Journal of clinical monitoring and computing
-
J Clin Monit Comput · Jun 2020
Comparative StudyThe value of a superior vena cava collapsibility index measured with a miniaturized transoesophageal monoplane continuous echocardiography probe to predict fluid responsiveness compared to stroke volume variations in open major vascular surgery: a prospective cohort study.
Superior vena cava collapsibility index (SVC-CI) and stroke volume variation (SVV) have been shown to predict fluid responsiveness. SVC-CI has been validated only with conventional transoesophageal echocardiography (TEE) in the SVC long axis, on the basis of SVC diameter variations, but not in the SVC short axis or by SVC area variations. SVV was not previously tested in vascular surgery patients. ⋯ Our study validated the value of the SVC-CI measured as area variations in the SVC short axis to predict fluid responsiveness in anesthetized patients. An hTEE probe was used to monitor and measure the hSVC-CI but conventional TEE may also offer this new dynamic parameter. In our cohort of significant preoperative hypovolemic patients undergoing major open vascular surgery, hSVC-CI and SVV cutoff values of 37% and 15%, respectively, predicted fluid responsiveness with good accuracy.
-
J Clin Monit Comput · Jun 2020
Randomized Controlled TrialEffects of vascular morphological features and ultrasound-guided vascular cannulation techniques on the success of femoral artery catheterisation in newborns.
Ultrasound-guided vascular access is a technique that can increase safety as well as technical and procedural success when performing invasive cardiovascular procedures. The aim of this study was to evaluate the effects of two cannulation techniques and vascular morphological properties on the success of femoral artery catheterisation in neonatal patients. We recruited 65 consecutive patients requiring femoral artery catheterisation and randomly divided them into two groups: Group 1, in-plane technique (n = 31) and Group 2, out-of-plane technique (n = 34). ⋯ Hematoma was strongly correlated with the number of venous punctures (r = 0.632; p = 0.001) and the number of needle advancements (r = 0.415; p = 0.001). In terms of artery-vein position, patients whose artery overlapped the vein by > 50% required clearly longer artery cannulation durations than the other patients (p < 0.001). Although the in-plane technique has a steep learning curve, it was found superior in terms of procedure-related factors such as the number of trials, the incidence of hematoma and arterial puncture counts, as it offers advantages such as the ability to evaluate the lumen and a better control of the needle advancement direction.
-
J Clin Monit Comput · Jun 2020
Randomized Controlled TrialDetection of gastric inflation using transesophageal echocardiography after different level of pressure-controlled mask ventilation: a prospective randomized trial.
This study aimed to assess the technique of using transesophageal echocardiography (TEE) to detect gastric inflation and to determine the optimal level of inspiratory pressure during face mask ventilation (FMV). In this prospective and randomized trial, seventy-five adults scheduled for cardiac surgery were enrolled to one of the three groups (P12, P15, P20) defined by the applied inspiratory pressure during FMV. After induction, mask ventilation was performed with the corresponding level of pressure-control ventilation for 2 min in each patient. ⋯ Peak airway pressure of 12-20 cmH2O could provide acceptable sufficient ventilation during mask ventilation, but 20 cmH2O result in higher incidence of gastric inflation. TEE is useful to detect the gastric inflation related to the entry of air into the stomach during pressure-controlled face mask ventilation. Trial Registration Number ChiCTR-IOR-14005325.
-
J Clin Monit Comput · Jun 2020
Do cerebral and somatic tissue oxygen saturation measurements correlate with each other during surgery?
Intraoperative maintenance of optimal tissue oxygenation is critical; however, it is uncertain whether measurements of different tissue beds correlate with each other. Cerebral tissue oxygen saturation (SctO2) measured on the forehead and somatic tissue oxygen saturation (SstO2) measured on limbs, using a tissue near-infrared spectroscopy, were simultaneously recorded every 2 s in patients having spine surgery or robotic hysterectomy. Simple linear regression was used to determine the static correlation between SctO2 and SstO2 using the median values of each min for each patient. ⋯ The static correlation between SctO2 and SstO2 was inconsistent (r ranging from - 0.86 to 0.93 in spine surgery and from - 0.74 to 0.85 in robotic hysterectomy). The proportional durations with CC ≤ - 0.3 (negative correlation), - 0.3 < CC < 0.3 (poor correlation) and CC ≥ 0.3 (positive correlation) were 18.3 ± 9.6%, 52.6 ± 12.1% and 29.0 ± 9.6%, respectively, in patients having spine surgery and 19.6 ± 9.0%, 58.6 ± 13.1% and 21.8 ± 8.0%, respectively, in patients having robotic hysterectomy. There are a large discrepancy and inconsistent correlation between intraoperative SctO2 and SstO2 measurements, suggesting their non-interchangeability.
-
J Clin Monit Comput · Jun 2020
Observational StudyValidity and reliability of pocket-sized ultrasound devices in measurement of optic nerve sheath diameter in ICU patients.
The measurement of the optic nerve sheath diameter (ONSD) by ultrasonography (USG) is particularly important for intracranial pressure (ICP) monitoring when invasive measurements are not possible or are contraindicated. Standard USG (SUDs) devices can be bulky and may break down the workflow. The validity and reliability of pocket-sized USG devices (PSUDs) compared to SUDs for ONSD measurement has not been investigated, yet. ⋯ There was a good correlation between mtONSD and msONSD (r = 0.767 for SUD and r = 0.816 for PSUD). The total variance between three different measurements in the transverse and sagittal axis was ± 0.6 mm. PSUDs can be used with similar validity and reliability as SUDs for ONSD measurement.