Journal of clinical monitoring and computing
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J Clin Monit Comput · Oct 2024
EditorialEditorial comment to intraoperative haemodynamic monitoring and management of adults having non-cardiac surgery: guidelines of the German society of Anaesthesiology and Intensive care medicine in collaboration with the German Association of the Scientific medical societies.
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Prediction and avoidance of intraoperative hypotension (IOH) can lead to less postoperative morbidity. Machine learning (ML) is increasingly being applied to predict IOH. We hypothesize that incorporating demographic and physiological features in an ML model will improve the performance of IOH prediction. ⋯ The multivariate model yielded average AUC = 0.97 in the static context of a single prediction made up to 8 min before a possible IOH event, and it outperformed a univariate model based on MAP-only (average AUC = 0.83). The MMV model demonstrated AUC = 0.96, PPV = 0.89, and NPV = 0.98 within the challenging context of a dynamic sliding window across 40 min prior to a possible IOH event. We present a novel ML model to predict IOH with a distinctive "dial" on sensitivity and specificity to predict first IOH episode during liver resection surgeries.
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J Clin Monit Comput · Sep 2024
ReviewA review of machine learning methods for non-invasive blood pressure estimation.
Blood pressure is a very important clinical measurement, offering valuable insights into the hemodynamic status of patients. Regular monitoring is crucial for early detection, prevention, and treatment of conditions like hypotension and hypertension, both of which increasing morbidity for a wide variety of reasons. ⋯ Non-invasive techniques, in contrast, reduce these risks and can provide intermittent or continuous blood pressure readings. This review explores modern machine learning-based non-invasive methods for blood pressure estimation, discussing their advantages, limitations, and clinical relevance.
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J Clin Monit Comput · Sep 2024
Left ventricular end-diastolic pressure response to spinal anaesthesia in euvolaemic vascular surgery patients.
Regional anaesthesia techniques provide highly effective alternative to general anaesthesia. Existing evidence on the effect of spinal anaesthesia (SA) on cardiac diastolic function is scarce. This study aimed to evaluate the effects of a single-injection, low-dose SA on left ventricular end-diastolic pressures (LVEDP) using echocardiography in euvolaemic patients undergoing elective vascular surgery. ⋯ This study in euvolaemic patients undergoing elective vascular surgery provides evidence that SA improved LVEDP.