Closing the loop: automation in anesthesiology is coming
AbstractAnesthesiology and intensive care medicine provide fertile ground for innovation in automation, but to date we have only achieved preliminary studies in closed-loop intravenous drug administration. Anesthesiologists have yet to implement these tools on a large scale despite clear evidence that they outperform manual titration. Closed-loops continuously assess a predefined variable as input into a controller and then attempt to establish equilibrium by administering a treatment as output. The aim is to decrease the error between the closed-loop controller ’s input and output. In this editorial we consider the avai...
Source: Journal of Clinical Monitoring and Computing - September 14, 2023 Category: Information Technology Source Type: research

Video plethysmography for contactless measurement of respiratory rate in surgical patients
The objective of our study was to determine whether VPPG can feasibly and accurately measure RR without contact in surgical patients at a clinical setting.  After research ethics approval, 216 patients undergoing ambulatory surgery consented to the study. Patients had a 1.5 min video of their faces taken via an iPad preoperatively, which was analyzed using VPPG to obtain RR information. The RR prediction by VPPG was compared to 60-s manual counting o f breathing by research assistants. We found that VPPG predicted RR with 88.8% accuracy and a bias of 1.40 ± 1.96 breaths per minute. A significant and high correlatio...
Source: Journal of Clinical Monitoring and Computing - September 12, 2023 Category: Information Technology Source Type: research

Performance of closed-loop systems for intravenous drug administration: a systematic review and meta-analysis of randomised controlled trials
AbstractClosed-loop drug delivery systems are autonomous computers able to administer medication in response to changes in physiological parameters (controlled variables). While limited evidence suggested that closed-loop systems can perform better than manual drug administration in certain settings, this technology remains a research tool with an uncertain risk/benefit profile. Our aim was comparing the performance of closed-loop systems with manual intravenous drug administration in adults. We searched MEDLINE, CENTRAL, and Embase from inception until November 2022, without restriction to language. We assessed for inclus...
Source: Journal of Clinical Monitoring and Computing - September 11, 2023 Category: Information Technology Source Type: research

Improving case duration accuracy of orthopedic surgery using bidirectional encoder representations from Transformers (BERT) on Radiology Reports
ConclusionThis proof-of-concept study demonstrated the successful application of NLP and machine leaning to extract features from unstructured clinical data resulting in improved prediction accuracy for surgical case duration. (Source: Journal of Clinical Monitoring and Computing)
Source: Journal of Clinical Monitoring and Computing - September 11, 2023 Category: Information Technology Source Type: research

Glucose measurements with accu check inform II versus hexokinase plasma method during surgery under general anesthesia, an observational cohort study
ConclusionThe agreement between glucose measurements using ACI II and the reference laboratory hexokinase test was clinically acceptable with a percentage error of 10.0% (95% CI 8.0 to 11.9). The use of TIVA may negatively affect the measurement performance of the ACI II. (Source: Journal of Clinical Monitoring and Computing)
Source: Journal of Clinical Monitoring and Computing - September 9, 2023 Category: Information Technology Source Type: research

Cardiac surgery-associated acute kidney injury and perioperative plasma viscosity: is there a relationship?
AbstractPlasma viscosity (PV) is a key factor in microcirculatory flow resistance and capillary perfusion during hemodilution, we hypothesized a possible relationship between cardiac surgery-associated acute kidney injury (CSA-AKI) and PV. We conducted a prospective, observational, single-center study on 50 adult cardiac surgery patients with cardiopulmonary bypass (age 64 years, male sex 80%, baseline serum creatinine 1.04  mg/dL). We assessed perioperative characteristics, management, short-term outcomes, blood analysis, PV, serum creatinine, and diuresis. CSA-AKI was identified using KDIGO criteria. Data were collected...
Source: Journal of Clinical Monitoring and Computing - August 23, 2023 Category: Information Technology Source Type: research

Optical crosstalk and other forms of light interference in pulse oximeter comparison studies
Conclusions: Crosstalk and other forms of optical interference can corrupt pulse oximeter readings. Proper sensor placement and use of optical shielding of sensors are crucial steps to help protect the integrity of the data. Studies to further characterize crosstalk during pulse oximeter comparison studies are needed. (Source: Journal of Clinical Monitoring and Computing)
Source: Journal of Clinical Monitoring and Computing - August 23, 2023 Category: Information Technology Source Type: research

