Journal of clinical monitoring and computing
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J Clin Monit Comput · Jun 2018
Observational StudyEffects of hypnosis on the relative parasympathetic tone assessed by ANI (Analgesia/Nociception Index) in healthy volunteers: a prospective observational study.
Hypnosis has shown an effect on the regulation of the autonomic nervous system by increasing parasympathetic activity. The Analgesia/Nociception Index (ANI) is derived from heart rate variability and represents the relative parasympathetic tone. We investigated the effects of hypnosis on ANI in healthy volunteers. ⋯ The median [25th-75th percentile] RR at T1 (16 [14-18] breaths/min) and T2 (14 [12-16] breaths/min) were significantly smaller than at T0 (18 [16-20] breaths/min) and T3 (18 [16-20] breaths/min). This study shows that hypnosis induces an increase in the relative parasympathetic tone assessed by ANI in healthy volunteers, with greater ANI values observed in women. These results suggest that ANI monitoring may provide an objective tool for the measurement of the intensity of the hypnotic process, although this should be confirmed by further studies.
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J Clin Monit Comput · Jun 2018
Observational StudyNear-infrared spectroscopy monitoring during immediate transition after birth: time to obtain cerebral tissue oxygenation.
Feasibility of cerebral tissue oxygenation measurements immediately after birth has been published starting with first values 2 min after birth. Aim of this study was to evaluate, the time periods from birth and from arrival at the resuscitation table to obtain the first cerebral tissue oxygenation values with two different near infrared spectroscopy (NIRS) devices. The present study is an analysis of exploratory parameters of two prospective observational studies. ⋯ The first displayed value tended to be higher for cTOI [54% (18-80)] compared to crSO2 [35% (15-87)]. There were no significant differences between devices in time periods and first values displayed. Cerebral tissue oxygenation can be measured within 1 min after arriving at the resuscitation table in term and preterm neonates after birth without difference between devices.
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J Clin Monit Comput · Jun 2018
Technical challenges related to implementation of a formula one real time data acquisition and analysis system in a paediatric intensive care unit.
Most existing, expert monitoring systems do not provide the real time continuous analysis of the monitored physiological data that is necessary to detect transient or combined vital sign indicators nor do they provide long term storage of the data for retrospective analyses. In this paper we examine the feasibility of implementing a long term data storage system which has the ability to incorporate real-time data analytics, the system design, report the main technical issues encountered, the solutions implemented and the statistics of the data recorded. McLaren Electronic Systems expertise used to continually monitor and analyse the data from F1 racing cars in real time was utilised to implement a similar real-time data recording platform system adapted with real time analytics to suit the requirements of the intensive care environment. ⋯ Recording data from bed-side monitors in intensive care/wards is feasible. It is possible to set up real time data recording and long term storage systems. These systems in future can be improved with additional patient specific metrics which predict the status of a patient thus paving the way for real time predictive monitoring.
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J Clin Monit Comput · Jun 2018
Pulse-contour derived cardiac output measurements in morbid obesity: influence of actual, ideal and adjusted bodyweight.
The non-invasive Nexfin cardiac output (CO) monitor shows a low level of agreement with the gold standard thermodilution method in morbidly obese patients. Here we investigate whether this disagreement is related to excessive bodyweight, and can be improved when bodyweight derivatives are used instead. We performed offline analyses of cardiac output recordings of patient data previously used and partly published in an earlier study by our group. ⋯ With adjusted bodyweight, bias improved to 0.04 ± 1.4 with LOA from -2.8 to 2.9 L min. Our study shows that agreement of the Nexfin-derived with invasive CO measurements in morbidly obese patients is influenced by body weight, suggesting that Nexfin CO measurements in patients with a BMI above 35 kg/m2 should be interpreted with caution. Using adjusted body weight in the Nexfin CO-trek algorithm reduced the bias.
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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.