Journal of clinical monitoring and computing
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J Clin Monit Comput · Jun 2022
Comparison of a modified Story approach to traditional evaluation of acid-base disturbances in patients with shock: a cohort study.
To compare whether the diagnostic evaluation of metabolic acidosis can be improved by using a modified Story method compared to the traditional evaluation in a population of critically ill patients with shock. This prospective cohort study included shock patients admitted to the ICU of a tertiary hospital in Brazil between May 2018 and November 2019. We collected laboratory data necessary for traditional evaluation and the simplified Stewart's method. ⋯ Therefore, of the 149 patients included in the study, the traditional approach failed to identify metabolic acidosis that was identified by the modified Story assessment in 13 (8.7%) patients. In addition, the determination of the severity of metabolic acidosis also differed between the two methods by a mean of - 7.8 mEq/L. We found that a modified Story method can identify and quantify metabolic acidosis in patients with disorders that were not revealed by the traditional approach.
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J Clin Monit Comput · Jun 2022
Accuracy of noncontact surface imaging for tidal volume and respiratory rate measurements in the ICU.
Tidal volume monitoring may help minimize lung injury during respiratory assistance. Surface imaging using time-of-flight camera is a new, non-invasive, non-contact, radiation-free, and easy-to-use technique that enables tidal volume and respiratory rate measurements. The objectives of the study were to determine the accuracy of Time-of-Flight volume (VTTOF) and respiratory rate (RRTOF) measurements at the bedside, and to validate its application for spontaneously breathing patients under high flow nasal canula. ⋯ Tidal volume monitoring using time-of-flight camera (VTTOF) is correlated to reference values. Time-of-flight camera enables continuous and non-contact respiratory monitoring under high-flow nasal canula, and enables to detect tidal volume and respiratory rate changes, while modifying flow. It enables respiratory monitoring for spontaneously patients, especially while using high-flow nasal oxygenation.
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J Clin Monit Comput · Jun 2022
Efficacy of evoked potential monitoring for predicting postoperative motor status in internal carotid artery aneurysm surgeries.
This study aimed to investigate the efficacy of intraoperative motor evoked potential (MEP) and somatosensory evoked potential (SSEP) monitoring for predicting postoperative motor deficits (PMDs) in patients with internal carotid artery (ICA) aneurysms. The data for 138 patients with ICA aneurysms who underwent surgical clipping as well as their intraoperative neuromonitoring data were retrospectively reviewed. The efficacy of MEP/SSEP changes for predicting PMDs was assessed using binary logistic regression analysis. ⋯ For SSEP, the value was 14.5 min (p = 0.042, AUC = 0.875). The MEP/SSEP changes adjusted by those optimal values were also identified as independent predictors for short-term (p < 0.001 and p = 0.005, respectively) and long-term PMDs (p = 0.019 and 0.003, respectively). Intraoperative MEP and SSEP deterioration durations are effective in predicting PMDs in patients with ICA aneurysms.
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J Clin Monit Comput · Jun 2022
The impact of video games on training: can it change the game of endotracheal intubation?
In recent years, several studies have demonstrated that the experience derived from video games improves interventions that require technical skills. Airway management is crucial to anesthesiologists, requiring technical and non-technical skills. We evaluated the benefits of video games for video stylet-guided tracheal intubation, which allows the use of video technology in airway management of residents with anesthesiology training. ⋯ Time to intubate the trachea by using video stylet in (Group 1) was found to be 29 s on average, and it was 59.9 s for Group 2 ( p < 0.01) The average number of tracheal intubation attempts was 1.1 in Group 1, and 1.4 in Group 2 (p = 0.19). Video gaming experience improves the visual attention. Those accustomed to playing with video games, video stylet- guided tracheal intubation, performed intubation in less time.
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J Clin Monit Comput · Jun 2022
Machine learning applied to a Cardiac Surgery Recovery Unit and to a Coronary Care Unit for mortality prediction.
Most established severity-of-illness systems used for prediction of intensive care unit (ICU) mortality were developed targeted at the general ICU population, based on logistic regression (LR). To date, no dynamic predictive tool for ICU mortality has been developed targeted at the Cardiac Surgery Recovery Unit (CSRU) and Coronary Care Unit (CCU) using machine learning (ML). CSRU and CCU adult patients from the MIMIC-III critical care database were studied. ⋯ The accuracy statistics less sensitive to unbalanced cohorts were higher for all the ML models. In conclusion, the predictive power of XGB was excellent, substantially outperforming the conventional systems and LR. The ML models developed in this work offer promising results that could benefit CSRU and CCU.