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.

A machine learning algorithm for detecting abnormal patterns in continuous capnography and pulse oximetry monitoring
This study pres ents a promising advancement in respiratory monitoring, focusing on reducing false alarms and enhancing accuracy of alarm systems. Our algorithm reliably distinguishes normal from abnormal waveforms. More research is needed to define patterns to distinguish abnormal ventilation from artifacts. (Source: Journal of Clinical Monitoring and Computing)
Source: Journal of Clinical Monitoring and Computing - April 15, 2024 Category: Information Technology Source Type: research

Effect of vertical stopcock position on start-up fluid delivery in syringe pumps used for microinfusions
AbstractThe purpose of this in vitro study was to evaluate the impact of the vertical level of the stopcock connecting the infusion line to the central venous catheter on start-up fluid delivery in microinfusions.  Start-up fluid delivery was measured under standardized conditions with the syringe outlet and liquid flow sensors positioned at heart level (0 cm) and exposed to a simulated CVP of 10 mmHg at a set flow rate of 1 ml/h. Flow and intraluminal pressures were measured with the infusion line connec ted to the stopcock primarily placed at vertical levels of 0 cm, + 30 cm and − 30 cm or primarily plac...
Source: Journal of Clinical Monitoring and Computing - April 15, 2024 Category: Information Technology Source Type: research

Is EIT-guided positive end-expiratory pressure titration for optimizing PEEP in ARDS the white elephant in the room? A systematic review with meta-analysis and trial sequential analysis
AbstractElectrical Impedance Tomography (EIT) is a novel real-time lung imaging technology for personalized ventilation adjustments, indicating promising results in animals and humans. The present study aimed to assess its clinical utility for improved ventilation and oxygenation compared to traditional protocols. Comprehensive electronic database screening was done until 30th November, 2023. Randomized controlled trials,  controlled clinical trials, comparative cohort studies, and assessments of EIT-guided PEEP titration and conventional methods in adult ARDS patients regarding outcome, ventilatory parameters, and P/F ra...
Source: Journal of Clinical Monitoring and Computing - April 15, 2024 Category: Information Technology Source Type: research

Knowledge-based, computerized, patient clinical decision support system for perioperative pain, nausea and constipation management: a clinical feasibility study
We report the development and feasibility validation of a knowledge-based CDSS aiming at optimizing the management of perioperative pain, postoperative nausea and vomiting (PONV), and laxative medications. This novel CDSS uses patient adaptive testing through a smartphone display, literature-based rules, and individual medical prescriptions to produce direct medical advice for the patient user. Our objective was to test the feasibility of the clinical use of our CDSS in the perioperative setting. This was a prospective single arm, single center, cohort study conducted in Strasbourg University Hospital. The primary outcome ...
Source: Journal of Clinical Monitoring and Computing - April 12, 2024 Category: Information Technology Source Type: research

The predictive role of carotid artery flow time for anesthesia-induced hypotension in high-risk elderly patients
AbstractHypotension induced by general anesthesia is associated with postoperative complications, increased mortality, and morbidity, particularly elderly patients. The aim of this study was to investigate the effectiveness of corrected carotid artery flow time (FTc) for predicting hypotension following anesthesia induction in patients over 65 years old.  After faculty ethical committee approval and written informed consent, 138 patients (65 years and older, ASA physical status I–III) who scheduled for elective surgery were included in this study. In the pre-operative anesthesia unit, the carotid artery FTc value was me...
Source: Journal of Clinical Monitoring and Computing - April 12, 2024 Category: Information Technology Source Type: research

Algor-ethics: charting the ethical path for AI in critical care
AbstractThe integration of Clinical Decision Support Systems (CDSS) based on artificial intelligence (AI) in healthcare is groundbreaking evolution with enormous potential, but its development and ethical implementation, presents unique challenges, particularly in critical care, where physicians often deal with life-threating conditions requiring rapid actions and patients unable to participate in the decisional process. Moreover, development of AI-based CDSS is complex and should address different sources of bias, including data acquisition, health disparities, domain shifts during clinical use, and cognitive biases in de...
Source: Journal of Clinical Monitoring and Computing - April 4, 2024 Category: Information Technology Source Type: research

The time constant of the cerebral arterial bed: exploring age-related implications
This study assessed differences in τ among healthy volunteers across different age groups. Simultaneous r ecordings of transcranial Doppler cerebral blood flow velocity (CBFV) and arterial blood pressure (ABP) were performed on two groups: young volunteers (below 30 years of age), and older volunteers (above 40 years of age). τ was estimated using mathematical transformation of ABP and CBFV pulse wav eforms. 77 healthy volunteers [52 in the young group, and 25 in the old group] were included. Pulse amplitude of ABP was higher [16.7 (14.6–19.4) mmHg] in older volunteers as compared to younger ones [12.5 (10.9–14.4)...
Source: Journal of Clinical Monitoring and Computing - April 4, 2024 Category: Information Technology Source Type: research

