Journal of clinical monitoring and computing
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J Clin Monit Comput · Oct 2021
Correlation between preoperative somatosensory evoked potentials and intraoperative neurophysiological monitoring in spinal cord tumors.
Intraoperative neurophysiological monitoring (IONM) is widely used in spinal cord tumors (SCTs) removal surgery. This study mainly hypothesized that patients with prolonged latency of preoperative somatosensory evoked potentials (preSEPLat) would have more deteriorated intraoperative evoked potentials. Among 506 patients who underwent SCTs removal surgery, 74 underwent both preSEPs and IONM. ⋯ PreSEPs are helpful in predicting the significant changes in ioSEPs during IDEM tumor removal surgery. The tumor-occupying area ratio and anatomical type are contributing factors for the transient PMD, whereas ioSEPs are prognostic factors in predicting the PMD that persists over 4 weeks after SCTs removal surgery. To our knowledge, this is the first study that mainly focused on the correlations of preoperative and intraoperative evoked potentials.
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J Clin Monit Comput · Oct 2021
Letter Meta AnalysisComparison between laryngeal handshake and palpation techniques in the identification of cricothyroid membrane: a meta-analysis.
Because the use of conventional digital palpation technique for the identification of cricothyroid membrane (CTM) has been widely believed to be unreliable, the 'laryngeal handshake' technique (LH) has been introduced for CTM identification in the event of cricothyroidotomy. To provide evidence for clinical practice, this pilot meta-analysis aimed at investigating whether identification of CTM with the LH is superior to that with the palpation technique. Studies that evaluated the accuracy of CTM identification by using LH or palpation techniques (i.e., LH group vs. ⋯ Four studies published from 2018 to 2020 were considered relevant and were read in full. We found no significant difference in success rate of CTM identification [Risk Ratio (RR) 1.09, 95% CI 0.89-1.34, p = 0.41] between the two groups. These preliminary results of the current study demonstrated no significant differences in success rate between the laryngeal handshake and conventional palpation techniques in cricothyroid membrane identification.
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J Clin Monit Comput · Oct 2021
Estimation of pulse pressure variation and cardiac output in patients having major abdominal surgery: a comparison between a mobile application for snapshot pulse wave analysis and invasive pulse wave analysis.
Pulse pressure variation (PPV) and cardiac output (CO) can guide perioperative fluid management. Capstesia (Galenic App, Vitoria-Gasteiz, Spain) is a mobile application for snapshot pulse wave analysis (PWAsnap) and estimates PPV and CO using pulse wave analysis of a snapshot of the arterial blood pressure waveform displayed on any patient monitor. We evaluated the PPV and CO measurement performance of PWAsnap in adults having major abdominal surgery. ⋯ In adults having major abdominal surgery, PPVPWAsnap moderately agrees with PPVProAQT. The absolute and trending agreement between COPWAsnap with COProAQT is poor. Technical improvements are needed before PWAsnap can be recommended for hemodynamic monitoring.
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J Clin Monit Comput · Oct 2021
Technical considerations when using the EEG export of the SEDLine Root device.
Electroencephalographic (EEG) patient monitoring during general anesthesia can help to assess the real-time neurophysiology of unconscious states. Some monitoring systems like the SEDLine Root allow export of the EEG to be used for retrospective analysis. We show that changes made to the SEDLine display during recording affected the recorded EEG. ⋯ Changing the display settings results in undocumented changes in EEG amplitude, sampling rate, and signal quality. The occult nature of these changes could make the analysis of data sets difficult if not invalid. We strongly suggest researchers adequately define and keep the EEG display settings to export good quality EEG and to ensure comparability among patients.
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J Clin Monit Comput · Oct 2021
A simple method of mechanical power calculation: using mean airway pressure to replace plateau pressure.
The reference method for mechanical power (MP) calculation proposed by Gattinoni et al. is based on plateau pressure (Pplat) which needs an inspiratory hold. This study aims to introduce and validate a simple surrogate for MP calculation without any intervention in ventilated patients with or without acute respiratory distress syndrome (ARDS). The introduced equation is as:[Formula: see text]where Pmean is mean airway pressure, VE is minute ventilation, PEEP is positive end-expiratory pressure, and Te/Ti is expiratory-to-inspiratory ratio. 50 patients with ARDS and 50 post-operative patients without ARDS were enrolled. ⋯ At both Tplat levels, the Pmean-derived MP correlated well with the reference MP both in patients with or without ARDS (non-ARDS: slopes = 1.05, 0.94, R2 = 0.95, 0.93, bias + 0.76, + 0.51; ARDS: slopes = 1.03, 0.95, R2 = 0.96, 0.96, bias + 0.97, + 0.78. P < 0.0001 for all). In patients with or without ARDS, Pmean-derived MP allows rapid and dynamic estimation of mechanical power without any intervention at the bedside.