Journal of clinical monitoring and computing
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J Clin Monit Comput · Oct 2022
Clinical TrialEfficacy of sonorheometry point of the care device in determining low fibrinogen levels in pregnant blood: an invitro dilution and reconstitution study.
Quantra® Hemostasis Analyzer is a Point of the care device that uses ultrasound technology to assess clot formation. In this study, we establish how Quantra® system performs compared to conventional coagulation tests at low levels of fibrinogen in the blood obtained from pregnant women. 24 mL blood was obtained from each healthy parturient. Blood was analyzed for Quantra® variables (Q): Clot time (CT), Clot stiffness (CS), platelet contribution to CS (PCS), fibrinogen contribution to CS (FCS), and conventional coagulation (CL) tests: PT, aPTT, INR, Factor VIII and fibrinogen. 6 ml blood were centrifuged to obtain pregnant plasma. 30 mL of saline was added to 10 mL of blood to simulate crystalloid resuscitation (DB) and was evaluated for Q and CL. ⋯ An FCS value 2.45 (sensitivity of 79.2 and specificity of 97.3%), and CS value 10.85 hPa (sensitivity of 83% and specificity of 100%) predicted fibrinogen of 200 mg/dL. This study demonstrates a good correlation between Quantra® CS, FCS and serum fibrinogen. Clinical Trial Number: NCT04301193.
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J Clin Monit Comput · Oct 2022
High-flow nasal cannula therapy, factors affecting effective inspired oxygen fraction: an experimental adult bench model.
Oxygenation through High Flow Delivery Systems (HFO) is described as capable of delivering accurate FiO2. Meanwhile, peak inspiratory flow [Formula: see text] ) of patients with acute hypoxemic respiratory failure can reach up to 120 L/min, largely exceeding HFO flow. Currently, very few data on the reliability of HFO devices at these high [Formula: see text] are available. ⋯ The present bench study did expose a weakness of HFO devices in reliability of delivering accurate FIO2 at high [Formula: see text] as well as, to a lesser extent, at [Formula: see text] below equivalent set HFO Flows. Moreover, set HFO flow and set FIO2 did influence the variability of effective inspired oxygen fraction. The adjunction of a dead space in the experimental set-up significantly amended this variability and should thus be further studied in order to improve success rate of HFO therapy.
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J Clin Monit Comput · Oct 2022
Positive end-expiratory pressure individualization guided by continuous end-expiratory lung volume monitoring during laparoscopic surgery.
To determine whether end-expiratory lung volume measured with volumetric capnography (EELVCO2) can individualize positive end-expiratory pressure (PEEP) setting during laparoscopic surgery. We studied patients undergoing laparoscopic surgery subjected to Fowler (F-group; n = 20) or Trendelenburg (T-group; n = 20) positions. EELVCO2 was measured at 0° supine (baseline), during capnoperitoneum (CP) at 0° supine, during CP with Fowler (head up + 20°) or Trendelenburg (head down - 30°) positions and after CP back to 0° supine. ⋯ Breath-by-breath noninvasive EELVCO2 detected changes in lung volume induced by capnoperitoneum and body position and was useful to individualize the level of PEEP during laparoscopy. Trial registry: Clinicaltrials.gov NCT03693352. Protocol started 1st October 2018.
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J Clin Monit Comput · Oct 2022
EditorialSample size determination in method comparison and observer variability studies.
The comparison of two quantitative measuring devices is often performed with the Limits of Agreement proposed by Bland and Altman in their seminal Lancet paper back in 1986. Sample size considerations were rare for such agreement analyses in the past, but recently several proposals have been made depending on how agreement is to be assessed and the number of replicates to be used. ⋯ These include current state-of-the-art analysis of and reporting guidelines for agreement studies. General recommendations close the paper.