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Journal of Clinical Monitoring and Computing

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https://www.readbyqxmd.com/read/28791567/the-oxygen-reserve-index-ori-a-new-tool-to-monitor-oxygen-therapy
#1
REVIEW
T W L Scheeren, F J Belda, A Perel
Supplemental oxygen is administered in the vast majority of patients in the perioperative setting and in the intensive care unit to prevent the potentially deleterious effects of hypoxia. On the other hand, the administration of high concentrations of oxygen may induce hyperoxia that may also be associated with significant complications. Oxygen therapy should therefore be precisely titrated and accurately monitored. Although pulse oximetry has become an indispensable monitoring technology to detect hypoxemia, its value in assessing the oxygenation status beyond the range of maximal arterial oxygen saturation (SpO2 ≥97%) is very limited...
August 8, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/28761996/discrepancy-between-in-vivo-and-in-vitro-comparisons-of-forced-oscillation-devices
#2
Sabine C Zimmermann, Joanna C Watts, Amy Bertolin, Kanika Jetmalani, Gregory G King, Cindy Thamrin
The forced oscillation technique (FOT) is an emerging clinical lung function test, with commercial devices becoming increasingly available. However comparability across existing devices has not been established. We evaluated in vivo and in vitro measurements made using three commercial devices against a custom-built device (WIMR): Resmon Pro Diary (Restech srl, Italy), tremoFlo C-100 (Thorasys Medical Systems, Canada), Jaeger Masterscope CT IOS (CareFusion, Hoechberg, Germany). Respiratory system resistance Rrs and reactance Xrs at 5 Hz were examined in twelve healthy subjects (mean age 33 ± 11 years, 7 males), and in two test standards of known resistance and reactance...
July 31, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/28752472/technical-challenges-related-to-implementation-of-a-formula-one-real-time-data-acquisition-and-analysis-system-in-a-paediatric-intensive-care-unit
#3
B Rajeswari Matam, Heather Duncan
Most existing, expert monitoring systems do not provide the real time continuous analysis of the monitored physiological data that is necessary to detect transient or combined vital sign indicators nor do they provide long term storage of the data for retrospective analyses. In this paper we examine the feasibility of implementing a long term data storage system which has the ability to incorporate real-time data analytics, the system design, report the main technical issues encountered, the solutions implemented and the statistics of the data recorded...
July 27, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/28733939/comparison-of-endotracheal-tube-cuff-pressure-values-before-and-after-training-seminar
#4
Ayça Tuba Dumanlı Özcan, Cihan Döğer, Abdülkadir But, Işık Kutlu, Şemsi Mustafa Aksoy
It is recommended that endotracheal cuff (ETTc) pressure be between 20 and 30 cm H2O. In this present study, we intend to observe average cuff pressure values in our clinic and the change in these values after the training seminar. The cuff pressure values of 200 patients intubated following general anesthesia induction in the operating theatre were measured following intubation. One hundred patients whose values were measured before the training seminar held for all physician assistants, and 100 patients whose values were measured after the training seminar were regarded as Group 1 and Group 2, respectively...
July 22, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/28730574/mechanical-ventilation-guided-by-electrical-impedance-tomography-in-pediatric-acute-respiratory-distress-syndrome
#5
Jeffrey Dmytrowich, Tanya Holt, Karen Schmid, Gregory Hansen
Mechanical ventilation strategies in pediatric acute respiratory distress syndrome (pARDS) continue to advance. Optimizing positive end expiratory pressure (PEEP) and ventilation to recruitable lung can be difficult to clinically achieve. This is in part, due to disease evolution, unpredictable changes in lung compliance, and the inability to assess regional tidal volumes in real time at the bedside. Here we report the utilization of thoracic electrical impedance tomography to guide daily PEEP settings and recruitment maneuvers in a child with pARDS...
