Journal of clinical monitoring and computing
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J Clin Monit Comput · Jun 2020
Event-triggered averaging of electrical impedance tomography (EIT) respiratory waveforms as compared to low-pass filtering for removal of cardiac related impedance changes.
Electrical impedance tomography (EIT) is used for bedside ventilation monitoring; cardiac related impedance changes represent a source of noise superimposed on the ventilation signal, commonly removed by low-pass filtering (LPF). We investigated if an alternative approach, based on an event-triggered averaging (ETA) process, is more effective at preserving the actual ventilation waveform. Ten paralyzed patients undergoing volume-controlled ventilation were studied; 30 breaths for each patient were identified to compare LPF and ETA. ⋯ Both for global and regional waveforms, minimum and maximum EIT slopes were steeper by ETA as compared to LPF (average difference respectively - 57 ± 60 mL/s and 144 ± 96 mL/s for global signal, p < 0.05); ventilator inspiratory peak airflow correlated with maximum slope measured by ETA (r = 0.902, p < 0.001), but not LPF (p = 0.319). Beginning of inspiration identified on the ventilator waveform and on the global EIT signal by ETA occurred simultaneously, (+ 0.04 ± 0.07 s, p = 0.081), while occurred earlier by LPF (- 0.26 ± 0.1 s, p < 0.001). Removal of cardiac related impedance changes by ETA results in a ventilation signal more similar to the waveforms recorded by the ventilator, particularly regarding the slope of impedance changes and time at the minimum values as compared to LPF.
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J Clin Monit Comput · Jun 2020
Comment LetterDiaphragm dysfunction after cardiac surgery: a global approach.
Diaphragm ultrasound is a noninvasive technique that can be used to assess diaphragm function. In cardiac surgery, the technique may help physicians during the weaning process, in addition with echocardiography after surgery.
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J Clin Monit Comput · Jun 2020
Warning criteria for MEP monitoring during carotid endarterectomy: a retrospective study of 571 patients.
Monitoring of transcranial electrical motor evoked potentials (tcMEP) during carotid endarterectomy (CEA) has been shown to effectively detect intraoperative cerebral ischemia. The unique purpose of this study was to evaluate changes of MEP amplitude (AMP), area under the curve (AUC) and signal morphology (MOR) as additional MEP warning criteria for clamping-associated ischemia during CEA. Therefore, the primary outcome was the number of MEP alerts (AMP, AUC and MOR) in the patients without postoperative motor deficit (false positives). ⋯ In combination of AMP/AUC and AMP/AUC/MOR false positives were found in 9.52% and 9.33% of the patients. This study is the first to evaluate the correctness of the MEP warning criteria AMP, AUC and MOR with regard to false positive monitoring results in the context of CEA. All additional MEP warning criteria investigated produced an unacceptably high number of false positives and therefore may not be useful in carotid surgery for adequate detection of clamping-associated ischemia.
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J Clin Monit Comput · Jun 2020
Retraction Of PublicationRetraction Note to: Implications of Entropy and Surgical Pleth Index-guided general anaesthesia on clinical outcomes in critically ill polytrauma patients. A prospective observational non-randomized single centre study.
The authors have retracted this article [1]. After publication it was discovered that Table 1 which reports the clinical and demographical characteristics of the patients in the study contains a number of statistical and typographical errors. The data reported in this article are therefore unreliable. All authors agree with this retraction.