Journal of clinical monitoring and computing
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J Clin Monit Comput · Feb 2024
Video plethysmography for contactless measurement of respiratory rate in surgical patients.
The accurate recording of respiratory rate (RR) without contact is important for patient care. The current methods for RR measurement such as capnography, pneumography, and plethysmography require patient contact, are cumbersome, or not accurate for widespread clinical use. Video Plethysmography (VPPG) is a novel automated technology that measures RR using a facial video without contact. ⋯ These results did not change with the ethnicity of patients. The success rate of the VPPG technology was 99.1%. Contactless RR monitoring of surgical patients at a hospital setting using VPPG is accurate and feasible, making this technology an attractive alternative to the current approaches to RR monitoring. Future developments should focus on improving reliability of the technology.
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J Clin Monit Comput · Feb 2024
Assessment of skin pigmentation-related bias in pulse oximetry readings among adults.
Recent reports that pulse oximeters may overestimate oxygen saturation in individuals with darker skin pigmentation have prompted concerns from regulatory authorities regarding racial bias. We investigated the performance of TruSignal SpO2 sensors (GE Healthcare, Helsinki, Finland) in adults with varying skin pigmentation. ⋯ TruSignal sensors demonstrated higher bias at lower oxygen saturation, with less than 0.5% difference between pigment groups. These findings raise new questions, such as ways to improve pulse oximetry measurements during challenging clinical conditions, including low perfusion.
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J Clin Monit Comput · Feb 2024
Separation of responsive and unresponsive patients under clinical conditions: comparison of symbolic transfer entropy and permutation entropy.
Electroencephalogram (EEG)-based monitoring during general anesthesia may help prevent harmful effects of high or low doses of general anesthetics. There is currently no convincing evidence in this regard for the proprietary algorithms of commercially available monitors. The purpose of this study was to investigate whether a more mechanism-based parameter of EEG analysis (symbolic transfer entropy, STE) can separate responsive from unresponsive patients better than a strictly probabilistic parameter (permutation entropy, PE) under clinical conditions. In this prospective single-center study, the EEG of 60 surgical ASA I-III patients was recorded perioperatively. ⋯ For the combination of LoR and RoR, values were 0.65 (0.59-0.71) for STE and 0.68 (0.62-0.74) for PE. The ability to differentiate between the clinical status of (un)responsiveness did not significantly differ between STE and PE at any time. Mechanism-based EEG analysis did not improve differentiation of responsive from unresponsive patients compared to the probabilistic PE. Trial registration: German Clinical Trials Register ID: DRKS00030562, November 4, 2022, retrospectively registered.
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J Clin Monit Comput · Feb 2024
Editorial Comment LetterClosing the loop: automation in anesthesiology is coming.
Anesthesiology and intensive care medicine provide fertile ground for innovation in automation, but to date we have only achieved preliminary studies in closed-loop intravenous drug administration. Anesthesiologists have yet to implement these tools on a large scale despite clear evidence that they outperform manual titration. ⋯ The aim is to decrease the error between the closed-loop controller's input and output. In this editorial we consider the available intravenous anesthesia closed-loop systems, try to clarify why they have not yet been implemented on a large scale, see what they offer, and propose the future steps towards automation in anesthesia.