Journal of clinical monitoring and computing
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J Clin Monit Comput · Aug 2016
Comparative StudyThe comparison of the technical parameters in endotracheal intubation devices: the Cmac, the Vividtrac, the McGrath Mac and the Kingvision.
Currently, there are plenty of videolaryngoscopes that appear on the market. They have different specifications. Some of these features favor the fact that they are more suited for educational purposes of future operators and others can be characterized with an excellent clinical use. ⋯ The C-MAC has a camera with the widest viewing angle (the OX axis-63.1, the axis OY-47.8), which in combination with the largest diagonal size of the display enables the operator to see the details relevant to clinical practice. It has also the strongest lamp intensity of the devices mentioned in this comparison (7800 Lx). In comparison of the clinical use in almost all compared parameters the Cmac D-blade is a winner, although for clinical education purpose we consider the Vividtrac a better device.
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J Clin Monit Comput · Aug 2016
Observational StudyDiagnostic accuracy of stroke volume variation measured with uncalibrated arterial waveform analysis for the prediction of fluid responsiveness in patients with impaired left ventricular function: a prospective, observational study.
Uncalibrated arterial waveform analysis enables dynamic preload assessment in a minimally invasive fashion. Evidence about the validity of the technique in patients with impaired left ventricular function is scarce, while adequate cardiac preload assessment would be of great value in these patients. The aim of this study was to investigate the diagnostic accuracy of stroke volume variation (SVV) measured with the FloTrac/Vigileo™ system in patients with impaired left ventricular function. ⋯ Overall accuracy was 64 %, positive and negative predictive values were 69 and 56 % respectively. SVV values to obtain more than 90 % true positive and negative predictions were 16 and 6 % respectively. The ability of uncalibrated arterial waveform analysis SVV to predict fluid responsiveness in patients with impaired LVF was low.
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J Clin Monit Comput · Aug 2016
Role of cerebral oxygenation for prediction of hypotension after spinal anesthesia for caesarean section.
To investigate the role of cerebral oxygen saturation (ScO2) for prediction of hypotension after spinal anesthesia for caesarean section. Forty-five parturients undergoing elective caesarean section under spinal anesthesia were selected. Blood pressure, heart rate and pulse oxygen saturation before and after anesthesia were recorded, and the association between changes in ScO2 before and after anesthesia with hypotension after spinal anesthesia was explored. ⋯ The area under the receiver operation characteristic curve was 0.83 for decrease in ScO2 for prediction of hypotension (P < 0.05), and the optimal threshold value was 4.5 %. The sensitivity, specificity, positive predictive value and negative predictive value of 4.5 % decrease in ScO2 for prediction of hypotension were 0.75, 0.78, 0.92 and 0.47, respectively. The decrease in ScO2 after spinal anesthesia is associated with hypotension after spinal anesthesia for cesarean section, and may be a clinically useful predictor.
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J Clin Monit Comput · Aug 2016
Comparative StudyA comparison of different synchronization measures in electroencephalogram during propofol anesthesia.
Electroencephalogram (EEG) synchronization is becoming an essential tool to describe neurophysiological mechanisms of communication between brain regions under general anesthesia. Different synchronization measures have their own properties to reflect the changes of EEG activities during different anesthetic states. However, the performance characteristics and the relations of different synchronization measures in evaluating synchronization changes during propofol-induced anesthesia are not fully elucidated. ⋯ Moreover, PCMI, NI, DET correlated closely with each other and they had a better robustness to noise and higher correlation with BIS and C eff than other synchronization indexes. Propofol caused EEG synchronization changes during the anesthetic period. Different synchronization measures had individual properties in evaluating synchronization changes in different anesthetic states, which might be related to various forms of neural activities and neurophysiological mechanisms under general anesthesia.
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J Clin Monit Comput · Aug 2016
A mainstream monitoring system for respiratory CO2 concentration and gasflow.
Continuous respiratory gas monitoring is an important tool for clinical monitoring. In particular, measurement of respiratory [Formula: see text] concentration and gasflow can reflect the status of a patient by providing parameters such as volume of carbon dioxide, end-tidal [Formula: see text] respiratory rate and alveolar deadspace. However, in the majority of previous work, [Formula: see text] concentration and gasflow have been studied separately. ⋯ Statistical analysis using the coefficient of variation was performed to find the optimal driving voltage of the pressure transducer. Calibration between variations and flows was used to avoid pressure signal drift. We carried out targeted experiments using the proposed device and confirmed that the device can produce stable signals.