Journal of clinical monitoring and computing
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J Clin Monit Comput · Dec 2019
Multicenter Study Comparative StudyPulmonary lung Doppler signals: normative data in a pediatric population compared with adults.
Lung Doppler signals (LDS) acquired via transthoracic echocardiography is a novel technology previously reported in adults for use in detecting pulmonary hypertension. The aim of this study was to characterize LDS in healthy children to establish normative pediatric LDS data, and compare the pediatric data to the previously published healthy adult LDS. In this prospective, two-center study, LDS were acquired in children without cardiopulmonary disease using a 2 MHz transthoracic pulsed Doppler transducer. ⋯ In this study, we defined the normal LDS profile for healthy children and have demonstrated differences in LDS between children and adults. Specifically, healthy children had lower atrial contraction power, differences in ventricular compliance and increased chronotropic response. Further studies are warranted to investigate the application of this technology, for example as a tool to aid in the detection of pulmonary hypertension in children.
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J Clin Monit Comput · Dec 2019
Randomized Controlled TrialUsefulness of combining clinical and biochemical parameters for prediction of postoperative pulmonary complications after lung resection surgery.
Early detection of patients with a high risk of postoperative pulmonary complications (PPCs) could improve postoperative strategies. We investigated the role of monitoring systemic and lung inflammatory biomarkers during surgery and the early postoperative period to detect patients at high risk of PPCs after lung resection surgery (LRS). This is a substudy of a randomized control trial on the inflammatory effects of anaesthetic drugs during LRS. ⋯ Model 3 had had an IDI of 0.29 (p < 0.001) and a net reclassification index of 0.28 (p = 0.007). A mathematical model combining inflammation biomarkers with clinical variables predicts PPCs after LRS better than a model that includes only clinical data. Clinical registration number Clinical Trial Registration NCT02168751; EudraCT 2011-002294-29.
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J Clin Monit Comput · Dec 2019
Significant factors influencing inadvertent hypothermia in pediatric anesthesia.
Thermal imbalances are very common during surgery. Hypothermia exposes the patient to post-operative shivering, cardiac dysfunction, coagulopathy, bleeding, wound infection, delayed anesthesia recovery, prolonged hospital stay and increased hospitalization cost. There are many factors contributing to intraoperative hypothermia. ⋯ Intraoperative hypothermia can be life threatening if it is not handled carefully. Various methods are used before, during and after surgery to maintain a patient's body temperature within the normothermia range. The use of an active warming device like the Bair Hugger® air-forced warming system seems to be a good method for reducing the risk of intraoperative hypothermia and effectively maintaining body temperature for all major and minor surgeries.
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J Clin Monit Comput · Dec 2019
An exploratory clinical evaluation of a head-worn display based multiple-patient monitoring application: impact on supervising anesthesiologists' situation awareness.
Supervising anesthesiologists overseeing several operating rooms must be aware of the status of multiple patients, so they can consult with the anesthetist in single operating rooms or respond quickly to critical events. However, maintaining good situation awareness can be challenging when away from patient bedsides or a central monitoring station. In this proof-of-concept study, we evaluated the potential of a head-worn display that showed multiple patients' vital signs and alarms to improve supervising anesthesiologists' situation awareness. ⋯ Head-worn displays can improve supervising anesthesiologists' situation awareness in multiple-patient monitoring situations. The anesthesiologists who participated in the study expressed enthusiasm about monitoring patients with a head-worn display and wished to use and evaluate it further.
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J Clin Monit Comput · Dec 2019
Observational StudyPreoperative cerebral and renal oxygen saturation and clinical outcomes in pediatric patients with congenital heart disease.
We examined the predictability of preoperative cerebral and renal rSO2 values for outcomes in pediatric patients undergoing cardiac surgery under cardiopulmonary bypass (CPB). Patients who underwent pediatric cardiac surgery under CPB between September 2015 and September 2017 were enrolled in this study. Patients monitored with both cerebral and renal rSO2 at the beginning of surgery were included. ⋯ The cut-off value (66%) of cerebral rSO2 value was associated with risk of mechanical ventilator-free day [OR of 11.3 (95% CI 1.05-25.3, p = 0.0456)] and the cut-off value (66%) of renal rSO2 value was associated with risk of ICU-free survival day [ORs of 33.0 (95% CI 2.25-484.0, p = 0.0107)] in the noncyanotic patients. The preoperative low rSO2 values were associated with outcomes including 30-day mortality and might be reflective of the severity of cardiopulmonary function. Further studies are needed to confirm our results.