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Journal of Clinical Monitoring and Computing

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https://www.readbyqxmd.com/read/28229353/cardiorespiratory-instability-in-monitored-step-down-unit-patients-using-cluster-analysis-to-identify-patterns-of-change
#1
Eliezer L Bose, Gilles Clermont, Lujie Chen, Artur W Dubrawski, Dianxu Ren, Leslie A Hoffman, Michael R Pinsky, Marilyn Hravnak
Cardiorespiratory instability (CRI) in monitored step-down unit (SDU) patients has a variety of etiologies, and likely manifests in patterns of vital signs (VS) changes. We explored use of clustering techniques to identify patterns in the initial CRI epoch (CRI1; first exceedances of VS beyond stability thresholds after SDU admission) of unstable patients, and inter-cluster differences in admission characteristics and outcomes. Continuous noninvasive monitoring of heart rate (HR), respiratory rate (RR), and pulse oximetry (SpO2) were sampled at 1/20 Hz...
February 22, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/28229352/linshom-thermodynamic-sensor-is-a-reliable-alternative-to-capnography-for-monitoring-respiratory-rate
#2
David Preiss, Benjamin A Drew, James Gosnell, Bhavani S Kodali, James H Philip, Richard D Urman
Monitoring ventilation accurately is a technically challenging, yet indispensable aspect of patient care in the intra- and post-procedural settings. A new prototypical device known as the Linshom Respiratory Monitoring Device (LRMD) has been recently designed to non-invasively, inexpensively, and portably measure respiratory rate. The purpose of this study was to measure the accuracy and variability of LRMD measurements of respiratory rate relative to the measurement of capnography. In this prospective study, participants were enrolled and individually fitted with a face mask monitored by the LRMD and capnography...
February 22, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/28224323/an-abrupt-reduction-in-end-tidal-carbon-di-oxide-concentration-in-a-mechanically-ventilated-patient-in-neurocritical-care-ward-a-capnogram-artifact
#3
LETTER
Byrappa Vinay
In patients with normal lung and reasonable cardiac function such as head injury patients, the PETCo2 can be used as a surrogate for partial pressure of Carbon dioxide (PaCO2) in mechanically ventilated patients. Thus early interpretation and accurate assessment of capnogram is crucial in neurocritical care patients. Here we present and discuss a scenario where in connection of a jet nebulizer to the ventilator lead to abrupt decrease in end tidal carbon dioxide leading to a diagnostic dilemma. Also this report highlights and discusses the importance of the proper placement of breathing circuit components to ensure accurate CO2 readings in particular the use of a jet nebulizer...
February 21, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/28220350/in-response-to-understanding-elevated-pv-aco2-gap-and-pv-aco2-ca-vo2-ratio-in-venous-hyperoxia-condition
#4
LETTER
P Saludes, L Proença, G Gruartmoner, L Enseñat, A Pérez-Madrigal, C Espinal, J Mesquida
No abstract text is available yet for this article.
February 20, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/28217824/understanding-elevated-pv-aco2-gap-and-pv-aco2-ca-vo2-ratio-in-venous-hyperoxia-condition
#5
LETTER
Huai-Wu He, Da-Wei Liu, Can Ince
No abstract text is available yet for this article.
February 20, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/28214930/investigation-of-optical-neuro-monitoring-technique-for-detection-of-maintenance-and-emergence-states-during-general-anesthesia
#6
Gabriela Hernandez-Meza, Meltem Izzetoglu, Mary Osbakken, Michael Green, Hawa Abubakar, Kurtulus Izzetoglu
The American Society of Anesthesiologist recommends peripheral physiological monitoring during general anesthesia, which offers no information regarding the effects of anesthetics on the brain. Since no "gold standard" method exists for this evaluation, such a technique is needed to ensure patient comfort, procedure quality and safety. In this study we investigated functional near infrared spectroscopy (fNIRS) as possible monitor of anesthetic effects on the prefrontal cortex. Anesthetic drugs, such as sevoflurane, suppress the cerebral metabolism and alter the cerebral blood flow...
