Journal of clinical monitoring and computing
-
J Clin Monit Comput · Jun 2022
Perfusion index as an objective measure of postoperative pain in children undergoing adenotonsillectomy: a cohort study.
Postoperative pain in children is usually undertreated because of their inability to complain. While several pain assessment scales have been developed, they have shortcomings such as subjectivity and being observer-dependent. This study aimed to assess the validity of the perfusion index as an objective measure of postoperative pain in children undergoing adenotonsillectomy. ⋯ The ΔPI-pre was an excellent predictor of postoperative pain (AUROC 0.83 with 71% sensitivity, 83% specificity, and a cut-off value of ≥ 0.26). The perfusion index is a good objective measure for predicting the presence of postoperative pain in children undergoing adenotonsillectomy under general anesthesia. Trial registration: ClinicalTrials.gov; ID: (NCT03854604) registered on February 2019.
-
J Clin Monit Comput · Jun 2022
Observational StudyAssociation of transcutaneous CO2 with respiratory support: a prospective double blind observational study in children with bronchiolitis and reactive airway disease.
The use of clinical scoring to assess for severity of respiratory distress and respiratory failure is challenging due to subjectivity and interrater variability. Transcutaneous Capnography (TcpCO2) can be used as an objective tool to assess a patient's ventilatory status. This study was designed to assess for any correlation of continuous monitoring of TcpCO2 with the respiratory clinical scores and deterioration in children admitted for acute respiratory distress. ⋯ No difference was found in bronchiolitis score or PEW score in subjects with normal and abnormal TcpCO2. A small but statistically significant increase in TcpCO2 was observed at the escalation of care. Even though odds of escalation of care are higher with abnormal TcpCO2 (OR 1.92), this difference did not reach statistical significance. pCO2 can provide additive information for non-invasive clinical monitoring of children requiring varying respiratory support; however, it does not provide predictive value for escalation or de-escalation of care.
-
J Clin Monit Comput · Jun 2022
Bayesian hierarchical modeling of operating room times for surgeries with few or no historic data.
In this work it is proposed a modeling for operating room times based on a Bayesian Hierarchical structure. Specifically, it is employed a Bayesian generalized linear mixed model with an additional hierarchical level on the random effects. This configuration allows the estimation of operating room times (ORT) with few or no historical observations, without requiring a prior surgeon's estimate. ⋯ We find that lognormal models outperform the gamma models in estimating upper prediction bounds (UB). Especially, the best ORT predictions for cases with few or no historical data (i.e., between 0 and 3 historical cases) are obtained with the [Formula: see text], SBeta2 model. With a deviation of less than 1% with respect to the nominal coverage of the upper bound predictions UB80% and UB90% and an average absolute percentage error of 38.5% in the point estimate.
-
J Clin Monit Comput · Jun 2022
Predicting the mortality risk of acute respiratory distress syndrome: radial basis function artificial neural network model versus logistic regression model.
To predict the mortality of acute respiratory distress syndrome (ARDS) by using a radial basis function (RBF) artificial neural network (ANN) model. This study included 217 patients who were admitted between June 2013 and November 2019. The RBF ANN model and logistic regression (LR) model were based on twelve factors related to ARDS. ⋯ LDH, organ failure, SP-D and PaO2/FiO2 were the most important independent variables. The RBF ANN model was more likely to predict the mortality of ARDS than the LR model. In addition, it can extract informative risk factors for ARDS.
-
J Clin Monit Comput · Jun 2022
Fire safety study on high-flow nasal oxygen in shared-airway surgeries with diathermy and laser: simulation based on a physical model.
High-flow nasal oxygen (HFNO) has been used in "tubeless" shared-airway surgeries but whether HFNO increased the fire hazard is yet to be examined. We used a physical model for simulation to explore fire safety through a series of ignition trials. An HFNO device was attached to a 3D-printed nose with nostrils connected to a degutted raw chicken. ⋯ The factors found to be related to a significantly increased chance of ignition included laser application, lower gas flow, and higher FiO2. The native tissue and smoke can ignite and turn into violent self-sustained fires under HFNO and continuous laser strikes, even in the absence of combustible materials. The results suggest that airway surgeries must be performed safely with HFNO if only a short intermittent laser is used in low FiO2.