July 20, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/28710663/a-multi-train-electrical-stimulation-protocol-facilitates-transcranial-electrical-motor-evoked-potentials-and-increases-induction-rate-and-reproducibility-even-in-patients-with-preoperative-neurological-deficits
#6
Shuta Ushio, Shigenori Kawabata, Satoshi Sumiya, Tsuyoshi Kato, Toshitaka Yoshii, Tsuyoshi Yamada, Mitsuhiro Enomoto, Atsushi Okawa
This study sought to evaluate the facilitation effect of repetitive multi-train transcranial electrical stimulation (mt-TES) at 2 repetition rates on transcranial electrical motor evoked potential (Tc-MEP) monitoring during spinal surgery, and to assess the induction rate in patients with impaired motor function from a compromised spinal cord or spinal nerve. We studied 32 consecutive patients with impaired motor function undergoing cervical or thoracic spinal surgery (470 muscles). A series of 10 TESs with 5 pulse trains were preoperatively delivered at 2 repetition rates (1 and 5 Hz)...
July 14, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/28710662/lung-real-time-three-dimensional-imaging-in-critically-ill-ventilated-patients-a-global-diagnosis-concordance-study
#7
Jean-Marc Le Goff, Claire Roger, Benjamin Louart, Pierre Géraud Claret, Aurélien Daurat, Stéphanie Bulyez, Jean-Yves Lefrant, Xavier Bobbia, Laurent Muller
Lung ultrasound (LUS) increases clinical diagnosis performance in intensive care unit (ICU). Real-time three-dimensional (3-D) imaging was compared with two-dimensional (2-D) LUS by assessing the global diagnosis concordance. In this single center, prospective, observational, pilot study, one trained operator performed a 3-D LUS immediately after a 2-D LUS in eight areas of interest on the same areas in 16 ventilated critically ill patients. All cine loops were recorded on a computer without visible link between 2-D and 3-D exams...
July 14, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/28688009/comparing-volume-clamp-method-and-intra-arterial-blood-pressure-measurements-in-patients-with-atrial-fibrillation-admitted-to-the-intensive-or-medium-care-unit
#8
G F N Berkelmans, S Kuipers, B E Westerhof, A M E Spoelstra-de Man, Y M Smulders
International guidelines highlight the importance of blood pressure (BP) in patients with atrial fibrillation (AF). However, BP measurement in AF is complicated by beat-to-beat fluctuation. Automated BP measurement devices are not validated for patients with AF and no consensus exists on how to measure BP in AF manually. Beat-to-beat BP measurement using the volume-clamp method (VCM) could represent a non-invasive method to accurately assess BP, but has not been validated in AF. 31 admitted patients with sustained AF and 10 control patients with sinus rhythm underwent simultaneous intra-arterial and non-invasive BP measurement using a VCM monitor (Nexfin(®), BMEYE, Amsterdam, The Netherlands)...
July 7, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/28660564/a-smartphone-application-to-determine-body-length-for-body-weight-estimation-in-children-a-prospective-clinical-trial
#9
Oliver Wetzel, Alexander R Schmidt, Michelle Seiler, Davide Scaramuzza, Burkhardt Seifert, Donat R Spahn, Philipp Stein
The aim of this study was to test the feasibility and accuracy of a smartphone application to measure the body length of children using the integrated camera and to evaluate the subsequent weight estimates. A prospective clinical trial of children aged 0-<13 years admitted to the emergency department of the University Children's Hospital Zurich. The primary outcome was to validate the length measurement by the smartphone application «Optisizer». The secondary outcome was to correlate the virtually calculated ordinal categories based on the length measured by the app to the categories based on the real length...
