Preoperative assessment of optic nerve sheath diameter and heart rate variability to predict intraoperative brain condition in patients with supratentorial tumors: a prospective observational study
This study was aimed to determine the usefulness of heart rate variability (HRV) parameters and ONSD preoperatively in predicting intraoperative brain relaxation in patients with supratentorial tumors undergoing surgery.This prospective observational study was conducted in a tertiary care centre. 58 patients with supratentorial brain tumors undergoing elective surgery were studied. Preoperative clinical presentation, computed tomography (CT) findings, ONSD and HRV parameters were assessed in determining intraoperative brain condition. Intraoperative hemodynamic parameters and brain relaxation score after craniotomy were st...
Source: Journal of Clinical Monitoring and Computing - May 11, 2023 Category: Information Technology Source Type: research

Normalization of low frontal regional cerebral oxygenation after evacuation of chronic subdural hematoma in a patient with bilateral internal carotid artery stenosis
We report a case wherein low values of frontal rSO2 normalized after evacuation of bilateral fronto-temporo-parietal (FTP) chronic subdural hematoma (CSDH) in a patient with bilateral internal carotid artery (ICA) stenosis. (Source: Journal of Clinical Monitoring and Computing)
Source: Journal of Clinical Monitoring and Computing - May 11, 2023 Category: Information Technology Source Type: research

Tracheal sound-based apnea detection using hidden Markov model in sedated volunteers and post anesthesia care unit patients
AbstractThe current method of apnea detection based on tracheal sounds is limited in certain situations. In this work, the Hidden Markov Model (HMM) algorithm based on segmentation is used to classify the respiratory and non-respiratory states of tracheal sounds, to achieve the purpose of apnea detection. Three groups of tracheal sounds were used, including two groups of data collected in the laboratory and a group of patient data in the post anesthesia care unit (PACU). One was used for model training, and the others (laboratory test group and clinical test group) were used for testing and apnea detection. The trained HMM...
Source: Journal of Clinical Monitoring and Computing - May 4, 2023 Category: Information Technology Source Type: research

Rocuronium action can be affected by hyperventilation: a case report and computational simulation
Conclusions: This case report and computational simulation suggest that respiratory alkalosis might delay the action of rocuronium. It is necessary to consider the delayed action of rocuronium when hyperventilation is performed. (Source: Journal of Clinical Monitoring and Computing)
Source: Journal of Clinical Monitoring and Computing - May 4, 2023 Category: Information Technology Source Type: research

Feasibility analysis of a novel non-invasive ultrasonographic method for the measurement of intra-abdominal pressure in the intensive care unit
This study aimed to validate a novel non-invasive ultrasonographic approach to IAP measurement against the gold standard intra-bladder pressure (IBP) method. We conducted a prospective observational study in an adult medical ICU of a university hospital. IAP measurements using ultrasonography by two independent operators, with different experience levels (experienced, IAPUS1; inexperienced, IAPUS2), were compared with the gold standard IBP method performed by a third blinded operator. For the ultrasonographic method, decremental external pressure was applied on the anterior abdominal wall using a bottle filled with decreas...
Source: Journal of Clinical Monitoring and Computing - May 3, 2023 Category: Information Technology Source Type: research

Multisensory alarm to benefit alarm identification and decrease workload: a feasibility study
This study tested a novel multisensory alarm system which aims to help medical personnel better interpret and respond to alarm annunciation during periods of high cognitive load such as those found within intensive care units. We tested a multisensory alarm that combined auditory and vibrotactile cues to convey alarm type, alarm priority, and patient identity. Testing was done in three phases: control (conventional auditory), Half (limited multisensory alarm), and Full (complete multisensory alarm). Participants (N  = 19, undergraduates) identified alarm type, priority, and patient identity (patient 1 or 2) using conve...
Source: Journal of Clinical Monitoring and Computing - May 3, 2023 Category: Information Technology Source Type: research

Linear thinking does not reflect the newer 21st-century anesthesia concepts. A narrative review
AbstractThe brain constitutes a good example of a chaotic, nonlinear biological system where large neuronal networks operate chaotically with random connectivity. This critical state is significantly affected by the anesthetic loss of consciousness induced by drugs whose pharmacological behavior has been classically based on linear kinetics and dynamics. Recent developments in pharmacology and brain monitoring during anesthesia suggest a different view that we tried to explore in this article. The concepts of effect-site for hypnotic drugs modeling a maximum effect, electroencephalographic dynamics during induction, mainte...
Source: Journal of Clinical Monitoring and Computing - May 2, 2023 Category: Information Technology Source Type: research

