Journals Journal of Clinical Monitoring...

Journal of Clinical Monitoring and Computing
Jakob Højlund, Mirjana Cihoric, Nicolai Bang Foss
General Anaesthesia (GA) is accompanied by a marked decrease in sympathetic outflow and thus loss of vasomotor control of cardiac preload. The use of vasoconstriction during GA has mainly focused on maintaining blood pressure. Phenylephrine (PE) is a pure α1-agonist without inotropic effects widely used to correct intraoperative hypotension. The potential of PE for augmenting cardiac stroke volume (SV) and -output (CO) by venous recruitment is controversial and no human studies have explored the effects of PE in preload dependent circulation using indicator dilution technique...
June 21, 2024: Journal of Clinical Monitoring and Computing
Zahra Moaiyeri, Jumana Mustafa, Massimo Lamperti, Francisco A Lobo
Although intraoperative electroencephalography (EEG) is not consensual among anesthesiologists, growing evidence supports its use to titrate anesthetic drugs, assess the level of arousal/consciousness, and detect ischemic cerebrovascular events; in addition, intraoperative EEG monitoring may decrease the incidence of postoperative neurocognitive disorders. Based on the known and potential benefits of intraoperative EEG monitoring, an educational program dedicated to staff anesthesiologists, residents of Anesthesiology and anesthesia technicians was started at Cleveland Clinic Abu Dhabi in May 2022 and completed in June 2022, aiming to have all patients undergoing general anesthesia with adequate brain monitoring and following international initiatives promoting perioperative brain health...
June 20, 2024: Journal of Clinical Monitoring and Computing
Minjee Kim, Joonmyeong Choi, Jun-Young Jo, Wook-Jong Kim, Sung-Hoon Kim, Namkug Kim
Hand hygiene among anesthesia personnel is important to prevent hospital-acquired infections in operating rooms; however, an efficient monitoring system remains elusive. In this study, we leverage a deep learning approach based on operating room videos to detect alcohol-based hand hygiene actions of anesthesia providers. Videos were collected over a period of four months from November, 2018 to February, 2019, at a single operating room. Additional data was simulated and added to it. The proposed algorithm utilized a two-dimensional (2D) and three-dimensional (3D) convolutional neural networks (CNNs), sequentially...
June 19, 2024: Journal of Clinical Monitoring and Computing
Tommaso Pozzi, Silvia Coppola, Giulia Catozzi, Andrea Colombo, Mara Chioccola, Eleonora Duscio, Fabiano Di Marco, Davide Chiumello
BACKGROUND: Robotic-assisted laparoscopic radical prostatectomy (RALP) requires pneumoperitoneum and steep Trendelenburg position. Our aim was to investigate the influence of the combination of pneumoperitoneum and Trendelenburg position on mechanical power and its components during RALP. METHODS: Sixty-one prospectively enrolled patients scheduled for RALP were studied in supine position before surgery, during pneumoperitoneum and Trendelenburg position and in supine position after surgery at constant ventilatory setting...
June 17, 2024: Journal of Clinical Monitoring and Computing
Jeffrey Miechels, Mark V Koning
PURPOSE: This study tests if the pressure variation in the HFNC-system may allow for monitoring of respiratory rate and the pressure difference during breathing may be a marker of respiratory effort. METHODS: A HFNC system (Fisher & Paykel Optiflow Thrive 950) was modified by adding a GE Healthcare D-Lite spirometry sensor attached to a respiratory module and a pressure transducer. Participants were instructed to breathe regularly, quickly and slowly during 4 different conditions (HFNC flow 30 l/min and 70 l/min and with an open and closed mouth)...
June 12, 2024: Journal of Clinical Monitoring and Computing
Michele Introna, Morgan Broggi, Paolo Ferroli, Donato Martino, Carmela Pinto, Monica Carpenedo, Marco Gemma
The potential use of TEG/ROTEM® in evaluating the bleeding risk for rare coagulation disorders needs to be assessed, considering the common mismatch among laboratory tests and the clinical manifestations. As a result, there is currently no published data on the use of viscoelastic tests to assess coagulation in FVII deficient patients undergoing elective neurosurgery. We describe the case of a patient affected by severe FVII deficiency who underwent microvascular decompression (MVD) craniotomy for hemifacial spasm (HFS)...
June 8, 2024: Journal of Clinical Monitoring and Computing
Mayuu Kobata, Kazunori Miyamoto, Shohei Ooba, Ayano Saeki, Hiroai Okutani, Ryusuke Ueki, Nobutaka Kariya, Munetaka Hirose
Both tissue hypoperfusion and elevated surgical stress during surgery are involved in the pathogenesis of postoperative acute kidney injury (AKI). Although intraoperative hypotension, which evokes renal hypoperfusion, has been reported to be associated with the development of postoperative AKI, there is no consensus on the association between surgical stress responses (e.g., hypertension and inflammation) and postoperative AKI. Given that intraoperative values of nociceptive response (NR) index are reportedly associated with surgical stress responses, the present study was performed to assess associations between intraoperative NR index and postoperative AKI in patients undergoing non-cardiac surgery...
