Journal of Clinical Monitoring and Computing This is an RSS file. You can use it to subscribe to this data in your favourite RSS reader or to display this data on your own website or blog.

Humidity and measurement of volatile propofol using MCC-IMS (EDMON)
AbstractThe bedsideExhaledDrugMONitor – EDMON measures exhaled propofol in ppbv every minute based on multi-capillary column – ion mobility spectrometry (MCC-IMS). The MCC pre-separates gas samples, thereby reducing the influence of the high humidity in human breath. However, preliminary analyses identified substantial measurement deviations between dry and humid calibration standards. We therefore performed an analytic al validation of the EDMON to evaluate the influence of humidity on measurement performance. A calibration gas generator was used to generate gaseous propofol standards measured by an EDMON device to as...
Source: Journal of Clinical Monitoring and Computing - September 21, 2022 Category: Information Technology Source Type: research

New guidelines for research in airway device evaluation: time for an updated approach (ADEPT-2) to the Difficult Airway Society ’s ‘ADEPT’ strategy?
AbstractIn this article we present the learning from a clinical study of airway device evaluation, conducted under the framework of the Difficult Airway Society (DAS, UK) ‘ADEPT’ (airway device evaluation project team) strategy. We recommend a change in emphasis from small scale randomised controlled trials conducted as research, to larger-scale observational, post-marketing evaluation audits as a way of obtaining more meaningful informati on. (Source: Journal of Clinical Monitoring and Computing)
Source: Journal of Clinical Monitoring and Computing - September 20, 2022 Category: Information Technology Source Type: research

Gastrointestinal endoscopy procedures under intravenous sedation in the prone position: keep LMA gastro handy!
AbstractGastrointestinal endoscopies are often done in the prone position and anesthesiologists are needed to provide sedation. Airway access is limited in the prone position and may make timely airway management difficult in case of airway obstruction during sedation. Specialized laryngeal mask airway devices customized for endoscopy procedures like LMA® Gastro ™ can be inserted in the prone position and may help anesthesiologists tide over such crisis situations while simultaneously allowing the endoscopy procedures through the dedicated conduit available for inserting the endoscopes. We have described one such case m...
Source: Journal of Clinical Monitoring and Computing - September 8, 2022 Category: Information Technology Source Type: research

Assessing a novel second generation laryngeal mask airway using the ‘ADEPT’ approach: results from the LMA® Protector™ observational study
AbstractTo address the problem of lack of clinical evidence for airway devices introduced to the market, the Difficult Airway Society (UK) developed an approach (termed ADEPT; Airway Device Evaluation Project Team) to standardise the model for device evaluation. Under this framework we assessed the LMA Protector, a second generation laryngeal mask airway. A total of 111 sequential adult patients were recruited and the LMA Protector inserted after induction of general anaesthesia. Effective insertion was confirmed by resistance to further distal movement, manual ventilation, and listening for gas leakage at the mouth. The b...
Source: Journal of Clinical Monitoring and Computing - September 5, 2022 Category: Information Technology Source Type: research

A machine learning approach to predicting early and late postoperative reintubation
AbstractAccurate estimation of surgical risks is important for informing the process of shared decision making and informed consent. Postoperative reintubation (POR) is a severe complication that is associated with postoperative morbidity. Previous studies have divided POR into early POR (within 72  h of surgery) and late POR (within 30 days of surgery). Using data provided by American College of Surgeons (ACS) National Surgical Quality Improvement Program (NSQIP), machine learning classification models (logistic regression, random forest classification, and gradient boosting classification ) were utilized to develop sc...
Source: Journal of Clinical Monitoring and Computing - September 3, 2022 Category: Information Technology Source Type: research

Intraoperative transabdominal MEPs: four case reports
AbstractFour recent cases utilizing transabdominal  motor-evoked potentials (TaMEPs) are presented as illustrative of the monitoring technique during lumbosacral fusion, sciatic nerve tumor resection, cauda equina tumor resection, and lumbar decompression. Case 1: In a high-grade lumbosacral spondylolisthesis revision fusion, both transcranial mot or-evoked potentials (TcMEPs) and TaMEPs detected a transient focal loss of left tibialis anterior response in conjunction with L5 nerve root decompression. Case 2: In a sciatic nerve tumor resection, TcMEPs responses were lost but TaMEPs remained unchanged, the patient was neur...
Source: Journal of Clinical Monitoring and Computing - August 23, 2022 Category: Information Technology Source Type: research

Effect of quantitative versus qualitative neuromuscular blockade monitoring on rocuronium consumption in patients undergoing abdominal and gynecological surgery: a retrospective cohort study
This study aims to compare the dosage of the neuromuscular blocking agents (NMBA) rocuronium and the need for reversion by sugammadex between those methods. A retrospective, observational analysis was conducted. In the tactile qualitative-neuromuscular monitoring-group (tactile NMM) (n  = 244), muscle contractions were assessed tactilely. In the quantitative neuromuscular monitoring-group (n = 295), contractions were accessed using an acceleromyograph. Primary endpoints were dosage of rocuronium per minute operation-time (milligram per kilogram bodyweight per minute (mg/kg BW/min)), count of repeated rocuronium adm...
Source: Journal of Clinical Monitoring and Computing - August 20, 2022 Category: Information Technology Source Type: research

