Journal of clinical monitoring and computing
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J Clin Monit Comput · Dec 2023
True intratracheal oxygen concentration delivered by SentriO Oxy™ masks under various respiratory conditions: a bench study.
SentriO Oxy™ is a newly available, Food and Drug Administration-approved oxygenation mask system that provides high oxygenation, even on low-flow (5-10 L/min) oxygen. This study aimed to accurately measure the intratracheal fraction of inspired oxygen (FiO2) using SentriO Oxy™ masks under relatively low oxygen flow rates. A manikin-ventilator-test lung simulation system was used. ⋯ In addition, using linear regression analysis, we found that TV, RR, and oxygen flow were all significant factors influencing the measured FiO2. Our experiment proposed two prediction equations considering the oxygen flow rate, TV, and RR. The results of our study may provide information and prediction of FiO2 for clinicians to use SentriO Oxy™ masks during sedative anesthetic procedures under low oxygen flow rates.
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J Clin Monit Comput · Dec 2023
Observational StudyCapnodynamic monitoring of lung volume and pulmonary blood flow during alveolar recruitment: a prospective observational study in postoperative cardiac patients.
Alveolar recruitment manoeuvres may mitigate ventilation and perfusion mismatch after cardiac surgery. Monitoring the efficacy of recruitment manoeuvres should provide concurrent information on pulmonary and cardiac changes. This study in postoperative cardiac patients applied capnodynamic monitoring of changes in end-expiratory lung volume and effective pulmonary blood flow. ⋯ Changes in oxygen delivery index after lung recruitment were correlated to changes in end-expiratory lung volume (r = 0.39, 95% CI 0.16-0.59, p = 0.002) and effective pulmonary blood flow (r = 0.60, 95% CI 0.41-0.74, p < 0.001). Capnodynamic monitoring of end-expiratory lung volume and effective pulmonary blood flow early in postoperative cardiac patients identified a characteristic parallel increase in both lung volume and perfusion after the recruitment manoeuvre in patients with a significant increase in oxygen delivery. Trial registration This study was registered on ClinicalTrials.gov (NCT05082168, 18th of October 2021).
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J Clin Monit Comput · Dec 2023
Observational StudyInternal jugular vein collapsibility does not predict fluid responsiveness in spontaneously breathing patients after cardiac surgery.
The objective of our study was to evaluate the diagnostic accuracy of internal jugular vein (IJV) collapsibility as a predictor of fluid responsiveness in spontaneously breathing patients after cardiac surgery. ⋯ In spontaneously breathing patients after surgical coronary revascularisation, collapsibility of the internal jugular vein did not predict fluid responsiveness.
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J Clin Monit Comput · Dec 2023
Oxygen Reserve Index and Arterial Partial Pressure of Oxygen: Relationship in Open Heart Surgery.
Mild to moderate hyperoxia is potentially beneficial to patients undergoing open heart surgery. Oxygen Reserve Index (ORI) is a novel parameter that correlates to arterial oxygen tension (PaO2) in the hyperoxic range. This prospective study aimed to assess whether the relationship between ORI and PaO2 remains intact in the setting of open-heart surgery. ⋯ The preserved relationship between ORI and PaO2 in the mild and moderate hyperoxic range can allow more precise titration of oxygen therapy to guide therapy targeting normoxia, mildly and moderately hyperoxia. Additionally, it could have a potential use as an early warning system for impeding hypoxia.
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Global pandemic due to COVID-19 has increased the interest for ventilators´ use worldwide. New devices have been developed and older ones have undergone a renewed interest, but we lack robust evidence about performance of each ventilator to match appropriate device to a given patient and care environment. The aim of this bench study was to investigate the performance of six devices for noninvasive ventilation, and to compare them in terms of volume delivered, trigger response, pressurization capacity and synchronization in volume assisted controlled and pressure support ventilation. ⋯ In general, Philips Trilogy Evo/EV300 and Hamilton C3 showed the best results. NIV devices successfully compensate air leaks but still underperform with low muscle effort and obstructive lungs. Clinicians´ must have a clear understanding of the goals of NIV both for devices´ choice and set main parameters to achieve therapy success.