Journal of clinical monitoring and computing
-
J Clin Monit Comput · Nov 2024
Regional cerebral oxygen saturation in the healthy population of western Sichuan: a multicenter cross-sectional study.
Regional cerebral oxygen saturation (rSO2) may vary in healthy individuals with different characteristics. Therefore, this study aimed to explore rSO2 in a healthy population of western Sichuan. This cross-sectional study enrolled healthy volunteers from the Health Management Center and Inpatient Department of Ya'an People's Hospital, Ya'an Vocational and Technical College, Ya'an Geriatric University, and Liziping Yi Township in Shimian County, Ya'an City, Sichuan Province. ⋯ Pearson correlation analysis showed a significantly negative correlation of rSO2 with age, ethics, past illness, and body mass index (BMI) but a significantly positive correlation with head circumference and height (all P < 0.05). The rSO2 values in the left brain are significantly higher than in the right brain. Sex, ethnicity, age, BMI, and past illness are closely related to rSO2 values in the healthy population.
-
J Clin Monit Comput · Nov 2024
Association of early perioperative stroke after cardiothoracic surgery with intraoperative regional cerebral oxygenation using near-infrared spectroscopy: an observational cohort study comparing affected versus non-affected hemispheres.
Patients undergoing cardiothoracic surgery are at risk of developing perioperative stroke, but residual effects of anesthesia may hamper timely detection. This study aims to determine if there is an association between intraoperative regional cerebral oxygenation (ScO2) monitoring using near-infrared spectroscopy (NIRS) and the occurrence of early perioperative stroke within three days after cardiothoracic surgery. ⋯ The duration of ScO2 values < 50% or a drop > 20% from baseline were associated with the occurrence of early perioperative global cerebral ischemia within three days after cardiothoracic surgery.
-
J Clin Monit Comput · Nov 2024
Avatar-based versus conventional patient monitoring with distant vision: a computer-based simulation study.
Patient monitoring in the perioperative setting can be challenging, especially when monitoring multiple patients simultaneously or managing dynamic situations that require movement around the operating room. We aimed to evaluate whether avatar-based patient monitoring, which presents vital signs in the form of changing colors, shapes and motion, improves remote vital sign recognition compared to conventional monitoring. We conducted a prospective, single-center, computer-based simulation study to evaluate how anesthesia providers recognize vital signs when using the Philips Visual Patient Avatar at different viewing distances (8 and 16 m) compared to conventional monitoring. ⋯ The correct recognition rate using the Visual Patient Avatar compared to conventional monitoring at 8 m was increased by 74% (rate ratio 1.74, 95% CI, 1.42 to 2.14, p < 0.001) and by 51% at 16-meter viewing distance (rate ratio 1.51, 95% CI, 1.23 to 1.87, p < 0.001). We observed scenario-specific superior performance for six vital signs at 8 m. The results provide empirical evidence that avatar-based monitoring can significantly improve the perception of vital signs when using distant vision.
-
J Clin Monit Comput · Nov 2024
Characterization of the temporal profile of the antinociceptive effects of an intravenous bolus of ketamine using the analgesia nociception index in no-anesthetized adult patients.
An effect-site target-controlled infusion (TCI) would allow a more precise titration of intravenous analgesics effect. The analgesia nociception index (ANI) continuously monitors the analgesia/nociception balance during general anesthesia. This study aims to derive a PKPD model of ketamine antinociceptive effect using the Domino PK parameter set and the ANI response data in awake patients without other drugs affecting the ANI response. ⋯ Hysteresis was characterized, incorporating an estimated Keo of 0.238 (CI95% 0.20-0.28) min-1 to the described PK parameters set. The developed PKPD model, using Domino's PK parameters and the ANI response data, adequately characterized the temporal profile of ketamine's antinociceptive effect. The current estimated model parameters can be used to perform an effect-site TCI of ketamine for analgesic purposes.
-
J Clin Monit Comput · Nov 2024
EditorialNew sensors for the early detection of clinical deterioration on general wards and beyond - a clinician's perspective.
The early detection of clinical deterioration could be the next significant step in enhancing patient safety in general hospital wards. Most patients do not deteriorate suddenly; instead, their vital signs are often abnormal or trending towards an abnormal range hours before severe adverse events requiring rescue intervention and/or ICU transfer. To date, at least 10 large clinical studies have demonstrated a significant reduction in severe adverse events when heart rate, blood pressure, oxygen saturation and/or respiratory rate are continuously monitored on medical and surgical wards. ⋯ Wireless and wearable sensors are particularly valuable, as they make continuous monitoring feasible even for ambulatory patients, raising questions about the future relevance of "stay-in-bed" solutions like capnography, bed sensors, and video-monitoring systems. While the number of wearable sensors and mobile monitoring solutions is rapidly growing, independent validation studies on their sensitivity and specificity in detecting abnormal vital signs in actual patients, rather than healthy volunteers, remain limited. Additionally, further research is needed to evaluate the cost-effectiveness of using wireless wearables for vital sign monitoring both within hospital wards and at home.