February 18, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/28210936/does-obesity-affect-the-non-invasive-measurement-of-cardiac-output-performed-by-electrical-cardiometry-in-children-and-adolescents
#7
Luis Altamirano-Diaz, Eva Welisch, Ralf Rauch, Michael Miller, Teresa Sohee Park, Kambiz Norozi
Electrical cardiometry (EC) is a non-invasive and inexpensive method for hemodynamic assessment and monitoring. However, its feasibility for widespread clinical use, especially for the obese population, has yet to be determined. In this study, we evaluated the agreement and reliability of EC compared to transthoracic Doppler echocardiography (TTE) in normal, overweight, and obese children and adolescents. We measured stroke volume (SV) and cardiac output (CO) of 131 participants using EC and TTE simultaneously...
February 17, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/28210935/the-effect-of-fluid-resuscitation-on-the-effective-circulating-volume-in-patients-undergoing-liver-surgery-a-post-hoc-analysis-of-a-randomized-controlled-trial
#8
Jaap Jan Vos, A F Kalmar, H G D Hendriks, J Bakker, T W L Scheeren
To assess the significance of an analogue of the mean systemic filling pressure (Pmsa) and its derived variables, in providing a physiology based discrimination between responders and non-responders to fluid resuscitation during liver surgery. A post-hoc analysis of data from 30 patients undergoing major hepatic surgery was performed. Patients received 15 ml kg(-1) fluid in 30 min. Fluid responsiveness (FR) was defined as an increase of 20% or greater in cardiac index, measured by FloTrac-Vigileo(®). Dynamic preload variables (pulse pressure variation and stroke volume variation: PPV, SVV) were recorded additionally...
February 16, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/28210934/adarri-a-novel-method-to-detect-spurious-r-peaks-in-the-electrocardiogram-for-heart-rate-variability-analysis-in-the-intensive-care-unit
#9
Dennis J Rebergen, Sunil B Nagaraj, Eric S Rosenthal, Matt T Bianchi, Michel J A M van Putten, M Brandon Westover
We developed a simple and fully automated method for detecting artifacts in the R-R interval (RRI) time series of the ECG that is tailored to the intensive care unit (ICU) setting. From ECG recordings of 50 adult ICU-subjects we selected 60 epochs with valid R-peak detections and 60 epochs containing artifacts leading to missed or false positive R-peak detections. Next, we calculated the absolute value of the difference between two adjacent RRIs (adRRI), and obtained the empirical probability distributions of adRRI values for valid R-peaks and artifacts...
February 16, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/28188408/cross-comparisons-of-trending-accuracies-of-continuous-cardiac-output-measurements-pulse-contour-analysis-bioreactance-and-pulmonary-artery-catheter
#10
Bouchra Lamia, Hyung Kook Kim, Donald A Severyn, Michael R Pinsky
We compared the similarity of cardiac-output (CO) estimates between available bolus thermodilution pulmonary-artery catheters (PAC), arterial pulse-contour analysis (LiDCOplus(™), FloTrac(™) and PiCCOplus(™)), and bioreactance (NICOM(™)). Repetitive simultaneous estimates of CO obtained from the above devices were compared in 21 cardiac-surgery patients during the first 2 h post-surgery. Mean and absolute values for CO across the devices were compared by ANOVA, Bland-Altman, Pearson moment, and linear-regression analyses...
February 10, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/28181055/endotracheal-bioimpedance-cardiography-improves-immediate-postoperative-outcome-a-case-control-study-in-off-pump-coronary-surgery
#11
Thomas Leclercq, Marc Lilot, Thomas Schulz, Alexandre Meyer, Fadi Farhat, Jean-Luc Fellahi
The feasibility and clinical utility of the endotracheal cardiac output monitor (ECOM) to optimize intraoperative hemodynamics and improve short-term outcome in off-pump coronary artery bypass grafting (OPCAB) is unknown. We aimed to compare ECOM with a standard of care in that specific surgical setting. Twenty consecutive adult ECOM-monitored patients undergoing OPCAB were prospectively included (ECOM group) and retrospectively compared to 42 patients scheduled for similar surgery without ECOM monitoring (Control group)...
