Journal of clinical monitoring and computing
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J Clin Monit Comput · Jun 2018
Comparative StudyComparison of endotracheal tube cuff pressure values before and after training seminar.
It is recommended that endotracheal cuff (ETTc) pressure be between 20 and 30 cm H2O. In this present study, we intend to observe average cuff pressure values in our clinic and the change in these values after the training seminar. The cuff pressure values of 200 patients intubated following general anesthesia induction in the operating theatre were measured following intubation. ⋯ Average pressure measure for Group I was 54 cm H2O, while average pressure in Group II declined to 33 cm H2O. It was observed that as the working period and experience of physician assistants increased, cuff pressure values decreased, however no statistically significant different was found (p < 0.375). We believe that clinical experience does not have significant effects on cuff pressure and that training seminars held at intervals would prevent high cuff pressure values and potential complications.
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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.
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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.
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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.
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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.