Journal of clinical monitoring and computing
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J Clin Monit Comput · Oct 2020
Clinical TrialAutomated echocardiography for measuring and tracking cardiac output after cardiac surgery: a validation study.
Echocardiographic measurement of cardiac output with automated software analyses of spectral curves in the left ventricular outflow tract has been introduced. This study aimed to assess the precision and accuracy of cardiac output measurements as well as the ability to track cardiac output changes over time comparing the automated echocardiographic method with the continuous pulmonary artery thermodilution cardiac output technique and the manual echocardiographic method in cardiac surgery patients. Cardiac output was measured simultaneously with all three methods in 50 patients on the morning after cardiac surgery. ⋯ Trending ability was poor when compared to the continuous thermodilution technique, but moderate when compared to the manual echocardiographic method. Trial registry number: NCT03372863. Retrospectively registered December 14th 2017.
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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
Observational StudyPhysiological abnormalities in patients admitted with acute exacerbation of COPD: an observational study with continuous monitoring.
Acute exacerbations of chronic obstructive pulmonary disease (AECOPD) may rapidly require intensive care treatment. Evaluation of vital signs is necessary to detect physiological abnormalities (micro events), but patients may deteriorate between measurements. We aimed to assess if continuous monitoring of vital signs in patients admitted with AECOPD detects micro events more often than routine ward rounds. ⋯ No events of SpO2 < 80% was detected by EWS. Micro events of tachycardia, tachypnoea, and bradypnoea were also more frequently detected by continuous monitoring (p < 0.02 for all). Moderate and severe episodes of desaturation and other cardiopulmonary micro events during hospitalization for AECOPD are common and most often not detected by EWS.
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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
Observational StudyEvaluation of Surgical Pleth Index and Analgesia Nociception Index as surrogate pain measures in conscious postoperative patients: an observational study.
We evaluated the performance of the Surgical Plethysmographic Index (SPI) and the Analgesia Nociception Index (ANI) as surrogate pain measures and determined their respective cut-off values for detecting pain in conscious postoperative patients. In total, 192 patients after elective surgery were enrolled. Baseline SPI and ANI data were acquired for 10 min in the operating room prior to surgery when the patients rated their pain as 0 on the numerical rating scale (NRS). ⋯ The areas under the receiver operating curves for SPI and ANI were 0.73 (P < 0.0001) and 0.67 (P < 0.0001), respectively. The cut-off values for SPI and ANI in predicting postoperative pain were 44 (sensitivity: 84%, specificity: 53%) and 63 (sensitivity: 52%, specificity: 82%), respectively, which are different from those suggested by their respective manufacturers for use in intraoperative state under general anaesthesia. The cut-off values of SPI and ANI for detecting pain were similar regardless of the type of anesthesia.