Journal of clinical monitoring and computing
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J Clin Monit Comput · Dec 2020
Observational StudyPerioperative measurement of core body temperature using an unobtrusive passive heat flow sensor.
Clinicians strive to maintain normothermia, which requires measurement of core-body temperature and may necessitate active warming of patients. Monitoring temperature currently requires invasive probes. This work investigates a novel foam-based flexible sensor worn behind the ear for the measurement of core body temperature. ⋯ The error bias and limits of agreement over these segments were on average of - 0.05 ± 0.28 °C (95% limits of agreement) overall. The dynamic model outperformed the simple heat-flow model for periods of surrounding temperature changes (12.7% of total time) while it had a similar, high, performance for the temperature-stable periods. The results suggest that our proposed topical sensor can replace invasive core temp sensors and provide a means of consistently measuring core body temperature despite surrounding temperature shifts.
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J Clin Monit Comput · Dec 2020
Randomized Controlled TrialA comparison of ventilation with a non-invasive ventilator versus standard O2 with a nasal cannula for colonoscopy with moderate sedation using propofol.
The aim of this study was to test the effects of CPAP on moderately sedated patients undergoing colonoscopy. Our hypothesis was that CPAP can reduce the incidence and duration of obstructive apnea and hemoglobin oxygen desaturation in patients undergoing procedural sedation for colonoscopy. Two groups of consenting adult patients scheduled to undergo routine colonoscopy procedures and sedated with propofol and fentanyl were monitored in this study: control and intervention. ⋯ Average AUC of patients in the control group was 70%-s (time (s) * oxygen saturation below < 90%) (95% CI 32.34-108.60%) whereas the average AUC in intervention group patients was 0%-s (% time (s) * oxygen saturation < 90%) (95% CI 0-0%), p = 0.01. This preliminary study found that CPAP via a tight-fitting mask may be an effective tool to reduce the incidence and duration of obstructive apneic events as well as hemoglobin oxygen desaturation during lower endoscopy procedures that use propofol and fentanyl for sedation. Clinical Trial Registration ClinicalTrials.gov ID: NCT02623270. https://clinicaltrials.gov/ct2/show/NCT02623270 .
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J Clin Monit Comput · Dec 2020
Randomized Controlled TrialShortening of the twitch stabilization period by tetanic stimulation in acceleromyography in infants, children and young adults (STSTS-Study): a prospective randomised, controlled trial.
Acceleromyography is characterised by an increase of the twitch response T1 (first twitch of the train-of-four [TOF]) during first 30 min of monitoring known as the staircase phenomenon. In adults the staircase phenomenon can be avoided by tetanic prestimulation. This study examined, if tetanic prestimulation eliminates the staircase phenomenon in children. ⋯ Tetanic prestimulation prevents the staircase phenomenon in these age groups. The stability of the TOFR reading confirms its value to monitor neuromuscular function over time. Registration: The study was registered as NCT02552875 on Clinical Trials.gov on July 29, 2014.
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J Clin Monit Comput · Dec 2020
Comment LetterThe artificial count of artifacts for thoracic ultrasound: what is the clinical usefulness?
Many works in the literature have shown that the increase in the number of B lines is a nonspecific sign of underlying pulmonary disease. Actually these artifacts are the result of a physical effect of ultrasound between the chest wall and the pulmonary air. Nevertheless the intra- and inter-operator variability in B-lines counting does not only reside only in the count itself but depends also on the type and frequency of the probe used, as well as the ultrasound scan machine setting and the patient's chest shape. In our opinion, proposing a software algorithm to count lines B seems like an unproductive effort.
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J Clin Monit Comput · Dec 2020
Right ventricular transverse displacement increases following cardiac surgery: possibly compensating loss in tricuspid annular plane systolic excursion (TAPSE).
Right Ventricular (RV) output mostly derives from longitudinal shortening in normal hearts. However, following even uncomplicated cardiac surgery with preserved RV function a significant and sustained decrease in longitudinal contraction has been observed. How the RV compensates and sustains output in this setting remains unsettled. ⋯ RV speckle tracking strain did not change significantly. Increased transverse displacement likely compensates for reduction in RV longitudinal contraction following cardiac surgery and maintains cardiac output. The sustained output from the right ventricle was not related to an increased contractility.