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Electrocardiogram alterations in non-traumatic brain injury: a systematic review
AbstractThe presence of abnormal electrocardiograms in individuals without known organic heart disease is one of the most common manifestations of cardiac dysfunction occurring during acute non traumatic brain injury. The primary goal of the present review is to provide an overview of the available data and literature regarding the presence of new-onset electrocardiographic (ECG) alterations in acute non traumatic brain injury. The secondary aim is to identify the incidence of ECG alterations and consider the prognostic significance of new-onset ECG changes in this setting. To do so, English language articles from January ...
Source: Journal of Clinical Monitoring and Computing - September 22, 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 - August 12, 2023 Category: Information Technology Source Type: research

“The peripheral perfusion index discriminates haemodynamic responses to induction of general anaesthesia”
AbstractInduction of general anaesthesia is often accompanied by hypotension. Standard haemodynamic monitoring during anaesthesia relies on intermittent blood pressure and heart rate. Continuous monitoring systemic blood pressure requires invasive or advanced modalities creating a barrier for obtaining important information of the circulation. The Peripheral Perfusion Index (PPI) is obtained non-invasively and continuously by standard photoplethysmography. We hypothesized that different patterns of changes in systemic haemodynamics during induction of general anaesthesia would be reflected in the PPI. Continuous values of ...
Source: Journal of Clinical Monitoring and Computing - June 8, 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

Bioimpedance based determination of cardiac index does not show enough trueness for point of care use in patients with systolic heart failure
AbstractCardiac output (CO) is a key parameter in diagnostics and therapy of heart failure (HF). The thermodilution method (TD) as gold standard for CO determination is an invasive procedure with corresponding risks. As an alternative, thoracic bioimpedance (TBI) has gained popularity for CO estimation as it is non-invasive. However, systolic heart failure (HF) itself might worsen its validity. The present study validated TBI against TD.  In patients with and without systolic HF (LVEF ≤ 50% or>  50% and NT-pro-BNP <  125 pg/ml, respectively) right heart catheterization including TD was performed. TBI (Ta...
Source: Journal of Clinical Monitoring and Computing - April 19, 2023 Category: Information Technology Source Type: research

Effects of tidal volume challenge on the reliability of plethysmography variability index in hepatobiliary and pancreatic surgeries: a prospective interventional study
ConclusionIn hepatobiliary and pancreatic surgeries, tidal volume challenge improves the reliability of PVI for predicting fluid responsiveness and changes in PVI values obtained after tidal volume challenge are comparable to the changes in SVI.
Source: Journal of Clinical Monitoring and Computing - March 18, 2023 Category: Information Technology Source Type: research

Point of care transthoracic echocardiography for the prediction of post – spinal anesthesia hypotension in elderly patients with cardiac diseases and left ventricular dysfunction
AbstractIn elderly patients with cardiac diseases, changes in cardiovascular physiology diminish cardiovascular reserve and predispose to hemodynamic instability after spinal anesthesia; hence, such patients could be at risk of postoperative complications. Additionally, transthoracic echocardiography (TTE) is used in clinical practice to evaluate cardiovascular hemodynamics. Therefore, we hypothesized that echocardiographic measurements could display significant diagnostic power in the prediction of post - spinal anesthesia hypotension in elderly patients with cardiac diseases and reduced left ventricular ejection fraction...
Source: Journal of Clinical Monitoring and Computing - February 21, 2023 Category: Information Technology Source Type: research

Relationships between common carotid artery blood flow and anesthesia, pneumoperitoneum, and head-down tilt position: a linear mixed-effect analysis
Conclusion: CCA blood flow was significantly decreased by anesthesia induction. Inducing pneumoperitoneum, with or without the head-down tilt position, did not further decrease CCA blood flow if the cardiac index remained unchanged. The cardiac index and stroke volume index were significantly associated with CCA blood flow.Clinical trial registration: Clinicaltrials.gov (NCT04233177, January 18, 2020).
Source: Journal of Clinical Monitoring and Computing - December 4, 2022 Category: Information Technology Source Type: research

Indicators of haemodynamic instability and left ventricular function in a porcine model of esmolol induced negative inotropy
AbstractTo investigate if the Hypotension Prediction Index was an early indicator of haemodynamic instability in a negative inotropy porcine model, and to assess the correlation of commonly measured indicators of left ventricular systolic function. Eight anaesthetised pigs were volume resuscitated and then underwent an incremental infusion of esmolol hydrochloride (0-3000  mg/hr), following which it was then reduced in a stepwise manner. Full haemodynamic measurements were taken at each stage and measurements of left ventricular systolic function including left ventricular stroke work index, ejection fraction and peripher...
Source: Journal of Clinical Monitoring and Computing - November 6, 2022 Category: Information Technology Source Type: research

