Journal of clinical monitoring and computing
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J Clin Monit Comput · Feb 2024
Review Meta AnalysisIntraoperative individualization of positive-end-expiratory pressure through electrical impedance tomography or esophageal pressure assessment: a systematic review and meta-analysis of randomized controlled trials.
This systematic review of randomized-controlled trials (RCTs) with meta-analyses aimed to compare the effects on intraoperative arterial oxygen tension to inspired oxygen fraction ratio (PaO2/FiO2), exerted by positive end-expiratory pressure (PEEP) individualized trough electrical impedance tomography (EIT) or esophageal pressure (Pes) assessment (intervention) vs. PEEP not tailored on EIT or Pes (control), in patients undergoing abdominal or pelvic surgery with an open or laparoscopic/robotic approach. ⋯ CRD 42021218306, 30/01/2023.
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J Clin Monit Comput · Feb 2024
Review Meta AnalysisPerformance of closed-loop systems for intravenous drug administration: a systematic review and meta-analysis of randomised controlled trials.
Closed-loop drug delivery systems are autonomous computers able to administer medication in response to changes in physiological parameters (controlled variables). While limited evidence suggested that closed-loop systems can perform better than manual drug administration in certain settings, this technology remains a research tool with an uncertain risk/benefit profile. Our aim was comparing the performance of closed-loop systems with manual intravenous drug administration in adults. ⋯ The certainty of the evidence was low or very low for most outcomes. Automatic technology may be used to improve the hemodynamic profile during noradrenaline and vasodilators administration and reduce the duration of postanaesthetic recovery. Registration: This systematic review was registered with PROSPERO (CRD42022336950) on the 7th of June 2022.
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J Clin Monit Comput · Oct 2023
Randomized Controlled TrialEffects of preoperative education using virtual reality on preoperative anxiety and information desire: a randomized clinical trial.
This study aimed to investigate the effect of preoperative education using virtual reality (VR) on preoperative anxiety and information desire. The participants were randomly assigned to the VR group and control group. The VR group received preoperative education using VR content describing preoperative and postoperative processes and their management, and the control group received preoperative education with traditional verbal education. ⋯ Preoperative education using VR effectively reduced preoperative anxiety and information desire. Trial registration CRIS, KCT0007489. Registered 30 June 2022. http://cris.nih.go.kr/cris/ .
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J Clin Monit Comput · Apr 2024
ReviewTen good reasons to consider gastrointestinal function after acute brain injury.
The brain-gut axis represents a bidirectional communication linking brain function with the gastrointestinal (GI) system. This interaction comprises a top-down communication from the brain to the gut, and a bottom-up communication from the gut to the brain, including neural, endocrine, immune, and humoral signaling. Acute brain injury (ABI) can lead to systemic complications including GI dysfunction. ⋯ Despite novel biomarkers represent a limitation in clinical practice, intra-abdominal pressure (IAP) is easy-to-use and measurable at bedside. Increased IAP can be both cause and consequence of GI dysfunction, and it can influence cerebral perfusion pressure and intracranial pressure via physiological mechanisms. Here, we address ten good reasons to consider GI function in patients with ABI, highlighting the importance of its assessment in neurocritical care.
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J Clin Monit Comput · Feb 2024
ReviewPredictor role of heart rate variability in subarachnoid hemorrhage: A systematic review.
Background- Subarachnoid hemorrhage (SAH) is one of the most devastating diseases with a high rate of morbidity and mortality. The heart rate variability (HRV) is a non-invasive method of monitoring various components of the autonomic nervous system activity that can be utilized to delineate autonomic dysfunctions associated with various physiological and pathological conditions. The reliability of HRV as a predictor of clinical outcome in aneurysmal subarachnoid hemorrhage (aSAH) is not yet well investigated in literature. ⋯ Results- This systematic review demonstrates a correlation between early changes in HRV indices (time and frequency domain) and the development of neuro-cardiogenic complications and poor neurologic outcome in patients with SAH. Conclusions- A correlation between absolute values or changes of the LF/HF ratio and neurologic and cardiovascular complications was found in multiple studies. Because of significant limitations of included studies, a large prospective study with proper handling of confounders is needed to generate high-quality recommendations regarding HRV as a predictor of post SAH complications and poor neurologic outcome.