Journal of clinical monitoring and computing
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J Clin Monit Comput · Aug 2022
Randomized Controlled TrialEffect of pressure-controlled ventilation-volume guaranteed mode combined with individualized positive end-expiratory pressure on respiratory mechanics, oxygenation and lung injury in patients undergoing laparoscopic surgery in Trendelenburg position.
The study aimed to investigate the efficacy of PCV-VG combined with individual PEEP during laparoscopic surgery in the Trendelenburg position. 120 patients were randomly divided into four groups: VF group (VCV plus 5cmH2O PEEP), PF group (PCV-VG plus 5cmH2O PEEP), VI group (VCV plus individual PEEP), and PI group (PCV-VG plus individual PEEP). Pmean, Ppeak, Cdyn, PaO2/FiO2, VD/VT, A-aDO2 and Qs/Qt were recorded at T1 (15 min after the induction of anesthesia), T2 (60 min after pneumoperitoneum), and T3 (5 min at the end of anesthesia). The CC16 and IL-6 were measured at T1 and T3. ⋯ At T3, the concentration of CC16 in PI group was lower compared with other groups, and IL-6 level of PI group was decreased than that in VF and VI group. In conclusion, the patients who underwent laparoscopic surgery, PCV-VG combined with individual PEEP produced favorable lung mechanics and oxygenation, and thus reducing inflammatory response and lung injury. Clinical Trial registry: chictr.org. identifier: ChiCTR-2100044928.
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J Clin Monit Comput · Aug 2022
Observational StudyPredictors of difficult intubation when using a videolaryngoscope with an intermediate-angled blade during the first attempt: a prospective observational study.
The curvature of a videolaryngoscope blade has been diversified from the standard macintosh-type to the hyperacute-angle-type, resulting in different performances. We aimed to determine the intubation success rate and identify predictors of difficult intubation when using an intermediate-angled videolaryngoscope in the first attempt of intubation under routine anaesthesia settings. We enrolled 808 patients between 19 and 79 years of age, scheduled for elective surgeries under general anaesthesia with orotracheal intubation from July 2017 to November 2018; patients who were candidates for awake intubation were excluded. ⋯ The use of the UEScope demonstrated a 99.4% success rate for intubation; however, increased difficulties were observed in patients who were male, obese, had a short thyromental distance, limited mouth opening, and high upper-lip-bite test class. Despite the high intubation success rate using an intermediate-angled videolaryngoscope, we recommend preparing backup plans, considering the increased difficulty in patients with certain preoperative features. Clinical trial number and registry URL: Clinical Trials.gov Identifier: NCT03215823 (Date of registration: 12 July).
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J Clin Monit Comput · Aug 2022
Laboratory evaluation of performance of pulse oximeters from six different manufacturers during motion artifacts produced by Fluke 2XL SpO2 simulator.
We performed laboratory evaluation of six pulse oximeters from different manufacturers using the Fluke 2XL SpO2 simulator. The pulse oximeter probes were labeled 1 through 6 and tested using the two pre-programed preset functions of the Fluke 2XL SpO2 simulator, level 01 and level 02, for their performance in the presence of motion artifacts. The pulse oximeters were also tested at low perfusion index (PI) settings. ⋯ When probes were attached directly in the presence of motion artifacts, probes 2 and 6 performed well, whereas all other probes performed poorly. Successively lowering the PI degraded performance of probes 3, 4, and 5 at extremely low PI. It is observed that during motion and/or low PI conditions, multiple probes see deterioration in performance.
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J Clin Monit Comput · Aug 2022
Observational StudyMonitoring postoperative lung recovery using electrical impedance tomography in post anesthesia care unit: an observational study.
With electrical impedance tomography (EIT) recruitment and de-recruitment phenomena can be quantified and monitored at bedside. The aim was to examine the feasibility of EIT with respect to monitor atelectasis formation and resolution in the post anesthesia care unit (PACU). In this observational study, 107 postoperative patients were investigated regarding the presence and recovery of atelectasis described by the EIT-derived parameters Global Inhomogeneity Index (GI Index), tidal impedance variation (TIV), and the changes in end-expiratory lung impedance (ΔEELI). ⋯ Furthermore, TIV showed a significantly lower value during the first 90 min of PACU stay as compared to the time period thereafter (p = 0.036). Our findings demonstrate that obesity has an influence on intraoperative atelectasis formation and de-recruitment during PACU stay. The application of EIT in spontaneously breathing PACU patients seems meaningful in monitoring pulmonary recovery.