Journal of clinical monitoring and computing
-
J Clin Monit Comput · Jun 2017
Clinical TrialEfficacy of bioelectrical impedance analysis during the perioperative period in children.
We evaluated the efficacy of bioelectrical impedance analysis (BIA) during the perioperative period by estimating the preoperative and postoperative body fluid status. After obtaining informed consent, we enrolled 100 children (3-12 years of age) scheduled for elective surgeries. All children had been fasted preoperatively. ⋯ The baseline and postoperative ICW showed a strong positive correlation (Pearson correlation coefficient = 0.992, P < 0.001), as did the baseline and postoperative ECW (Pearson correlation coefficient = 0.990, P < 0.001). Also there was no dehydration and irritability on medical recording preoperatively. BIA may be an alternative method for estimating the perioperative fluid status in children and determining details of fluid administration.
-
J Clin Monit Comput · Jun 2017
Observational StudyConsistency of cardiac function index and global ejection fraction with global end-diastolic volume in patients with femoral central venous access for transpulmonary thermodilution: a prospective observational study.
Global ejection fraction (GEF) and cardiac function index (CFI) are transpulmonary thermodilution (TPTD)-derived indices of the systolic function. Their validity relies on an accurate determination of the global end-diastolic volume (GEDV). Due to an overestimation of GEDV using a femoral central venous catheter (CVC) a correction formula for indexed GEDV (GEDVI) has been implemented in the latest PiCCO™-algorithm. ⋯ By contrast, GEFcalculated (23.1 ± 8.7 %) was not substantially different from GEFdisplayed (22.4 ± 8.6 %). Although GEDV and GEF are corrected for femoral CVC site, this does not apply to CFI. However, all indices derived from GEDV should be calculated consistently.
-
J Clin Monit Comput · Apr 2017
Comparative StudyThe effects of anesthetic agents on pupillary function during general anesthesia using the automated infrared quantitative pupillometer.
Pupil reactivity can be used to evaluate central nervous system function and can be measured using a quantitative pupillometer. However, whether anesthetic agents affect the accuracy of the technique remains unclear. We examined the effects of anesthetic agents on pupillary reactivity. ⋯ Fentanyl given alone decreased pupil size and %CH in light reflex, but did not change the NPi. NPi was decreased by inhalational anesthesia not but intravenous anesthesia. The difference in pupil reactivity between inhalational anesthetic and propofol may indicate differences in the alteration of midbrain reflexs in patients under inhalational or intravenous anesthesia.
-
J Clin Monit Comput · Apr 2017
FLOW-i ventilator performance in the presence of a circle system leak.
Recently, the FLOW-i anaesthesia ventilator was developed based on the SERVO-i intensive care ventilator. The aim of this study was to test the FLOW-i's tidal volume delivery in the presence of a leak in the breathing circuit. We ventilated a test lung model in volume-, pressure-, and pressure-regulated volume-controlled modes (VC, PC, and PRVC, respectively) with a FLOW-i. ⋯ Interestingly, VT did not differ appreciably from 6 to 0.3 L/min of fresh air flow among the 3 ventilatory modes. In the absence of leakage, peak inspiratory pressures were similar, while they were 35-45 % smaller in PRVC and VC than in PC mode in the presence of leaks. In conclusion, FLOW-i maintained VT (down to fresh gas flows of 0.3 L/min) to 90 % of its preset value in PC mode, which was 4-5 times greater than in VC or PRVC modes.
-
J Clin Monit Comput · Apr 2017
Smart respiratory monitoring: clinical development and validation of the IPI™ (Integrated Pulmonary Index) algorithm.
Continuous electronic monitoring of patient respiratory status frequently includes PetCO2 (end tidal CO2), RR (respiration rate), SpO2 (arterial oxygen saturation), and PR (pulse rate). Interpreting and integrating these vital signs as numbers or waveforms is routinely done by anesthesiologists and intensivists but is challenging for clinicians in low acuity areas such as medical wards, where continuous electronic respiratory monitoring is becoming more common place. We describe a heuristic algorithm that simplifies the interpretation of these four parameters in assessing a patient's respiratory status, the Integrated Pulmonary Index (IPI). ⋯ Receiver operating curves analysis resulted in high levels of sensitivity (ranging from 0.83 to 1.00), and corresponding specificity (ranging from 0.96 to 0.74), based on IPI thresholds 3-6. The IPI reliably interpreted the respiratory status of patients in multiple areas of care using off-line continuous respiratory data. Further prospective studies are required to evaluate IPI in real time in clinical settings.