Journal of clinical monitoring and computing
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The aim was to assess the reproducibility of the Pleth Variability Index (PVI), developed for non-invasive monitoring of peripheral perfusion, in preterm neonates below 32 weeks of gestational age. Three PVI measurements were consecutively performed in stable, comfortable preterm neonates in the first 48 h of life. On each occasion, pulse oximeter sensors were attached to two different limbs for 5 min. ⋯ Intra-limb comparison showed fair to moderate ICC for right foot-right foot ICC = 0.380 (-0.014-0.677); and good ICC for right hand-right hand ICC = 0.646 (0.194-0.852). Bland-Altman plots showed moderate reproducibility of measurements between different limbs and of the same limb in consecutive time periods, with large biases and wide limits of agreement. The findings from this study indicate that PVI measurement is poorly reproducible when measured on different limbs and on the same limb in stable and comfortable preterm neonates.
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J Clin Monit Comput · Jun 2018
Pre-anesthetic stroke volume variation can predict cardiac output decrease and hypotension during induction of general anesthesia.
This study aimed to assess the reliability of stroke volume variation (SVV) in predicting cardiac output (CO) decrease and hypotension during induction of general anesthesia. Forty-five patients undergoing abdominal surgery under general anesthesia were enrolled. Before induction of anesthesia, patients were required to maintain deep breathing (6-8 times/min), and pre-anesthetic SVV was measured for 1 min by electrical cardiometry. ⋯ Patients with lower SVV exhibited a significantly slower onset and lower incidence of decreased CO than those with higher SVV (p = 0.003). Multivariate logistic regression analysis indicated high pre-anesthetic SVV as being an independent risk factor for decreased CO and hypotension (odds ratio, 1.43 and 1.16, respectively). In conclusions, pre-anesthetic SVV can predict incidence of decreased CO and hypotension during induction of general anesthesia.
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J Clin Monit Comput · Jun 2018
Closed-loop mechanical ventilation for lung injury: a novel physiological-feedback mode following the principles of the open lung concept.
Adherence to low tidal volume (VT) ventilation and selected positive end-expiratory pressures are low during mechanical ventilation for treatment of the acute respiratory distress syndrome. Using a pig model of severe lung injury, we tested the feasibility and physiological responses to a novel fully closed-loop mechanical ventilation algorithm based on the "open lung" concept. Lung injury was induced by surfactant washout in pigs (n = 8). ⋯ Using the "open lung" approach, tidal volume delivery required low lung distending pressures, increased recruitment and ventilation of dorsal lung regions and improved arterial blood oxygenation. Physiological feedback closed-loop mechanical ventilation according to the principles of the open lung concept is feasible and provides low tidal volume ventilation without human intervention. Of importance, the "open lung approach"-ventilation improved gas exchange and reduced lung driving pressures by opening atelectasis and shifting of ventilation to dorsal lung regions.
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J Clin Monit Comput · Jun 2018
Correction to: Changes in transcranial motor evoked potentials during hemorrhage are associated with increased serum propofol concentrations.
In the original publication of the article, the corresponding author inadvertently omitted one of the co-authors in the author group. The corrected author group is given in this erratum.
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J Clin Monit Comput · Jun 2018
Efficiency of oxygen delivery through different oxygen entrainment devices during sedation under low oxygen flow rate: a bench study.
Sedative anesthetic procedures outside the operating room may depend on cylinders as oxygen source. Cylinders have limited storage capacity and a low oxygen flow rate improves the durability. We conducted the bench study to evaluate the fraction of inspired oxygen (FiO2) in different oxygen entrainment devices under low oxygen flow rate. ⋯ In the hypoventilation group, oxygen reservoir units helped oxygen retention in local area and maintained a higher oxygen concentration. There were multiple factors lead to different oxygen fraction that we measured, such as different devices, respiratory patterns, and oxygen reservoir units. The result of our bench study provided some information for anesthesiologist to choose appropriate oxygen entrainment devices in various sedative anesthetic procedures.