Journal of clinical monitoring and computing
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J Clin Monit Comput · Oct 2024
Clinical evaluation of a smart wristband for monitoring oxygen saturation, pulse rate, and respiratory rate.
Recently, photoplethysmography-based vital parameter measurements have increased in popularity. However, clinical evaluation of these measurements is lacking. The objective of this study was to rigorously evaluate the clinical accuracy and reliability of a novel photoplethysmography-based wristband for measuring key vital parameters-oxygen saturation (SpO2), respiratory rate (RR), and pulse rate (PR)-during heart catheterisations. ⋯ This study shows that photoplethysmography-based SpO2, RR, and PR measurements can be accurate during heart catheterisations. Future investigations are required to evaluate the wristband's performance under dynamic circumstances as well as over an extended time period. Trial registration: www.clinicaltrials.gov, NCT05566886.
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J Clin Monit Comput · Oct 2024
ReviewWearable devices as part of postoperative early warning score systems: a scoping review.
Postoperative deterioration is often preceded by abnormalities in vital parameters, but limited resources prevent their continuous monitoring in patients with no indication to ICU admission. The development of new technologies allowed the introduction of wearable devices (WDs), enabling the possibility of postoperative monitoring in surgical wards. We performed a Scoping Review to determine the current use of wearable devices as part of Continuous Remote Early Warning Score (CREWS) systems and their efficiency during postoperative period. ⋯ Furthermore, with the aid of other technologies (LoRa and Artificial Intelligence), they shorten Length of Stay (LOS) and reduce the number of ICU admissions with a reduction in healthcare costs. Continuous monitoring in surgical departments can facilitate the correct and timely identification of postoperative complications. This article is a starting point for the development of new protocols and for the application of these monitoring systems in clinical practice.
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J Clin Monit Comput · Oct 2024
Evaluation of a low-cost portable NIRS device for monitoring muscle ischemia.
The main objective of this study is to evaluate the low-cost, open-source HEGduino device as a tissue oximetry monitor to advance the research of somatic NIRS monitoring. Specifically, this study analyzes the use of this portable functional NIRS system for detecting the cessation of blood flow due to vascular occlusion in an upper limb. 19 healthy patients aged between 25 and 50 were recruited and monitored using HEGduino device. Participants underwent a vascular occlusion test on one forearm. ⋯ Furthermore, the difference between the normalized baseline values recorded by the infrared led (IR) and the corresponding normalized minimum value was also different from zero (p < 0.001). The R-squared coefficient of determination for the noise variables considered in this study on the normalized RED and IR values was 0.08 and 0.105, respectively. The study confirms the potential of HEGduino system to detect an interruption of the blood flow by means of variations in regional tissue oxygen saturation. This study demonstrates the potential of the HEGduino device as a monitoring alternative to advance the study of the applicability of NIRS in muscle tissue oximetry.
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J Clin Monit Comput · Oct 2024
Vasoconstriction with phenylephrine increases cardiac output in preload dependent patients.
General Anaesthesia (GA) is accompanied by a marked decrease in sympathetic outflow and thus loss of vasomotor control of cardiac preload. The use of vasoconstriction during GA has mainly focused on maintaining blood pressure. Phenylephrine (PE) is a pure α1-agonist without inotropic effects widely used to correct intraoperative hypotension. ⋯ During PE-infusion SVV was reduced to 6 ± 3%, CI increased to 2,6 ± 0,5 L/min*m2, and SVI increased to 49 ± 11mL/m2. All differences p < 0,001. In conclusion: Infusion of phenylephrine during preload dependency increased venous return abolishing preload dependency as evaluated by SVV and increased cardiac stroke volume and -output as measured by indicator-dilution technique. (ClinicalTrials.gov NCT05193097).
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J Clin Monit Comput · Oct 2024
Observational StudyCentral venous pressure waveform analysis during sleep/rest: a novel approach to enhance intensive care unit post-extubation monitoring of extubation failure.
This pilot study aimed to investigate the relation between cardio-respiratory parameters derived from Central Venous Pressure (CVP) waveform and Extubation Failure (EF) in mechanically ventilated ICU patients during post-extubation period. This study also proposes a new methodology for analysing these parameters during rest/sleep periods to try to improve the identification of EF. We conducted a prospective observational study, computing CVP-derived parameters including breathing effort, spectral analyses, and entropy in twenty critically ill patients post-extubation. ⋯ We also identified a possible improvement in the differentiation between the two groups of patients when assessed during rest/sleep states. Although with caveats regarding the sample size, the results of this pilot study may suggest that CVP-derived cardio-respiratory parameters are valuable for monitoring respiratory failure during post-extubation, which could aid in managing non-invasive interventions and possibly reduce the incidence of EF. Our findings also indicate the possible importance of considering sleep/rest state when assessing cardio-respiratory parameters, which could enhance respiratory failure detection/monitoring.