Pressure response to fluid challenge administration in hypotensive surgical patients: a post-hoc pharmacodynamic analysis of five datasets
In this study we  evaluated the effect of fluid challenge (FC) administration in elective surgical patients with low or normal blood pressure. Secondarily, we appraised the pharmacodynamic effect of FC in normotensive and hypotensive patients. We assessed five merged datasets of patients with a baseline mean arteri al pressure (MAP) above or below 65 mmHg and assessed the changes of systolic, diastolic, mean and dicrotic arterial pressures, dynamic indexes of fluid responsiveness and arterial elastance over a 10-min infusion. The hemodynamic effect was assessed by considering the net area under the curve (AUC ), the maxi...
Source: Journal of Clinical Monitoring and Computing - October 5, 2022 Category: Information Technology Source Type: research

Continuous transthoracic echocardiographic monitoring for changes in maternal cardiac hemodynamics during cesarean section under combined epidural –spinal anesthesia: a prospective, observational study
In conclusion, continuous transthoracic echocardiographic monitoring revealed that there were significant changes in hemodynamic parameters during cesarean section after delivery of the newborn and placenta, which warranted furt her investigation.
Source: Journal of Clinical Monitoring and Computing - September 24, 2022 Category: Information Technology Source Type: research

What is new in microcirculation and tissue oxygenation monitoring?
AbstractEnsuring and maintaining adequate tissue oxygenation at the microcirculatory level might be considered the holy grail of optimal hemodynamic patient management. However, in clinical practice we usually focus on macro-hemodynamic variables such as blood pressure, heart rate, and sometimes cardiac output. Other macro-hemodynamic variables like pulse pressure or stroke volume variation are additionally  used as markers of fluid responsiveness. In recent years, an increasing number of technological devices assessing tissue oxygenation or microcirculatory blood flow have been developed and validated, and some of them h...
Source: Journal of Clinical Monitoring and Computing - March 11, 2022 Category: Information Technology Source Type: research

Accuracy of pulse pressure variations for fluid responsiveness prediction in mechanically ventilated patients with biphasic positive airway pressure mode
AbstractThe accuracy of pulse pressure variation (PPV) to predict fluid responsiveness using pressure-controlled (PC) instead of volume-controlled modes is under debate. To specifically address this issue, we designed a study to evaluate the accuracy of PPV to predict fluid responsiveness in severe septic patients who were mechanically ventilated with biphasic positive airway pressure (BIPAP) PC-ventilation mode. 45 patients with sepsis or septic shock and who were mechanically ventilated with BIPAP mode and a target tidal volume of 7 –8 ml/kg were included. PPV was automatically assessed at baseline and after a standar...
Source: Journal of Clinical Monitoring and Computing - December 5, 2021 Category: Information Technology Source Type: research

Postoperative continuous non-invasive cardiac output monitoring on the ward: a feasibility study
AbstractPostoperative hypotension is common (occurring in one third of patients) and is associated with worse clinical outcomes. The LiDCO CNAP (continuous non-invasive arterial pressure) device measures haemodynamics but has not been widely adopted in ward environments. Improved early detection of hypotension by CNAP might guide interventions to improve clinical outcomes. We aimed to find the proportion of patients who tolerated LiDCO CNAP for 12  h postoperatively, to unmask episodes of hypotension detected by continuous monitoring and to characterise the haemodynamic profile at the time of hypotension. In this feasibil...
Source: Journal of Clinical Monitoring and Computing - October 25, 2021 Category: Information Technology Source Type: research

Indirect measurement of absolute cardiac output during exercise in simulated altered gravity is highly dependent on the method
ConclusionThere is a poor agreement in absolute stroke volume and cardiac output values between measurement via PCA (Nexfin) and IGR (Innocor) in subjects who are exercising in simulated altered gravity environments. These results suggest that the chosen measurement method and device greatly impacts absolute measurements of cardiac output. However, there is a good level of agreement between the two devices when measuring relative changes. Either of these devices seem adequate to capture cardiac changes, but should not be solely relied upon for accurate measurement of absolute cardiac output.
Source: Journal of Clinical Monitoring and Computing - October 22, 2021 Category: Information Technology Source Type: research

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