Journal of clinical monitoring and computing
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J Clin Monit Comput · Dec 2021
Clinical TrialEEG-derived pain threshold index for prediction of postoperative pain in patients undergoing laparoscopic urological surgery: a comparison with surgical pleth index.
Recently a novel pain recognition indicator derived from electroencephalogram(EEG) signals, pain threshold index(PTI) has been developed. The aim of this study was to determine whether PTI can be used for prediction of postoperative acute pain while surgical pleth index(SPI) applied as control. Eighty patients undergoing laparoscopic urological surgery under general anesthesia were enrolled. ⋯ Further analysis indicated that PTI had a best predictive accuracy reflected by highest area under curve (AUC)(0.772, 95% CI: 0.661-0.860)with sensitivity(62.50%) and specificity(90.91%) and a best positive predictive value(83.3%,95% CI: 68.4-98.2%). PTI obtained at the end of surgery, which have better predictive accuracy for postoperative pain than SPI, could differentiate the patients with moderate-to-severe pain from those with mild pain after they awaken from anesthesia. Clinical trial registration Chinese Clinical Trials Registry: ChiCTR1900024789.
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J Clin Monit Comput · Dec 2021
Feasibility study of a smartphone pupillometer and evaluation of its accuracy.
Measurement of pupillary characteristics, such as pupillary unrest in ambient light, and reflex dilation have been shown to be useful in a variety of clinical situations. Dedicated pupillometers typically capture images in the near-infrared to allow imaging in both light and darkness. However, because a subset of pupillary measurements can be acquired with levels of visible light suitable for conventional cameras, it is theoretically possible to capture data using general purpose cameras and computing devices such as those found on smartphones. ⋯ In 77% of the scans the software was able to successfully identify the pupil and iris. The raw data as well as calculated values of pupillary unrest in ambient light were in clinically acceptable levels of agreement; Bland-Altman analysis of raw pupil measurements yielded a 95% confidence interval of 0.26 mm. In certain situations a smartphone pupillometer may be an appropriate alternative to a commercial pupillometer.
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J Clin Monit Comput · Dec 2021
Clinical TrialComparison of the Conox (qCON) and Sedline (PSI) depth of anaesthesia indices to predict the hypnotic effect during desflurane general anaesthesia with ketamine.
Comparison of two depth of anesthesia indices, qCON (Conox) and PSI (Sedline), during desflurane sedation and their sensitivity to random ketamine boluses in patients undergoing routine surgery. The performance of desflurane and ketamine on both indices was analyzed for 11 patients, and the ketamine sensitivity was compared with another group of 11 patients under sevoflurane and propofol. The MOAA/S was used to determine sedation level and pain. ⋯ However, during desflurane anesthesia the qCON index did not change significantly after ketamine administration, qCON (before = 33 (4), after = 30 (17); Wilcoxon, p = 0.89), while the PSI experienced a significant increase, PSI (before = 31(6), after = 39(16) Wilcoxon, p = 0.013). This study shows that qCON and PSI have similar performance under desflurane with good discrimination between the awake and anesthetized states. While both indices exhibited similar behavior under ketamine boluses under a sevoflurane-propofol anesthesia, the qCON index had a better performance under ketamine during desflurane anesthesia.
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J Clin Monit Comput · Dec 2021
Observational StudyNormative values for SedLine-based processed electroencephalography parameters in awake volunteers: a prospective observational study.
Processed electroencephalography (pEEG) is used to monitor depth of anaesthesia and/or sedation. A novel device (SedLine®) has been recently introduced into clinical practice. However, there are no published data on baseline SedLine values for awake adult subjects. ⋯ There was a significant positive correlation between EMG and PSI with eyes closed (p = 0.01) but not with eyes open, which was confirmed with linear regression analysis (p = 0.01). In awake volunteers, keeping eyes open induces significant changes to SedLine-derived parameters, most likely due to increased EMG activity (e.g. eye blinking). These findings have implications for the clinical interpretation of PSI parameters and for the planning of future research.
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J Clin Monit Comput · Dec 2021
Observational StudyUse of eye tracking in analyzing distribution of visual attention among critical care nurses in daily professional life: an observational study.
Patient safety is a priority in healthcare, yet it is unclear how sources of errors should best be analyzed. Eye tracking is a tool used to monitor gaze patterns in medicine. The aim of this study was to analyze the distribution of visual attention among critical care nurses performing non-simulated, routine patient care on invasively ventilated patients in an ICU. ⋯ Eye tracking is helpful to analyze the distribution of visual attention of critical care nurses. It demonstrates that the respirator, the patient data management system and the patient form cornerstones in the treatment of critically ill patients. This offers insights into complex work patterns in critical care and the possibility of improving work flows, avoiding human error and maximizing patient safety.