Journal of clinical monitoring and computing
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J Clin Monit Comput · Dec 2024
Clot formation risk in the clearing fluid after arterial catheter blood sampling: coagulation factors consumption over time - a prospective pilot study.
After blood sampling from an arterial catheter, the reinjection of the clearing fluid (a mixture of saline solution and blood) is proposed to limit blood loss. However, reinjecting clots may cause embolic complications. The primary objective was to assess fibrinogen consumption in the clearing fluid as an indicator of clot formation over time. ⋯ Unfractionated heparin anti-Xa activity was higher than 0.10 UI/ml in 17 (57%). Although no macroscopic clots were observed in the clearing fluid, its coagulation factors decreased over the 5 min following reservoir filling, indicating potential initiation of clot formation. Our findings stress the need for further studies assessing the safety of reinjecting clearing fluid as part of patient blood management.
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J Clin Monit Comput · Dec 2024
Capnodynamic determination of end-expiratory lung volume in a porcine model of hypoxic pulmonary vasoconstriction.
The capnodynamic method, End Expiratory Lung Volume CO2 (EELV-CO2), utilizes exhaled carbon dioxide analysis to estimate End-Expiratory Lung Volume (EELV) and has been validated in both normal lungs and lung injury models. Its performance under systemic hypoxia and variations in CO2 elimination is not examined. This study aims to validate EELV-CO2 against inert gas wash in/wash out (EELV- SF6, sulfur hexafluoride) in a porcine model of stable hemodynamic conditions followed by hypoxic pulmonary vasoconstriction and inhaled nitric oxide (iNO). ⋯ EELV-CO2 generates absolute values in parallel with EELV -SF6. Stressing EELV-CO2 with hypoxic pulmonary vasoconstriction and iNO, transiently impairs the agreement which stabilizes once normoxemia is reestablished.
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J Clin Monit Comput · Dec 2024
Electrical cardiometry for non-invasive cardiac output monitoring: a method comparison study in patients after coronary artery bypass graft surgery.
Cardiac output can be estimated non-invasively by electrical cardiometry with the ICON® monitor (Osypka Medical GmbH, Berlin, Germany). Conflicting results have been reported regarding the cardiac output measurement performance of electrical cardiometry. In this prospective method comparison study, we compared cardiac output measured using electrical cardiometry (EC-CO; test method) with cardiac output measured using intermittent pulmonary artery thermodilution (PATD-CO; reference method) in patients after coronary artery bypass graft (CABG) surgery. ⋯ The concordance rate for cardiac output changes was 48%. In this study, the agreement between EC-CO and PATD-CO was not clinically acceptable in patients after CABG surgery. The trending ability of EC-CO was poor.
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J Clin Monit Comput · Dec 2024
Relationship between the amplitudes of cerebral blood flow velocity and intracranial pressure using linear and non-linear approach.
Intracranial pressure (ICP), cerebral blood flow and volume are affected by craniospinal elasticity and cerebrospinal fluid dynamics, interacting in complex, nonlinear ways. Traumatic brain injury (TBI) may significantly alter this relationship. This retrospective study investigated the relationship between the vascular and parenchymal intracranial compartments by analysing two amplitudes: cerebral blood flow velocity (AmpCBFV) and ICP (AMP) during hypocapnia manoeuvre in TBI patients. ⋯ The relative frequency of symmetrical word types (JSAsym) describing the AmpCBFV-AMP interaction decreased during hypocapnia (0.35 ± 0.30) compared to baseline (0.44 ± 0.030; p = 0.004). Our results indicate that while the grouped-averaged AmpCBFV and AMP were not significantly correlated, either at baseline or during hypocapnia, significant changes were observed when using RAMP and JSA indices. Further validation of these new parameters, which reflect the association between the vascular and parenchymal intracranial compartments, is needed in a larger cohort.