Journal of clinical monitoring and computing
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J Clin Monit Comput · Dec 2024
Letter Case ReportsProne-position decreases airway closure in a patient with ARDS undergoing venovenous extracorporeal membrane oxygenation.
Airway closure is a interruption of communication between larger and smaller airways. The presence of airway closure during mechanical ventilation may lead to the overestimation of driving pressure (DP), introducing errors in the assessment of respiratory mechanics and in positive end-expiratory pressure (PEEP) setting on the ventilator. Patients with severe acute respiratory distress syndrome (ARDS) may exhibit the airway closure phenomenon, which can be easily diagnosed with a low-flow inflation. Prone positioning is a therapeutic manoeuver proven to reduce mortality in ARDS patients, and has been widely implemented also in patients requiring veno-venous extracorporeal membrane oxygenation (V-V ECMO). To date, the impact of prone positioning on changes in airway closure has not been described. ⋯ Prone positioning reduced airway closure in an ARDS patient on VV ECMO support.
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J Clin Monit Comput · Nov 2024
Regional cerebral oxygen saturation in the healthy population of western Sichuan: a multicenter cross-sectional study.
Regional cerebral oxygen saturation (rSO2) may vary in healthy individuals with different characteristics. Therefore, this study aimed to explore rSO2 in a healthy population of western Sichuan. This cross-sectional study enrolled healthy volunteers from the Health Management Center and Inpatient Department of Ya'an People's Hospital, Ya'an Vocational and Technical College, Ya'an Geriatric University, and Liziping Yi Township in Shimian County, Ya'an City, Sichuan Province. ⋯ Pearson correlation analysis showed a significantly negative correlation of rSO2 with age, ethics, past illness, and body mass index (BMI) but a significantly positive correlation with head circumference and height (all P < 0.05). The rSO2 values in the left brain are significantly higher than in the right brain. Sex, ethnicity, age, BMI, and past illness are closely related to rSO2 values in the healthy population.
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J Clin Monit Comput · Nov 2024
Association of early perioperative stroke after cardiothoracic surgery with intraoperative regional cerebral oxygenation using near-infrared spectroscopy: an observational cohort study comparing affected versus non-affected hemispheres.
Patients undergoing cardiothoracic surgery are at risk of developing perioperative stroke, but residual effects of anesthesia may hamper timely detection. This study aims to determine if there is an association between intraoperative regional cerebral oxygenation (ScO2) monitoring using near-infrared spectroscopy (NIRS) and the occurrence of early perioperative stroke within three days after cardiothoracic surgery. ⋯ The duration of ScO2 values < 50% or a drop > 20% from baseline were associated with the occurrence of early perioperative global cerebral ischemia within three days after cardiothoracic surgery.
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J Clin Monit Comput · Nov 2024
EditorialNew sensors for the early detection of clinical deterioration on general wards and beyond - a clinician's perspective.
The early detection of clinical deterioration could be the next significant step in enhancing patient safety in general hospital wards. Most patients do not deteriorate suddenly; instead, their vital signs are often abnormal or trending towards an abnormal range hours before severe adverse events requiring rescue intervention and/or ICU transfer. To date, at least 10 large clinical studies have demonstrated a significant reduction in severe adverse events when heart rate, blood pressure, oxygen saturation and/or respiratory rate are continuously monitored on medical and surgical wards. ⋯ Wireless and wearable sensors are particularly valuable, as they make continuous monitoring feasible even for ambulatory patients, raising questions about the future relevance of "stay-in-bed" solutions like capnography, bed sensors, and video-monitoring systems. While the number of wearable sensors and mobile monitoring solutions is rapidly growing, independent validation studies on their sensitivity and specificity in detecting abnormal vital signs in actual patients, rather than healthy volunteers, remain limited. Additionally, further research is needed to evaluate the cost-effectiveness of using wireless wearables for vital sign monitoring both within hospital wards and at home.