Journal of clinical monitoring and computing
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J Clin Monit Comput · Jun 2013
Randomized Controlled TrialUltrasound-guided radial arterial cannulation: long axis/in-plane versus short axis/out-of-plane approaches?
Arterial cannulation with ultrasound (US) guidance increases the success rate and reduces complications. US-guided vascular access has two main approaches: long axis in-plane (LA-IP) and short axis out-of-plane (SA-OOP) approaches. The purpose of this study was to compare performance time and possible complications between two techniques. ⋯ Posterior wall damage during arterial cannulation were found in 30 patients with SA-OOP Group (56 %) and 11 patients with LA-IP Group (20 %), (p < 0.05). In our study, the use of LA-IP approach during US-guided radial artery cannulation has higher success rate at first insertion. We also found LA-IP approach results in shorter cannulation time and decreased the incidence of complications.
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J Clin Monit Comput · Jun 2013
Randomized Controlled TrialOutcome impact of goal directed fluid therapy during high risk abdominal surgery in low to moderate risk patients: a randomized controlled trial.
Intraoperative goal directed fluid therapy (GDT) guided by an arterial pressure-based cardiac output system has been reported to improve gastrointestinal (GI) recovery in high-risk patients. This study evaluates the impact of this approach on GI recovery in low to moderate risk patients undergoing major abdominal surgery. IRB approved randomized controlled trial in low to moderate risk adults scheduled for major surgery. ⋯ The GDT group had faster return of GI function (p = 0.004) and higher quality of recovery scores. In low to moderate risk patients undergoing major abdominal surgery, intraoperative GDT guided by SVV optimization was associated with faster restoration of GI recovery and higher quality of recovery scores. These results suggest that outcome benefits related to the use of an intraoperative goal directed fluid protocol guided by SVV are not limited to high-risk patients.
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J Clin Monit Comput · Jun 2013
Randomized Controlled TrialComposite-, plain-auditory evoked potentials index and bispectral index to measure the effects of sevoflurane.
The composite auditory evoked potentials index (cAAI) uses both cortical electroencephalogram (EEG) and response to auditory stimuli, while the bispectral index (BIS) uses only the cortical EEG and auditory evoked potentials index (AAI) uses only response to auditory stimuli. We expected that the cAAI was more useful to monitor anesthetic effect of sevoflurane than the BIS and AAI. The present study compared the changes of cAAI, AAI, and BIS in different sevoflurane concentration. ⋯ The cAAI had the largest and AAI had the smallest inter-individual variation. In sevoflurane-nitrous oxide anesthesia, cAAI was inferior to AAI and BIS to discriminate different anesthetic effect. The cAAI had larger inter-individual variation than the AAI and BIS.
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J Clin Monit Comput · Jun 2013
Clinical TrialDevelopment of a practicable non-contact bedside autonomic activation monitoring system using microwave radars and its clinical application in elderly people.
We developed a practicable, non-contact, autonomic activation monitoring system using microwave radars without imposing any stress on monitored individuals. Recently, the rapid increase in the aging population has raised concerns in developed countries. Thus, hospitals and care facilities will need to perform long-term health monitoring of elderly patients. ⋯ Previous studies using conventional ECG reveal that diabetic neuropathy decreases LF, and also MI causes parasympathetic attenuation which leads to HF reduction. Our study showed that average SDNN of post-MI patients is smaller than 50 ms which is known to have high mortality. The non-contact autonomic activation monitoring system allows a long-term health management especially during sleeping hours for elderly people at healthcare facilities.