Journal of clinical monitoring and computing
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J Clin Monit Comput · Dec 2024
Letter Case ReportsProne-position decreases airway closure in a patient with ARDS undergoing venovenous extracorporeal membrane oxygenation.
Airway closure is a interruption of communication between larger and smaller airways. The presence of airway closure during mechanical ventilation may lead to the overestimation of driving pressure (DP), introducing errors in the assessment of respiratory mechanics and in positive end-expiratory pressure (PEEP) setting on the ventilator. Patients with severe acute respiratory distress syndrome (ARDS) may exhibit the airway closure phenomenon, which can be easily diagnosed with a low-flow inflation. Prone positioning is a therapeutic manoeuver proven to reduce mortality in ARDS patients, and has been widely implemented also in patients requiring veno-venous extracorporeal membrane oxygenation (V-V ECMO). To date, the impact of prone positioning on changes in airway closure has not been described. ⋯ Prone positioning reduced airway closure in an ARDS patient on VV ECMO support.
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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.
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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.
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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.