June 28, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/28653135/closed-loop-mechanical-ventilation-for-lung-injury-a-novel-physiological-feedback-mode-following-the-principles-of-the-open-lung-concept
#10
David Schwaiberger, Philipp A Pickerodt, Anake Pomprapa, Onno Tjarks, Felix Kork, Willehad Boemke, Roland C E Francis, Steffen Leonhardt, Burkhard Lachmann
Adherence to low tidal volume (VT) ventilation and selected positive end-expiratory pressures are low during mechanical ventilation for treatment of the acute respiratory distress syndrome. Using a pig model of severe lung injury, we tested the feasibility and physiological responses to a novel fully closed-loop mechanical ventilation algorithm based on the "open lung" concept. Lung injury was induced by surfactant washout in pigs (n = 8). Animals were ventilated following the principles of the "open lung approach" (OLA) using a fully closed-loop physiological feedback algorithm for mechanical ventilation...
June 26, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/28653134/goal-directed-therapy-hit-early-and-personalize
#11
EDITORIAL
Bernd Saugel, Frederic Michard, Thomas W L Scheeren
No abstract text is available yet for this article.
June 26, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/28647806/pre-anesthetic-stroke-volume-variation-can-predict-cardiac-output-decrease-and-hypotension-during-induction-of-general-anesthesia
#12
Takashi Juri, Koichi Suehiro, Sayaka Tsujimoto, Shigemune Kuwata, Akira Mukai, Katsuaki Tanaka, Tokuhiro Yamada, Takashi Mori, Kiyonobu Nishikawa
This study aimed to assess the reliability of stroke volume variation (SVV) in predicting cardiac output (CO) decrease and hypotension during induction of general anesthesia. Forty-five patients undergoing abdominal surgery under general anesthesia were enrolled. Before induction of anesthesia, patients were required to maintain deep breathing (6-8 times/min), and pre-anesthetic SVV was measured for 1 min by electrical cardiometry. General anesthesia was induced with propofol, remifentanil, rocuronium, and sevoflurane...
June 24, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/28643187/suprasternal-notch-echocardiography-a-potential-alternative-for-the-measurement-of-respiratory-variation-in-aortic-blood-flow-peak-velocity-in-mechanically-ventilated-children
#13
LETTER
Pauline Devauchelle, Mathilde de Queiroz Siqueira, Marc Lilot, Dominique Chassard, François-Pierrick Desgranges
We conducted a prospective, observational study to investigate the relationship between the respiratory variation in aortic blood flow peak velocity (ΔVPeak) measured by echocardiography in the proximal ascending aorta from the suprasternal notch window and the ΔVPeak measured at the level of the aortic annulus from the classical apical five-chamber view. We studied children aged from 1 to 10 years referred for surgery under general anesthesia with positive pressure ventilation, after induction of general anesthesia...
June 22, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/28631050/analgesia-nociception-index-ani-monitoring-in-patients-with-thoracic-paravertebral-block-a-randomized-controlled-study
#14
Nurseda Dundar, Alparslan Kus, Yavuz Gurkan, Kamil Toker, Mine Solak
The goal of the study was to evaluate the effectiveness of analgesia nociception index (ANI) monitoring during intraoperative period for patients with thoracic paravertebral block (TPVB) undergoing breast surgery under general anesthesia. This prospective randomized trial was performed after receiving ethics committee approval in 44 patients who were scheduled to undergo breast surgery under general anesthesia. TPVB was performed in the preoperative period using 20 mL of bupivacaine 0.25% at T4 level. Anesthesia maintenance was provided with sevoflurane in O2: air mixture and remifentanil infusion...
June 19, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/28623472/failure-to-replace-a-co2-absorber-due-to-shifted-metal-pins-a-potential-source-of-hazard-to-patients
#15
LETTER
Hendrik Drinhaus, Valentina Rahn, Thorsten Annecke
No abstract text is available yet for this article.
June 16, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/28623471/the-effect-of-intravenous-lidocaine-infusion-on-bispectral-index-during-major-abdominal-surgery
#16
Patrick Bazin, James Padley, Matthew Ho, Jennifer Stevens, Erez Ben-Menachem
Intraoperative lidocaine infusion has become widely accepted as an adjunct to general anesthesia where its use has been associated with opioid-sparing and enhanced recovery. The aims of this study were to determine whether or not intravenous (IV) lidocaine infusion (a) has an anesthetic sparing effect during major colorectal procedures and (b) if it also affects level of hypnosis as measured by bispectral index (BIS). Twenty-five patients undergoing laparotomy for resection of colorectal tumours were randomized to receive either IV lidocaine (1...
