Journal of clinical monitoring and computing
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J Clin Monit Comput · Dec 2024
Noninvasive estimation of PaCO2 from volumetric capnography in animals with injured lungs: an Artificial Intelligence approach.
To investigate the feasibility of non-invasively estimating the arterial partial pressure of carbon dioxide (PaCO2) using a computational Adaptive Neuro-Fuzzy Inference System (ANFIS) model fed by noninvasive volumetric capnography (VCap) parameters. In 14 lung-lavaged pigs, we continuously measured PaCO2 with an optical intravascular catheter and VCap on a breath-by-breath basis. Animals were mechanically ventilated with fixed settings and subjected to 0 to 22 cmH2O of positive end-expiratory pressure steps. ⋯ The Bland-Altman plot performed in 10 independent tested ANFIS models showed a mean bias between reference and estimated PaCO2 of 0.03 ± 0.03 mmHg, with limits of agreement of 2.25 ± 0.42 mmHg, and a root mean square error of 1.15 ± 0.06 mmHg. A good trending ability was confirmed by four quadrant and polar plots concordance indexes of 95.5% and 94.3%, respectively. In an animal lung injury model, the Adaptive Neuro-Fuzzy Inference System model fed by noninvasive volumetric capnography parameters can estimate PaCO2 with high accuracy, acceptable precision, and good trending ability.
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J Clin Monit Comput · Dec 2024
Entropy of difference works similarly to permutation entropy for the assessment of anesthesia and sleep EEG despite the lower computational effort.
EEG monitoring during anesthesia or for diagnosing sleep disorders is a common standard. Different approaches for measuring the important information of this biosignal are used. The most often and efficient one for entropic parameters is permutation entropy as it can distinguish the vigilance states in the different settings. ⋯ The distinguishing of the vigilance states between both measures is similar as the AUC values for the classification do not differ significantly. As the runtimes for the entropy of difference are smaller than for the permutation entropy, even though the performance stays the same, we state the entropy of difference could be a useful method for analyzing EEG data. Higher orders of entropic features may also be investigated better and more easily.
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J Clin Monit Comput · Dec 2024
ReviewElectroencephalogram monitoring during anesthesia and critical care: a guide for the clinician.
Perioperative anesthetic, surgical and critical careinterventions can affect brain physiology and overall brain health. The clinical utility of electroencephalogram (EEG) monitoring in anesthesia and intensive care settings is multifaceted, offering critical insights into the level of consciousness and depth of anesthesia, facilitating the titration of anesthetic doses, and enabling the detection of ischemic events and epileptic activity. ⋯ This review provides a comprehensive overview of the fundamental principles of electroencephalography, including the foundations of processed and quantitative electroencephalography. It further explores the characteristic EEG signatures associated wtih anesthetic drugs, the interpretation of the EEG data during anesthesia, and the broader clinical benefits and applications of EEG monitoring in both anesthetic practice and intensive care environments.
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J Clin Monit Comput · Dec 2024
What is the minimum time interval for reporting of intraoperative core body temperature measurements in pediatric anesthesia? A secondary analysis.
Given that perioperative normothermia represents a quality parameter in pediatric anesthesia, numerous studies have been conducted on temperature measurement, albeit with heterogeneous measurement intervals, ranging from 30 s to fifteen minutes. We aimed to determine the minimum time interval for reporting of intraoperative core body temperature across commonly used measurement intervals in children. Data were extracted from the records of 65 children who had participated in another clinical study and analyzed using a quasibinomial mixed linear model. ⋯ Probabilities for the detection of hyperthermia (n = 9) were lower and omitted for hypothermia due to low prevalence (n = 1). In conclusion, the core body temperature should be reported at intervals of no more than five minutes to ensure the detection of any temperature change in normothermic ranges. Further studies should focus on hypothermic and hyperthermic ranges.
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J Clin Monit Comput · Dec 2024
An open source autoregulation-based neuromonitoring algorithm shows PRx and optimal CPP association with pediatric traumatic brain injury.
This study aimed to develop an open-source algorithm for the pressure-reactivity index (PRx) to monitor cerebral autoregulation (CA) in pediatric severe traumatic brain injury (sTBI) and compared derived optimal cerebral perfusion pressure (CPPopt) with real-time CPP in relation to long-term outcome. Retrospective study in children (< 18 years) with sTBI admitted to the pediatric intensive care unit (PICU) for intracranial pressure (ICP) monitoring between 2016 and 2023. ICP was analyzed on an insult basis and correlated with outcome. ⋯ PRx thresholds 0.0, 0.20, 0.25 and 0.30 resulted in OR 1.01 (1.00-1.02) (p < 0.006). CPP in optimal range associated with unfavorable outcome on day one (0.018, p = 0.029) and four (-0.026, p = 0.025). Our algorithm can obtain optimal targets for pediatric neuromonitoring that showed association with long-term outcome, and is now available open source.