Journal of clinical monitoring and computing
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J Clin Monit Comput · Oct 2023
Observational StudyEchocardiographic hemodynamic assessment in decompensated cirrhosis: comparison between Intensivists and Gastroenterologists.
Ascites is a frequent complication of cirrhosis. In intensive care units, initial hemodynamic assessment is frequently performed by echocardiography. This study evaluated the feasibility and usefulness of early hemodynamic assessment in the gastroenterology ward. ⋯ NCT03650660.
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J Clin Monit Comput · Oct 2023
Intra-renal microcirculatory alterations on non-traumatic hemorrhagic shock induced acute kidney injury in pigs.
Acute kidney injury (AKI) is frequently seen in patients with hemorrhagic shock due to hypotension, tissue hypoxia, and inflammation despite adequate resuscitation. There is a lack of information concerning the alteration of renal microcirculation and perfusion during shock and resuscitation. The aim of this study was to investigate the possible role of renal microcirculatory alterations on development of renal dysfunction in a pig model of non-traumatic hemorrhagic shock (HS) induced AKI. ⋯ We also showed that total vessel density (TVD) and functional capillary density (FCD) were depleted during resuscitation (p < 0.05). In this study, we showed that the correction of systemic hemodynamic variables may not be accompanied with the improvement of renal cortical perfusion, intra-renal blood volume and renal damage following fluid resuscitation. We suggest that the measurement of renal injury biomarkers, systemic and renal microcirculation can be used for guiding to the optimization of fluid therapies.
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J Clin Monit Comput · Oct 2023
Randomized Controlled TrialBlood pressure control with phenylephrine or dobutamine: a randomized controlled trial comparing effects on cerebral and paravertebral tissue oxygen saturation measured with near-infrared spectroscopy.
Preserving haemodynamics is expected to positively affect tissue oxygen saturation. We hypothesized that maintaining mean arterial blood pressure (MAP) (using phenylephrine (PE) or dobutamine (Dobu)) would equally affect regional cerebral and paravertebral tissue saturation (rScO2 and rSpvO2, respectively). Thirty-four patients were randomly assigned to receive either PE or Dobu, in order to keep MAP within 20% of the preoperative value. ⋯ Current guidelines advocate maintaining adequate systemic blood pressures to prevent spinal cord ischaemia in specific procedures. However, it is still unknown which circulatory supportive drug is more beneficial for maintaining spinal cord perfusion. Our data indicates that, when used for maintenance of blood pressure within a 20% range of preoperative values, neither phenylephrine nor dobutamine affect paravertebral tissue saturation.
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J Clin Monit Comput · Oct 2023
Randomized Controlled TrialEffects of preoperative education using virtual reality on preoperative anxiety and information desire: a randomized clinical trial.
This study aimed to investigate the effect of preoperative education using virtual reality (VR) on preoperative anxiety and information desire. The participants were randomly assigned to the VR group and control group. The VR group received preoperative education using VR content describing preoperative and postoperative processes and their management, and the control group received preoperative education with traditional verbal education. ⋯ Preoperative education using VR effectively reduced preoperative anxiety and information desire. Trial registration CRIS, KCT0007489. Registered 30 June 2022. http://cris.nih.go.kr/cris/ .
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J Clin Monit Comput · Oct 2023
Software development to standardize the clinical diagnosis of exercise oscillatory ventilation in heart failure.
Exercise oscillatory ventilation (EOV) is characterized by periodic oscillations of minute ventilation during cardiopulmonary exercise testing (CPET). Despite its prognostic value in chronic heart failure (HF), its diagnosis is complex due to technical limitations. An easier and more accurate way of EOV identification can contribute to a better approach and clinical diagnosis. This study aims to describe a software development to standardize the EOV diagnosis from CPET's raw data in heart failure patients and test its reliability (intra- and inter-rater). ⋯ The present study proposes novel semi-automated software to detect EOV in HF, with high inter and intra-rater agreements. The software project and its tutorial are freely available for download.