Towards autoregulation-oriented management after traumatic brain injury: increasing the reliability and stability of the CPPopt algorithm
ConclusionThe CPPopt calculation algorithm was fine-tuned and adapted for prospective use with acceptable lower yield, improved stability and maintained prognostic power. (Source: Journal of Clinical Monitoring and Computing)
Source: Journal of Clinical Monitoring and Computing - April 29, 2023 Category: Information Technology Source Type: research

Tracheal intubating conditions in elderly patients when train-of-four count is zero after rocuronium 0.6 or 0.9  mg/kg. A secondary analysis
Conclusion: The proportion of patients with vocal cords in abducted position was significantly larger after rocuronium 0.9 mg/kg compared to rocuronium 0.6 mg/kg at TOF 0 monitored at the uln ar nerve. (Source: Journal of Clinical Monitoring and Computing)
Source: Journal of Clinical Monitoring and Computing - April 29, 2023 Category: Information Technology Source Type: research

Hypotension Prediction Index guided Goal Directed therapy and the amount of Hypotension during Major Gynaecologic Oncologic Surgery: a Randomized Controlled clinical Trial
AbstractIntraoperative hypotension (IOH) is associated with increased morbidity and mortality. Hypotension Prediction Index (HPI) is a machine learning derived algorithm that predicts IOH shortly before it occurs. We tested the hypothesis that the application of the HPI in combination with a pre-defined Goal Directed Therapy (GDT) hemodynamic protocol reduces IOH during major gynaecologic oncologic surgery. We enrolled women scheduled for major gynaecologic oncologic surgery under general anesthesia with invasive arterial pressure monitoring. Patients were randomized to a GDT protocol aimed at optimizing stroke volume inde...
Source: Journal of Clinical Monitoring and Computing - April 29, 2023 Category: Information Technology Source Type: research

Diuretics depletion improves cardiac output and ventriculo-arterial coupling in congestive ICU patients during hemodynamic de-escalation
Conclusion: The initiation of diuretics in ICU congestive patients with stabilized shock was associated with improvement of cardiac index, ventriculo-arterial coupling, and tissue perfusion parameter. These effects were not observed in non-congestive patients. (Source: Journal of Clinical Monitoring and Computing)
Source: Journal of Clinical Monitoring and Computing - April 25, 2023 Category: Information Technology Source Type: research

From Big Data ’s 5Vs to clinical practice’s 5Ws: enhancing data-driven decision making in healthcare
AbstractThe use of AI-based algorithms is rapidly growing in healthcare, but there is still an ongoing debate about how to manage and ensure accountability for their clinical use. While most of the studies focus on demonstrating a good algorithm performance it is important to acknowledge that several additional steps are needed for reaching an effective implementation of AI-based models in daily clinical practice, with implementation being one of the main key factors. We propose a model characterized by five questions that can guide in this process. Additionally, we believe that a hybrid intelligence, human and artificial ...
Source: Journal of Clinical Monitoring and Computing - April 25, 2023 Category: Information Technology Source Type: research

Correction to: Dyspnea: perfusion index and triage status
(Source: Journal of Clinical Monitoring and Computing)
Source: Journal of Clinical Monitoring and Computing - April 25, 2023 Category: Information Technology Source Type: research

The elephant in the room: cybersecurity in healthcare
AbstractCybersecurity has seen an increasing frequency and impact of cyberattacks and exposure of Protected Health Information (PHI). The uptake of an Electronic Medical Record (EMR), the exponential adoption of Internet of Things (IoT) devices, and the impact of the COVID-19 pandemic has increased the threat surface presented for cyberattack by the healthcare sector.  Within healthcare generally and, more specifically, within anaesthesia and Intensive Care, there has been an explosion in wired and wireless devices used daily in the care of almost every patient—the Internet of Medical Things (IoMT); ventilators, anaesth...
Source: Journal of Clinical Monitoring and Computing - April 24, 2023 Category: Information Technology Source Type: research

Assessment of stress response due to C-Mac D-blade guided videolaryngoscopic endotracheal intubation and docking of da Vinci surgical robot using perfusion index in patients undergoing transoral robotic oncosurgery
AbstractClinical utility of perfusion index (PI) has entered a new realm as a non-invasive, quantitative index of stress response to endotracheal intubation. Transoral robotic surgery (TORS) involves F-K retractor aided docking of the surgical robot producing haemodynamic and stress responses akin to laryngoscopy. We compared the stress response to videolaryngoscopy with that due to docking of da Vinci surgical robot using PI, heart rate and mean arterial pressure evaluated at specific time points post-laryngoscopy and post-docking. Twenty-six adult patients, scheduled for TORS under general endotracheal anaesthesia were i...
Source: Journal of Clinical Monitoring and Computing - April 24, 2023 Category: Information Technology Source Type: research