Journal of clinical monitoring and computing
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J Clin Monit Comput · Dec 2018
Observational StudyAccuracy and trending of non-invasive hemoglobin measurement during different volume and perfusion statuses.
The evolution of non-invasive hemoglobin measuring technology would save time and improve transfusion practice. The validity of pulse co-oximetry hemoglobin (SpHb) measurement in the perioperative setting was previously evaluated; however, the accuracy of SpHb in different volume statuses as well as in different perfusion states was not well investigated. The aim of this work is to evaluate the accuracy and trending of SpHb in comparison to laboratory hemoglobin (Lab-Hb) during acute bleeding and after resuscitation. ⋯ In conclusion, SpHb showed excellent correlation with Lab-Hb in fluid responders, fluid non-responders, low-PI, and high PI states. Despite a favorable mean bias of 0.01 g/dL for SpHb, the relatively wide levels of agreement (- 1.3 to 1.3 g/dL) might limit its accuracy. SpHb showed good performance as a trend monitor.
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J Clin Monit Comput · Dec 2018
LetterOptimizing peripheral venous pressure waveforms in an awake pediatric patient by decreasing signal interference.
The purpose of this technological notes paper is to describe our institution's experience collecting peripheral venous pressure (PVP) waveforms using a standard peripheral intravenous catheter in an awake pediatric patient. PVP waveforms were collected from patients with hypertrophic pyloric stenosis. ⋯ Interference in the PVP waveforms data collection was associated with the following: patient or device motion, system set-up error, type of IV catheter, and peripheral intravenous catheter location. PVP waveforms can be collected in an awake pediatric patient and adjuncts to decrease signal interference can be used to optimize data collection.
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J Clin Monit Comput · Dec 2018
Comparative StudyA novel device for air removal from vascular access line: a bench study.
Efficient air removal from a vascular access line is a key step to prevent air embolism. Existing devices, especially for rapid infusers, are far from optimum. In this study, we developed a novel device, vascular access line air removal device (VALARD), and compared its efficiency of air removal and pause time of forward bulk flow with a commonly used device, the Belmont pump. ⋯ The Belmont pump: air bubbles > 10 µL were detected in 60% of the tests with pause of the forward flow. The VALARD eliminates air efficiently without pause of the forward bulk flow. Further clinical trials are needed to compare the VALARD with other devices and to assess its efficiency, safety, and user friendliness.
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J Clin Monit Comput · Dec 2018
Respiratory changes in subclavian vein diameters predicts fluid responsiveness in intensive care patients: a pilot study.
The present pilot study investigated whether respiratory variation in subclavian vein (SCV) diameters correlates with fluid responsiveness in mechanically ventilated patients. Monocentric, prospective clinical study on fluid responsiveness in adult sedated, mechanically ventilated ICU patient, monitored with the PiCCO™ system (Pulsion Medical System, Germany), and requiring a fluid challenge (FC). A 10-min fluid bolus of 500 mL of 0.9% saline was administered. ⋯ Other parameters, such as SVV and PPV, could not predict fluid responsiveness. The correlation coefficient between CO variation and the SCVvariability index was 0.73 (p < 0.001). The SCVvariability index was a reliable, non-invasive parameter for the prediction of fluid responsiveness at the bedside of mechanically ventilated, critically ill patients in this pilot study.
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J Clin Monit Comput · Dec 2018
Letter Case ReportsMagnetic resonance imaging (MRI) induced 'hypoxia artifacts' on pulse oximetry: how reliable are MRI compatible monitoring devices?
Distinguishing a monitoring artifact requires expertise and adeptness. This can be practically challenging during the course of an anesthetic. We report a case, wherein we experienced episodes of aberrant pulse-oximeter values suggestive of desaturation with normal waveforms, occurring during a particular sequence of magnetic resonance imaging (MRI) performed under general anesthesia, which in fact was an artifact induced by the 3 T MRI during the diffusion tensor imaging sequence.