Journal of clinical monitoring and computing
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J Clin Monit Comput · Oct 2021
Letter Meta AnalysisComparison between laryngeal handshake and palpation techniques in the identification of cricothyroid membrane: a meta-analysis.
Because the use of conventional digital palpation technique for the identification of cricothyroid membrane (CTM) has been widely believed to be unreliable, the 'laryngeal handshake' technique (LH) has been introduced for CTM identification in the event of cricothyroidotomy. To provide evidence for clinical practice, this pilot meta-analysis aimed at investigating whether identification of CTM with the LH is superior to that with the palpation technique. Studies that evaluated the accuracy of CTM identification by using LH or palpation techniques (i.e., LH group vs. ⋯ Four studies published from 2018 to 2020 were considered relevant and were read in full. We found no significant difference in success rate of CTM identification [Risk Ratio (RR) 1.09, 95% CI 0.89-1.34, p = 0.41] between the two groups. These preliminary results of the current study demonstrated no significant differences in success rate between the laryngeal handshake and conventional palpation techniques in cricothyroid membrane identification.
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J Clin Monit Comput · Oct 2021
Quantitative assessment of consciousness during anesthesia without EEG data.
Assessing the depth of anesthesia (DoA) is a daily challenge for anesthesiologists. The best assessment of the depth of anesthesia is commonly thought to be the one made by the doctor in charge of the patient. This evaluation is based on the integration of several parameters including epidemiological, pharmacological and physiological data. ⋯ This protocol constitutes the very first step on the way towards a multimodal approach of anesthesia. The fact that our first classifier already demonstrated a good predictability is very encouraging for the future. Indeed, this first model was merely a proof of concept to encourage research ways in the field of machine learning and anesthesia.
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J Clin Monit Comput · Oct 2021
Technical considerations when using the EEG export of the SEDLine Root device.
Electroencephalographic (EEG) patient monitoring during general anesthesia can help to assess the real-time neurophysiology of unconscious states. Some monitoring systems like the SEDLine Root allow export of the EEG to be used for retrospective analysis. We show that changes made to the SEDLine display during recording affected the recorded EEG. ⋯ Changing the display settings results in undocumented changes in EEG amplitude, sampling rate, and signal quality. The occult nature of these changes could make the analysis of data sets difficult if not invalid. We strongly suggest researchers adequately define and keep the EEG display settings to export good quality EEG and to ensure comparability among patients.
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J Clin Monit Comput · Oct 2021
A new implementation of EN1839 method T mixture preparation to prepare calibration gas mixtures for anesthetic gas monitors.
In this study different mixtures from anesthetic liquids vapours in air and O2-sevoflurane/air, sevoflurane/O2 and isoflurane/O2-were prepared according to EN1839 method T. The gases mixtures were used to calibrate anesthetic gas monitors. The targeted concentrations (TCs) from sevoflurane and isoflurane in air and O2 were 0 vol%, 0.15 vol%, 0.7 vol%, 1 vol%, 1.5 vol%, 2.5 vol%, 5 vol%, 6 vol% and 8 vol%. ⋯ Full validation was performed to assure the suitability of the method for preparing gas mixtures to calibrate anesthetic gas monitors. Linearity, limit of detection (LOD), limit of quantification (LOQ), precision, method robustness and uncertainty of measurement results were evaluated in the validation study. The results indicated that the method is valid for the purpose of analysis.
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J Clin Monit Comput · Oct 2021
Estimation of pulse pressure variation and cardiac output in patients having major abdominal surgery: a comparison between a mobile application for snapshot pulse wave analysis and invasive pulse wave analysis.
Pulse pressure variation (PPV) and cardiac output (CO) can guide perioperative fluid management. Capstesia (Galenic App, Vitoria-Gasteiz, Spain) is a mobile application for snapshot pulse wave analysis (PWAsnap) and estimates PPV and CO using pulse wave analysis of a snapshot of the arterial blood pressure waveform displayed on any patient monitor. We evaluated the PPV and CO measurement performance of PWAsnap in adults having major abdominal surgery. ⋯ In adults having major abdominal surgery, PPVPWAsnap moderately agrees with PPVProAQT. The absolute and trending agreement between COPWAsnap with COProAQT is poor. Technical improvements are needed before PWAsnap can be recommended for hemodynamic monitoring.