Evaluation of the venting principle to reduce start-up delays in syringe infusion pumps used for microinfusions
AbstractStart-up delays of syringe pump assemblies can impede the timely commencement of an effective drug therapy when using microinfusions in hemodynamically unstable patients. The application of the venting principle has been proposed to eliminate start-up delays in syringe pump assemblies. However, effectively delivered infusion volumes using this strategy have so far not been measured. This invitro study used two experimental setups to measure the effect of the venting principle compared to a standard non-venting approach on delivered start-up infusion volumes at various timepoints, backflow volumes, flow inversion an...
Source: Journal of Clinical Monitoring and Computing - August 23, 2023 Category: Information Technology Source Type: research

Comparison of the effects of dexmedetomidine and propofol on the cardiovascular autonomic nervous system during spinal anesthesia: preliminary randomized controlled observational study
AbstractSpinal anesthesia induces sympatholysis and is usually combined with dexmedetomidine or propofol which induce different hemodynamic changes. The purpose of this study was to compare the effect on autonomic nervous system between dexmedetomidine and propofol combined with spinal anesthesia. Patients aged 20 –65 undergoing elective surgery under spinal anesthesia were randomly assigned to dexmedetomidine or propofol group. Heart rate variability (HRV) and hemodynamic variables were measured at four time points: T0, baseline; T1, 10 min after spinal anesthesia; T2, 10 min after sedative administratio n; and T3, 20...
Source: Journal of Clinical Monitoring and Computing - August 12, 2023 Category: Information Technology Source Type: research

Internal jugular vein collapsibility does not predict fluid responsiveness in spontaneously breathing patients after cardiac surgery
Conclusion: In spontaneously breathing patients after surgical coronary revascularisation, collapsibility of the internal jugular vein did not predict fluid responsiveness. (Source: Journal of Clinical Monitoring and Computing)
Source: Journal of Clinical Monitoring and Computing - August 12, 2023 Category: Information Technology Source Type: research

Optic nerve sheath diameter measurement for prediction of postdural puncture headache
ConclusionThe difference between the ONSD values measured before and after spinal anesthesia may be an important parameter for predicting the risk of PDPH development. (Source: Journal of Clinical Monitoring and Computing)
Source: Journal of Clinical Monitoring and Computing - August 9, 2023 Category: Information Technology Source Type: research

Efficacy and safety of three inflation methods of the laryngeal mask airway Ambu ® Auraonce™: a randomized controlled study
This study was designed to determine the best cuff inflation method of AuraOnce ™ LMA during bronchoscopy and EBUS (Endobronquial Ultrasound Bronchoscopy) procedure. We designed a Randomized controlled, doble-blind, clinical trial to compare the efficacy and safety of three cuff inflation methods of AuraOnce™ LMA. 210 consenting patients scheduled for EBUS procedure under g eneral anesthesia, using AuraOnce™ LMA were randomized into three groups depending on cuff insufflation: residual volume (RV), half of the maximum volume (MV), unchanged volume (NV). Parameters regarding intracuff pressure (IP), airway leak pressu...
Source: Journal of Clinical Monitoring and Computing - August 4, 2023 Category: Information Technology Source Type: research

Autonomic dysfunction as a predictor of infection in neurocritical care unit: a prospective cohort study
ConclusionAD assessment can be used as a tool to predict development of infection in NCCU. This can help triage and institute early investigation and treatment. (Source: Journal of Clinical Monitoring and Computing)
Source: Journal of Clinical Monitoring and Computing - August 3, 2023 Category: Information Technology Source Type: research

Behaviour and stability of thermodilution signals in a closed extracorporeal circuit: a bench study
AbstractThermodilution is the gold standard for cardiac output measurement in critically ill patients. Its application in extracorporeal therapy is limited, as a portion of the thermal indicator is drawn into the extracorporeal circuit. The behaviour of thermodilution signals in extracorporeal circuits is unknown. We investigated thermodilution curves within a closed-circuit and assessed the impact of injection volume, flow and distance on the behaviour of the thermodilution signals and catheter constants. We injected 3, 5, 7 and 10  ml of thermal indicator into a heated closed circuit. Thermistors at distances of 40, 60,...
Source: Journal of Clinical Monitoring and Computing - July 27, 2023 Category: Information Technology Source Type: research

Dyspnea: perfusion index and triage status
Conclusion: The perfusion index can help to determine the triage classification in emergency departments for dyspnea. (Source: Journal of Clinical Monitoring and Computing)
Source: Journal of Clinical Monitoring and Computing - July 27, 2023 Category: Information Technology Source Type: research