Journal of clinical monitoring and computing
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J Clin Monit Comput · Dec 2024
ReviewAutomated and reference methods for the calculation of left ventricular outflow tract velocity time integral or ejection fraction by non-cardiologists: a systematic review on the agreement of the two methods.
Echocardiography is crucial for evaluating patients at risk of clinical deterioration. Left ventricular ejection fraction (LVEF) and velocity time integral (VTI) aid in diagnosing shock, but bedside calculations can be time-consuming and prone to variability. Artificial intelligence technology shows promise in providing assistance to clinicians performing point-of-care echocardiography. ⋯ The accuracy and precision of these automated methods should be considered within the clinical context and decision-making. Such variability could be acceptable, especially in the hands of trained operators. PROSPERO number CRD42024564868.
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J Clin Monit Comput · Dec 2024
Noninvasive estimation of PaCO2 from volumetric capnography in animals with injured lungs: an Artificial Intelligence approach.
To investigate the feasibility of non-invasively estimating the arterial partial pressure of carbon dioxide (PaCO2) using a computational Adaptive Neuro-Fuzzy Inference System (ANFIS) model fed by noninvasive volumetric capnography (VCap) parameters. In 14 lung-lavaged pigs, we continuously measured PaCO2 with an optical intravascular catheter and VCap on a breath-by-breath basis. Animals were mechanically ventilated with fixed settings and subjected to 0 to 22 cmH2O of positive end-expiratory pressure steps. ⋯ The Bland-Altman plot performed in 10 independent tested ANFIS models showed a mean bias between reference and estimated PaCO2 of 0.03 ± 0.03 mmHg, with limits of agreement of 2.25 ± 0.42 mmHg, and a root mean square error of 1.15 ± 0.06 mmHg. A good trending ability was confirmed by four quadrant and polar plots concordance indexes of 95.5% and 94.3%, respectively. In an animal lung injury model, the Adaptive Neuro-Fuzzy Inference System model fed by noninvasive volumetric capnography parameters can estimate PaCO2 with high accuracy, acceptable precision, and good trending ability.
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J Clin Monit Comput · Dec 2024
Entropy of difference works similarly to permutation entropy for the assessment of anesthesia and sleep EEG despite the lower computational effort.
EEG monitoring during anesthesia or for diagnosing sleep disorders is a common standard. Different approaches for measuring the important information of this biosignal are used. The most often and efficient one for entropic parameters is permutation entropy as it can distinguish the vigilance states in the different settings. ⋯ The distinguishing of the vigilance states between both measures is similar as the AUC values for the classification do not differ significantly. As the runtimes for the entropy of difference are smaller than for the permutation entropy, even though the performance stays the same, we state the entropy of difference could be a useful method for analyzing EEG data. Higher orders of entropic features may also be investigated better and more easily.
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J Clin Monit Comput · Dec 2024
Rapid non-invasive measurement of mitochondrial oxygen tension after microneedle pre-treatment: a feasibility study in human volunteers.
Mitochondrial oxygen tension (MitoPO2) is a promising novel non-invasive bedside marker of circulatory shock and is associated with organ failure. The measurement of mitoPO2 requires the topical application of 5-aminolevulinc acid (ALA) to induce sufficient concentrations of the fluorescent protein protoporphyrin-IX within (epi)dermal cells. Currently, its clinical potential in guiding resuscitation therapies is limited by the long induction time prior to obtaining a reliable measurement signal. ⋯ We demonstrate that pre-treatment with microneedling before topical application of 5-aminolevulinic acid enables obtaining a reliable and accurate mitoPO2 signal at least an hour faster than on untreated skin in our population of human volunteers. This potentially increases the applicability of mitoPO2 measurements in acute settings. Trial registration number: R21.106 (01-01-2022).
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J Clin Monit Comput · Dec 2024
ReviewElectroencephalogram monitoring during anesthesia and critical care: a guide for the clinician.
Perioperative anesthetic, surgical and critical careinterventions can affect brain physiology and overall brain health. The clinical utility of electroencephalogram (EEG) monitoring in anesthesia and intensive care settings is multifaceted, offering critical insights into the level of consciousness and depth of anesthesia, facilitating the titration of anesthetic doses, and enabling the detection of ischemic events and epileptic activity. ⋯ This review provides a comprehensive overview of the fundamental principles of electroencephalography, including the foundations of processed and quantitative electroencephalography. It further explores the characteristic EEG signatures associated wtih anesthetic drugs, the interpretation of the EEG data during anesthesia, and the broader clinical benefits and applications of EEG monitoring in both anesthetic practice and intensive care environments.