Journal of clinical monitoring and computing
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J Clin Monit Comput · Apr 2024
Case ReportsDiagnostic utility of perfusion index in identifying radial artery embolism during hyperthermic intraperitoneal chemotherapy procedure: a case report.
Invasive arterial cannulation is a widely used method in intensive care units and operating rooms. However it has potential complications such as thrombosis, peripheral embolism, hematoma formation, and infection. The Masimo Root Radical-7 Pulse CO-Oximeter® (Masimo Corporation, Irvine, CA, USA) is a non-invasive hemodynamic monitoring device that measures perfusion index and pleth variability index, provides guidance to anaesthesiologists in the cases where hemodynamic fluctuations are expected. In this particular case, the perfusion index played a crucial role in the immediate diagnosis of radial artery embolism in a patient undergoing cytoreductive surgery and hyperthermic intraperitoneal chemotherapy procedure.
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J Clin Monit Comput · Apr 2024
Accuracy and clinical utility of heart rate variability derived from a wearable heart rate monitor in patients undergoing major abdominal surgery.
Low heart rate variability (HRV) can potentially identify patients at risk of intraoperative hypotension. However, it is unclear whether cheaper, readily accessible consumer heart rate (HR) monitors can provide similar utility to clinical Holter electrocardiograph (ECG) monitors. The objectives of this study were (1) to assess the validity of using the Polar H10 HR monitor as an alternative to a clinical Holter ECG and (2) to test total power (TP) as a predictor of intraoperative hypotension. ⋯ Patients with reduced TP were significantly more likely to require vasoactive drugs to maintain blood pressure. The substantial agreement between Polar H10 and Holter ECG may justify its use clinically. The use of preoperative recordings of HRV has the potential to become part of routine preoperative assessment as a useful screening tool to predict hemodynamic instability in patients undergoing general anesthesia.
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We review the study by Xu et al. (J Clin Monit Comput 37(4):985-992, 2023. https://doi.org/10.1007/s10877-022-00968-1 ) on ultrasound-guided regional blocks in clavicle surgery, assessing the effects on anaesthesia and postoperative outcomes. However, there are concerns. The defined population of the study differs from the registered title (Xu et al. ⋯ In addition, the method of measuring the diaphragm is not clear (Xu et al. J Clin Monit Comput 37(4):985-992, 2023. https://doi.org/10.1007/s10877-022-00968-1 ). This affects the accurate interpretation of their results.
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J Clin Monit Comput · Apr 2024
Observational StudyAssessment of changes in blood volume during lower body negative pressure-induced hypovolemia using bioelectrical impedance analysis.
Lower body negative Pressure (LBNP)-induced hypovolemia is simulating acute hemorrhage by sequestrating blood into lower extremities. Bioelectrical Impedance Analysis (BIA) is based on the electrical properties of biological tissues, as electrical current flows along highly conductive body tissues (such as blood). Changes in blood volume will lead to changes in bioimpedance. This study aims to study changes in upper (UL) and lower (LL) extremities bioimpedance during LBNP-induced hypovolemia. ⋯ During LBNP-induced hypovolemia, there were reciprocal changes in UL&LL bioimpedance. These changes reflected hemodynamic compensatory mechanisms to hypovolemia.
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J Clin Monit Comput · Feb 2024
Review Meta AnalysisIntraoperative individualization of positive-end-expiratory pressure through electrical impedance tomography or esophageal pressure assessment: a systematic review and meta-analysis of randomized controlled trials.
This systematic review of randomized-controlled trials (RCTs) with meta-analyses aimed to compare the effects on intraoperative arterial oxygen tension to inspired oxygen fraction ratio (PaO2/FiO2), exerted by positive end-expiratory pressure (PEEP) individualized trough electrical impedance tomography (EIT) or esophageal pressure (Pes) assessment (intervention) vs. PEEP not tailored on EIT or Pes (control), in patients undergoing abdominal or pelvic surgery with an open or laparoscopic/robotic approach. ⋯ CRD 42021218306, 30/01/2023.