Journal of clinical monitoring and computing
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J Clin Monit Comput · Apr 2024
Randomized Controlled TrialEffect of incremental PEEP titration on postoperative pulmonary complications in patients undergoing emergency laparotomy: a randomized controlled trial.
Postoperative pulmonary complications (PPC) has a significant negative impact and are associated with increased length of hospital stay and cost of care. Emergency surgery is a well-established risk factor for PPC. Previous studies reported that personalized positive end-expiratory pressure (PEEP) might reduce postoperative atelectasis and postoperative pulmonary complications. ⋯ Incidence of PPC was not reduced with the use of an individualized PEEP strategy based on lowest driving pressure. However, the incidence of hypotension and bradycardia was also not increased with titrated PEEP. Trial Registration: www.ctri.nic.in ; CTRI/2020/12/029765.
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J Clin Monit Comput · Apr 2024
Observational StudyMonitoring persistent pulmonary hypertension of the newborn using the arterial to end tidal carbon dioxide gradient.
Persistent pulmonary hypertension of the newborn (PPHN) can be monitored theoretically by the difference of the partial pressure of arterial (PaCO2) to end-tidal CO2 (EtCO2). We aimed to test the hypothesis that the PaCO2-EtCO2 gradient in infants with PPHN would be higher compared to infants without PPHN. Prospective, observational study of term-born ventilated infants with echocardiographically-confirmed PPHN with right-to-left shunting and term-born control infants without respiratory disease. ⋯ The median difference in the gradient was significantly higher in infants with PPHN (6.2 mmHg) compared to infants without PPHN (-3.2 mmHg, p = 0.022). The PaCO2-EtCO2 gradient was higher in infants with PPHN compared to term born infants without PPHN and decreased over the first week of life in infants with PPHN. The gradient might be utilised to monitor the evolution and resolution of PPHN.
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J Clin Monit Comput · Apr 2024
Autonomic dysfunction as a predictor of infection in neurocritical care unit: a prospective cohort study.
Infection in the neurocritical care unit ( NCCU) can cause significant mortality and morbidity. Autonomic nervous system plays an important role in defense against infection. Autonomic dysfunction causing inflammatory dysregulation can potentiate infection. We aimed to study the relationship between autonomic dysfunction and occurrence of infection in neurologically ill patients. ⋯ AD assessment can be used as a tool to predict development of infection in NCCU. This can help triage and institute early investigation and treatment.
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J Clin Monit Comput · Apr 2024
Support-vector classification of low-dose nitrous oxide administration with multi-channel EEG power spectra.
Support-vector machines (SVMs) can potentially improve patient monitoring during nitrous oxide anaesthesia. By elucidating the effects of low-dose nitrous oxide on the power spectra of multi-channel EEG recordings, we quantified the degree to which these effects generalise across participants. In this single-blind, cross-over study, 32-channel EEG was recorded from 12 healthy participants exposed to 0, 20, 30 and 40% end-tidal nitrous oxide. ⋯ This showed the relative importance of decreased delta power and the frontal region. SVM classification identified that the most important effects of nitrous oxide were found in the delta band in the frontal electrodes that was consistent between participants. Furthermore, support-vector classification of nitrous oxide dosage is a promising method that might be used to improve patient monitoring during nitrous oxide anaesthesia.
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J Clin Monit Comput · Apr 2024
FiO2 prediction formula during low flow oxygen therapy in an adult model: a bench study.
During low-flow oxygen therapy, the true value of inspired oxygen fraction (FiO2) is generally unknown. Knowledge of delivered FiO2 values may be useful as well as to adjust oxygen therapy, as well as to predict patient deterioration. This study proposes a New FiO2 Prediction Formula (NFiO2) for low-flow oxygenation and compares its predictive value to precedent formulas. ⋯ Bias and limits of agreement between predicted FiO2 and benchtop FiO2 highlighted consistent differences between different FiO2 prediction formulas. The NFiO2 and the Duprez Formula 2018 seemed to be the most accurate formulas, followed by the Vincent Formula, and lastly the Shapiro Formula. A New FiO2 Prediction Formula was developed using clinical readily available variables (RR and O2 Flow rate) which showed good accuracy in predicting FiO2 during oxygenation at low flow.