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Journal of Clinical Monitoring and Computing

Tomasz Gaszyński
No abstract text is available yet for this article.
October 17, 2016: Journal of Clinical Monitoring and Computing
Jarkko Harju, Antti Vehkaoja, Ville Lindroos, Pekka Kumpulainen, Sasu Liuhanen, Arvi Yli-Hankala, Niku Oksala
Alterations in arterial blood oxygen saturation, heart rate (HR), and respiratory rate (RR) are strongly associated with intra-hospital cardiac arrests and resuscitations. A wireless, easy-to-use, and comfortable method for monitoring these important clinical signs would be highly useful. We investigated whether the Nellcor™ OxiMask MAX-FAST forehead sensor could provide data for vital sign measurements when located at the distal forearm instead of its intended location at the forehead to provide improved comfortability and easy placement...
October 17, 2016: Journal of Clinical Monitoring and Computing
Rodney A Gabriel, Anair Beverly, Richard P Dutton, Richard D Urman
Total shoulder arthroplasty (TSA) is typically performed in the beach-chair position. Maintenance of adequate mean arterial pressure is required to provide appropriate cerebral perfusion pressure and prevent cerebral ischemia. Placement of an arterial line to facilitate invasive monitoring is discretionary, based on clinical judgment. We aimed to describe patient, surgical and institutional factors associated with the current use of blood pressure monitoring via an arterial line for TSA. We used de-identified patient data from the National Anesthesia Clinical Outcomes Registry between 2010 and 2015 to identify patients undergoing TSA under general anesthesia...
October 13, 2016: Journal of Clinical Monitoring and Computing
E Christiaan Boerma, Thomas W L Scheeren
No abstract text is available yet for this article.
October 11, 2016: Journal of Clinical Monitoring and Computing
Brigit A Weld, Thomas J Morgan, Jeffrey J Presneill, Steven Weier, David Cowley
An estimated 25 % of indirect ion selective electrode (ISE) ICU plasma sodium measurements differ from corresponding direct ISE values by at least 4 mmol/L, the dominant factor being indirect ISE over-estimation driven by hypoproteinemia. Since direct measurements are considered unaffected by protein concentrations, we investigated whether direct ISE plasma sodium measurements in the laboratory and at point of care in ICU show sufficient agreement to be clinically interchangeable. From a 5 year clinical chemistry database, 9910 ICU plasma samples were assessed for agreement between direct ISE sodium measurements in ICU (ABL 700) and in the central laboratory (Vitros Fusion)...
September 28, 2016: Journal of Clinical Monitoring and Computing
Youn Joung Cho, Jungil Bae, Tae Kyong Kim, Deok Man Hong, Jeong-Hwa Seo, Jae-Hyon Bahk, Yunseok Jeon
General anesthesia can affect microcirculatory properties. However, differential effects on the microcirculation according to the anesthetic technique used during thoracoscopic surgery have not been well documented. We conducted a randomized clinical trial in which the effects of desflurane and propofol, both with remifentanil, on systemic arterial oxygenation during one-lung ventilation were compared in patients undergoing thoracoscopic surgery. As a subgroup analysis, we compared the effects of two commonly used anesthetic techniques, desflurane-remifentanil (n = 52) and propofol-remifentanil (n = 48), on tissue oxygen saturation using a vascular occlusion test in patients undergoing thoracoscopic surgery...
September 26, 2016: Journal of Clinical Monitoring and Computing
Ahmed Hasanin, Sabah Abdel Raouf Mohamed, Akram El-Adawy
Pain is a common and undertreated problem in critically ill patients. Pain assessment in critically ill patients is challenging and relies on complex scoring systems. The aim of this work was to find out the possible role of the perfusion index (PI) measured by a pulse oximeter (Masimo Radical 7; Masimo Corp., Irvine, CA, USA) in pain assessment in critically ill patients. A prospective observational study was carried out on 87 sedated non-intubated patients in a surgical intensive care unit. In addition to routine monitoring, a Masimo pulse oximeter probe was used for PI measurement...
September 24, 2016: Journal of Clinical Monitoring and Computing
Janine Krüger, Matthias Kraft, Matthias Gründling, Sigrun Friesecke, Simone Gärtner, Lena J Vogt, Nicole Schüler, Antje Steveling, Markus M Lerch, Ali A Aghdassi
Continuous measurement of resting energy expenditure (REE) in critically ill patients remains challenging but is required to prevent malnutrition. SenseWear Pro 3 Armband (SWA) is a research grade accelerometer for assessment of REE with the advantage of easy handling. In a prospective study we compared SWA with indirect calorimetry (IC) and predictive equations in critically ill, ventilated patients. REE was measured by SWA, IC and calculated by predictive formulas. Potential confounding factors that influence REE were also recorded...
