Journal of clinical monitoring and computing
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J Clin Monit Comput · Feb 2021
A brief airway occlusion is sufficient to measure the patient's inspiratory effort/electrical activity of the diaphragm index (PEI).
Pressure generated by patient's inspiratory muscles (Pmus) during assisted mechanical ventilation is of significant relevance. However, Pmus is not commonly measured since an esophageal balloon catheter is required. We have previously shown that Pmus can be estimated by measuring the electrical activity of the diaphragm (EAdi) through the Pmus/EAdi index (PEI). ⋯ After correcting the error bias, the PEI0.2 percentage error was lower than ± 30% in all but one subjects (range - 39 to + 29%). It is possible to calculate PEI over a brief airway occlusion of 200 ms at inspiratory onset without the need for a full patient's inspiratory effort. Automated and repeated brief airway occlusions performed by the ventilator can provide a real time measurement of PEI; combining the automatically measured PEI with the EAdi trace could be used to continuously display the Pmus waveform at the bedside without the need of an esophageal balloon catheter.
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J Clin Monit Comput · Feb 2021
Increase in regional cerebral saturation after elective electrical cardioversion of atrial fibrillation is only transient and without beneficial effects on neuropsychological functioning: cerebral saturation during electrical cardioversion.
We aimed to confirm the positive association between a successful electrical cardioversion (ECV) and increase in SctO2 and investigated whether this increase is persisting or not. Secondary, the influence of a successful ECV on the neuropsychological function and the association with SctO2 was assessed as well. SctO2 was measured continuously during elective ECV using near-infrared spectroscopy. ⋯ A transient, instant SctO2 increase was observed after successful ECV. This temporary increase in SctO2 did not influence the neuropsychological functioning of the patients. Though, the quality of life of patients with a successful ECV improved.
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J Clin Monit Comput · Feb 2021
Review Meta AnalysisAccuracy and precision of zero-heat-flux temperature measurements with the 3M™ Bair Hugger™ Temperature Monitoring System: a systematic review and meta-analysis.
Zero-heat-flux thermometers provide clinicians with the ability to continuously and non-invasively monitor body temperature. These devices are increasingly being used to substitute for more invasive core temperature measurements during surgery and in critical care. The aim of this review was to determine the accuracy and precision of zero-heat-flux temperature measurements from the 3M™ Bair Hugger™ Temperature Monitoring System. ⋯ The range of uncertainty in the accuracy of a thermometer should be taken into account when using this device to inform clinical decision-making. Clinicians should therefore consider the potential that a temperature measurement from a 3M™ Bair Hugger™ Temperature Monitoring System could be as much as 1 °C higher or lower than core temperature. Use of this device may not be appropriate in situations where a difference in temperature of less than 1 °C is important to detect.
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From home to intensive care units, innovations in pulse oximetry are susceptible to improve the monitoring and management of patients developing acute respiratory failure, and particularly those with the coronavirus disease 2019 (COVID-19). They include self-monitoring of oxygen saturation (SpO2) from home, continuous wireless SpO2 monitoring on hospital wards, and the integration of SpO2 as the input variable for closed-loop oxygen administration systems. The analysis of the pulse oximetry waveform may help to quantify respiratory efforts and prevent intubation delays. Tracking changes in the peripheral perfusion index during a preload-modifying maneuver may be useful to predict preload responsiveness and rationalize fluid therapy.
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J Clin Monit Comput · Feb 2021
Randomized Controlled TrialLow-dose droperidol suppresses transcranial electrical motor-evoked potential amplitude: a retrospective study.
Low-dose droperidol has been widely used as an antiemetic during and after surgery. Although high-dose droperidol affects motor-evoked potential, the effects of low-dose droperidol on motor-evoked potential amplitude are unclear. The aim of this study was to investigate whether low-dose droperidol affects motor-evoked potential amplitude. ⋯ Motor-evoked potential amplitude was suppressed by low-dose droperidol. During intraoperative motor-evoked potential monitoring in spine surgery, anesthesiologists should pay careful attention to the timing of administration of droperidol, even at low doses. Based on the results of this study, we are conducting a randomized controlled trial.