Journal of clinical monitoring and computing
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J Clin Monit Comput · Apr 2021
Ocular blood flow by laser speckle flowgraphy to detect cerebral ischemia during carotid endarterectomy.
Laser speckle flowgraphy (LSFG) is a noninvasive technique that can measure relative blood flow velocity in the optic fundus contributed by the ophthalmic artery, the main first branch originating from the internal carotid artery (ICA). The aim of this study was to assess the feasibility of ocular blood flow measurement by LSFG to detect ischemic stress due to carotid clamping during carotid endarterectomy (CEA). Nineteen patients undergoing CEA with ocular blood flow measurement by LSFG and intraoperative monitoring (IOM) were prospectively enrolled between August 2016 and March 2019. ⋯ The MBR reduction ratio was positively correlated with the rSO2 index (r = 0.694, 95% confidence interval: 0.336-0.877, p = 0.001). The MBR reduction ratio of ocular blood flow by LSFG after carotid clamping was significantly correlated with the rSO2 index. The ocular blood flow by LSFG could be considered an adjunct modality for evaluating cerebral ischemic tolerance during CEA.
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J Clin Monit Comput · Apr 2021
A physiology-based mathematical model for the selection of appropriate ventilator controls for lung and diaphragm protection.
Mechanical ventilation is used to sustain respiratory function in patients with acute respiratory failure. To aid clinicians in consistently selecting lung- and diaphragm-protective ventilation settings, a physiology-based decision support system is needed. To form the foundation of such a system, a comprehensive physiological model which captures the dynamics of ventilation has been developed. ⋯ Finally, the model is seen to be able to provide robust predictions of esophageal pressure, transpulmonary pressure and blood pH for patient parameters with realistic variability. The LDPV model is a robust physiological model which produces outputs which directly target and reflect the risk of ventilator-induced lung and diaphragm injury. Ventilation and sedation parameters are seen to modulate the model outputs in accordance with what is currently known in literature.
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J Clin Monit Comput · Apr 2021
Review Meta AnalysisComparison of common perioperative blood loss estimation techniques: a systematic review and meta-analysis.
Estimating intraoperative blood loss is one of the daily challenges for clinicians. Despite the knowledge of the inaccuracy of visual estimation by anaesthetists and surgeons, this is still the mainstay to estimate surgical blood loss. This review aims at highlighting the strengths and weaknesses of currently used measurement methods. ⋯ The majority of the studies chose known imprecise procedures as the method of comparison. Colorimetric methods offer the highest degree of accuracy in blood loss estimation. Systems that use colorimetric techniques have a significant advantage in the real-time assessment of blood loss.
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J Clin Monit Comput · Apr 2021
Randomized Controlled Trial Observational StudyA randomized controlled study on the visual grading of the glottis and the hemodynamics response to laryngoscopy when using I-View and MacGrath Mac videolaryngoscopes in super obese patients.
Videolaryngoscopes improve visualization of glottic in morbidly obese patients. Super-obesity is one of the risk factors influencing probability of difficult mask ventilation and difficult intubation. Super-obese (BMI > 50 kg/m2) patients should be intubated either with fiberscope awake intubation or with video laryngoscopes. ⋯ The POGO score was better for McGrath Mac than for I-view videolaryngoscope, however, both devices allowed for safe and effective intubation in super-obese patients. The hemodynamic response to videolaryngoscopy was similar between devices.
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Oxygen gas flowmeters (OGF) are used to regulate the oxygen flow in acute and chronic care. In hospitals, Thorpe tubes (TT) are the classical systems most used for delivering oxygen. In recent years, the oxygen flow restrictor (OFR) has appeared. ⋯ With the increasing flow, some data fell outside the limits of agreement, and the trend increased with the elevated oxygen flow. TTs were less accurate compared to OFRs due to the increased flow variability. However, for TTs and OFRs, as the required flow is elevated, the dispersion of values increases on both sides of the actual flow.