Journal of clinical monitoring and computing
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J Clin Monit Comput · Dec 2021
Observational StudyPrognostic value and time course evolution left ventricular global longitudinal strain in septic shock: an exploratory prospective study.
Our main objective was to describe the course of GLS during the first days of septic shock and to assess the agreement between GLS values and longitudinal strain measured in apical four chambers. A prospective observational single centre study was conducted at the Nimes University Hospital's ICU. All patients admitted for a diagnosis of septic shock without pre-existing heart disease were eligible. ⋯ Based on the Bland and Altman method, the mean of differences for T1 exams was 0.1 (95% CI [- 0.6; 0.8]) with limits of agreement ranging from - 4 to 4. Myocardial strain is depressed at the early phase of septic shock and improves over time. A single measurement of LS4C view appears sufficient at bedside.
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J Clin Monit Comput · Dec 2021
A systematic review of invasive, high-fidelity pressure studies documenting the amplification of blood pressure from the aorta to the brachial and radial arteries.
It is commonly accepted that systolic blood pressure (SBP) is significantly higher in the brachial/radial artery than in the aorta while mean (MBP) and diastolic (DBP) pressures remain unchanged. This may have implications for outcome studies and for non-invasive devices calibration. We performed a systematic review of invasive high-fidelity pressure studies documenting BP in the aorta and brachial/radial artery. ⋯ Further studies on SPAmp phenotypes (positive, null, negative) are advocated. Non-invasive device calibration assumptions were confirmed, namely unchanged MBP and DBP from the aorta to the brachial artery. Data did not allow for firm conclusions on the amount of BP changes from the aorta to the radial artery, and from the aorta to the brachial/radial arteries in other populations.
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J Clin Monit Comput · Dec 2021
Non-contact thermography-based respiratory rate monitoring in a post-anesthetic care unit.
In patients at high risk of respiratory complications, pulse oximetry may not adequately detect hypoventilation events. Previous studies have proposed using thermography, which relies on infrared imaging, to measure respiratory rate (RR). These systems lack support from real-world feasibility testing for widespread acceptance. ⋯ Limits of agreement analysis revealed a bias of 1.3 and limits of agreement of 10.8 (95% confidence interval 9.07 to 12.5) and - 8.13 (- 6.41 to - 9.84) between direct measurements and bioimpedance, and a bias of -0.139 and limits of agreement of 2.65 (2.14 to 3.15) and - 2.92 (- 2.41 to 3.42) between direct measurements and thermography. Thermography allowed tracking of the manually measured RR in the post-anesthesia recovery unit without requiring patient contact. Additional work is required for image acquisition automation and nostril identification.
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J Clin Monit Comput · Dec 2021
Train-of-four monitoring with the twitchview monitor electctromyograph compared to the GE NMT electromyograph and manual palpation.
The purpose of this study was to compare train-of-four count and ratio measurements with the GE electromyograph to the TwitchView electromyograph, that was previously validated against mechanomography, and to palpation of train-of-four count. Electrodes for both monitors were applied to the same arm of patients undergoing an unrestricted general anesthetic. Train-of-four measurements were performed with both monitors approximately every 5 min. ⋯ For 7% of data pairs, the GE monitor train-of-four count was 4 when the palpation count was 0. The GE electromyograph may overestimate the train-of-four count and ratio. The GE electromyograph frequently reported 4 twitches when none were actually present due to misinterpretation of artifacts.
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J Clin Monit Comput · Dec 2021
Artifact reduction by using alternating polarity stimulus pairs in intraoperative peripheral nerve action potential recording.
Intraoperative nerve action potential (NAP) recording permits direct study of an injured nerve for functional assessment of lesions in continuity. Stimulus artifact contamination often hampers NAP recording and interferes with its interpretation. In the present study, we evaluated the artifact reduction method using alternating polarity in peripheral nerve recording. ⋯ Finally, we applied the method during nerve inching and demonstrated its usefulness in intraoperative NAP recordings as the method made the recording more resilient to short conduction distances. Thus, our findings demonstrate that this artifact reduction method can be used as a supplemental tool together with our previously described bridge grounding technique or the nonlifting nerve recording configuration to further improve intraoperative peripheral nerve recording. The method can be applied in clinical settings.