Journal of clinical monitoring and computing
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J Clin Monit Comput · Oct 2023
Observational StudyEvaluation of the accuracy of oscillometric non-invasive blood pressure measurement at the ankle in children during general anesthesia.
This study aimed to evaluate the accuracy of oscillometric blood pressure measurement at the ankle in children using invasive blood pressure as reference standard. This prospective observational study included children undergoing noncardiac surgery. Paired radial invasive and ankle non-invasive blood pressure measurements were obtained. ⋯ The concordance rate of ankle blood pressure was 72%, 71%, and 77% for delta SBP, DBP and MAP, respectively. The AUC (95% confidence interval) for ankle MAP ability to detect hypotension was 0.91 (0.89-0.93) with negative predictive value of 100% at cut-off value ≤ 70 mmHg, We concluded that in pediatric population undergoing noncardiac surgery, ankle blood pressure was not interchangeable with the corresponding invasive readings with the ankle MAP having the least bias compared to SBP and DBP. An ankle MAP > 70 mmHg can exclude hypotension with negative predictive value of 100%.
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J Clin Monit Comput · Oct 2023
Observational StudyEarly detection of oliguric events in critically ill patients in the ICU with a novel continuous urine flow measurement device: results of an initial validation study.
Urine output is used to evaluate fluid status and is an important marker for acute kidney injury (AKI). Our primary aim was to validate a new automatic urine output monitoring device by comparison to the current practice - the standard urometer. ⋯ The Serenno Medical Automatic urine output measuring device required minimal supervision, little ICU nursing staff attention, and is sufficiently accurate and precise. In addition to providing continuous assessments of urine output, it was considerably more accurate than hourly nursing assessments.
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J Clin Monit Comput · Oct 2023
Reliability and reproducibility of the DICART device to assess capillary refill time: a bench and in-silico study.
Capillary refill time (CRT) is an important indicator of peripheral perfusion with a strong prognostic value, but it is sensitive to environmental factors and numerous measurement methods are reported in the litterature. DiCARTECH has developed a device that assesses CRT. We sought to investigate the robustness of the device and the reproducibility of the algorithm in a bench and in-silico study. ⋯ For the color-jitter modified video the coefficient of variation was 62% (95%CI: 55-70). We confirmed the ability of the DiCART™ II device to perform multiple measurements without mechanical or electronic dysfunction. The precision and reproducibility of the algorithm are compatible with the assessment of clinical small changes in CRT.
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J Clin Monit Comput · Oct 2023
Case ReportsNoninvasive neuromonitoring with rheoencephalography: a case report.
Cerebral blood flow (CBF) autoregulation (AR) can be monitored using invasive modalities, such as intracranial pressure (ICP) and arterial blood pressure (ABP) to calculate the CBF AR index (PRx). Monitoring PRx can reduce the extent of secondary brain damage in patients. Rheoencephalography (REG) is an FDA-approved non-invasive method to measure CBF. ⋯ REG pulse wave morphology changed from poor ICC to good ICC morphology. Bioimpedance recording made it possible to quantify the active/passive status of CBF AR, indicate the worsening of ICC, and present it in real time. REGx can be a suitable, non-invasive alternative to PRx for use in head-injured patients.
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J Clin Monit Comput · Oct 2023
Effects of tidal volume challenge on the reliability of plethysmography variability index in hepatobiliary and pancreatic surgeries: a prospective interventional study.
The plethysmography variability index (PVI) is a non-invasive, real-time, and automated parameter for evaluating fluid responsiveness, but it does not reliably predict fluid responsiveness during low tidal volume (VT) ventilation. We hypothesized that in a 'tidal volume challenge' with a transient increase in tidal volume from 6 to 8 ml Kg- 1, the changes in PVI could predict fluid responsiveness reliably. ⋯ In hepatobiliary and pancreatic surgeries, tidal volume challenge improves the reliability of PVI for predicting fluid responsiveness and changes in PVI values obtained after tidal volume challenge are comparable to the changes in SVI.