Journal of clinical monitoring and computing
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J Clin Monit Comput · Dec 2024
Randomized Controlled Trial Comparative StudyComparing the haemodynamic effects of high- and low-dose opioid anaesthesia: a secondary analysis of a randomised controlled trial.
Post-induction hypotension (MAP < 65 mmHg) occurs frequently and is usually caused by the cardiovascular adverse effects of the anaesthetic induction drugs used. We hypothesize that a clinically significant difference in the incidence and severity of hypotension will be found when different doses of propofol and remifentanil are used for induction of anaesthesia. ⋯ Induction of anaesthesia with different predicted equipotent combinations of propofol and remifentanil did result in statistically different but clinically irrelevant differences in haemodynamic endpoints during induction of anaesthesia. Our study could not identify preferable drug combinations that decrease the risk for hypotension after induction, although they all yield a similar predicted PTOL.
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J Clin Monit Comput · Dec 2024
Multicenter Study Observational StudyCharacterization of intracranial compliance in healthy subjects using a noninvasive method - results from a multicenter prospective observational study.
An FDA-approved non-invasive intracranial pressure (ICP) monitoring system enables the assessment of ICP waveforms by revealing and analyzing their morphological variations and parameters associated with intracranial compliance, such as the P2/P1 ratio and time-to-peak (TTP). The aim of this study is to characterize intracranial compliance in healthy volunteers across different age groups. ⋯ The study revealed that the P2/P1 ratio and TTP are influenced by age and sex in healthy individuals, with men displaying lower values than women, and both ratios increasing with age. These findings suggest potential avenues for further research with larger and more diverse samples to establish reference values for comparison in various health conditions.
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J Clin Monit Comput · Dec 2024
Review Meta AnalysisBeyond the debut: unpacking six years of Hypotension Prediction Index software in intraoperative hypotension prevention - a systematic review and meta-analysis.
Intraoperative hypotension (IOH) during general anesthesia is associated with higher morbidity and mortality, although randomized trials have not established a causal relation. Historically, our approach to IOH has been reactive. The Hypotension Prediction Index (HPI) is a machine learning software that predicts hypotension minutes in advance. This systematic review and meta-analysis explores whether using HPI alongside a personalized treatment protocol decreases intraoperative hypotension. ⋯ While the combination of HPI software with personalized treatment protocols may prevent intraoperative hypotension (IOH), the large heterogeneity among the studies and the lack of reliable data on its clinical significance necessitate further investigation.
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J Clin Monit Comput · Dec 2024
Letter ReviewMonitor smart, use better: the future of haemodynamic monitoring.
The review article "Haemodynamic Monitoring During Noncardiac Surgery" offers valuable insights but lacks evidence linking specific haemodynamic strategies to improved outcomes. There's a need for standardized protocols, ongoing clinician education, and further validation of new technologies. Additionally, balancing the use of invasive versus noninvasive methods and addressing cost-effectiveness and sustainability are essential. Continued research and adaptive practices are crucial for optimizing perioperative care.