Journal of clinical monitoring and computing
-
J Clin Monit Comput · Aug 2023
Towards autoregulation-oriented management after traumatic brain injury: increasing the reliability and stability of the CPPopt algorithm.
CPPopt denotes a Cerebral Perfusion Pressure (CPP) value at which the Pressure-Reactivity index, reflecting the global state of Cerebral Autoregulation, is best preserved. CPPopt has been investigated as a potential dynamically individualised CPP target in traumatic brain injury patients admitted in intensive care unit. The prospective bedside use of the concept requires ensured safety and reliability of the CPP recommended targets based on the automatically-generated CPPopt. We aimed to: Increase stability and reliability of the CPPopt automated algorithm by fine-tuning; perform outcome validation of the adjusted algorithm in a multi-centre TBI cohort. ⋯ The CPPopt calculation algorithm was fine-tuned and adapted for prospective use with acceptable lower yield, improved stability and maintained prognostic power.
-
J Clin Monit Comput · Aug 2023
Multisensory alarm to benefit alarm identification and decrease workload: a feasibility study.
The poor design of conventional auditory medical alarms has contributed to alarm desensitization, and eventually, alarm fatigue in medical personnel. This study tested a novel multisensory alarm system which aims to help medical personnel better interpret and respond to alarm annunciation during periods of high cognitive load such as those found within intensive care units. We tested a multisensory alarm that combined auditory and vibrotactile cues to convey alarm type, alarm priority, and patient identity. ⋯ The Half multisensory phase produced the lowest mental demand, temporal demand, and overall perceived workload score. These data suggest that implementation of a multisensory alarm with alarm and patient information may decrease perceived workload without significant changes in alarm identification performance. Additionally, a ceiling effect may exist for multisensory stimuli, with only part of an alarm benefitting from multisensory integration.
-
J Clin Monit Comput · Aug 2023
Tracheal intubating conditions in elderly patients when train-of-four count is zero after rocuronium 0.6 or 0.9 mg/kg. A secondary analysis.
The neuromuscular blocking agent rocuronium can be administered to facilitate tracheal intubation. We hypothesized that rocuronium 0.9 mg/kg provided a larger proportion of patients with vocal cords in abducted position compared to rocuronium 0.6 mg/kg at train-of-four (TOF) 0. ⋯ The proportion of patients with vocal cords in abducted position was significantly larger after rocuronium 0.9 mg/kg compared to rocuronium 0.6 mg/kg at TOF 0 monitored at the ulnar nerve.
-
J Clin Monit Comput · Aug 2023
Continuous perioperative heart rate variability monitoring in video-assisted thoracoscopic surgery lobectomy-a pilot study.
Heart rate variability (HRV) is a measure of cardiac autonomic modulation and is potentially related to hypotension, postoperative atrial fibrillation, and orthostatic intolerance. However, there is a lack of knowledge on which specific time points and indices to measure. To improve future study design, there is a need for procedure-specific studies in an enhanced recovery after surgery (ERAS) video-assisted thoracic surgery (VATS) lobectomy setting, and for continuous measurement of perioperative HRV. ⋯ Further, preoperative HRV measures showed circadian variation. The patch was well tolerated among participants, but actions should be taken to ensure proper mounting of the measuring device. These results demonstrate a valid design platform for future HRV studies in relation to postoperative outcomes.
-
J Clin Monit Comput · Aug 2023
Robust Non-Contact Monitoring of Respiratory Rate using a Depth Camera.
Respiratory rate (RR) is one of the most common vital signs with numerous clinical uses. It is an important indicator of acute illness and a significant change in RR is often an early indication of a potentially serious complication or clinical event such as respiratory tract infection, respiratory failure and cardiac arrest. Early identification of changes in RR allows for prompt intervention, whereas failing to detect a change may result in poor patient outcomes. Here, we report on the performance of a depth-sensing camera system for the continuous non-contact 'touchless' monitoring of Respiratory Rate. ⋯ We have demonstrated high accuracy in performance for respiratory rate based on a depth camera system. We have shown the ability to perform well at both high and low rates which are clinically important.