Journal of clinical monitoring and computing
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J Clin Monit Comput · Oct 2024
Predictive value of TCCD and regional cerebral oxygen saturation for detecting early postoperative brain injury.
This study aims to analyze the risk factors for early postoperative brain injury in patients undergoing cardiovascular surgery and explore the predictive value of transcranial color Doppler (TCCD) and regional cerebral oxygen saturation (rSO2) for detecting early postoperative brain injury in cardiovascular surgery patients. ⋯ The decreased rSO2 and cerebral blood flow levels, aorta occlusion time, and history of atrial fibrillation were independent risk factors for early postoperative brain injury. TCCD and rSO2 could effectively monitor brain metabolism and cerebral blood flow and predict early postoperative brain injury.
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J Clin Monit Comput · Oct 2024
Relationship between preinduction electroencephalogram patterns and propofol sensitivity in adult patients.
To determine the precise induction dose, an objective assessment of individual propofol sensitivity is necessary. This study aimed to investigate whether preinduction electroencephalogram (EEG) data are useful in determining the optimal propofol dose for the induction of general anesthesia in healthy adult patients. ⋯ Preinduction EEG, particularly relative delta power, is associated with propofol requirements during the induction of general anesthesia. The utilization of preinduction EEG data may improve the precision of induction dose selection for individuals.
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Prediction and avoidance of intraoperative hypotension (IOH) can lead to less postoperative morbidity. Machine learning (ML) is increasingly being applied to predict IOH. We hypothesize that incorporating demographic and physiological features in an ML model will improve the performance of IOH prediction. ⋯ The multivariate model yielded average AUC = 0.97 in the static context of a single prediction made up to 8 min before a possible IOH event, and it outperformed a univariate model based on MAP-only (average AUC = 0.83). The MMV model demonstrated AUC = 0.96, PPV = 0.89, and NPV = 0.98 within the challenging context of a dynamic sliding window across 40 min prior to a possible IOH event. We present a novel ML model to predict IOH with a distinctive "dial" on sensitivity and specificity to predict first IOH episode during liver resection surgeries.
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J Clin Monit Comput · Sep 2024
An accelerometry and gyroscopy-based system for detecting swallowing and coughing events.
Measuring spontaneous swallowing frequencies (SSF), coughing frequencies (CF), and the temporal relationships between swallowing and coughing in patients could provide valuable clinical insights into swallowing function, dysphagia, and the risk of pneumonia development. Medical technology with these capabilities has potential applications in hospital settings. In the management of intensive care unit (ICU) patients, monitoring SSF and CF could contribute to predictive models for successful weaning from ventilatory support, extubation, or tracheal decannulation. ⋯ SSF, CF and the temporal relationship between swallowing and coughing are parameters that could have value as predictive tools for diagnosis and therapeutic guidance. Based on 2 tri-axial accelerometry and gyroscopic sensors, a model was developed with an acceptable sensitivity and precision for the detection of swallowing and coughing movements. Also due to simplicity and robustness of the set-up, the model is promising for further scientific research in a wide range of clinical indications.
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J Clin Monit Comput · Sep 2024
Left ventricular end-diastolic pressure response to spinal anaesthesia in euvolaemic vascular surgery patients.
Regional anaesthesia techniques provide highly effective alternative to general anaesthesia. Existing evidence on the effect of spinal anaesthesia (SA) on cardiac diastolic function is scarce. This study aimed to evaluate the effects of a single-injection, low-dose SA on left ventricular end-diastolic pressures (LVEDP) using echocardiography in euvolaemic patients undergoing elective vascular surgery. ⋯ This study in euvolaemic patients undergoing elective vascular surgery provides evidence that SA improved LVEDP.