Journal of clinical monitoring and computing
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J Clin Monit Comput · Feb 2023
Multicenter Study Observational StudyIntra-abdominal hypertension in cardiac surgery patients: a multicenter observational sub-study of the Accuryn registry.
Intra-abdominal hypertension (IAH) is frequently present in the critically ill and is associated with increased morbidity and mortality. Conventionally, intermittent 'spot-check' manual measurements of bladder pressure in those perceived as high risk are used as surrogates for intra-abdominal pressure (IAP). True patterns of IAH remain unknown. ⋯ For maximum consecutive duration of IAH, 84% (115/137) of patients spent at least 12 h in grade I, 62% (85/137) in grade II, 18% (25/137) in grade III, and 2% (3/137) in grade IV IAH. During the first 48 h after cardiac surgery, IAH is common and persistent. Improved and automated monitoring of IAP will increase the detection of IAH-which normally would remain undetected using traditional intermittent monitoring methods.
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J Clin Monit Comput · Feb 2023
Observational StudyRelationship between ANI and qNOX and between MAC and qCON during outpatient laparoscopic cholecystectomy using remifentanil and desflurane without muscle relaxants: a prospective observational preliminary study.
This study was designed to investigate qCON and qNOX variations during outpatient laparoscopic cholecystectomy using remifentanil and desflurane without muscle relaxants and compare these indices with ANI and MAC. Adult patients undergoing outpatient laparoscopic cholecystectomy were included in this prospective observational study. Maintenance of anesthesia was performed using remifentanil targeted to ANI 50-80 and desflurane targeted to MAC 0.8-1.2 without muscle relaxants. ⋯ While qCON correlated with MAC, the correlation of overall qCON and ANI was poor but significant. Additionally, the qNOX weakly correlated with the remifentanil infusion rate. This observational study suggests that the proposed ranges of 40-60 for both indexes may correspond to adequate levels of hypnosis and analgesia during general anesthesia, although this should be confirmed by further research.
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J Clin Monit Comput · Feb 2023
Randomized Controlled TrialPerformance of the bispectral index and electroencephalograph derived parameters of anesthetic depth during emergence from xenon and sevoflurane anesthesia.
Many processed EEG monitors (pEEG) are unreliable when non-GABAergic anesthetic agents are used. The primary aim of the study was to compare the response of the Bispectral Index (BIS) during emergence from anesthesia maintained by xenon and sevoflurane. To better understand the variation in response of pEEG to these agents, we also compared several EEG derived parameters relevant to pEEG monitoring during emergence. Twenty-four participants scheduled for lithotripsy were randomized to receive xenon or sevoflurane anesthesia. ⋯ The spectral edge frequency and composite cortical state parameters increased significantly in both groups during emergence. The BIS index is lower at equivalent stages of behavioural response during emergence from xenon anesthesia when compared to sevoflurane anesthesia, most likely due to differences in how these two agents influence the relative beta ratio. The spectral edge frequency and composite cortical state might better reflect emergence from xenon anaesthesia. Clinical trial number and registry Australia New Zealand Clinical Trials Registry Number: ACTRN12618000916246.
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J Clin Monit Comput · Feb 2023
Intraoperative hypothermia in the neonate population: risk factors, outcomes, and typical patterns.
The risk factors, outcomes, and typical patterns of intraoperative hypothermia were studied in neonates to better guide the application of insulation measures in the operating room. This retrospective study enrolled 401 neonates undergoing surgery under general anaesthesia with tracheal intubation, including abdominal surgery, thoracic surgery, brain surgery, and others. The study collected basic characteristics, such as age, sex, weight, birth weight, gestational week, primary diagnosis and American Society of Anaesthesiologists (ASA) grade. ⋯ This study shows that there is a high incidence of intraoperative hypothermia in the neonate population. The intraoperative body temperature of neonates dropped to the lowest point in 1-1.5 h. The greatest decrease in core temperatures occurred in preterm babies and neonates with lower preoperative temperature.
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J Clin Monit Comput · Feb 2023
Evaluation of the Temple Touch Pro™ noninvasive core-temperature monitoring system in 100 adults under general anesthesia: a prospective comparison with esophageal temperature.
Perioperative hypothermia is still common and has relevant complication for the patient. An effective perioperative thermal management requires essentially an accurate method to measure core temperature. So far, only one study has investigated the new Temple Touch Pro™ (Medisim Ltd., Beit-Shemesh, Israel). during anesthesia Therefore, we assessed the agreement between the Temple Touch Pro™ thermometer (TTP) and distal esophageal temperature (TEso) in a second study. ⋯ We consider the TTP as a reasonable tool for perioperative temperature monitoring. It is not accurate enough to be used as a reference method in scientific studies, but may be a useful tool especially for conscious patients undergoing neuraxial anesthesia or regional anesthesia with sedation. Trial registration This study was registered in the German Clinical Trials Register (DRKS-ID: 00024050), day of registration 12/01/2021.