Journal of clinical monitoring and computing
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J Clin Monit Comput · Feb 2022
Impact of chronic treatment by β1-adrenergic antagonists on Nociceptive-Level (NOL) index variation after a standardized noxious stimulus under general anesthesia: a cohort study.
During the perioperative period, nociception control is certainly one of the anesthesiologist's main objectives when assuming care of a patient. There exists some literature demonstrating that the nociceptive stimuli experienced during surgery are responsible for peripheral and central sensitization phenomena, which can in turn lead to persistent postsurgical pain. An individualized approach to the evaluation and treatment of perioperative nociception is beneficial in order to avoid the sensitization phenomena that leads to prolonged postoperative pain and to minimize the consumption of opiates and their adverse effects. ⋯ In conclusion, the NOL index is a reliable monitor to assess nociception in a population of patients under chronic beta-blocker therapy. Patients under such therapy achieve similar maximal NOL values over a 180 s period after a standardized noxious stimulus and the NOL variation over time, represented by the AUC is not significantly different from a cohort of non-beta-blocked patients. Whether the patient takes beta-blockers or not, sensitivity of the NOL index is greater than that seen for BIS index or heart rate to detect an experimental noxious stimulus under general anesthesia.
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J Clin Monit Comput · Feb 2022
Randomized Controlled TrialQuantitative assessment of cytochrome C oxidase patterns in muscle tissue by the use of near-infrared spectroscopy (NIRS) in healthy volunteers.
Cytochrome C oxidase (CCO) acts as final electron acceptor in the respiratory chain, possibly providing information concerning cellular oxygenation. CCO is a chromophore with a broad absorption peak in the near-infrared spectrum in its reduced state (835 nm). However, this peak overlaps with deoxygenated haemoglobin (HHb; 755 nm) which is present in much higher concentrations. ⋯ HHb and CCO follow a significant different trend over time during the intervention period for both arterial occlusion (F = 20.645, edf = 3.419, p < 0.001) and venous stasis (F = 9.309, edf = 4.931, p < 0.001). Our data indicate that CCO concentration changes were not affected by HHb changes, thereby proving independency. Clinical trial registration: B670201732023 on June 28, 2017.
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J Clin Monit Comput · Feb 2022
Observational StudyClinical validation of a computerized algorithm to determine mean systemic filling pressure.
Mean systemic filling pressure (Pms) is a promising parameter in determining intravascular fluid status. Pms derived from venous return curves during inspiratory holds with incremental airway pressures (Pms-Insp) estimates Pms reliably but is labor-intensive. A computerized algorithm to calculate Pms (Pmsa) at the bedside has been proposed. ⋯ Further studies should be performed to determine the place of Pmsa in the circulatory management of critically ill patients. ( www.clinicaltrials.gov ; TRN NCT04202432, release date 16-12-2019; retrospectively registered). Clinical Trial Registration www. ClinicalTrials.gov , TRN: NCT04202432, initial release date 16-12-2019 (retrospectively registered).
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J Clin Monit Comput · Feb 2022
Intraoperative evoked potentials in patients with ossification of posterior longitudinal ligament.
Preoperative somatosensory evoked potentials (preSEPs) are used to evaluate the severity of myelopathy, and intraoperative neurophysiological monitoring (IONM) is used to reduce iatrogenic damage during operations. However, the correlation between preSEPs and IONM on postoperative neurologic deterioration (PND) in ossification of the posterior longitudinal ligament (OPLL) has not been studied. Thus, under the hypothesis that the patients with deteriorated preSEPs would be more likely to have significant changes in intraoperative SEPs (ioSEPs), and that this would be correlated with PND, we investigated the prognostic value of preSEPs on IONM and PND. ⋯ There was a positive correlation between amount of blood loss and maximum percentage of ioSEPs latency prolongation and a negative correlation with PMD at 48 h and 4 weeks postoperatively. PreSEPs predict significant changes in ioSEPs. Furthermore, bleeding control is important to reduce PMD in OPLL.