June 7, 2024: Journal of Clinical Monitoring and Computing
Sérgio Brasil, Danilo Cardim, Juliana Caldas, Chiara Robba, Fabio Silvio Taccone, Marcelo de-Lima-Oliveira, Márcia Harumy Yoshikawa, Luiz Marcelo Sá Malbouisson, Wellingson S Paiva
Neurocritical patients frequently exhibit abnormalities in cerebral hemodynamics (CH) and/or intracranial compliance (ICC), all of which significantly impact their clinical outcomes. Transcranial Doppler (TCD) and the cranial micro-deformation sensor (B4C) are valuable techniques for assessing CH and ICC, respectively. However, there is a scarcity of data regarding the predictive value of these techniques in determining patient outcomes. We prospectively included neurocritical patients undergoing intracranial pressure (ICP) monitoring within the first 5 days of hospital admission for TCD and B4C assessments...
June 6, 2024: Journal of Clinical Monitoring and Computing
Ricardo Castro, Eduardo Kattan, Glenn Hernández, Jan Bakker
This study retrospectively examined the hemodynamic effects of passive leg raising (PLR) in mechanically ventilated patients during fluid removal before spontaneous breathing trials. In previous studies, we noticed varying cardiac responses after PLR completion, particularly in positive tests. Using a bioreactance monitor, we recorded and analyzed hemodynamic parameters, including stroke volume and cardiac index (CI), before and after PLR in post-acute ICU patients. We included 27 patients who underwent 60 PLR procedures...
June 6, 2024: Journal of Clinical Monitoring and Computing
Mark D Twite, Aaron W Roebuck, Stephanie R Anderson
Nitric oxide (NO), a selective pulmonary vasodilator, can be delivered via conventional ICU and anesthesia machine ventilators. Anesthesia machines are designed for rebreathing of circulating gases, reducing volatile anesthetic agent quantity used. Current cylinder- and ionizing-based NO delivery technologies use breathing circuit flow to determine NO delivery and do not account for recirculated gases; therefore, they cannot accurately dose NO at FGF below patient minute ventilation (MV). A novel, cassette-based NO delivery system (GENOSYL® DS, Vero Biotech Inc...
June 1, 2024: Journal of Clinical Monitoring and Computing
Mateusz Zawadka, Cristina Santonocito, Veronica Dezio, Paolo Amelio, Simone Messina, Luigi Cardia, Federico Franchi, Antonio Messina, Chiara Robba, Alberto Noto, Filippo Sanfilippo
The Inferior Vena Cava (IVC) is commonly utilized to evaluate fluid status in the Intensive Care Unit (ICU),with more recent emphasis on the study of venous congestion. It is predominantly measured via subcostal approach (SC) or trans-hepatic (TH) views, and automated border tracking (ABT) software has been introduced to facilitate its assessment. Prospective observational study on patients ventilated in pressure support ventilation (PSV) with 2 × 2 factorial design. Primary outcome was to evaluate interchangeability of measurements of the IVC and the distensibility index (DI) obtained using both M-mode and ABT, across both SC and TH...
May 31, 2024: Journal of Clinical Monitoring and Computing
E Boselli, S Radoykov, X Paqueron, C Virot
This study was designed to evaluate the effects on hand catalepsy on parasympathetic tone assessed using Analgesia/Nociception Index (ANI) and on subjective rating of absorption, dissociation, and time perception among healthy volunteers. This was a randomized controlled trial including participants to a medical hypnosis congress in France. Ninety volunteers were randomized in two arms, all receiving a fifteen-minute positive hypnotic trance, with or without hand catalepsy. The relative parasympathetic tone assessed by ANI (Analgesia/Nociception Index), heart rate and respiratory rate were recorded at different times of the study protocol...
May 29, 2024: Journal of Clinical Monitoring and Computing
Alberto Fogagnolo, Salvatore Grasso, Elena Morelli, Francesco Murgolo, Rosa Di Mussi, Luigi Vetrugno, Riccardo La Rosa, Carlo Alberto Volta, Savino Spadaro
PURPOSE: Growing evidence shows the complex interaction between lung and kidney in critically ill patients. The renal resistive index (RRI) is a bedside measurement of the resistance of the renal blood flow and it is correlated with kidney injury. The positive end-expiratory pressure (PEEP) level could affect the resistance of renal blood flow, so we assumed that RRI could help to monitoring the changes in renal hemodynamics at different PEEP levels. Our hypothesis was that the RRI at ICU admission could predict the risk of acute kidney injury in mechanical ventilated critically ill patients...
