Journal of clinical monitoring and computing
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J Clin Monit Comput · Oct 2021
Observational StudyA modified train-of-four ratio to assess recovery from depolarizing neuromuscular blockade after succinylcholine, a prospective observational study.
Succinylcholine is still used in clinical practice. Its duration is highly variable and neuromuscular monitoring is recommended to assess its recovery. Unfortunately, depolarizing neuromuscular block cannot be evaluated by train-of-four (TOF) as no fade occurs. ⋯ It was10.0 [8.0-13.0] min vs 10.0 [8.0-12.0] min, P = 0.307 and 10.0 [9.0-15.0] min vs 10.0 [8.0-15.0] min, P = 0.546; respectively; median [IQR]. Agreement between both parameters was excellent. The T4/Tref can be used accurately to measure recovery from depolarizing neuromuscular block.
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J Clin Monit Comput · Oct 2021
ReviewThe newborn infant parasympathetic evaluation in pediatric and neonatology: a literature review.
The Newborn Infant Parasympathetic Evaluation (NIPE) is a heart rate variability-based technology for assessing pain and comfort in neonates and infants under 2-years-old. This review aims to investigate the clinical utility of the NIPE. ⋯ The results regarding NIPE's performances differ between studies. Given the limited number of studies and the heterogeneous outcomes, more studies are required to confirm the NIPE usefulness in the different clinical settings.
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J Clin Monit Comput · Oct 2021
Trans-ocular brain impedance index for assessment of cerebral autoregulation in a porcine model of cerebral hemodynamic perturbation.
Cerebrovascular autoregulation (CA) is often impaired following traumatic brain injury. Established technologies and metrics used to assess CA are invasive and conducive for measurement, but not for continuous monitoring. We developed a trans-ocular brain impedance (TOBI) method that may provide non-invasive and continuous indices to assess CA. ⋯ Receiver operator curve test showed high predictive performance of DZx when compared to PRx with area under the curve above 0.86, with high sensitivity and specificity. Impedance indices appear to track changes in PRx and hemodynamics that affect cerebral autoregulation. TOBI may be a suitable less invasive surrogate to PRx and capable of tracking cerebral autoregulation.
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J Clin Monit Comput · Oct 2021
Iterative heuristic design of temporal graphic displays with clinical domain experts.
Conventional electronic health record information displays are not optimized for efficient information processing. Graphical displays that integrate patient information can improve information processing, especially in data-rich environments such as critical care. We propose an adaptable and reusable approach to patient information display with modular graphical components (widgets). ⋯ Participants stated graphical widgets would be used to identify correlating patterns and compare abnormal measures across related data elements at a specific time. Combining theoretical principles and validated design methods was an effective and reproducible approach to designing widgets for healthcare displays. The findings suggest our widget design features and recommendations match critical care clinician expectations for graphical information display of continuous and frequently updated patient data.
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J Clin Monit Comput · Oct 2021
Randomized Controlled TrialEffects of anesthetics on microvascular reactivity measured by vascular occlusion tests during off-pump coronary artery bypass surgery: a randomized controlled trial.
Microvascular function may be modulated by various anesthetics. Desflurane and propofol anesthesia have different effects on microvascular function. However, there are few reports on the effects of sevoflurane and desflurane on microvascular function during cardiac surgery. ⋯ Microvascular reactivity, as measured by the VOT during OPCAB, showed no difference between the sevoflurane and desflurane groups. Also, there were no group differences in macrohemodynamics or the rate of postoperative adverse events. TRIAL REGISTRATION : Clinicaltrials.gov, identifier NCT03209193; registered on July 3, 2017.