Journal of clinical monitoring and computing
-
J Clin Monit Comput · Jun 2018
Pulse-contour derived cardiac output measurements in morbid obesity: influence of actual, ideal and adjusted bodyweight.
The non-invasive Nexfin cardiac output (CO) monitor shows a low level of agreement with the gold standard thermodilution method in morbidly obese patients. Here we investigate whether this disagreement is related to excessive bodyweight, and can be improved when bodyweight derivatives are used instead. We performed offline analyses of cardiac output recordings of patient data previously used and partly published in an earlier study by our group. ⋯ With adjusted bodyweight, bias improved to 0.04 ± 1.4 with LOA from -2.8 to 2.9 L min. Our study shows that agreement of the Nexfin-derived with invasive CO measurements in morbidly obese patients is influenced by body weight, suggesting that Nexfin CO measurements in patients with a BMI above 35 kg/m2 should be interpreted with caution. Using adjusted body weight in the Nexfin CO-trek algorithm reduced the bias.
-
J Clin Monit Comput · Jun 2018
Technical challenges related to implementation of a formula one real time data acquisition and analysis system in a paediatric intensive care unit.
Most existing, expert monitoring systems do not provide the real time continuous analysis of the monitored physiological data that is necessary to detect transient or combined vital sign indicators nor do they provide long term storage of the data for retrospective analyses. In this paper we examine the feasibility of implementing a long term data storage system which has the ability to incorporate real-time data analytics, the system design, report the main technical issues encountered, the solutions implemented and the statistics of the data recorded. McLaren Electronic Systems expertise used to continually monitor and analyse the data from F1 racing cars in real time was utilised to implement a similar real-time data recording platform system adapted with real time analytics to suit the requirements of the intensive care environment. ⋯ Recording data from bed-side monitors in intensive care/wards is feasible. It is possible to set up real time data recording and long term storage systems. These systems in future can be improved with additional patient specific metrics which predict the status of a patient thus paving the way for real time predictive monitoring.
-
J Clin Monit Comput · Jun 2018
Letter Observational StudySuprasternal notch echocardiography: a potential alternative for the measurement of respiratory variation in aortic blood flow peak velocity in mechanically ventilated children.
We conducted a prospective, observational study to investigate the relationship between the respiratory variation in aortic blood flow peak velocity (ΔVPeak) measured by echocardiography in the proximal ascending aorta from the suprasternal notch window and the ΔVPeak measured at the level of the aortic annulus from the classical apical five-chamber view. We studied children aged from 1 to 10 years referred for surgery under general anesthesia with positive pressure ventilation, after induction of general anesthesia. ⋯ There was a significant relationship between the ΔVPeak recorded via the suprasternal notch view and the ΔVPeak recorded via the apical five-chamber view (r = 0.62 [95% confidence interval 0.25-0.84], P = 0.003). The ΔVPeak measured using the suprasternal notch route could be considered to predict fluid responsiveness in children under mechanical ventilation, notably when the access to the chest wall is limited during surgery.
-
J Clin Monit Comput · Jun 2018
LetterMonitoring tissue oxygen heterogeneities and their influence on optical glucose measurements in an animal model.
The purpose of this study was to characterize the heterogeneity of oxygen partial pressure in different adipose tissue zones and to assess the possibility of compensating these heterogeneities during optical glucose measurements. In this proof of concept study, the heterogeneity of oxygen partial pressure was determined in the adipose tissue of a pig by using 48 oxygen sensors in 3 zones of the abdominal region at two different blood oxygen levels. ⋯ The low heterogeneity on one cannula allows the compensation of physiological oxygen variations for optical glucose measurements by using an additional oxygen sensor in close proximity to the glucose sensor. In addition, this setup can be used to continuously monitor tissue oxygenation e.g. in patients with adipose tissue dysfunction or serve limb ischemia.
-
J Clin Monit Comput · Jun 2018
Correction to: The oxygen reserve index (ORI): a new tool to monitor oxygen therapy.
In the original publication of the article, the authors have realized an error in Fig. 1. The corrected version of Fig. 1 is given below.