Journal of clinical monitoring and computing
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J Clin Monit Comput · Jun 2020
Comparative StudyThe value of a superior vena cava collapsibility index measured with a miniaturized transoesophageal monoplane continuous echocardiography probe to predict fluid responsiveness compared to stroke volume variations in open major vascular surgery: a prospective cohort study.
Superior vena cava collapsibility index (SVC-CI) and stroke volume variation (SVV) have been shown to predict fluid responsiveness. SVC-CI has been validated only with conventional transoesophageal echocardiography (TEE) in the SVC long axis, on the basis of SVC diameter variations, but not in the SVC short axis or by SVC area variations. SVV was not previously tested in vascular surgery patients. ⋯ Our study validated the value of the SVC-CI measured as area variations in the SVC short axis to predict fluid responsiveness in anesthetized patients. An hTEE probe was used to monitor and measure the hSVC-CI but conventional TEE may also offer this new dynamic parameter. In our cohort of significant preoperative hypovolemic patients undergoing major open vascular surgery, hSVC-CI and SVV cutoff values of 37% and 15%, respectively, predicted fluid responsiveness with good accuracy.
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J Clin Monit Comput · Jun 2020
Do cerebral and somatic tissue oxygen saturation measurements correlate with each other during surgery?
Intraoperative maintenance of optimal tissue oxygenation is critical; however, it is uncertain whether measurements of different tissue beds correlate with each other. Cerebral tissue oxygen saturation (SctO2) measured on the forehead and somatic tissue oxygen saturation (SstO2) measured on limbs, using a tissue near-infrared spectroscopy, were simultaneously recorded every 2 s in patients having spine surgery or robotic hysterectomy. Simple linear regression was used to determine the static correlation between SctO2 and SstO2 using the median values of each min for each patient. ⋯ The static correlation between SctO2 and SstO2 was inconsistent (r ranging from - 0.86 to 0.93 in spine surgery and from - 0.74 to 0.85 in robotic hysterectomy). The proportional durations with CC ≤ - 0.3 (negative correlation), - 0.3 < CC < 0.3 (poor correlation) and CC ≥ 0.3 (positive correlation) were 18.3 ± 9.6%, 52.6 ± 12.1% and 29.0 ± 9.6%, respectively, in patients having spine surgery and 19.6 ± 9.0%, 58.6 ± 13.1% and 21.8 ± 8.0%, respectively, in patients having robotic hysterectomy. There are a large discrepancy and inconsistent correlation between intraoperative SctO2 and SstO2 measurements, suggesting their non-interchangeability.
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J Clin Monit Comput · Apr 2020
Editorial CommentAn easy and accurate respiratory rate monitor is necessary.