Journal of clinical monitoring and computing
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J Clin Monit Comput · Dec 2023
Cardiac surgery-associated acute kidney injury and perioperative plasma viscosity: is there a relationship?
Plasma viscosity (PV) is a key factor in microcirculatory flow resistance and capillary perfusion during hemodilution, we hypothesized a possible relationship between cardiac surgery-associated acute kidney injury (CSA-AKI) and PV. We conducted a prospective, observational, single-center study on 50 adult cardiac surgery patients with cardiopulmonary bypass (age 64 years, male sex 80%, baseline serum creatinine 1.04 mg/dL). We assessed perioperative characteristics, management, short-term outcomes, blood analysis, PV, serum creatinine, and diuresis. ⋯ However, CSA-AKI was related to increased BMI, lower hemoglobin and hematocrit levels, and pre-existing CKD. The present study found no significant association between PV and CSA-AKI. Nevertheless, more research is needed to validate this finding and to investigate the role of PV in other clinical settings.
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J Clin Monit Comput · Dec 2023
Quantifying pulse oximeter accuracy during hypoxemia and severe anemia using an in vitro circulation system.
Anemia and hypoxemia are common clinical conditions that are difficult to study and may impact pulse oximeter performance. Utilizing an in vitro circulation system, we studied performance of three pulse oximeters during hypoxemia and severe anemia. Three oximeters including one benchtop, one handheld, and one fingertip device were selected to reflect a range of cost and device types. ⋯ The fingertip device was the least accurate of the three oximeters. Pulse oximeter performance is impacted by severe anemia in vitro. The use of in vitro calibration systems may play an important role in augmenting in vivo performance studies evaluating pulse oximeter performance in challenging conditions.
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J Clin Monit Comput · Dec 2023
Observational StudyDeviations in continuously monitored electrodermal activity before severe clinical complications: a clinical prospective observational explorative cohort study.
Monitoring of high-risk patients in hospital wards is crucial in identifying and preventing clinical deterioration. Sympathetic nervous system activity measured continuously and non-invasively by Electrodermal activity (EDA) may relate to complications, but the clinical use remains untested. The aim of this study was to explore associations between deviations of EDA and subsequent serious adverse events (SAE). ⋯ We included 714 patients and found a total of 192 statistically significant associations between EDA-derived features and clinical outcomes. 79% of these associations were EDA-derived features of absolute and relative increases in EDA and 14% were EDA-derived features with normalized EDA above a threshold. The highest F1-scores for primary outcome with the four time-perspectives were 20.7-32.8%, with precision ranging 34.9-38.6%, recall 14.7-29.4%, and specificity 83.1-91.4%. We identified statistically significant associations between specific deviations of EDA and subsequent SAE, and patterns of EDA may be developed to be considered indicators of upcoming clinical deterioration in high-risk patients.
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J Clin Monit Comput · Dec 2023
Evaluation of the effectiveness of analgesia nociception index (ANI) predictability for surgical stimuli under personal analgesic sufficiency status (PASS) measured by pre-tetanus-induced ANI: a pilot study.
The Analgesia Nociception Index (ANI) is a promising monitor to evaluate the balance of nociception and anti-nociception based on heart rate variability. This prospective, interventional, monocentric pilot study aimed to verify the effectiveness of the personal analgesic sufficiency status (PASS) measured by pre-tetanus-induced ANI variation for surgical stimuli. After Ethics approval and informed consent, participants were anesthetized with sevoflurane and increased effect-site concentrations of remifentanil step by step (2, 4, 6 ng ml-1). ⋯ The PASS under pre-tetanus-induced ANI identification didn't meet the analgesic needs under surgical stimuli. Further investigations are required to provide a reliable prediction of individualized analgesia by objective nociception monitors. Trial registration NCT05063461.