Journal of clinical monitoring and computing
-
J Clin Monit Comput · Oct 2015
Radial artery cannulation decreases the distal arterial blood flow measured by power Doppler ultrasound.
Radial arterial cannulation is a popular technique for continuous hemodynamic monitoring in an area of anesthesia and intensive care. Although the risk for invasive monitoring is considerable, there is scarce information about the change in blood flow of cannulated vessel after the catheterization. In the current investigation, we evaluated the change in the cannulated arterial blood flow. ⋯ Study 2: There was no difference between the diameters of right and left RA, however, the UA was larger [3.4 (0.60) vs. 2.8 (0.83) mm] and the DBRA was narrower [1.4 (0.43) vs. 2.0 (0.47) mm] in the cannulated side. The diameters of DBRA were different between the intact and cannulated side in the patients. Although there is no information of relationships between cause of severe complication and decreased flow, significant reduction of blood flow should be concerned.
-
J Clin Monit Comput · Aug 2015
Observational StudyProspective evaluation of regional oxygen saturation to estimate central venous saturation in sepsis.
Current treatment guidelines for sepsis claim an early goal-directed hemodynamic optimization including fluid resuscitation, use of vasopressors and inotropic agents. We investigated the correlation between the prominent treatment goal central venous saturation (ScvO2) and the frontal and the thenar regional oxygen saturation (rSO2) measured by near infrared spectroscopy. Secondary, we examined the value of ScvO2, lactate levels and rSO2 as surrogate markers of an impaired tissue oxygenation for outcome prediction in sepsis. ⋯ In the group with ScvO2 <70% and lactate levels <2.5 mmol/l no patients died during the observation period. Frontal rSO2 correlates with ScvO2 but both frontal and thenar rSO2 do not exactly discriminate between patients with high or low ScvO2 in sepsis. The combination of elevated lactate >2.5 mmol/l and ScvO2 >70 % is highly associated with poor outcome in ICU patients with sepsis, severe sepsis and septic shock.
-
J Clin Monit Comput · Aug 2015
Effect of concurrent oxygen therapy on accuracy of forecasting imminent postoperative desaturation.
Episodic postoperative desaturation occurs predominantly from respiratory depression or airway obstruction. Monitor display of desaturation is typically delayed by over 30 s after these dynamic inciting events, due to perfusion delays, signal capture and averaging. Prediction of imminent critical desaturation could aid development of dynamic high-fidelity response systems that reduce or prevent the inciting event from occurring. ⋯ In conclusion, we report the use of autoregressive models to predict [Formula: see text] and forecast imminent critical desaturation events in the postoperative period with high degree of accuracy. These models reliably predict critical desaturation in patients receiving supplemental oxygen therapy. While high-fidelity prophylactic interventions that could modify these inciting events are in development, our current study offers proof of concept that the afferent limb of such a system can be modeled with a high degree of accuracy.