during the first 24 h after ICU admission and compared these data with age-matched healthy controls (n  =  20). Semi-automated image analysis was performed. The average retinal arteriolar and venular caliber were calculated and summarized as the central retin...
Source: Journal of Clinical Monitoring and Computing - October 24, 2019 Category: Information Technology Source Type: research

Near-infrared spectroscopy for assessing microcirculation during laparoscopic gynaecological surgery under combined spinal-general anaesthesia or general anaesthesia alone: a randomised controlled trial
AbstractWhile pneumoperitoneum causes negative macrohaemodynamic effects, much less is known about microcirculatory effects of different anaesthetic techniques and laparoscopy. Therefore, we aimed to explore microcirculatory effects of combined spinal –general anaesthesia and laparoscopy, as measured by near-infrared spectroscopy over forearm and calf muscles utilising a 3-min ischemic challenge. Patients (n = 102) undergoing elective laparoscopic gynaecological surgery were randomised to receive general anaesthesia alone or in combination with high-dose or low-dose spinal analgesia (levobupivacaine 7.5...
Source: Journal of Clinical Monitoring and Computing - October 23, 2019 Category: Information Technology Source Type: research

Retraction Note to: Implications of Entropy and Surgical Pleth Index-guided general anaesthesia on clinical outcomes in critically ill polytrauma patients. A prospective observational non-randomized single centre study
The authors have retracted this article [1]. After publication it was discovered that Table 1 which reports the clinical and demographical characteristics of the patients in the study contains a number of statistical and typographical errors. The data reported in this article are therefore unreliable. All authors agree with this retraction. (Source: Journal of Clinical Monitoring and Computing)
Source: Journal of Clinical Monitoring and Computing - October 22, 2019 Category: Information Technology Source Type: research

Evaluation of Surgical Pleth Index and Analgesia Nociception Index as surrogate pain measures in conscious postoperative patients: an observational study
AbstractWe evaluated the performance of the Surgical Plethysmographic Index (SPI) and the Analgesia Nociception Index (ANI) as surrogate pain measures and determined their respective cut-off values for detecting pain in conscious postoperative patients. In total, 192 patients after elective surgery were enrolled. Baseline SPI and ANI data were acquired for 10  min in the operating room prior to surgery when the patients rated their pain as 0 on the numerical rating scale (NRS). Upon arrival in the post-anaesthesia care unit (PACU) after surgery, SPI and ANI data were recorded for 10 min. The means of the recorded...
Source: Journal of Clinical Monitoring and Computing - October 18, 2019 Category: Information Technology Source Type: research

Warming efficacy of Ranger ™ and FT2800 fluid warmer under different room temperatures and flow rates
AbstractThe comparison of the heating capabilities with different warming system between 3M ™ Ranger™ warmer (3M) and FT2800 fluid warmer (FT) under different room temperatures and infusion rates, has been rarely reported previously. The study was then aimed to compare the warming efficacies of dry heat technology (3M) and coaxial warming system (FT) under different room temperatures a nd infusion rates, the advantages and disadvantages of both infusion systems would be compared to provide reference for clinical infusion practice. In the study, both target warming temperatures of 3M and FT warmer were set at 41...
Source: Journal of Clinical Monitoring and Computing - October 17, 2019 Category: Information Technology Source Type: research

Noninvasive measurement of stroke volume changes in critically ill patients by means of electrical impedance tomography
AbstractPrevious animal experiments have suggested that electrical impedance tomography (EIT) has the ability to noninvasively track changes in cardiac stroke volume (SV). The present study intended to reproduce these findings in patients during a fluid challenge. In a prospective observational study including critically ill patients on mechanical ventilation, SV was estimated via ECG-gated EIT before and after a fluid challenge and compared to transpulmonary thermodilution reference measurements. Relative changes in EIT-derived cardiosynchronous impedance changes in the heart (\(\Delta {\text{Z}}_{\text{H}}\)) and lung re...
Source: Journal of Clinical Monitoring and Computing - October 17, 2019 Category: Information Technology Source Type: research

