Journal of clinical monitoring and computing
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J Clin Monit Comput · Oct 2020
Clinical TrialMultimodal non-invasive monitoring to apply an open lung approach strategy in morbidly obese patients during bariatric surgery.
To evaluate the use of non-invasive variables for monitoring an open-lung approach (OLA) strategy in bariatric surgery. Twelve morbidly obese patients undergoing bariatric surgery received a baseline protective ventilation with 8 cmH2O of positive-end expiratory pressure (PEEP). Then, the OLA strategy was applied consisting in lung recruitment followed by a decremental PEEP trial, from 20 to 8 cmH2O, in steps of 2 cmH2O to find the lung's closing pressure. ⋯ The OLA strategy can be monitored using noninvasive variables during bariatric surgery. This strategy decreased lung strain, elastance and driving pressure compared with standard protective ventilatory settings. Clinical trial number NTC03694665.
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J Clin Monit Comput · Oct 2020
A clinical study comparing ultrasound-measured pyloric antrum cross-sectional area to computed tomography-measured gastric content volume to detect high-risk stomach in supine patients undergoing emergency abdominal surgery.
The main aim of this study was to assess whether the ultrasound examination and measurement of the pyloric antral cross-sectional area (antral-CSA) in the supine position could be useful to diagnose a full stomach using a computed tomography (CT) as a comparator in emergency patients. Immediately before general anesthesia induction in patients undergoing emergency abdominal surgery, antral-CSA was measured and the volume of the gastric contents was evaluated via ultrasound in the supine position. Gastric content volume was also calculated from a CT image taken prior to the operation. ⋯ Antral-CSA measured in the supine position may help to assess the high-risk stomach patients undergoing emergency surgery. Trial registration: www.umin.ac.jp (UMIN 000013416). Registered 14 March 2014.
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J Clin Monit Comput · Oct 2020
Clinical TrialAutomated echocardiography for measuring and tracking cardiac output after cardiac surgery: a validation study.
Echocardiographic measurement of cardiac output with automated software analyses of spectral curves in the left ventricular outflow tract has been introduced. This study aimed to assess the precision and accuracy of cardiac output measurements as well as the ability to track cardiac output changes over time comparing the automated echocardiographic method with the continuous pulmonary artery thermodilution cardiac output technique and the manual echocardiographic method in cardiac surgery patients. Cardiac output was measured simultaneously with all three methods in 50 patients on the morning after cardiac surgery. ⋯ Trending ability was poor when compared to the continuous thermodilution technique, but moderate when compared to the manual echocardiographic method. Trial registry number: NCT03372863. Retrospectively registered December 14th 2017.
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J Clin Monit Comput · Oct 2020
Observational StudyNoninvasive measurement of stroke volume changes in critically ill patients by means of electrical impedance tomography.
Previous animal experiments have suggested that electrical impedance tomography (EIT) has the ability to noninvasively track changes in cardiac stroke volume (SV). The present study intended to reproduce these findings in patients during a fluid challenge. In a prospective observational study including critically ill patients on mechanical ventilation, SV was estimated via ECG-gated EIT before and after a fluid challenge and compared to transpulmonary thermodilution reference measurements. ⋯ Our results indicate that ECG-gated EIT measurements of [Formula: see text] are able to noninvasively monitor changes in SV during a fluid challenge in critically ill patients. However, this was not possible using [Formula: see text]. The present approach is limited by the influences induced by ventilation, posture or changes in electrode-skin contact and requires further validation.
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J Clin Monit Comput · Oct 2020
Observational StudyPhysiological abnormalities in patients admitted with acute exacerbation of COPD: an observational study with continuous monitoring.
Acute exacerbations of chronic obstructive pulmonary disease (AECOPD) may rapidly require intensive care treatment. Evaluation of vital signs is necessary to detect physiological abnormalities (micro events), but patients may deteriorate between measurements. We aimed to assess if continuous monitoring of vital signs in patients admitted with AECOPD detects micro events more often than routine ward rounds. ⋯ No events of SpO2 < 80% was detected by EWS. Micro events of tachycardia, tachypnoea, and bradypnoea were also more frequently detected by continuous monitoring (p < 0.02 for all). Moderate and severe episodes of desaturation and other cardiopulmonary micro events during hospitalization for AECOPD are common and most often not detected by EWS.