May 21, 2024: Journal of Clinical Monitoring and Computing
Zain Wedemeyer, Andrew Bowdle, Srdjan Jelacic, Aidan Lopez, Willis Silliman, Kelly E Michaelsen
Mechanomyography is currently the accepted laboratory reference standard for quantitative neuromuscular blockade monitoring. Mechanomyographs are not commercially available. Previously, a mechanomyograph was built by our laboratory and used in several clinical studies. It was subsequently redesigned to improve its usability and functionality and to accommodate a wider range of hand sizes and shapes using an iterative design process. Each version of the redesigned device was initially tested for usability and functionality in the lab with the investigators as subjects without electrical stimulation...
May 17, 2024: Journal of Clinical Monitoring and Computing
Moritz Flick, Anneke Lohr, Friederike Weidemann, Ashkan Naebian, Phillip Hoppe, Kristen K Thomsen, Linda Krause, Karim Kouz, Bernd Saugel
Intraoperative hypotension is common and associated with organ injury. Hypotension can not only occur during surgery, but also thereafter. After surgery, most patients are treated in post-anesthesia care units (PACU). The incidence of PACU hypotension is largely unknown - presumably in part because arterial pressure is usually monitored intermittently in PACU patients. We therefore aimed to evaluate the incidence, duration, and severity of PACU hypotension in low-risk patients recovering from non-cardiac surgery...
May 17, 2024: Journal of Clinical Monitoring and Computing
Luca Bastia, Roberta Garberi, Lorenzo Querci, Cristiana Cipolla, Francesco Curto, Emanuele Rezoagli, Roberto Fumagalli, Arturo Chieregato
To determine how percutaneous tracheostomy (PT) impacts on respiratory system compliance (Crs ) and end-expiratory lung volume (EELV) during volume control ventilation and to test whether a recruitment maneuver (RM) at the end of PT may reverse lung derecruitment. This is a single center, prospective, applied physiology study. 25 patients with acute brain injury who underwent PT were studied. Patients were ventilated in volume control ventilation. Electrical impedance tomography (EIT) monitoring and respiratory mechanics measurements were performed in three steps: (a) baseline, (b) after PT, and (c) after a standardized RM (10 sighs of 30 cmH2 O lasting 3 s each within 1 min)...
May 17, 2024: Journal of Clinical Monitoring and Computing
Yu Liu, Lin Zhao, Xinlei Wang, Zhouquan Wu
OBJECTIVE: This study aims to analyze the risk factors for early postoperative brain injury in patients undergoing cardiovascular surgery and explore the predictive value of transcranial color Doppler (TCCD) and regional cerebral oxygen saturation (rSO2 ) for detecting early postoperative brain injury in cardiovascular surgery patients. METHODS: A total of 55 patients undergoing cardiovascular surgery with cardiopulmonary bypass in Changzhou No.2 The People's Hospital of Nanjing Medical University were included in this study...
May 17, 2024: Journal of Clinical Monitoring and Computing
Kevin L Webb, Wyatt W Pruter, Ruth J Poole, Robert W Techentin, Christopher P Johnson, Riley J Regimbal, Kaylah J Berndt, David R Holmes, Clifton R Haider, Michael J Joyner, Victor A Convertino, Chad C Wiggins, Timothy B Curry
PURPOSE: The compensatory reserve metric (CRM) is a novel tool to predict cardiovascular decompensation during hemorrhage. The CRM is traditionally computed using waveforms obtained from photoplethysmographic volume-clamp (PPGVC ), yet invasive arterial pressures may be uniquely available. We aimed to examine the level of agreement of CRM values computed from invasive arterial-derived waveforms and values computed from PPGVC -derived waveforms. METHODS: Sixty-nine participants underwent graded lower body negative pressure to simulate hemorrhage...
May 11, 2024: Journal of Clinical Monitoring and Computing
Chen Wang, Xiang Yan, Chao Gao, Simeng Liu, Di Bao, Di Zhang, Jia Jiang, Anshi Wu
BACKGROUND: Postoperative sore throat (POST) is a common complication following endotracheal tube removal, and effective preventive strategies remain elusive. This trial aimed to determine whether actively regulating intraoperative cuff pressure below the tracheal capillary perfusion pressure threshold could effectively reduce POST incidence in patients undergoing gynecological laparoscopic procedures. METHODS: This single-center, randomized controlled superiority trial allocated 60 patients scheduled for elective gynecological laparoscopic procedures into two groups: one designated for cuff pressure measurement and adjustment (CPMA) group, and a control group where only cuff pressure measurement was conducted without any subsequent adjustments...
May 11, 2024: Journal of Clinical Monitoring and Computing
Alberto Sánchez Fustes, Francisco Reinoso Barbero, Carolina Elvira Lafuente, Blanca Torres Maestro, Paula Burgos Morales, Patricio González Pizarro
No abstract text is available yet for this article.
May 11, 2024: Journal of Clinical Monitoring and Computing
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