Agreement between different non-invasive methods of ventricular elastance assessment for the monitoring of ventricular –arterial coupling in intensive care
The objective of the present study was to determine whether ESP/ESV simplification can be used instead of the Chen formula to measure ventricular –arterial coupling and to monitor changes following therapeutic intervention. In this retrospective, single-center study, 3 non-invasive EA/Ees calculation methods were applied to 86 cardiac ICU patients. The Chen method was used as the reference method. Ees was also calculated according to method 1: Ees1 = 0.9 × SAP/ESV and method 2: Ees2=  EA/(1/LVEF)  − 1. EA was estimated as 0.9  × SAP/SV (...
Source: Journal of Clinical Monitoring and Computing - October 10, 2019 Category: Information Technology Source Type: research

Impact of intravenous phenylephrine bolus administration on the nociceptive level index (NOL)
AbstractRecently, the nociceptive level index (NOL) was shown to more specifically and sensitively detect noxious stimuli during anesthesia, in comparison to previous methods that relied on such parameters as heart rate (HR) and mean blood pressure (MAP). An ongoing study (NCT#03410485) evaluates the intraoperative combination of both NOL and bispectral (BIS) indices to improve quality of recovery after colorectal surgery. Our ethical committee (REB approval #CER15083) initially agreed on an interim analysis of the data from the first 30 patients. More specifically, this present report analyzed all the intravenous phenylep...
Source: Journal of Clinical Monitoring and Computing - October 9, 2019 Category: Information Technology Source Type: research

The incidence and interpretation of large differences in EIT-based measures for PEEP titration in ARDS patients
AbstractPositive end-expiratory pressure (PEEP) can be titrated by electrical impedance tomography (EIT). The aim of the present study was to examine the performance of different EIT measures during PEEP trials with the aim of identifying “optimum” PEEP and to provide possible interpretations of largely diverging results. After recruitment (maximum plateau pressure 35 cmH2O), decremental PEEP trial with steps of 2 cmH2O and duration of 2  min per step was performed. Ventilation gain and loss, the global inhomogeneity (GI) index, trend of end-expiratory lung impedance (EELI) and regional compliance (Creg) f...
Source: Journal of Clinical Monitoring and Computing - October 5, 2019 Category: Information Technology Source Type: research

Comparison of high versus low frequency cerebral physiology for cerebrovascular reactivity assessment in traumatic brain injury: a multi-center pilot study
AbstractCurrent accepted cerebrovascular reactivity indices suffer from the need of high frequency data capture and export for post-acquisition processing. The role for minute-by-minute data in cerebrovascular reactivity monitoring remains uncertain. The goal was to explore the statistical time-series relationships between intra-cranial pressure (ICP), mean arterial pressure (MAP) and pressure reactivity index (PRx) using both 10-s and minute data update frequency in TBI. Prospective data from 31 patients from 3 centers with moderate/severe TBI and high-frequency archived physiology were reviewed. Both 10-s by 10-s and min...
Source: Journal of Clinical Monitoring and Computing - October 1, 2019 Category: Information Technology Source Type: research

Patient intermittent epidural boluses (PIEB) plus very low continuous epidural infusion (CEI) versus patient-controlled epidural analgesia (PCEA) plus continuous epidural infusion (CEI) in primiparous labour: a randomized trial
AbstractEpidural maintenance technique for labour analgesia updates constantly. Thanks to infusion pumps, the recently developed programmed intermittent epidural bolus (PIEB) may reduce the use of anesthetic drugs and minimize unintended consequences such as cardio or neurotoxicity. Nevertheless, it is not yet a general practice. So far, there are no comparative studies in the literature that address levobupivacaine-based CEI  + PCEA versus CEI + PIEB + PCEA. A randomized double-blind trial was carried out to evaluate if PIEB could reduce local anesthetic use compare to PCEA. Primi...
Source: Journal of Clinical Monitoring and Computing - August 27, 2019 Category: Information Technology Source Type: research

Development and validation of an android-based application for anaesthesia neuromuscular monitoring
AbstractQuantitative neuromuscular block (NMB) assessment is an internationally recognised necessity in anesthesia care whenever neuromuscular blocking agents are administered. Despite this, the incidence of residual neuromuscular block and its associated major respiratory morbidity and mortality remain unacceptably high considering its preventable nature. Recent surveys show that quantitative NMB assessment is not consistently employed by anesthesiologists. Availability, price and practical concerns are some of the factors determining this phenomenon. Clinically assess and validate an Android cell phone application concei...
Source: Journal of Clinical Monitoring and Computing - August 27, 2019 Category: Information Technology Source Type: research

