Journal of clinical monitoring and computing
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J Clin Monit Comput · Dec 2018
Observational StudyRespiratory quotient estimations as additional prognostic tools in early septic shock.
Central venous-to-arterial carbon dioxide difference (PcvaCO2), and its correction by the arterial-to-venous oxygen content difference (PcvaCO2/CavO2) have been proposed as additional tools to evaluate tissue hypoxia. Since the relationship between pressure and content of CO2 (CCO2) might be affected by several factors, some authors advocate for the use of CcvaCO2/CavO2. The aim of the present study was to explore the factors that might intervene in the difference between PcvaCO2/CavO2 and CcvaCO2/CavO2, and to analyze their association with mortality. ⋯ Initial ScvO2, PcvaCO2, CcvaCO2/CavO2, and cardiac index were not different in survivors and non-survivors. In a population of early septic shock patients, simultaneous values of PcvaCO2/CavO2 and CcvaCO2/CavO2 were not equivalent, and the main determinant of the magnitude of the difference between these two parameters was pH. The PcvaCO2/CavO2 ratio was associated with ICU mortality, whereas CcvaCO2/CavO2 was not.
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J Clin Monit Comput · Dec 2018
Letter Case ReportsMagnetic resonance imaging (MRI) induced 'hypoxia artifacts' on pulse oximetry: how reliable are MRI compatible monitoring devices?
Distinguishing a monitoring artifact requires expertise and adeptness. This can be practically challenging during the course of an anesthetic. We report a case, wherein we experienced episodes of aberrant pulse-oximeter values suggestive of desaturation with normal waveforms, occurring during a particular sequence of magnetic resonance imaging (MRI) performed under general anesthesia, which in fact was an artifact induced by the 3 T MRI during the diffusion tensor imaging sequence.
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J Clin Monit Comput · Dec 2018
Comment LetterIn response to: phenylephrine and paradoxically increased muscle tissue oxygenation: is the mechanism related to local venoconstriction or augmented venous return?
Abstract
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J Clin Monit Comput · Dec 2018
Comparative StudyExperimental comparison of performances of Mega Acer Kit, Ranger and ThermoSens according to flow rates and distances.
We experimentally investigated the fluid warming performances of three warmers with different technology, according to flow rates and distances. We used the following intravenous fluid warmers: Mega Acer Kit (Group M, n = 8), Ranger (group R, n = 8), and ThermoSens (group T, n = 8). Fluids that had been stored in the operating room over the previous 24 h were delivered at sequent flow rates of from 440 mL/h up to 2500 mL/h through preheated warming devices. ⋯ It was significantly higher at the Pout1 than the Pout2 at all flow rates for each device (P < 0.001). Mega Acer Kit can warm fluid more effectively compared with ThermoSens and Ranger at the low flow rate whereas the ThermoSens and the Ranger are suitable at higher flow rates. Furthermore, the device performance is more effective with shorter extension lines.
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J Clin Monit Comput · Dec 2018
Randomized Controlled TrialImpact of continuous non-invasive blood pressure monitoring on hemodynamic fluctuation during general anesthesia: a randomized controlled study.
This study assessed the ability of a continuous non-invasive blood pressure (BP) monitoring system to reduce intra-anesthetic hemodynamic fluctuation compared with intermittent BP cuff measurement. Forty patients undergoing total knee arthroplasty under general anesthesia were enrolled and randomly divided into two groups (Control and CS group). BP management was performed using the same protocol with BP measured by intermittent BP cuff in the Control and that by continuous non-invasive BP monitoring in the CS group. ⋯ Hypertension occurred more frequently in the Control group during emergence from anesthesia (p = 0.037). The duration of hemodynamic stability (systolic BP 80-110% of baseline) intraoperatively was longer in the CS group than in the Control group (87.7 vs. 61.9%; p < 0.001). Accuracy and trending ability of the continuous non-invasive BP monitoring was clinically acceptable, and lead to hemodynamic stability and reduction of intra-anesthetic hypotension and hypertension intraoperatively.