Journal of clinical monitoring and computing
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J Clin Monit Comput · Feb 2020
Comparative Study Observational StudyAcoustic respiration rate and pulse oximetry-derived respiration rate: a clinical comparison study.
Respiration rate (RR) is a critical vital sign that provides early detection of respiratory compromise. The acoustic technique of measuring continuous respiration rate (RRa) interprets the large airway sound envelope to calculate respiratory rate while pulse oximetry-derived respiratory rate (RRoxi) interprets modulations of the photoplethsymograph in response to hemodynamic changes during the respiratory cycle. The aim of this study was to compare the performance of these technologies to each other and to a capnography-based reference device. ⋯ RRoxi also displayed a value for significantly longer time periods than RRa when the subjects produced physiological sounds and moved their heads, but not during shallow breathing or ambient noise. RRoxi may be more accurate than RRa during development of bradypnea. Also, RRoxi may display a more reliable RR value during routine patient activities.
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J Clin Monit Comput · Feb 2020
Observational StudyMeasuring the accuracy of propofol target-controlled infusion (TCI) before and after surgery with major blood loss.
Target-controlled infusion (TCI) is based on pharmacokinetic models designed to achieve a desired drug level in the blood. TCI's predictive accuracy of plasma propofol levels at the end of surgery with major blood loss has not been well established. This prospective observational study included adult patients (BMI 20-35 kg/m2) undergoing surgery with expected blood loss ≥ 1500 mL. ⋯ Propofol TCI allows clinically unproblematic conduct of general anaesthesia. In cases of major blood loss, the probability of propofol TCI overestimating plasma levels increases. Trial registration German Clinical Trials Register (DRKS; DRKS00009312).
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J Clin Monit Comput · Feb 2020
Postoperative desaturation and bradypnea after general anesthesia in non-ICU patients: a retrospective evaluation.
Respiratory depression, presenting as desaturation and bradypnea, is common during the early postoperative period. However, it has not been evaluated by appropriate monitoring. The purpose of the present study was to identify the incidence and predictors of desaturation and bradypnea following general anesthesia, using a continuous and centralized monitoring system, in non-ICU patients who did not have serious complications and did not undergo major surgery. ⋯ Age (OR 1.04, 95% CI 1.01-1.07; p = 0.010) and postoperative opioid administration (OR 3.16, 95% CI 1.22-7.87; p = 0.019) showed a significant association with the occurrence of both desaturation and bradypnea. This study demonstrated the incidence and predictors of postoperative desaturation and bradypnea, and suggests the need for monitoring oxygen saturation and respiratory rate for at least 8 h after surgery in non-ICU patients. Use of monitoring systems might provide a safety net for postoperative patients.