Reduced postoperative pain in patients receiving nociception monitor guided analgesia during elective major abdominal surgery: a randomized, controlled trial
This study was d esigned as a single-center, prospective randomized, controlled study. After Institutional Review Board approval and written informed consent, 75 ASA 1–3 adult patients undergoing major abdominal surgery, were randomized to NOL-guided fentanyl dosing (NOL) or standard care (SOC) and completed the s tudy. The sevoflurane target MAC range was 0.8–1.2. In the NOL-guided group (N = 36), when NOL values were >  25 for at least 1 min, a weight adjusted fentanyl bolus was administered. In the control group (N = 39) fentanyl administration was based on hemodynamic indices and clinician judgement...
Source: Journal of Clinical Monitoring and Computing - August 17, 2022 Category: Information Technology Source Type: research

Median nerve somatosensory evoked potential alarm related to head and neck positioning for carotid surgery
AbstractHead positioning in carotid surgery represents an often overlooked but sensitive period in the surgical plan. A 53-year-old male presented a significant decrement in median nerve somatosensory evoked potential (mSEP) following head and neck positioning for carotid pseudoaneurysm repair before skin incision.Neurophysiological monitoring was performed with mSEP and electroencephalography early during the patient ’s preparation and surgery. Within five minutes after rotation and extension of the head to properly expose the surgical field, the contralateral m-SEP significantly decreased in both cortical (N20/P25) and...
Source: Journal of Clinical Monitoring and Computing - August 12, 2022 Category: Information Technology Source Type: research

Clinical performance of lung ultrasound in predicting time-dependent changes in lung aeration in ARDS patients
AbstractTo evaluate whether lung ultrasound is reliable bedside tool to monitor changes of lung aeration at the early and late stages of ARDS. LUS was performed in ARDS patients that underwent at least two consecutive CT scan at ICU admission and at least 1  week after admission. Twelve fields were evaluated and graded from 0 (normal) to 3 (consolidation). Changes of LUS score in twelve fields (ΔLUStot) and in four ventral ( ΔLUSV), intermediate ( ΔLUSI) and dorsal ( ΔLUSD) zones were calculated at each time points. Three categories were described: Improve ( ΔLUS <  0), Equal (ΔLUS = 0) or Worse (ΔLUS ...
Source: Journal of Clinical Monitoring and Computing - August 8, 2022 Category: Information Technology Source Type: research

Development and usage of an anesthesia data warehouse: lessons learnt from a 10-year project
We reported the main concerns and barriers during the development of this project and we provided 8 tips to handle them. We have implemented our data warehouse into the OMOP common data model as a complementary downstream data model. The next step of the project will be to disseminate the use of the OMOP data model for anesthesia and critical care, and drive the trend towards federated learning to enhance collaborations and multicenter studies. (Source: Journal of Clinical Monitoring and Computing)
Source: Journal of Clinical Monitoring and Computing - August 6, 2022 Category: Information Technology Source Type: research

Reply to Capogna et al.
(Source: Journal of Clinical Monitoring and Computing)
Source: Journal of Clinical Monitoring and Computing - August 5, 2022 Category: Information Technology Source Type: research

Prediction of acute postoperative pain based on intraoperative nociception level (NOL) index values: the impact of machine learning-based analysis
The objective of the ancillary analysis of the NOLGYN study was to evaluate the ability of a machine-learning aglorithm to predict moderate to severe acute postoperative pain based on intraoperative NOL values. Our study uses the data from the NOLGYN study, a randomized con trolled trial that evaluated the impact of NOL-guided intraoperative administration of fentanyl on overall fentanyl consumption compared to standard of care. Seventy patients (ASA class I–III, aged 18–75 years) scheduled for gynecological laparoscopic surgery were enrolled. Variables included b aseline demographics, NOL reaction to incision or intu...
Source: Journal of Clinical Monitoring and Computing - August 4, 2022 Category: Information Technology Source Type: research

Non-invasive over-distension measurements: data driven vs model-based
This study introduces a non-invasive, real-time over-distension measurement, which is robust, predictable, and more intuitive than current methods. The proposed over-distension measurement, denoted as OD, is compared with the clinically proven stress index (SI). Correlation is analysed via R2 and Spearman rs. The OD safe range corresponding to the unit-less SI safe range (0.95 –1.05) is calibrated by sensitivity and specificity test. Validation is fulfilled with 19 acute respiratory distress syndrome (ARDS) patients data (196 cases), including assessment across ARDS severity. Overall correlation between OD and SI yielded...
Source: Journal of Clinical Monitoring and Computing - August 3, 2022 Category: Information Technology Source Type: research

Comparison of mainstream end tidal carbon dioxide on Y-piece side versus patient side of heat and moisture exchanger filters in critically ill adult patients: a prospective observational study
AbstractThe purpose of the study was to investigate the accuracy of mainstream EtCO2 measurements on the Y-piece (filtered) side of the heat and moisture exchanger filter (HMEF) in adult critically ill patients, compared to that on the patient (unfiltered) side of HMEF. We conducted a prospective observational method comparison study between July 2019 and December 2019. Critically ill adult patients receiving mechanical ventilation with HMEF were included. We performed a noninferiority comparison of the accuracy of EtCO2 measurements on the two sides of HMEF. The accuracy was measured by the absolute difference between PaC...
Source: Journal of Clinical Monitoring and Computing - August 3, 2022 Category: Information Technology Source Type: research