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Journal of Clinical Monitoring and Computing

Jeongmin Kim, Jun Hwan Kwon, Eungjin Kim, Sun Kook Yoo, Cheung-Soo Shin
We aimed to evaluate changes in respiratory pattern after sedation by simultaneously applying a respiratory volume monitor (ExSpiron1Xi, RVM) and infrared thermography (IRT) to patients undergoing spinal anesthesia during endoscopic urologic surgeries. After spinal anesthesia was performed, the patient was placed in a lithotomy position for surgery. Then, we established the baseline of the RVM, and started monitoring the mouth and nose with the infrared camera. SpO2 was continuously measured throughout these processes...
November 14, 2018: Journal of Clinical Monitoring and Computing
M A Punke, C Decker, M Petzoldt, D A Reuter, K H Wodack, H Reichenspurner, M Kubik, S Kluge
In critical illness hypo-and hyperglycemia have a negative influence on patient outcome. Continuous glucose monitoring (CGM) could help in early detection of hypo-and hyperglycemia. A requirement for these new methods is an acceptable accuracy and precision in clinical practice. In this pilot study we prospectively evaluated the accuracy and precision of two CGM sensors (subcutaneous sensor: Sentrino®, Medtronic and intravasal sensor: Glucoclear®, Edwards) in 20 patients on a cardio-surgical ICU in a head to head comparison...
November 12, 2018: Journal of Clinical Monitoring and Computing
Hee Yong Kang, Ann Hee You, Youngsoon Kim, Jeong-Hyun Choi
No abstract text is available yet for this article.
November 12, 2018: Journal of Clinical Monitoring and Computing
Barret Rush, Leo Anthony Celi, David J Stone
The use of machine learning (ML) in healthcare has enormous potential for improving disease detection, clinical decision support, and workflow efficiencies. In this commentary, we review published and potential applications for the use of ML for monitoring within the hospital environment. We present use cases as well as several questions regarding the application of ML to the analysis of the vast amount of complex data that clinicians must interpret in the realm of continuous physiological monitoring. ML, especially employed in bidirectional conjunction with electronic health record data, has the potential to extract much more useful information out of this currently under-analyzed data source from a population level...
November 11, 2018: Journal of Clinical Monitoring and Computing
Pınar Yalınay Dikmen, V Emre Ozden, Goksel Dikmen, Elif Ilgaz Aydınlar, I Remzi Tozun
The aim of this study was to evaluate the anterior root muscle (ARM) response monitorability during total hip arthroplasty (THA) under spinal anesthesia. A total of 20 adults (64.6 ± 13.87 years old) were monitored using ARM response and free-run electromyography during THA. To elicit the ARM response from muscles, percutaneous stimulation of the lumbosacral roots was performed by self-adhesive electrodes placed over the skin of the projection of the first and third lumbar interspinous space (anode) and over the abdominal skin of the umbilicus (cathode)...
November 10, 2018: Journal of Clinical Monitoring and Computing
Simon T Vistisen, Jonas M Berg, Mattheus F Boekel, Marco Modestini, Remco Bergman, Jayant S Jainandunsing, Massimo A Mariani, Thomas W L Scheeren
Fluid responsiveness prediction is difficult during cardiac surgery. The micro-fluid challenge (micro-FC; rapid central infusion of 50 ml) and the extrasystolic method utilising post-extrasystolic preload increases may predict fluid responsiveness. Two study windows during coronary artery bypass graft surgery were defined, 1: After anaesthesia induction until surgical incision, 2: Left internal mammarian artery surgical preparation period. Each window consisted of 10-15 min observation for extrasystoles before a micro-FC was performed, after which a traditional fluid challenge (FC) was performed (5 ml/kg)...
November 9, 2018: Journal of Clinical Monitoring and Computing
Simon Tilma Vistisen, Benjamin Moody, Leo Anthony Celi, Christina Chen
Right ventricular dysfunction (RVD) is associated with end-organ dysfunction and mortality, but has been an overlooked condition in the ICU. We hypothesized that analysis of the arterial waveform in the presence of ventricular extrasystoles could differentiate patients with RVD from patients with a normally functioning right ventricle, because the 2nd and 3rd post-ectopic beat could reflect right ventricular state (pulmonary transit time) during the preceding ectopy. We retrospectively identified patients with echocardiographic evidence of moderate-to-severe RVD and patients with a normal functioning right ventricle (control) from the MIMIC database...
