Journal of clinical monitoring and computing
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J Clin Monit Comput · Jun 2023
Benefits of secretion clearance with high frequency percussive ventilation in tracheostomized critically ill patients: a pilot study.
Clearance of secretions remains a challenge in ventilated patients. Despite high-frequency percussive ventilation (HFPV) showing benefits in patients with cystic fibrosis and neuromuscular disorders, very little is known about its effects on other patient categories. Therefore, we designed a physiological pilot study investigating the effects on lung aeration and gas exchange of short HFPV cycles in tracheostomized patients undergoing mechanical ventilation. ⋯ The ratio between arterial partial pressure and inspired fraction of oxygen (PaO2/FiO2) also increased after the treatment (p < 0.001 for all comparison) whereas TIV (p = 0.132) and GI (p = 0.114) remained unchanged. Short cycles of HFPV superimposed to mechanical ventilation promoted alveolar recruitment, as suggested by improved ∆EELI, and improved oxygenation in tracheostomized patients with high load of secretion. Trial Registration Prospectively registered on www.clinicaltrials.gov (NCT05200507; dated 6th January 2022).
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J Clin Monit Comput · Jun 2023
Feasibility and optimal choice of stimulation parameters for supramaximal stimulation of motor evoked potentials.
The aim was to investigate the feasibility and optimal stimulation parameters for supramaximal stimulation of muscle recorded transcranial electrical stimulation motor evoked potentials (mTc-MEP). ⋯ We recommend using setting 1 when monitoring mTc-MEPs with supramaximal stimulation, after which an individualized ISI optimization can be performed. Moreover, when using supramaximal stimulation, short ISI's (i.e. 1ms or 1.5ms) can be the optimal ISI for obtaining the highest mTc-MEP amplitude.
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J Clin Monit Comput · Jun 2023
Stomach, liver, kidney and skeletal muscle autoregulation evaluated by near-infrared spectroscopy in a swine model.
Different organs have different autoregulatory capacities for blood pressure changes and/or circulatory volume changes. This study assessed the autoregulation of the stomach, liver, kidney and skeletal muscle, under baseline, hypovolemic, and post-fluid-resuscitation conditions using near-infrared spectroscopy (NIRS). ⋯ In our NIRS-based assessment of autoregulatory capacity, the liver oxygenation is highly blood pressure dependent, and the kidney is highly susceptible and the skeletal muscle is highly tolerable to low blood pressure and volume loss.
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J Clin Monit Comput · Jun 2023
LetterNormalization of low frontal regional cerebral oxygenation after evacuation of chronic subdural hematoma in a patient with bilateral internal carotid artery stenosis.
Near infrared spectroscopy (NIRS) technology is frequently used to measure regional cerebral tissue oxygen saturation (rSO2). The measurement of rSO2 has diverse range of clinical application for its easy bed-side applicability, continuous monitoring, interpretation and valuable information on cerebral oxygenation. However, it also has few technical limitations; absorption by skull tissues, presence of hematomas, and other pigments such as melanin, bilirubin can affect the rSO2 measurements and thus interfere with the accuracy of monitoring. We report a case wherein low values of frontal rSO2 normalized after evacuation of bilateral fronto-temporo-parietal (FTP) chronic subdural hematoma (CSDH) in a patient with bilateral internal carotid artery (ICA) stenosis.