Journal of clinical monitoring and computing
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J Clin Monit Comput · Aug 2014
Clinical TrialMulti-scale sample entropy of electroencephalography during sevoflurane anesthesia.
The electroencephalogram (EEG) has been widely applied in the assessment of depth of anesthesia (DoA). Recent research has found that multi-scale EEG analysis describes brain dynamics better than traditional non-linear methods. In this study, we have adopted a modified sample entropy (MSpEn) method to analyze anesthetic EEG series as a measure of DoA. ⋯ Scales 1, 3 and 5 tended to make the greatest contribution to MSpEn. For this data set, the MSpEn is superior to the ApEn, the RE and the SE for tracking drug concentration change during sevoflurane anesthesia. It is suggested that the MSpEn may be further studied for application in clinical monitoring of DoA.
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J Clin Monit Comput · Aug 2014
Poincaré plot analysis of autocorrelation function of RR intervals in patients with acute myocardial infarction.
The Poincaré plot of RR intervals (RRI) is obtained by plotting RRIn+1 against RRIn. The Pearson correlation coefficient (ρRRI), slope (SRRI), Y-intercept (YRRI), standard deviation of instantaneous beat-to-beat RRI variability (SD1RR), and standard deviation of continuous long-term RRI variability (SD2RR) can be defined to characterize the plot. Similarly, the Poincaré plot of autocorrelation function (ACF) of RRI can be obtained by plotting ACFk+1 against ACFk. ⋯ The ρACF and SACF correlated significantly and negatively with normalized high-frequency power (nHFP), and significantly and positively with normalized very low-frequency power (nVLFP) of heart rate variability in both groups of patients. On the contrary, the RMSSDACF/SDACF and SD1ACF/SD2ACF correlated significantly and positively with nHFP, and significantly and negatively with nVLFP and low-/high-frequency power ratio (LHR) in both groups of patients. We concluded that the ρACF, SACF, RMSSDACF/SDACF, and SD1ACF/SD2ACF, among many other indices of ACF Poincaré plot, can be used to differentiate between patients with AMI and patients with PCA, and that the increase in ρACF and SACF and the decrease in RMSSDACF/SDACF and SD1ACF/SD2ACF suggest an increased sympathetic and decreased vagal modulations in both groups of patients.
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J Clin Monit Comput · Aug 2014
Controlled Clinical TrialRight ventricular function in late-onset Pompe disease.
Pompe's disease is a glycogen storage disease (type II) characterized by inherited autosomal recessive transmission. The right ventricular (RV) function is a determinant parameter of clinical outcome in patients with heart failure. We sought to characterize the RV function using Doppler-echocardiography completed by Doppler tissular imaging and tricuspid annular plane systolic excursion (TAPSE) measurement. ⋯ Mean peak systolic RV velocity Sm was not significantly different in the two groups (17.11 ± 3.4 cm/s in Pompe disease vs 16.14 ± 3.8 cm/s in control group p = 0.61). Mean peak early diastolic Ea velocity in the RV were not significantly different in the two groups (15.6 ± 5.6 vs 18.2 ± 4.9 cm/s p = 0.34). According to our data, RV systolic function seems preserved in late-onset Pompe disease.
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J Clin Monit Comput · Aug 2014
Clinical TrialBedside monitoring of ventilation distribution and alveolar inflammation in community-acquired pneumonia.
It is unclear whether bedside monitoring tools such as exhaled nitric oxide measurements (FENO) and electrical impedance tomography (EIT) could help guiding patient management in community-acquired pneumonia (CAP). We hypothesized that exhaled NO would be increased in CAP patients and could be used to assess resolution of inflammation in the course of CAP therapy. Feasibility of multiple-breath (mb) and single-breath (sb) approach has been investigated. ⋯ EIT images at T2 showed a more homogeneous ventilation distribution in displayed EIT. FENO could be a prospective supplementary tool to describe local lung inflammation as individual trend parameter. EIT could be a suitable supplementary tool to monitor functional lung status in CAP.
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J Clin Monit Comput · Aug 2014
An autocalibrating algorithm for non-invasive cardiac output determination based on the analysis of an arterial pressure waveform recorded with radial artery applanation tonometry: a proof of concept pilot analysis.
We aimed to describe and evaluate an autocalibrating algorithm for determination of cardiac output (CO) based on the analysis of an arterial pressure (AP) waveform recorded using radial artery applanation tonometry (AT) in a continuous non-invasive manner. To exemplarily describe and evaluate the CO algorithm, we deliberately selected 22 intensive care unit patients with impeccable AP waveforms from a database including AP data obtained with AT (T-Line system; Tensys Medical Inc.). When recording AP data for this prospectively maintained database, we had simultaneously noted CO measurements obtained from just calibrated pulse contour analysis (PiCCO system; Pulsion Medical Systems) every minute. ⋯ Bland-Altman analysis demonstrated a bias of +0.1 L/min (standard deviation 0.8 L/min; 95% limits of agreement -1.5 to 1.7 L/min, percentage error 23%). CO can be computed based on the analysis of the AP waveform recorded with AT. In the selected patients included in this pilot analysis, a percentage error of 23% indicates clinically acceptable agreement between AT-CO and PC-CO.