Journal of clinical monitoring and computing
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J Clin Monit Comput · Oct 2020
Multicenter Study Observational StudyMonitoring tissue perfusion: a pilot clinical feasibility and safety study of a urethral photoplethysmography-derived perfusion device in high-risk patients.
Continuous monitoring of tissue perfusion in patients with hemodynamic instability remains challenging because of the lack of tools available. Through using urethral photoplethysmography, the urethral perfusion index (uPI) could allow tissue perfusion monitoring through a modified urinary catheter. The first objective of our study was to evaluate the feasibility and safety of the IKORUS UP (Advanced Perfusion Diagnostics, Villeurbanne, France), a new device in the field. ⋯ The IKORUS UP probe was well tolerated and allowed urethral perfusion monitoring. Clinically relevant changes in tissue perfusion could be recorded during the observational period. Trial Registration: ( www.clinicaltrials.gov NCT03410069) registered January 25, 2018.
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J Clin Monit Comput · Oct 2020
Observational StudyZero-heat-flux core temperature monitoring system: an observational secondary analysis to evaluate agreement with naso-/oropharyngeal probe during anesthesia.
General anesthesia impairs thermoregulation and contributes to perioperative hypothermia; core body temperature monitoring is recommended during surgical procedures lasting > 30 min. Zero-heat-flux core body temperature measurement systems enable continuous non-invasive perioperative monitoring. During a previous trial evaluating the benefits of preoperative forced-air warming, intraoperative temperatures were measured with both a zero-heat-flux sensor and a standard naso-/oropharyngeal temperature probe. ⋯ The zero-heat-flux sensor demonstrated moderate agreement with the naso-/oropharyngeal temperature probe, which was not fully within the generally accepted ± 0.5 °C limit. This is consistent with previous studies. The zero-heat-flux system offers clinical utility for non-invasive and continuous core body temperature monitoring throughout the perioperative period using a single sensor.
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J Clin Monit Comput · Oct 2020
A clinical study comparing ultrasound-measured pyloric antrum cross-sectional area to computed tomography-measured gastric content volume to detect high-risk stomach in supine patients undergoing emergency abdominal surgery.
The main aim of this study was to assess whether the ultrasound examination and measurement of the pyloric antral cross-sectional area (antral-CSA) in the supine position could be useful to diagnose a full stomach using a computed tomography (CT) as a comparator in emergency patients. Immediately before general anesthesia induction in patients undergoing emergency abdominal surgery, antral-CSA was measured and the volume of the gastric contents was evaluated via ultrasound in the supine position. Gastric content volume was also calculated from a CT image taken prior to the operation. ⋯ Antral-CSA measured in the supine position may help to assess the high-risk stomach patients undergoing emergency surgery. Trial registration: www.umin.ac.jp (UMIN 000013416). Registered 14 March 2014.
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J Clin Monit Comput · Oct 2020
Observational StudyNoninvasive measurement of stroke volume changes in critically ill patients by means of electrical impedance tomography.
Previous animal experiments have suggested that electrical impedance tomography (EIT) has the ability to noninvasively track changes in cardiac stroke volume (SV). The present study intended to reproduce these findings in patients during a fluid challenge. In a prospective observational study including critically ill patients on mechanical ventilation, SV was estimated via ECG-gated EIT before and after a fluid challenge and compared to transpulmonary thermodilution reference measurements. ⋯ Our results indicate that ECG-gated EIT measurements of [Formula: see text] are able to noninvasively monitor changes in SV during a fluid challenge in critically ill patients. However, this was not possible using [Formula: see text]. The present approach is limited by the influences induced by ventilation, posture or changes in electrode-skin contact and requires further validation.
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J Clin Monit Comput · Oct 2020
Clinical TrialThe incidence and interpretation of large differences in EIT-based measures for PEEP titration in ARDS patients.
Positive end-expiratory pressure (PEEP) can be titrated by electrical impedance tomography (EIT). The aim of the present study was to examine the performance of different EIT measures during PEEP trials with the aim of identifying "optimum" PEEP and to provide possible interpretations of largely diverging results. After recruitment (maximum plateau pressure 35 cmH2O), decremental PEEP trial with steps of 2 cmH2O and duration of 2 min per step was performed. ⋯ The existence of differences in the recommended PEEP among the analyzed EIT measures might be an indicator of non-recruitable lungs and heterogeneous airway resistances. In these extreme cases, the largely diverging results may prompt the attending clinician to develop individual ventilation strategies. Clinical Trial Registration Registration number NCT03112512, https://clinicaltrials.gov/ Registered 13 April 2017.