The accuracy and trending ability of cardiac index measured by the fourth-generation FloTrac/Vigileo system ™ and the Fick method in cardiac surgery patients
AbstractTo compare the accuracy and trending ability of the cardiac index (CI) measured by FloTrac/Vigileo ™ (CIFT) or derived by the Fick equation (CIFick) using E-CAiOVX (enables continuous monitoring of oxygen consumption) with that measured by thermodilution (CITD) in patients with off-pump coronary artery bypass surgery. Twenty-two patients undergoing elective off-pump coronary artery bypass surgery were included. CIFT and CIFick were determined simultaneously at six time-points during off-pump coronary artery bypass surgery. At each time-point, phenylephrine (50  µg) was administered to increase syst...
Source: Journal of Clinical Monitoring and Computing - August 27, 2019 Category: Information Technology Source Type: research

Head-to-head comparison of two continuous glucose monitoring systems on a cardio-surgical ICU
AbstractIn critical illness hypo-and hyperglycemia have a negative influence on patient outcome. Continuous glucose monitoring (CGM) could help in early detection of hypo-and hyperglycemia. A requirement for these new methods is an acceptable accuracy and precision in clinical practice. In this pilot study we prospectively evaluated the accuracy and precision of two CGM sensors (subcutaneous sensor: Sentrino ®, Medtronic and intravasal sensor: Glucoclear®, Edwards) in 20 patients on a cardio-surgical ICU in a head to head comparison. CGM data were recorded for up to 48 h and values were compared with blood-gas...
Source: Journal of Clinical Monitoring and Computing - August 27, 2019 Category: Information Technology Source Type: research

Applying machine learning to continuously monitored physiological data
We present use cases as well as several questions regarding the application of ML to the analysis of the vast amount of complex data that clinicians must interpret in the realm of continuous physiological monitoring. ML, especially employed in bidirectional conjunction with electronic health record data, has the potential to extract much more useful information out of this currently under-analyzed data source from a population level. As a data driven entity, ML is dependent on copious, high quality input data so that error can be introduced by low quality data sources. At present, while ML is being studied in hybrid formul...
Source: Journal of Clinical Monitoring and Computing - August 27, 2019 Category: Information Technology Source Type: research

Laser speckle contrast imaging for quantitative assessment of facial flushing during mesenteric traction syndrome in upper gastrointestinal surgery
AbstractThe mesenteric traction syndrome (MTS) is associated with prostacyclin (PGI2) facilitated systemic vasodilatation during surgery and is identified by facial flushing. We hypothesized that severe facial flushing would be related to the highest concentrations of plasma PGI2 and accordingly to the highest levels of skin blood flow measured by laser speckle contrast imaging (LSCI). Patients scheduled for major upper abdominal surgery were consecutively included. Within the first hour of the procedure, facial flushing was scored according to a standardized scale, and skin blood flow (LSPU) was continuously measured on t...
Source: Journal of Clinical Monitoring and Computing - August 27, 2019 Category: Information Technology Source Type: research

Identification of return of spontaneous circulation during cardiopulmonary resuscitation via pulse oximetry in a porcine animal cardiac arrest model
AbstractIn this prospective study we investigated whether the pulse oximetry plethysmographic waveform (POP) could be used to identify return of spontaneous circulation (ROSC) during cardio-pulmonary resuscitation (CPR). Tweleve pigs (28  ± 2 kg) were randomly assigned to two groups: Group I (non-arrested with compressions) (n = 6); Group II (arrested with CPR and defibrillation) (n = 6). Hemodynamic parameters and POP were collected and analyzed. POP was analyzed using both a time domain method and a frequency domain method. In Group I, when compressions were carried o...
Source: Journal of Clinical Monitoring and Computing - August 27, 2019 Category: Information Technology Source Type: research

Can ultrasonographic measurement of carotid intima-media thickness predict hypotension after induction of general anesthesia?
AbstractHypotension in patients under general anesthesia is prevalent and causes unfavorable outcomes. Carotid intima-media thickness (CIMT) is a surrogate marker for atherosclerosis and useful for evaluating the risk of cardiovascular diseases. We investigated the usefulness of preoperative CIMT measurement as a predictor of post-induction hypotension (PIH). The ultrasonographic measurement of CIMT was performed preoperatively on 82 patients scheduled for elective surgery under general anesthesia in a prospective, observational study. Mean blood pressure (MBP) was recorded before induction. Hypotension was defined as a 20...
Source: Journal of Clinical Monitoring and Computing - August 27, 2019 Category: Information Technology Source Type: research

