Journal of clinical monitoring and computing
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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
Anesthetics affect peripheral venous pressure waveforms and the cross-talk with arterial pressure.
Analysis of peripheral venous pressure (PVP) waveforms is a novel method of monitoring intravascular volume. Two pediatric cohorts were studied to test the effect of anesthetic agents on the PVP waveform and cross-talk between peripheral veins and arteries: (1) dehydration setting in a pyloromyotomy using the infused anesthetic propofol and (2) hemorrhage setting during elective surgery for craniosynostosis with the inhaled anesthetic isoflurane. PVP waveforms were collected from 39 patients that received propofol and 9 that received isoflurane. ⋯ The k-NN prediction models had 82% and 77% accuracy for detecting propofol and MAC, respectively. The cross-talk relationship at each stage was: (a) ρ = 0.95, (b) ρ = 0.96, and (c) could not be evaluated using this cohort. Future research should consider anesthetic agents when analyzing PVP waveforms developing future clinical monitoring technology that uses PVP.
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J Clin Monit Comput · Feb 2022
Editorial CommentOne small wearable, one giant leap for patient safety?
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J Clin Monit Comput · Feb 2022
Review Meta AnalysisEffectiveness of consumer-grade contactless vital signs monitors: a systematic review and meta-analysis.
The objective of this systematic review and meta-analysis was to analyze the effectiveness of contactless vital sign monitors that utilize a consumer-friendly camera versus medical grade instruments. A multiple database search was conducted from inception to September 2020. Inclusion criteria were as follows: studies that used a consumer-grade camera (smartphone/webcam) to examine contactless vital signs in adults; evaluated the non-contact device against a reference medical device; and used the participants' face for measurement. ⋯ Currently available consumer-friendly contactless monitors measure HR accurately compared to standard medical devices. More studies are needed to assess the accuracy of contactless BP and RR monitors. Implementation of contactless vital sign monitors for clinical use will require validation in a larger population, in a clinical setting, and expanded to encompass other vital signs including BP, RR, and SpO2.