Journal of clinical monitoring and computing
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J Clin Monit Comput · Aug 2022
Correlation between brain tissue oxygen tension and regional cerebral oximetry in uninjured human brain under conditions of changing ventilation strategy.
Controversy surrounds regional cerebral oximetry (rSO2) because extracranial contamination and unmeasured changes in cerebral arterial:venous ratio confound readings. Correlation of rSO2 with brain tissue oxygen (PbrO2), a "gold standard" for cerebral oxygenation, could help resolve this controversy but PbrO2 measurement is highly invasive. This was a prospective cohort study. ⋯ From set point 1 to set point 2, PbrO2 increased from median 6.0, IQR 4.0-11.3 to median 22.5, IQR 9.8-43.6, p = 0.015; rSO2 increased from median 68.0, IQR 62.5-80.5 to median 83.0, IQR 74.0-90.0, p = 0.047. Correlation between PbrO2 and rSO2 is evident. Increasing FiO2 and PaCO2 results in significant increases in cerebral oxygenation measured by both monitors.
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J Clin Monit Comput · Aug 2022
Observational StudyAssessment of different computing methods of inspiratory transpulmonary pressure in patients with multiple mechanical problems.
While plateau airway pressure alone is an unreliable estimate of lung overdistension inspiratory transpulmonary pressure (PL) is an important parameter to reflect it in patients with ARDS and there is no concensus about which computation method should be used to calculate it. Recent studies suggest that different formulas may lead to different tidal volume and PEEP settings. The aim of this study is to compare 3 different inspiratory PL measurement method; direct measurement (PLD), elastance derived (PLE) and release derived (PLR) methods in patients with multiple mechanical abnormalities. 34 patients were included in this prospective observational study. ⋯ There was a good aggreement and there was no bias between the measurements in Bland-Altman analysis. The estimated bias was similar between the PLD and PLE (- 3.12 ± 11 cmH2O) and PLE and PLR (3.9 ± 10.9 cmH2O) measurements. Our results suggest that standardization of calculation method of inspiratory PL is necessary before using it routinely to estimate alveolar overdistension.
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J Clin Monit Comput · Aug 2022
Clinical TrialComparisons of the efficiency of respiratory rate monitoring devices and acoustic respiratory sound during endoscopic submucosal dissection.
During moderate sedation for gastrointestinal endoscopic submucosal dissection (ESD), monitoring of ventilatory function is recommended. We compared the following techniques of respiratory rate (RR) measurement with respiratory sound (RRa): capnography (RRc), thoracic impedance (RRi), and plethysmograph (RRp). This study enrolled patients aged ≥ 20 years who underwent esophageal (n = 19) and colorectal (n = 5) ESDs. ⋯ During esophageal ESD, RRa and RRp may be a good parameter to detect bradypnea or apnea. RRc, RRa and RRp are useful for reliable during colorectal ESD. Trial registration UMIN-CTR (UMIN000025421).