Artifactual increase in bispectral index caused by connector contaminated with povidone –iodine
(Source: Journal of Clinical Monitoring and Computing)
Source: Journal of Clinical Monitoring and Computing - August 27, 2019 Category: Information Technology Source Type: research

The use of end-tidal argon to detect venous air embolism: foiled by “fake oxygen!”
AbstractVenous air-embolism (VAE) potentially catastrophic complication surgery. Based on previous data using changes in end-tidal nitrogen as an indicator of VAE, we surmised that changes in end-tidal argon (EtAr) may be an indicator of VAE. We sought to determine if a commercial mass-spectrometer (PCT Proline Analyzer 61700-8 Class 85, Ametek, Pittsburgh, PA 15238) could be used to detect changes in EtAr in an invitro model. A Drager Apollo ™ (Drager, Lubeck, Germany) anesthesia machine was used to ventilate a dummy lung (2 L bag) with a minute ventilation of 6 L/min in 100% oxygen. The quadrupole mass-spectro...
Source: Journal of Clinical Monitoring and Computing - August 27, 2019 Category: Information Technology Source Type: research

The relationship between the time of cerebral desaturation episodes and outcome in aneurysmal subarachnoid haemorrhage: a preliminary study
AbstractIn this preliminary study we investigated the relationship between the time of cerebral desaturation episodes (CDEs), the severity of the haemorrhage, and the short-term outcome in patients with aneurysmal subarachnoid haemorrhage (aSAH). Thirty eight patents diagnosed with aneurysmal subarachnoid haemorrhage were analysed in this study. Regional cerebral oxygenation (rSO2) was assessed using near infrared spectroscopy (NIRS). A CDE was defined as rSO2 
Source: Journal of Clinical Monitoring and Computing - August 20, 2019 Category: Information Technology Source Type: research

Differentiation of skin incision and laparoscopic trocar insertion via quantifying transient bradycardia measured by electrocardiogram
AbstractMost surgical procedures involve structures deeper than the skin. However, the difference in surgical noxious stimulation between skin incision and laparoscopic trocar insertion is unknown. By analyzing instantaneous heart rate (IHR) calculated from the electrocardiogram, in particular the transient bradycardia in response to surgical stimuli, this study investigates surgical noxious stimuli arising from skin incision and laparoscopic trocar insertion, and their difference. Thirty-five patients undergoing laparoscopic cholecystectomy were enrolled in this prospective observational study. Sequential surgical steps i...
Source: Journal of Clinical Monitoring and Computing - August 20, 2019 Category: Information Technology Source Type: research

Administration of anesthetic drugs according to pharmacological principles: are we heading in the right direction?
(Source: Journal of Clinical Monitoring and Computing)
Source: Journal of Clinical Monitoring and Computing - August 16, 2019 Category: Information Technology Source Type: research

Changes in nonlinear dynamic complexity measures of blood pressure during anesthesia for cardiac surgeries using cardio pulmonary bypass
AbstractNonlinear complexity measures computed from beat-to-beat arterial BP dynamics have shown associations with standard cardiac surgical risk indices. They reflect the physiological adaptability of a system and has been proposed as dynamical biomarkers of overall health status. We sought to determine the impact of anesthetic induction and cardiopulmonary bypass (CPB) upon the complexity measures computed from perioperative BP time series. In this prospective, observational study, 300 adult patients undergoing cardiac surgery were included. Perioperative period was divided as: (1) Preoperative (PreOp); (2) ORIS —i...
Source: Journal of Clinical Monitoring and Computing - August 13, 2019 Category: Information Technology Source Type: research

