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Can the values of the venous-to-arterial PCO2 difference (pCO2 gap) be negative?
AbstractIn this manuscript, we discussed if it is physiologically sound that the difference between venous-to-arterial carbon dioxide partial pressure difference (pCO2 gap) can yield negative values. (Source: Journal of Clinical Monitoring and Computing)
Source: Journal of Clinical Monitoring and Computing - March 4, 2024 Category: Information Technology Source Type: research

Perfusion tomography in early follow-up of acute traumatic subdural hematoma: a case series
AbstractPerfusion Computed Tomography (PCT) is an alternative tool to assess cerebral hemodynamics during trauma. As acute traumatic subdural hematomas (ASH) is a severe primary injury associated with poor outcomes, the aim of this study was to evaluate the cerebral hemodynamics in this context. Five adult patients with moderate and severe traumatic brain injury (TBI) and ASH were included. All individuals were indicated for surgical evacuation. Before and after surgery, PCT was performed and cerebral blood flow (CBF), cerebral blood volume (CBV) and mean transit time (MTT) were evaluated. These parameters were associated ...
Source: Journal of Clinical Monitoring and Computing - February 21, 2024 Category: Information Technology Source Type: research

Intraoperative haemodynamic monitoring and management of adults having non-cardiac surgery: Guidelines of the German Society of Anaesthesiology and Intensive Care Medicine in collaboration with the German Association of the Scientific Medical Societies
AbstractHaemodynamic monitoring and management are cornerstones of perioperative care. The goal of haemodynamic management is to maintain organ function by ensuring adequate perfusion pressure, blood flow, and oxygen delivery. We here present guidelines on “Intraoperative haemodynamic monitoring and management of adults having non-cardiac surgery” that were prepared by 18 experts on behalf of the German Society of Anaesthesiology and Intensive Care Medicine (Deutsche Gesellschaft für Anästhesiologie und lntensivmedizin; DGAI). (Source: Journal of Clinical Monitoring and Computing)
Source: Journal of Clinical Monitoring and Computing - February 21, 2024 Category: Information Technology Source Type: research

Ultrasound-guided versus conventional lung recruitment manoeuvres in thoracic surgery: a randomised controlled study
AbstractLung recruitment manoeuvres (RMs) during mechanical ventilation may reduce atelectasis, however, the optimal recruitment strategy for patients undergoing thoracic surgery remains unknown. Our study was designed to investigate whether ultrasound-guided lung RMs is superior to conventional RMs in reducing perioperative atelectasis during thoracic surgery with one-lung ventilation. We conducted a randomised controlled clinical trial from August 2022 to September 2022. Sixty patients scheduled for video-assisted thoracoscopic surgery (VATS) under general anaesthesia were enrolled. Subjects were randomly divided into th...
Source: Journal of Clinical Monitoring and Computing - February 17, 2024 Category: Information Technology Source Type: research

ICP wave morphology as a screening test to exclude intracranial hypertension in brain-injured patients: a non-invasive perspective
In this study, we propose evaluating the noninvasive ICPW (nICPW —B4C sensor) as a screening method for ICPi monitoring in patients with moderate to high probability of IH. This is a retrospective analysis of a prospective, multicenter study that recruited adult patients requiring ICPi monitoring from both Federal University of São Paulo and University of São Paulo Medical School Hospitals. ICPi values and the nICPW parameters were obtained from both the invasive and the noninvasive methods simultaneously 5 min after the closure of the EVD drainage. ICP assessment was performed using a catheter inserted into the ventri...
Source: Journal of Clinical Monitoring and Computing - February 14, 2024 Category: Information Technology Source Type: research

Short-term mild hyperventilation on intracranial pressure, cerebral autoregulation, and oxygenation in acute brain injury patients: a prospective observational study
AbstractCurrent guidelines suggest a target of partial pressure of carbon dioxide (PaCO2) of 32 –35 mmHg (mild hypocapnia) as tier 2 for the management of intracranial hypertension. However, the effects of mild hyperventilation on cerebrovascular dynamics are not completely elucidated. The aim of this study is to evaluate the changes of intracranial pressure (ICP), cerebral autoregulation (m easured through pressure reactivity index, PRx), and regional cerebral oxygenation (rSO2) parameters before and after induction of mild hyperventilation. Single center, observational study including patients with acute brain injury (...
Source: Journal of Clinical Monitoring and Computing - February 4, 2024 Category: Information Technology Source Type: research

