Journal of clinical monitoring and computing
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J Clin Monit Comput · Dec 2024
A novel wearable bioimpedance sensor for continuous monitoring of fluid balance: a study on isotonic hypovolemia in healthy adults.
This study aimed to investigate the ability of a novel wearable bioimpedance sensor to monitor changes in fluid balance induced by furosemide. Because iso-osmotic fluid loss is expected to primarily comprise fluid from the extracellular compartment it was hypothesized that isotonic hypovolemia would increase the extracellular resistance (RE). ⋯ This study demonstrates that the wearable bioimpedance device tested is very sensitive to furosemide-induced changes in fluid volume in healthy volunteers in a controlled environment. Additional research is needed to evaluate the ability of the device to track fluid status in a clinical setting.
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This correspondence is in response to Dr. David Allison's comments to the Editor, regarding the American Society of Neurophysiological Monitoring's (ASNM) updated intraoperative somatosensory evoked potential (SEP) monitoring position statement.
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J Clin Monit Comput · Dec 2024
The time constant of the cerebral arterial bed: exploring age-related implications.
The time constant of the cerebral arterial bed (τ) represents an estimation of the transit time of flow from the point of insonation at the level of the middle cerebral artery to the arteriolar-capillary boundary, during a cardiac cycle. This study assessed differences in τ among healthy volunteers across different age groups. Simultaneous recordings of transcranial Doppler cerebral blood flow velocity (CBFV) and arterial blood pressure (ABP) were performed on two groups: young volunteers (below 30 years of age), and older volunteers (above 40 years of age). τ was estimated using mathematical transformation of ABP and CBFV pulse waveforms. 77 healthy volunteers [52 in the young group, and 25 in the old group] were included. Pulse amplitude of ABP was higher [16.7 (14.6-19.4) mmHg] in older volunteers as compared to younger ones [12.5 (10.9-14.4) mm Hg; p < 0.001]. CBFV was lower in older volunteers [59 (50-66) cm/s] as compared to younger ones [72 (63-78) cm/s p < 0.001]. τ was longer in the younger volunteers [217 (168-237) ms] as compared to the older volunteers [183 (149-211) ms; p = 0.004]. τ significantly decreased with age (rS = - 0.27; p = 0.018). τ is potentially an integrative marker of the changes occurring in cerebral vasculature, as it encompasses the interplay between changes in compliance and resistance that occur with age.
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J Clin Monit Comput · Dec 2024
Review Meta AnalysisBeyond the debut: unpacking six years of Hypotension Prediction Index software in intraoperative hypotension prevention - a systematic review and meta-analysis.
Intraoperative hypotension (IOH) during general anesthesia is associated with higher morbidity and mortality, although randomized trials have not established a causal relation. Historically, our approach to IOH has been reactive. The Hypotension Prediction Index (HPI) is a machine learning software that predicts hypotension minutes in advance. This systematic review and meta-analysis explores whether using HPI alongside a personalized treatment protocol decreases intraoperative hypotension. ⋯ While the combination of HPI software with personalized treatment protocols may prevent intraoperative hypotension (IOH), the large heterogeneity among the studies and the lack of reliable data on its clinical significance necessitate further investigation.
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J Clin Monit Comput · Dec 2024
Letter ReviewMonitor smart, use better: the future of haemodynamic monitoring.
The review article "Haemodynamic Monitoring During Noncardiac Surgery" offers valuable insights but lacks evidence linking specific haemodynamic strategies to improved outcomes. There's a need for standardized protocols, ongoing clinician education, and further validation of new technologies. Additionally, balancing the use of invasive versus noninvasive methods and addressing cost-effectiveness and sustainability are essential. Continued research and adaptive practices are crucial for optimizing perioperative care.