Journal of clinical monitoring and computing
-
J Clin Monit Comput · Feb 2021
Clinical TrialPerformance of the Hypotension Prediction Index with non-invasive arterial pressure waveforms in non-cardiac surgical patients.
An algorithm derived from machine learning uses the arterial waveform to predict intraoperative hypotension some minutes before episodes, possibly giving clinician's time to intervene and prevent hypotension. Whether the Hypotension Prediction Index works well with noninvasive arterial pressure waveforms remains unknown. We therefore evaluated sensitivity, specificity, and positive predictive value of the Index based on non-invasive arterial waveform estimates. ⋯ Hypotension prediction, along with appropriate management, can potentially reduce intraoperative hypotension. Being able to use the non-invasive pressure waveform will widen the range of patients who might benefit. Clinical Trial Number: ClinicalTrials.gov NCT02872896.
-
J Clin Monit Comput · Feb 2021
EditorialMeasuring endotracheal tube intracuff pressure: no room for complacency.
Tracheal intubation constitutes a routine part in the care of critically ill and anaesthetised patients. Prolonged use of endotracheal with inflated cuff is one of the major multifactorial causes of complications. Both under-inflation and over-inflation of cuff are associated with complications. Despite known problems, regular measurement of cuff pressure is not routine, and it is performed on an ad hoc basis.
-
J Clin Monit Comput · Feb 2021
Evaluation of accuracy of capillary refill index with pneumatic fingertip compression.
Capillary refill time (CRT) is a method of measuring a patient's peripheral perfusion status through a visual assessment performed by a clinician. We developed a new method of measuring CRT using standard pulse oximetry sensor, which was designated capillary refill index (CRI). We evaluated the accuracy of CRI in comparison to CRT image analysis. ⋯ The same difference and correlation patterns were verified in the ED setting. CRI was as reliable as CRT by image analysis. The values of CRI was approximately 1 s higher than CRT.
-
J Clin Monit Comput · Feb 2021
Increase in regional cerebral saturation after elective electrical cardioversion of atrial fibrillation is only transient and without beneficial effects on neuropsychological functioning: cerebral saturation during electrical cardioversion.
We aimed to confirm the positive association between a successful electrical cardioversion (ECV) and increase in SctO2 and investigated whether this increase is persisting or not. Secondary, the influence of a successful ECV on the neuropsychological function and the association with SctO2 was assessed as well. SctO2 was measured continuously during elective ECV using near-infrared spectroscopy. ⋯ A transient, instant SctO2 increase was observed after successful ECV. This temporary increase in SctO2 did not influence the neuropsychological functioning of the patients. Though, the quality of life of patients with a successful ECV improved.
-
J Clin Monit Comput · Feb 2021
Improper monitoring and deviations from physiologic treatment goals in patients with brain injury in the early phases of emergency care.
Severe traumatic brain injury (TBI), out-of-hospital cardiac arrest (OHCA) and intracerebral- and subarachnoid hemorrhage (ICH/SAH) are conditions associated with high mortality and morbidity. The aim of this study was to investigate the feasibility of obtaining continuous physiologic data and to identify possible harmful physiological deviations in these patients, in the early phases of emergency care. Patients with ICH/SAH, OHCA and severe TBI treated by the Physician-staffed Emergency Medical Service (P-EMS) between September and December 2016 were included. ⋯ Continuous physiological data was not possible to obtain in this study of critically ill and injured patients with brain injury. The patients had frequent deviations in blood pressure, SpO2 and end tidal CO2-levels, and measurements were frequently missing. There is a potential for improved monitoring as a tool for quality improvement in pre-hospital critical care.