Diagnostic accuracy of somatosensory evoked potentials during intracranial aneurysm clipping for perioperative stroke
AbstractSomatosensory evoked potentials (SSEPs) are utilized during aneurysm clipping to detect intraoperative ischemia. We assess the diagnostic accuracy of SSEPs in predicting perioperative stroke during aneurysm clipping. A retrospective review was conducted of 429 consecutive patients who underwent surgical clipping for ruptured and unruptured cerebral aneurysms with intraoperative SSEP monitoring from 2006 to 2013. The relationship between perioperative stroke and SSEP changes was analyzed by calculating the sensitivity, specificity, and area under a Receiving Operating Characteristic curve. Sensitivity and specificit...
Source: Journal of Clinical Monitoring and Computing - August 9, 2019 Category: Information Technology Source Type: research

Facing SpO 2 and SaO 2 discrepancies in ICU patients: is the perfusion index helpful?
AbstractPeripheral oxygen saturation (SpO2) measured by pulse oximetry is an unreliable surrogate marker for arterial oxygenation (SaO2) in critically ill patients. We hypothesized that a higher perfusion index (PFI) would be associated with better accuracy of SpO2 measurement. We retrospectively collected SaO2, SpO2, and PFI data for each arterial blood gas (ABG) analysis in a cohort of intensive care unit patients. PFI was categorised as low (PFI    2.5). The correlation between SpO2 and SaO2 was studied using Pearson ’s correlation. The Bland–Altman plot was used to analyse the agreement betwee...
Source: Journal of Clinical Monitoring and Computing - August 7, 2019 Category: Information Technology Source Type: research

Letter to the editor
(Source: Journal of Clinical Monitoring and Computing)
Source: Journal of Clinical Monitoring and Computing - August 7, 2019 Category: Information Technology Source Type: research

Continuous hemoglobin and plethysmography variability index monitoring can modify blood transfusion practice and is associated with lower mortality
AbstractTo determine the effect of implementing an algorithm of fluid and blood administration based on continuous monitoring of hemoglobin (SpHb) and PVI (plethysmography variability index) on mortality and transfusion on a whole hospital scale. This single-center quality program compared transfusion at 48  h and mortality at 30 days and 90 days after surgery between two 11-month periods in 2013 and 2014 during which all the operating and recovery rooms and intensive care units were equipped with SpHb/PVI monitors. The entire team was trained to use monitors and the algorithm. Team members were fre e to dec...
Source: Journal of Clinical Monitoring and Computing - August 3, 2019 Category: Information Technology Source Type: research

Machine learning based framework to predict cardiac arrests in a paediatric intensive care unit
AbstractA cardiac arrest is a life-threatening event, often fatal. Whilst clinicians classify some of the cardiac arrests as potentially predictable, the majority are difficult to identify even in a post-incident analysis. Changes in some patients ’ physiology when analysed in detail can however be predictive of acute deterioration leading to cardiac or respiratory arrests. This paper seeks to exploit the causally-related changing patterns in signals such as heart rate, respiration rate, systolic blood pressure and peripheral cutaneous oxyg en saturation to evaluate the predictability of cardiac arrests in critically...
Source: Journal of Clinical Monitoring and Computing - July 2, 2019 Category: Information Technology Source Type: research

Selection of cuffed endotracheal tube for children with congenital heart disease based on an ultrasound-based linear regression formula
AbstractIt remains to be discovered whether a formula predicting the subglottic transverse diameter measured by ultrasound (SGDformula) for the selection of an appropriate endotracheal tube (ETT) for children without congenital heart disease (CHD) is useful for children with CHD. A formula for predicting SGD was established after assessing 60 children ≤ 8 years without CHD and validated on 60 children with CHD. We selected the cuffed ETT size based on the SGD by ultrasound (SGDultra). Subsequently, the fit of the ETT cuff in 60 children with CHD was examined via air-leak test. The maximum allowed difference ...
Source: Journal of Clinical Monitoring and Computing - July 2, 2019 Category: Information Technology Source Type: research

What ’s all that noise—Improving the hospital soundscape
AbstractHospital noise levels regularly exceed those recommended by the World Health Organization (WHO). It is uncertain whether high noise levels have adverse effects on patient health. High levels of noise increase patient sleep loss, anxiety levels, length of hospital stay, and morbidity rates. Staff conversation and auditory medical alarms are amongst the leading noise producing stimuli, with combinations of stimuli accounting for much of the high noise levels. The Hospital Consumer Assessment of Healthcare Providers and Systems survey shows a slight improvement in overall hospital noise levels in the United States, in...
Source: Journal of Clinical Monitoring and Computing - July 2, 2019 Category: Information Technology Source Type: research