Journal of clinical monitoring and computing
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J Clin Monit Comput · Oct 2021
Multi-model generalised predictive control for intravenous anaesthesia under inter-individual variability.
Inter-individual variability possesses a major challenge in the regulation of hypnosis in anesthesia. Understanding the variability towards anesthesia effect is expected to assist the design of controller for anesthesia regulation. However, such studies are still very scarce in the literature. ⋯ Both the parameters [Formula: see text] and [Formula: see text], which are unknown before anesthesia procedure, were found to be highly significant in contributing the uncertainty of BIS. Their range of variability must be considered during the design and evaluation of controller. A linear controller may be sufficient to tackle most of the variability since both [Formula: see text] and [Formula: see text] would be translated into process gain upon linearization.
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J Clin Monit Comput · Oct 2021
A new implementation of EN1839 method T mixture preparation to prepare calibration gas mixtures for anesthetic gas monitors.
In this study different mixtures from anesthetic liquids vapours in air and O2-sevoflurane/air, sevoflurane/O2 and isoflurane/O2-were prepared according to EN1839 method T. The gases mixtures were used to calibrate anesthetic gas monitors. The targeted concentrations (TCs) from sevoflurane and isoflurane in air and O2 were 0 vol%, 0.15 vol%, 0.7 vol%, 1 vol%, 1.5 vol%, 2.5 vol%, 5 vol%, 6 vol% and 8 vol%. ⋯ Full validation was performed to assure the suitability of the method for preparing gas mixtures to calibrate anesthetic gas monitors. Linearity, limit of detection (LOD), limit of quantification (LOQ), precision, method robustness and uncertainty of measurement results were evaluated in the validation study. The results indicated that the method is valid for the purpose of analysis.
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J Clin Monit Comput · Oct 2021
Randomized Controlled TrialEvaluation of the Integrated Pulmonary Index® during non-anesthesiologist sedation for percutaneous endoscopic gastrostomy.
Standard monitoring of heart rate, blood pressure and arterial oxygen saturation during endoscopy is recommended by current guidelines on procedural sedation. A number of studies indicated a reduction of hypoxic (art. oxygenation < 90% for > 15 s) and severe hypoxic events (art. oxygenation < 85%) by additional use of capnography. Therefore, U. ⋯ Sensitivity is good for most parameters, but specificity is poor. In conclusion, IPI can be a useful metric to assess respiratory status during propofol-sedation in PEG-placement. However, IPI was not superior to PetCO2 and apnea > 10 s.
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J Clin Monit Comput · Oct 2021
Estimation of pulse pressure variation and cardiac output in patients having major abdominal surgery: a comparison between a mobile application for snapshot pulse wave analysis and invasive pulse wave analysis.
Pulse pressure variation (PPV) and cardiac output (CO) can guide perioperative fluid management. Capstesia (Galenic App, Vitoria-Gasteiz, Spain) is a mobile application for snapshot pulse wave analysis (PWAsnap) and estimates PPV and CO using pulse wave analysis of a snapshot of the arterial blood pressure waveform displayed on any patient monitor. We evaluated the PPV and CO measurement performance of PWAsnap in adults having major abdominal surgery. ⋯ In adults having major abdominal surgery, PPVPWAsnap moderately agrees with PPVProAQT. The absolute and trending agreement between COPWAsnap with COProAQT is poor. Technical improvements are needed before PWAsnap can be recommended for hemodynamic monitoring.
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J Clin Monit Comput · Oct 2021
Observational StudyForeseeing postoperative pain in neurosurgical patients: pupillometry predicts postoperative pain ratings-an observational study.
Pupillary reflex dilation (PRD) is triggered by noxious stimuli and diminished by opioid administration. In the postoperative period, PRD has been shown to be correlated with pain reporting and a useful tool to guide opioid administration. In this study we assessed whether pupillary measurements taken before extubation were related with the patient's reported pain in the Post-Anesthesia Care Unit (PACU) using the Numerical Rating Scale (NRS). ⋯ We also found a negative correlation between pupil diameter and age (rS = - 0.42, P = 0.04). The statistically significant correlation between pre-extubation PPI scores and NRS scores, as well as between the pupillary diameter before tetanic stimulation and NRS scores suggest the possibility of titrating analgesia at the end of the intraoperative period based on individual responses. This could allow clinicians to identify the ideal remifentanil concentration for the postoperative period.