Machine learning based analysis and detection of trend outliers for electromyographic neuromuscular monitoring
ConclusionsEngineered TOF-R trend features and the resulting Cost-Sensitive Logistic Regression (CSLR) models provide useful insights and serve as a potential first step towards the automated removal of outliers for neuromuscular monitoring devices.Trial registrationNCT04518761 (clinicaltrials.gov), registered on 19 August 2020. (Source: Journal of Clinical Monitoring and Computing)
Source: Journal of Clinical Monitoring and Computing - April 4, 2024 Category: Information Technology Source Type: research

Towards the automatic detection and correction of abnormal arterial pressure waveforms
AbstractBoth over and underdamping of the arterial pressure waveform are frequent during continuous invasive radial pressure monitoring. They may influence systolic blood pressure measurements and the accuracy of cardiac output monitoring with pulse wave analysis techniques. It is therefore recommended to regularly perform fast flush tests to unmask abnormal damping. Smart algorithms have recently been developed for the automatic detection of abnormal damping. In case of overdamping, air bubbles, kinking, and partial obstruction of the arterial catheter should be suspected and eliminated. In the case of underdamping, reson...
Source: Journal of Clinical Monitoring and Computing - April 4, 2024 Category: Information Technology Source Type: research

Continuity with caveats in anesthesia: state and response entropy of the EEG
AbstractThe growing use of neuromonitoring in general anesthesia provides detailed insights into the effects of anesthetics on the brain. Our study focuses on the processed EEG indices State Entropy (SE), Response Entropy (RE), and Burst Suppression Ratio (BSR) of the GE EntropyTM Module, which serve as surrogate measures for estimating the level of anesthesia. While retrospectively analyzing SE and RE index values from patient records, we encountered a technical anomaly with a conspicuous distribution of index values. In this single-center, retrospective study, we analyzed processed intraoperative electroencephalographic ...
Source: Journal of Clinical Monitoring and Computing - April 3, 2024 Category: Information Technology Source Type: research

Relationship between preinduction electroencephalogram patterns and propofol sensitivity in adult patients
ConclusionPreinduction EEG, particularly relative delta power, is associated with propofol requirements during the induction of general anesthesia. The utilization of preinduction EEG data may improve the precision of induction dose selection for individuals. (Source: Journal of Clinical Monitoring and Computing)
Source: Journal of Clinical Monitoring and Computing - April 2, 2024 Category: Information Technology Source Type: research

The modern anesthesiologist's manual: the development and maintenance of an anesthesia case reference application
AbstractAnesthesia clinicians care for patients undergoing a wide range of procedures, making access to reliable references crucial. However, existing resources have key limitations. This technical report describes the development of an in-house anesthesia case reference application designed for use in a tertiary academic hospital. Additionally, it details our experiences in maintaining this system over a 22-month period and compares this system to alternative resources. Utilizing JavaScript and the React library, we developed a cross-platform perioperative reference application. Over fifty articles, encompassing anestheti...
Source: Journal of Clinical Monitoring and Computing - April 2, 2024 Category: Information Technology Source Type: research

Impact of graft reperfusion on cardiac function assessed by transesophageal echocardiography during liver transplantation: an observational retrospective study
AbstractCardiovascular instability is common during the reperfusion phase of orthotopic liver transplantation (OLT), and some patients experience a postreperfusion syndrome (PRS). However, there are no reports comparing the cardiac dysfunction between patients with PRS and those without. Thus, the aim of this study was to evaluate cardiac dysfunction in patients exhibiting PRS. This observational retrospective study included 34 patients who underwent OLT and were monitored with transesophageal echocardiography (TEE). The right ventricular/left ventricular (RV/LV) end diastolic area, tricuspid annular plane systolic excursi...
Source: Journal of Clinical Monitoring and Computing - April 1, 2024 Category: Information Technology Source Type: research

An in-depth analysis of parameter settings and probability distributions of specific ordinal patterns in the Shannon permutation entropy during different states of consciousness in humans
AbstractAs electrical activity in the brain has complex and dynamic properties, the complexity measure permutation entropy (PeEn) has proven itself to reliably distinguish consciousness states recorded by the EEG. However, it has been shown that the focus on specific ordinal patterns instead of all of them produced similar results. Moreover, parameter settings influence the resulting PeEn value. We evaluated the impact of the embedding dimensionm and the length of the EEG segment on the resulting PeEn. Moreover, we analysed the probability distributions of monotonous and non-occurring ordinal patterns in different paramete...
Source: Journal of Clinical Monitoring and Computing - April 1, 2024 Category: Information Technology Source Type: research

Effect of incremental PEEP titration on postoperative pulmonary complications in patients undergoing emergency laparotomy: a randomized controlled trial
AbstractPostoperative pulmonary complications (PPC) has a significant negative impact and are associated with increased length of hospital stay and cost of care. Emergency surgery is a well-established risk factor for PPC. Previous studies reported that personalized positive end-expiratory pressure (PEEP) might reduce postoperative atelectasis and postoperative pulmonary complications.N = 168 adult patients undergoing major emergency laparotomy under general anesthesia were recruited in this study. A minimum driving pressure based incremental PEEP titration was compared to a fixed PEEP of 5 cmH2O. The primary outcome w...
Source: Journal of Clinical Monitoring and Computing - April 1, 2024 Category: Information Technology Source Type: research