Control of mean arterial pressure using a closed-loop system for norepinephrine infusion in severe brain injury patients: the COMAT randomized controlled trial
AbstractBrain injury patients require precise blood pressure (BP) management to maintain cerebral perfusion pressure (CPP) and avoid intracranial hypertension. Nurses have many tasks and norepinephrine titration has been shown to be suboptimal. This can lead to limited BP control in patients that are in critical need of cerebral perfusion optimization. We have designed a closed-loop vasopressor (CLV) system capable of maintaining mean arterial pressure (MAP) in a narrow range and we aimed to assess its performance when treating severe brain injury patients. Within the first 48  h of intensive care unit (ICU) admission, 18...
Source: Journal of Clinical Monitoring and Computing - February 4, 2024 Category: Information Technology Source Type: research

Cerebral regional oxygen saturation as a predictive parameter for preoperative heart failure and delayed hemodynamic recovery in transcutaneous aortic valve implantation: a retrospective cohort study
This study aimed to investigate the relationship of perioperative cerebral regional oxygen saturation (rSO2) with various preoperative clinical variables and hemodynamic changes during transfemoral transcatheter aortic valve implantation (TAVI) under general anesthesia. We retrospectively analyzed cerebral rSO2 values from left-hemisphere measurements obtained using near-infrared spectroscopy (O3 ™ regional oximetry) at five time points: pre-induction, the start of the procedure, the start of valve deployment, time of lowest cerebral rSO2 value during valve deployment, and the end of the procedure. This study included 91...
Source: Journal of Clinical Monitoring and Computing - February 4, 2024 Category: Information Technology Source Type: research

A novel adaptive filter with a heart-rate-based reference signal for esophageal pressure signal denoising
In this study, we present an adaptive filtering-based method by constructing a reference signal based on the heart rate and sine function to remove CGOs in real-time. The proposed technique is tested using clinical data acquired from 20 patients admitted to the intensive care unit. Lung compliance ( QUOTE ) and esophageal pressure swings ( △Pes) are used to evaluate the performance and efficiency of the proposed technique. The CGO can be efficiently suppressed when the constructional reference signal contains the fundamental, and second and third harmonic frequencies of the heart rate signal. The analysis of the data of ...
Source: Journal of Clinical Monitoring and Computing - February 4, 2024 Category: Information Technology Source Type: research

Natural language processing for electronic health records in anaesthesiology: an introduction to clinicians with recommendations and pitfalls
(Source: Journal of Clinical Monitoring and Computing)
Source: Journal of Clinical Monitoring and Computing - February 4, 2024 Category: Information Technology Source Type: research

Cerebral oxygenation saturation in childhood: difference by age and comparison of two cerebral oximetry algorithms
In this study, we aimed to assess and compare rSO2 levels in pediatric patients of different age groups undergoing non-cardiac surgery. We used two oximeters, tNIRS-1, which uses time-resolved spectroscopy, and conventional INVOS 5100C. Seventy-eight children —26 infants, 26 toddlers, and 26 schoolchildren—undergoing non-cardiac surgery were included. We investigated the differences in the rSO2 levels among the age groups and the correlation between the models and physiological factors influencing the rSO2 values. rSO2 measured by INVOS 5100C was significantly lower in infants than those in other patients. rSO2 measure...
Source: Journal of Clinical Monitoring and Computing - February 4, 2024 Category: Information Technology Source Type: research

The 10  Hz dynamic response of a fluid-filled pressure monitoring system is a novel alternative to the fast flush test and indicative of unacceptable systolic pressure overshoot
In conclusion, the gain at 10 Hz is sufficiently useful as an indicator to determine the correct systolic blood pressure. (Source: Journal of Clinical Monitoring and Computing)
Source: Journal of Clinical Monitoring and Computing - February 4, 2024 Category: Information Technology Source Type: research

In response: Improvement in vocal ‑cord visualization with Trachway video intubating stylet using direct oxygen flow and effective analysis of the fraction of inspired oxygen: a bench study
(Source: Journal of Clinical Monitoring and Computing)
Source: Journal of Clinical Monitoring and Computing - February 1, 2024 Category: Information Technology Source Type: research

Age-related changes in intraoperative mean values of nociceptive response in patients undergoing non-cardiac surgery under general anesthesia: A retrospective cohort study
In conclusion, there is likely an association between age and intraoperative mean NR index in patients under general anesthesia. (Source: Journal of Clinical Monitoring and Computing)
Source: Journal of Clinical Monitoring and Computing - January 27, 2024 Category: Information Technology Source Type: research

Automatic assessment of left ventricular function for hemodynamic monitoring using artificial intelligence and transesophageal echocardiography
In conclusion, autoMAPSE is feasible as an automatic tool for rapid and quantitative assessment of LV function, indicating its potential for hemodynamic monitoring.Graphical Abstract (Source: Journal of Clinical Monitoring and Computing)
Source: Journal of Clinical Monitoring and Computing - January 27, 2024 Category: Information Technology Source Type: research