November 8, 2018: Journal of Clinical Monitoring and Computing
Takuma Maeda, Eisuke Hamaguchi, Naoko Kubo, Akira Shimokawa, Hiroko Kanazawa, Yoshihiko Ohnishi
To compare the accuracy and trending ability of the cardiac index (CI) measured by FloTrac/Vigileo™ (CIFT ) or derived by the Fick equation (CIFick ) using E-CAiOVX (enables continuous monitoring of oxygen consumption) with that measured by thermodilution (CITD ) in patients with off-pump coronary artery bypass surgery. Twenty-two patients undergoing elective off-pump coronary artery bypass surgery were included. CIFT and CIFick were determined simultaneously at six time-points during off-pump coronary artery bypass surgery...
November 7, 2018: Journal of Clinical Monitoring and Computing
Anthony J Oleksy, Joseph J Schlesinger
Hospital noise levels regularly exceed those recommended by the World Health Organization (WHO). It is uncertain whether high noise levels have adverse effects on patient health. High levels of noise increase patient sleep loss, anxiety levels, length of hospital stay, and morbidity rates. Staff conversation and auditory medical alarms are amongst the leading noise producing stimuli, with combinations of stimuli accounting for much of the high noise levels. The Hospital Consumer Assessment of Healthcare Providers and Systems survey shows a slight improvement in overall hospital noise levels in the United States, indicating a minor reduction in noise levels...
November 2, 2018: Journal of Clinical Monitoring and Computing
Jakub Kletecka, Irena Holeckova, Pavel Brenkus, Jiri Pouska, Jan Benes, Ivan Chytra
Postoperative cognitive dysfunction (POCD) is diagnosed in up to 30% patients after anaesthesia. The causative role of anaesthetic toxicity remains unclear. Using clinical tests, no clear-cut differences have been observed between anaesthetics so far. The aim of this trial was to compare the incidence of POCD diagnosed by a battery of neuropsychologic tests after propofol and sevoflurane anaesthesia. Secondary goal was to examine possible relationship between POCD positivity and changes in auditory event-related potentials (ERPs)...
October 31, 2018: Journal of Clinical Monitoring and Computing
Jeffrey H Gertsch, Joseph J Moreira, George R Lee, John D Hastings, Eva Ritzl, Matthew Allan Eccher, Bernard Allan Cohen, Jay L Shils, Michael T McCaffrey, Gene K Balzer, Jeffrey R Balzer, Willy Boucharel, Lanjun Guo, Leah L Hanson, Laura B Hemmer, Faisal R Jahangiri, Jorge A Mendez Vigil, Richard W Vogel, Lawrence R Wierzbowski, W Bryan Wilent, James S Zuccaro, Charles D Yingling
The American Society of Neurophysiological Monitoring (ASNM) was founded in 1989 as the American Society of Evoked Potential Monitoring. From the beginning, the Society has been made up of physicians, doctoral degree holders, Technologists, and all those interested in furthering the profession. The Society changed its name to the ASNM and held its first Annual Meeting in 1990. It remains the largest worldwide organization dedicated solely to the scientifically-based advancement of intraoperative neurophysiology...
October 30, 2018: Journal of Clinical Monitoring and Computing
Audrey Tantot, Anais Caillard, Arthur Le Gall, Joaquim Mateo, Sandrine Millasseau, Alexandre Mebazaa, Etienne Gayat, Fabrice Vallée
Cardiac output (CO) optimisation during surgery reduces post-operative morbidity. Various methods based on pulse pressure analysis have been developed to overcome difficulties to measure accurate CO variations in standard anaesthetic settings. Several of these methods include, among other parameters, the ratio of pulse pressure to mean arterial pressure (PP/MAP). The aim of this study was to evaluate whether the ratio of radial pulse pressure to mean arterial pressure (ΔPPrad/MAP) could track CO variations (ΔCO) induced by various therapeutic interventions such as fluid infusions and vasopressors boluses [phenylephrine (PE), norepinephrine (NA) or ephedrine (EP)] in the operating room...
October 25, 2018: Journal of Clinical Monitoring and Computing
Danilo Cardim, Chiara Robba, Basil Matta, Graham Tytherleigh-Strong, Niel Kang, Bernhard Schmidt, Joseph Donnelly, Leanne Calviello, Peter Smielewski, Marek Czosnyka
Although the beach-chair position (BCP) is widely used during shoulder surgery, it has been reported to associate with a reduction in cerebral blood flow, oxygenation, and risk of brain ischaemia. We assessed cerebral haemodynamics using a multiparameter transcranial Doppler-derived approach in patients undergoing shoulder surgery. 23 anaesthetised patients (propofol (2 mg/kg)) without history of neurologic pathology undergoing elective shoulder surgery were included. Arterial blood pressure (ABP, monitored with a finger-cuff plethysmograph calibrated at the auditory meatus level) and cerebral blood flow velocity (FV, monitored in the middle cerebral artery) were recorded in supine and in BCP...