September 14, 2016: Journal of Clinical Monitoring and Computing
Albert Wu, Bhavani S Kodali, Hugh L Flanagan, Richard D Urman
To evaluate the effect of deploying a new electronic medical record (EMR) system on first case starts in the operating room. Data on first case start times were collected after implementation of a new EMR (Epic) from June 2015 to May 2016, which replaced a legacy system of both paper and electronic records. These were compared to data from the same months in the three proceeding years. First patient in room (FPIR) on time was true if the patient was in operating room before 7:35 AM (or 9:35 AM on Wednesdays) and first case on time start (FCOTS) was true if completion of anesthetic induction was less than 20 min after the patient entered the operating room (or 35 min for cardiac and neurosurgery)...
September 13, 2016: Journal of Clinical Monitoring and Computing
Neda Eskandari, Z Jane Wang, Guy A Dumont
With the motivation of providing safety for a patient under anesthesia, this paper suggests conditions for evaluating the correctness of an available user interface for systems under shared control based on observability and predictability requirements. Situation awareness is necessary for the user to make correct decisions about the inputs. In this article, we develop a technique to investigate the conditions under which an anesthetists can attain situation awareness about a limited but important aspect of anesthesia, namely depth of hypnosis (DOH)...
September 2, 2016: Journal of Clinical Monitoring and Computing
Daniel San-Juan, Manuel Escanio Cortés, Martha Tena-Suck, Adolfo Josué Orozco Garduño, Jesús Alejandro López Pizano, Jonathan Villanueva Domínguez, Maricarmen Fernández Gónzalez-Aragón, Juan Luis Gómez-Amador
This paper reports the case of a patient with optic nerve schwannoma and the first use of neurophysiological intraoperative monitoring of visual evoked potentials during the removal of such tumor with no postoperative visual damage. Schwannomas are benign neoplasms of the peripheral nervous system arising from the neural crest-derived Schwann cells, these tumors are rarely located in the optic nerve and the treatment consists on surgical removal leading to high risk of damage to the visual pathway. Case report of a thirty-year-old woman with an optic nerve schwannoma...
September 1, 2016: Journal of Clinical Monitoring and Computing
Andrea Carsetti, Hollmann D Aya, Silvia Pierantozzi, Simone Bazurro, Abele Donati, Andrew Rhodes, Maurizio Cecconi
Analysis of the microcirculation is currently performed offline, is time consuming and operator dependent. The aim of this study was to assess the ability and efficiency of the automatic analysis software CytoCamTools 1.7.12 (CC) to measure microvascular parameters in comparison with Automated Vascular Analysis (AVA) software 3.2. 22 patients admitted to the cardiothoracic intensive care unit following cardiac surgery were prospectively enrolled. Sublingual microcirculatory videos were analysed using AVA and CC software...
September 1, 2016: Journal of Clinical Monitoring and Computing
Koichi Suehiro, Tomoharu Funao, Yohei Fujimoto, Akira Mukai, Mitsuyo Nakamura, Kiyonobu Nishikawa
We aimed to assess the ability of near-infrared spectroscopy (NIRS) to detect spinal cord ischemia, and to evaluate changes in regional oxygen saturation (rSO2) following recovery of spinal cord circulation and cerebrospinal fluid drainage. Four 12-month-old female swine weighing 28.7-29.5 kg were acquired for this study. NIRS probes were placed along the midline of the upper (T6/7) and lower (T9/T10) thoracic vertebrae. The thoracic aorta was clamped distal of the left subclavian artery to induce spinal ischemia...
August 27, 2016: Journal of Clinical Monitoring and Computing
Bernardo Bollen Pinto, Glen Atlas, Bart F Geerts, Karim Bendjelid
The oesophageal Doppler (OD) is a minimally invasive haemodynamic monitor used in the surgical theatre and the ICU. Using the OD, goal-directed therapy (GDT) has been shown to reduce perioperative complications in high-risk surgical patients. However, most GDT protocols currently in use are limited to stroke volume optimisation. In the present manuscript, we examine the conceptual models behind new OD-based measurements. These would provide the clinician with a comprehensive view of haemodynamic pathophysiology; including pre-load, contractility, and afterload...
