Journal of clinical monitoring and computing
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J Clin Monit Comput · Apr 2023
Randomized Controlled TrialTo compare the influence of blind insertion and up-down optimized glottic exposure manoeuvre on oropharyngeal leak pressure using SaCoVLM™ video laryngeal mask among patients undergoing general anesthesia.
To compare the potential influences of blind insertion and up-down optimized glottic exposure manoeuvre on the oropharyngeal leak pressure (OPLP) in using SaCoVLM™ video laryngeal mask (VLM) among patients undergoing general anesthesia. A randomized self-control study controlled was conducted to investigate the effect of two insertion techniques on OPLP. A total of 60 patients (male or female, 18-78 years, BMI 18.0-30.0 kg m-2 and ASA I-II) receiving selective surgery under general anesthesia were randomly recruited. ⋯ Our results suggests that up-down optimized glottic exposure manoeuver may be a useful technique for SaCoVLM™ insertion. Trial registration: ChiCTR, ChiCTR2000028802. Registered 4 January 2020, http://www.chictr.org.cn/ChiCTR2000028802.
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J Clin Monit Comput · Apr 2023
Observational StudyRelationships between common carotid artery blood flow and anesthesia, pneumoperitoneum, and head-down tilt position: a linear mixed-effect analysis.
This study investigated the effects of pneumoperitoneum and the head-down tilt position on common carotid artery (CCA) blood flow in surgical patients. ⋯ Clinicaltrials.gov (NCT04233177, January 18, 2020).
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J Clin Monit Comput · Apr 2023
A machine learning approach to predicting early and late postoperative reintubation.
Accurate estimation of surgical risks is important for informing the process of shared decision making and informed consent. Postoperative reintubation (POR) is a severe complication that is associated with postoperative morbidity. Previous studies have divided POR into early POR (within 72 h of surgery) and late POR (within 30 days of surgery). ⋯ The scoring systems developed from the logistic regression models demonstrated strong performance in terms of both accuracy and discrimination across the different POR outcomes (Average Brier score, 0.172; Average c-statistic, 0.852). These results were only marginally worse than prediction using the full set of risk variables (Average Brier score, 0.145; Average c-statistic, 0.870). While more work needs to be done to identify clinically relevant differences between the early and late POR outcomes, the scoring systems provided here can be used by surgeons and patients to improve the quality of care overall.
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J Clin Monit Comput · Apr 2023
EditorialNew guidelines for research in airway device evaluation: time for an updated approach (ADEPT-2) to the Difficult Airway Society's 'ADEPT' strategy?
In this article we present the learning from a clinical study of airway device evaluation, conducted under the framework of the Difficult Airway Society (DAS, UK) 'ADEPT' (airway device evaluation project team) strategy. We recommend a change in emphasis from small scale randomised controlled trials conducted as research, to larger-scale observational, post-marketing evaluation audits as a way of obtaining more meaningful information.
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J Clin Monit Comput · Apr 2023
Randomized Controlled TrialReduced postoperative pain in patients receiving nociception monitor guided analgesia during elective major abdominal surgery: a randomized, controlled trial.
The Nociception Level index (NOL™) is a multiparameter index, based on artificial intelligence for the monitoring of nociception during anesthesia. We studied the influence of NOL-guided analgesia on postoperative pain scores in patients undergoing major abdominal surgery during sevoflurane/fentanyl anesthesia. This study was designed as a single-center, prospective randomized, controlled study. After Institutional Review Board approval and written informed consent, 75 ASA 1-3 adult patients undergoing major abdominal surgery, were randomized to NOL-guided fentanyl dosing (NOL) or standard care (SOC) and completed the study. ⋯ Postoperative pain scores were significantly improved in nociception level index-guided patients. We attribute this to more objective fentanyl dosing when timed to actual nociceptive stimuli during anesthesia, contributing to lower levels of sympathetic activation and surgical stress. Clinicaltrials.gov identifier: NCT03970291 date of registration May 31, 2019.