October 17, 2018: Journal of Clinical Monitoring and Computing
Neeraja Ajayan, Keta Thakkar, Karen Ruby Lionel, Ajay Prasad Hrishi
One of the primary goals of anaesthesia in neurosurgical procedures is prevention of cerebral hypoxia leading to secondary neurological injury. Cerebral oximetry detects periods of cerebral hypoxemia and allows intervention for prevention of secondary brain injury and its sequelae. This can be achieved by the use of Near Infrared Spectroscopy (NIRS). In this regard, we present two cases where erroneous values of NIRS were shown which hindered monitoring of cerebral oxygenation in the intraoperative setting...
October 12, 2018: Journal of Clinical Monitoring and Computing
M Neckebroek, C M Ionescu, K van Amsterdam, T De Smet, P De Baets, J Decruyenaere, R De Keyser, M M R F Struys
PURPOSE: We evaluated the feasibility and robustness of three methods for propofol-to-bispectral index (BIS) post-operative intensive care sedation, a manually-adapted target controlled infusion protocol (HUMAN), a computer-controlled predictive control strategy (EPSAC) and a computer-controlled Bayesian rule-based optimized control strategy (BAYES). METHODS: Thirty-six patients undergoing short lasting sedation following cardiac surgery were included to receive propofol to maintain a BIS between 40 and 60...
October 11, 2018: Journal of Clinical Monitoring and Computing
Agnieszka Uryga, Magdalena Kasprowicz, Małgorzata Burzyńska, Leanne Calviello, Katarzyna Kaczmarska, Marek Czosnyka
The cerebral arterial blood volume changes (∆Ca BV) during a single cardiac cycle can be estimated using transcranial Doppler ultrasonography (TCD) by assuming pulsatile blood inflow, constant, and pulsatile flow forward from large cerebral arteries to resistive arterioles [continuous flow forward (CFF) and pulsatile flow forward (PFF)]. In this way, two alternative methods of cerebral arterial compliance (Ca ) estimation are possible. Recently, we proposed a TCD-derived index, named the time constant of the cerebral arterial bed (τ), which is a product of Ca and cerebrovascular resistance and is independent of the diameter of the insonated vessel...
October 5, 2018: Journal of Clinical Monitoring and Computing
Keisuke Tomita, Taka-Aki Nakada, Taku Oshima, Takehiko Oami, Tuerxun Aizimu, Shigeto Oda
We evaluated the accuracy and precision of a novel non-invasive monitoring device in comparison with conventional monitoring methods used in intensive care units (ICU). The study device was developed to measure blood pressure, pulse rate, respiratory rate, and oxygen saturation, continuously with a single sensor using the photoplethysmographic technique. Patients who were monitored with arterial pressure lines in the ICU were enrolled. Systolic and diastolic blood pressure, pulse rate, respiratory rate, and arterial oxygen saturation were measured continuously for 30 min at 5-min intervals using the conventional methods and the study device...
October 4, 2018: Journal of Clinical Monitoring and Computing
Maddalena Ardissino, Nicoletta Nicolaou, Marcela Vizcaychipi
Heart rate variability (HRV) provides an excellent proxy for monitoring of autonomic function, but the clinical utility of such characterization has not been investigated. In a clinical setting, the baseline autonomic function can reflect ability to adapt to stressors such as anesthesia. No monitoring tool has yet been developed that is able to track changes in HRV in real time. This study is a proof-of-concept for a non-invasive, real-time monitoring model for autonomic function via continuous Poincaré quantification of HRV dynamics...
October 3, 2018: Journal of Clinical Monitoring and Computing
Hyunyoung Lim, Minseok Oh, Yang Hoon Chung, Hyunseo Ki, Jeong Jin Lee
In patients with obstructive sleep apnea, short-term use of a continuous positive airway pressure mask improves oxygenation, decreases the apnea-hypopnea index, and reduces hemodynamic instability. In this study, we investigated the effects of use of a continuous positive airway pressure mask in patients at high risk of obstructive sleep apnea during propofol sedation after spinal anesthesia. Forty patients who underwent propofol sedation after spinal anesthesia for transurethral bladder or prostate resection with a STOP-Bang score of 3 or more were enrolled in this study...
October 3, 2018: Journal of Clinical Monitoring and Computing
Michael J Harrison, Christopher W Connor, David Cumin
Expected values for blood pressure are known for both unanesthetized and anesthetized children. The statistics of changes in blood pressure during anesthesia, which may have important diagnostic significance, have not been reported. The purpose of this study was to report the variation in changes in blood pressure in four pediatric age groups, undergoing both cardiac and non-cardiac surgery. An analysis of the changes in blood pressure using normalization and principal component analysis techniques was performed using an existing electronic dataset of intra-arterial pediatric blood pressure values during anesthesia...
September 28, 2018: Journal of Clinical Monitoring and Computing
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