June 16, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/28602010/closed-loop-regulation-of-arterial-pressure-after-acute-brain-death
#17
Kristian Soltesz, Trygve Sjöberg, Tomas Jansson, Rolf Johansson, Anders Robertsson, Audrius Paskevicius, Quiming Liao, Guangqi Qin, Stig Steen
The purpose of this concept study was to investigate the possibility of automatic mean arterial pressure (MAP) regulation in a porcine heart-beating brain death (BD) model. Hemodynamic stability of BD donors is necessary for maintaining acceptable quality of donated organs for transplantation. Manual stabilization is challenging, due to the lack of vasomotor function in BD donors. Closed-loop stabilization therefore has the potential of increasing availability of acceptable donor organs, and serves to indicate feasibility within less demanding patient groups...
June 10, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/28600624/desflurane-usage-during-anesthesia-with-and-without-n2o-using-flow-i-automatic-gas-control-with-three-different-wash-in-speeds
#18
Robrecht De Medts, Rik Carette, Andre M De Wolf, Jan F A Hendrickx
AGC(®) (Automatic Gas Control) is the FLOW-i's automated low flow tool (Maquet, Solna, Sweden) that target controls the inspired O2 (FIO2) and end-expired desflurane concentration (FAdes) while (by design) exponentially decreasing fresh gas flow (FGF) during wash-in to a maintenance default FGF of 300 mL min(-1). It also offers a choice of wash-in speeds for the inhaled agents. We examined AGC performance and hypothesized that the use of lower wash-in speeds and N2O both reduce desflurane usage (Vdes). After obtaining IRB approval and patient consent, 78 ASA I-II patients undergoing abdominal surgery were randomly assigned to 1 of 6 groups (n = 13 each), depending on carrier gas (O2/air or O2/N2O) and wash-in speed (AGC speed 2, 4, or 6) of desflurane, resulting in groups air/2, air/4, air/6, N2O/2, N2O/4, and N2O/6...
June 9, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/28593456/impact-of-hemodynamic-goal-directed-resuscitation-on-mortality-in-adult-critically-ill-patients-a-systematic-review-and-meta-analysis
#19
Maria Cronhjort, Olof Wall, Erik Nyberg, Ruifeng Zeng, Christer Svensen, Johan Mårtensson, Eva Joelsson-Alm
The effect of hemodynamic optimization in critically ill patients has been challenged in recent years. The aim of the meta-analysis was to evaluate if a protocolized intervention based on the result of hemodynamic monitoring reduces mortality in critically ill patients. We performed a systematic review and meta-analysis according to the Cochrane Handbook for Systematic Reviews of Interventions. The study was registered in the PROSPERO database (CRD42015019539). Randomized controlled trials published in English, reporting studies on adult patients treated in an intensive care unit, emergency department or equivalent level of care were included...
June 8, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/28593455/monitoring-tissue-oxygen-heterogeneities-and-their-influence-on-optical-glucose-measurements-in-an-animal-model
#20
LETTER
M Rumpler, M Hajnsek, P Baumann, T R Pieber, I Klimant
The purpose of this study was to characterize the heterogeneity of oxygen partial pressure in different adipose tissue zones and to assess the possibility of compensating these heterogeneities during optical glucose measurements. In this proof of concept study, the heterogeneity of oxygen partial pressure was determined in the adipose tissue of a pig by using 48 oxygen sensors in 3 zones of the abdominal region at two different blood oxygen levels. Sensor oxygen values correlated well with reference blood oxygen values and we identified heterogeneities in oxygen partial pressure among the defined zones of the abdominal region...
June 7, 2017: Journal of Clinical Monitoring and Computing
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