Journal of clinical monitoring and computing
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J Clin Monit Comput · Dec 2019
Non-sinusoidal waves in the EEG and their simulated effect on anaesthetic quantitative EEG monitors.
The effect of anaesthetic drugs on the cortex are commonly estimated from the electroencephalogram (EEG) by quantitative EEG monitors such as the Bispectral Index (BIS). These monitors use ratios of high to low frequency power which assumes that each neurological process contributes a unique frequency pattern. However, recent research of the effect of deep brain stimulation on EEG beta oscillations suggests that wave shape, a non-sinusoidal feature that is only measurable in the time-domain, can change the frequency 'signature' of a neurological rhythmical process by the inclusion or removal of harmonic frequencies. ⋯ Age was found to be the only significant predictor of alpha wave triangularity. The artificially modified square-alpha waves increased the power in the frequency spectrum at 26 Hz by 1-5 dB, and increased the BetaRatio by 0.7. The alpha-wave of anaesthetised patients contains non-sinusoidal components which likely impact depth of anaesthesia calculations.
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J Clin Monit Comput · Dec 2019
Letter Case ReportsBilateral erector spinae plane block with single injection.
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J Clin Monit Comput · Dec 2019
Near-real-time pulmonary shunt and dead space measurement with micropore membrane inlet mass spectrometry in pigs with induced pulmonary embolism or acute lung failure.
The multiple inert gas elimination technique (MIGET) using gas chromatography (GC) is an established but time-consuming method of determining ventilation/perfusion (VA/Q) distributions. MIGET-when performed using Micropore Membrane Inlet Mass Spectrometry (MMIMS)-has been proven to correlate well with GC-MIGET and reduces analysis time substantially. We aimed at comparing shunt fractions and dead space derived from MMIMS-MIGET with Riley shunt and Bohr dead space, respectively. ⋯ MM-S and MM-VD correlated and agreed well with Riley shunt and with Bohr dead space. MM-S increased significantly after lung injury only in the lavage group, whereas MM-VD increased significantly in both groups. This is the first work evaluating and demonstrating the feasibility of near real-time VA/Q distribution measurements with the MIGET and the MMIMS methods.
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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
Observational StudyLevel of agreement of point-of-care and laboratory HbA1c measurements in the preoperative outpatient clinic in non-diabetic patients who are overweight or obese.
Implementation of point-of-care HbA1c devices in the preoperative outpatient clinic might facilitate the early diagnosis of glycemic disturbances in overweight or obese patients undergoing surgery, but validation studies in this setting do not exist. We determined the level of agreement between a point-of-care and laboratory HbA1c test in non-diabetic patients visiting the outpatient clinic for preoperative risk profiling. Point-of-care HbA1c levels were measured in whole blood obtained by a finger prick (Siemens DCA Vantage HbA1c analyzer) and in hemolysed EDTA blood in the central laboratory (LAB). ⋯ Clarke's error grid analysis showed that 48 out of 49 measurements were located in area A (98%). Point-of-care HbA1c measurements showed a high level of agreement with the laboratory test in the outpatient setting, and may be used for preoperative risk profiling in patients prone to cardiometabolic complications. Trial registration: Netherlands Trial Register NTR3057.