February 8, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/28176049/experimental-comparison-of-performances-of-mega-acer-kit-ranger-and-thermosens-according-to-flow-rates-and-distances
#12
Hong Ju Seo, Sang Hun Kim, Tae Hun An, Dong Joon Kim
We experimentally investigated the fluid warming performances of three warmers with different technology, according to flow rates and distances. We used the following intravenous fluid warmers: Mega Acer Kit (Group M, n = 8), Ranger (group R, n = 8), and ThermoSens (group T, n = 8). Fluids that had been stored in the operating room over the previous 24 h were delivered at sequent flow rates of from 440 mL/h up to 2500 mL/h through preheated warming devices. The fluid temperatures were recorded at the inlet point, 76-cm proximal (Pout1) and 166-cm distal outlet points (Pout2) every 1 min for 10 min...
February 7, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/28176048/influences-of-environmental-noise-level-and-respiration-rate-on-the-accuracy-of-acoustic-respiration-rate-monitoring
#13
Shizuha Yabuki, Hiroaki Toyama, Yusuke Takei, Toshihiro Wagatsuma, Hiroshi Yabuki, Masanori Yamauchi
We tested the hypothesis that the environmental noise generated by a forced-air warming system reduces the monitoring accuracy of acoustic respiration rate (RRa). Noise levels were adjusted to 45-55, 56-65, 66-75, and 76-85 dB. Healthy participants breathed at set respiration rates (RRset) of 6, 12, and 30/min. Under each noise level at each RRset, the respiration rates by manual counting (RRm) and RRa were recorded. Any appearance of the alarm display on the RRa monitor was also recorded. Each RRm of all participants agreed with each RRset at each noise level...
February 7, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/28168583/the-future-of-intraoperative-blood-pressure-management
#14
EDITORIAL
Frederic Michard, Ngai Liu, Andrea Kurz
No abstract text is available yet for this article.
February 7, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/28161791/can-spirometry-be-a-new-tool-to-predict-the-difficult-airway
#15
EDITORIAL
Andrea Vannucci
No abstract text is available yet for this article.
February 4, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/28138900/in-response-to-tracheal-tube-stylets-as-a-habit
#16
LETTER
Patrick Schoettker, Sina Grape
No abstract text is available yet for this article.
January 30, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/28130679/in-vivo-investigation-of-ear-canal-pulse-oximetry-during-hypothermia
#17
K Budidha, P A Kyriacou
Pulse oximeters rely on the technique of photoplethysmography (PPG) to estimate arterial oxygen saturation (SpO[Formula: see text]). In conditions of poor peripheral perfusion such as hypotension, hypothermia, and vasoconstriction, the PPG signals detected are often weak and noisy, or in some cases unobtainable. Hence, pulse oximeters produce erroneous SpO[Formula: see text] readings in these circumstances. The problem arises as most commercial pulse oximeter probes are designed to be attached to peripheral sites such as the finger or toe, which are easily affected by vasoconstriction...
January 27, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/28124227/tracheal-tube-stylets-as-a-habit
#18
LETTER
Marco Gemma
No abstract text is available yet for this article.
January 25, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/28124226/erratum-to-journal-of-clinical-monitoring-and-computing-2016-end-of-year-summary-cardiovascular-and-hemodynamic-monitoring
#19
Bernd Saugel, Karim Bendjelid, Lester A Critchley, Steffen Rex, Thomas W L Scheeren
No abstract text is available yet for this article.
January 25, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/28124225/feasibility-of-automated-titration-of-vasopressor-infusions-using-a-novel-closed-loop-controller
#20
Joseph Rinehart, Michael Ma, Michael-David Calderon, Maxime Cannesson
Blood pressure management is a central concern in critical care patients. For a variety of reasons, titration of vasopressor infusions may be an ideal use-case for computer assistance. Using our previous experience gained in the bench-to-bedside development of a computer-assisted fluid management system, we have developed a novel controller for this purpose. The aim of this preliminary study was to assess the feasibility of using this controller in simulated patients to maintain a target blood pressure in both stable and variable blood-pressure scenarios...
January 25, 2017: Journal of Clinical Monitoring and Computing
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