August 27, 2016: Journal of Clinical Monitoring and Computing
Tsuyoshi Deguchi, Shunji Tsutsui, Hiroki Iwahashi, Yukihiro Nakagawa, Munehito Yoshida
Recently, low-frequency multi-train stimulation (MTS) was shown to effectively enhance transcranial motor-evoked potentials (TcMEPs). In contrast, high- frequency double-train stimulation was reported to elicit a marked facilitation. The aim of this study was to evaluate the efficacy of high-frequency MTS in the augmentation of potentials. In addition, we investigated the safety of high-frequency MTS, behaviorally and histologically. TcMEPs were recorded from the triceps surae muscle in 38 rats. A multipulse stimulus was delivered repeatedly at different rates (2, 5, 10, 20, and 50 Hz), and was defined as MTS...
August 26, 2016: Journal of Clinical Monitoring and Computing
Frederic Michard
Many mobile phone or tablet applications have been designed to control cardiovascular risk factors (obesity, smoking, sedentary lifestyle, diabetes and hypertension) or to optimize treatment adherence. Some have been shown to be useful but the long-term benefits remain to be demonstrated. Digital stethoscopes make easier the interpretation of abnormal heart sounds, and the development of pocket-sized echo machines may quickly and significantly expand the use of ultrasounds. Daily home monitoring of pulmonary artery pressures with wireless implantable sensors has been shown to be associated with a significant decrease in hospital readmissions for heart failure...
August 26, 2016: Journal of Clinical Monitoring and Computing
Mirko Belliato, Antonella Degani, Antonino Buffa, Fabio Sciutti, Michele Pagani, Carlo Pellegrini, Giorgio Antonio Iotti
Monitoring veno-venous extracorporeal membrane oxygenation (vvECMO) during 76 days of continuous support in a 42-years old patient with end-stage pulmonary disease, listed for double-lung transplantation. Applying a new monitor (Landing(®), Eurosets, Medolla, Italy) and describing how measured and calculated parameters can be used to understand the variable interdependency between artificial membrane lung (ML) and patient native lung (NL). During vvECMO, in order to understand how the respiratory function is shared between ML and NL, ideally we should obtain data about oxygen transfer and CO2 removal, both by ML and NL...
August 24, 2016: Journal of Clinical Monitoring and Computing
Laurent Godinas, Frédéric Lador, Rachel Schatzberger, Sven Günther, Michael J Segel, Yoram Palti, Ernesto Maisuls, Olivier Sitbon, Gérald Simonneau
Transthoracic Parametric Doppler (TPD) is a novel ultrasound technique recently developed for the investigation of pulmonary blood vessels. Lung Doppler Signals (LDS) recorded from TPD provide information regarding the functional mechanical characteristics of pulmonary blood vessels. We aimed to define the specific profile of LDS generated from TPD imaging in patients with pulmonary hypertension (PH), and to evaluate the diagnostic performance of LDS to detect PH using right heart catheterization (RHC) as gold standard reference...
August 19, 2016: Journal of Clinical Monitoring and Computing
Elisa Damiani, Can Ince, Claudia Scorcella, Roberta Domizi, Andrea Carsetti, Nicoletta Mininno, Silvia Pierantozzi, Erica Adrario, Rocco Romano, Paolo Pelaia, Abele Donati
We aimed to assess the impact of image quality on microcirculatory evaluation with sidestream dark-field (SDF) videomicroscopy in critically ill patients and explore factors associated with low video quality. This was a retrospective analysis of a single-centre prospective observational study. Videos of the sublingual microcirculation were recorded using SDF videomicroscopy in 100 adult patients within 12 h from admittance to the intensive care unit and every 24 h until discharge/death. Parameters of vessel density and perfusion were calculated offline for small vessels...
August 18, 2016: Journal of Clinical Monitoring and Computing
Rebecca J Yerworth, Inéz Frerichs, Richard Bayford
Electrical impedance tomography (EIT) is increasingly being used as a bedside tool for monitoring regional lung ventilation. However, most clinical systems use serial data collection which, if uncorrected, results in image distortion, particularly at high breathing rates. The objective of this study was to determine the extent to which this affects derived parameters. Raw EIT data were acquired with the GOE-MF II EIT device (CareFusion, Höchberg, Germany) at a scan rate of 13 images/s during both spontaneous breathing and mechanical ventilation...
August 17, 2016: Journal of Clinical Monitoring and Computing
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