European journal of anaesthesiology
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Randomized Controlled Trial Comparative Study
A comparison between bispectral index analysis and auditory-evoked potentials for monitoring the time to peak effect to calculate the plasma effect site equilibration rate constant of propofol.
To the best of our knowledge, the value of the plasma effect site equilibration rate constant (k(e0)) of propofol has not been reported in Chinese patients. The aim of this prospective, randomized study was to examine the characteristics of the time to peak effect (T(PEAK)) of propofol, a pharmacokinetic-independent descriptor of blood-brain equilibration, and k(e0) derived from T(PEAK) with A-line auditory-evoked potential monitor and Aspect A-2000 bispectral index monitor in Chinese patients. ⋯ The T(PEAK) of propofol measured by the A-line auditory-evoked potential monitor is different from that measured by the Aspect A-2000 bispectral index monitor. The T(PEAK)s of propofol from auditory-evoked potential index and bispectral index, and the values of k(e0) calculated based on T(PEAK)s are different from previous reports and appear to be not affected by age. Further studies need to be taken to validate clinically the k(e0) values of propofol.
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Comparative Study
Clinical validation of electromyography and acceleromyography as sensors for muscle relaxation.
The aim of this study was to determine which of two clinically applied methods, electromyography or acceleromyography, was less affected by external disturbances, had a higher sensitivity and which would provide the better input signal for closed loop control of muscle relaxation. ⋯ Electromyography is more reliable for use in daily practice as it is less influenced by external disturbances than acceleromyography.
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Clinical Trial
An evaluation of capnography monitoring during the apnoea test in brain-dead patients.
Diagnosis of brain death usually requires the absence of spontaneous respiratory movements during the apnoea test and an arterial carbon dioxide partial pressure above 60 mmHg. On the other hand, although capnography (end-tidal CO(2)) is currently monitored in intensive care unit patients, it has not been evaluated during the apnoea test in brain-dead patients. Therefore, the aim of this prospective study was first to investigate the usefulness of capnography monitoring, and secondly to evaluate the variation of the carbon dioxide partial pressure-end-tidal CO(2) gradient during the apnoea test in clinically brain-dead patients. ⋯ End-tidal CO(2) should be systematically monitored and recorded, at least for medico-legal considerations, during the apnoea test in brain-dead patients. The high variability in the carbon dioxide partial pressure-end-tidal CO(2) gradient increase precludes any extrapolation of the carbon dioxide partial pressure from the end-tidal CO(2) at the end of the apnoea test.
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Comparative Study Clinical Trial
Comparison of FloTrac cardiac output monitoring system in patients undergoing coronary artery bypass grafting with pulmonary artery cardiac output measurements.
Arterial pulse waveform analysis has been proposed for cardiac output (CO) determination and monitoring without calibration or thermodilution (FloTrac/Vigileo; Edwards Lifesciences, Irvine, CA, USA). The accuracy and clinical applicability of this technology has not been fully evaluated. We designed this prospective study to compare the accuracy of the FloTrac system (CO(FT)) vs. pulmonary artery catheter standard bolus thermodilution (CO(PAC) ) in patients undergoing coronary artery bypass grafting. ⋯ We found clinically acceptable agreement between CO(FT) and CO(PAC) in this setting. This new device has potential clinical applications.