Journal of clinical monitoring and computing
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J Clin Monit Comput · Dec 2024
A novel wearable bioimpedance sensor for continuous monitoring of fluid balance: a study on isotonic hypovolemia in healthy adults.
This study aimed to investigate the ability of a novel wearable bioimpedance sensor to monitor changes in fluid balance induced by furosemide. Because iso-osmotic fluid loss is expected to primarily comprise fluid from the extracellular compartment it was hypothesized that isotonic hypovolemia would increase the extracellular resistance (RE). ⋯ This study demonstrates that the wearable bioimpedance device tested is very sensitive to furosemide-induced changes in fluid volume in healthy volunteers in a controlled environment. Additional research is needed to evaluate the ability of the device to track fluid status in a clinical setting.
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This correspondence is in response to Dr. David Allison's comments to the Editor, regarding the American Society of Neurophysiological Monitoring's (ASNM) updated intraoperative somatosensory evoked potential (SEP) monitoring position statement.
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J Clin Monit Comput · Dec 2024
Predicting short-term outcomes in brain-injured patients: a comprehensive approach with transcranial Doppler and intracranial compliance assessment.
Neurocritical patients frequently exhibit abnormalities in cerebral hemodynamics (CH) and/or intracranial compliance (ICC), all of which significantly impact their clinical outcomes. Transcranial Doppler (TCD) and the cranial micro-deformation sensor (B4C) are valuable techniques for assessing CH and ICC, respectively. However, there is a scarcity of data regarding the predictive value of these techniques in determining patient outcomes. ⋯ The combined noninvasive neuromonitoring approach using eCPP and P2/P1 ratio demonstrated improved performance in predicting outcomes during the early phase after acute brain injury. The correlation with intracranial hypertension was moderate, by means of eICP and P2/P1 ratio. These results support the need for interpretation of this information in the ICU and warrant further investigations for the definition of therapy strategies using ancillary tests.
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J Clin Monit Comput · Dec 2024
Case ReportsPerioperative ROTEM® evaluation in a patient affected by severe VII factor deficiency undergoing microvascular decompression craniotomy for hemifacial spasm.
The potential use of TEG/ROTEM® in evaluating the bleeding risk for rare coagulation disorders needs to be assessed, considering the common mismatch among laboratory tests and the clinical manifestations. As a result, there is currently no published data on the use of viscoelastic tests to assess coagulation in FVII deficient patients undergoing elective neurosurgery. We describe the case of a patient affected by severe FVII deficiency who underwent microvascular decompression (MVD) craniotomy for hemifacial spasm (HFS). ⋯ The values of coagulation in standard tests, on the contrary, were indicative of a coagulopathy, which was corrected by the administration of replacement therapy. Whether this difference between ROTEM® and standard tests is due to the inadequacy of thromboelastographic normal ranges in this setting, or to the absence of clinically significant coagulopathy, has yet to be clarified. Neurosurgery is a typical high bleeding risk surgery; additional data is required to clarify the potential role for thromboelastographic tests in the perioperative evaluation of the FVII deficient neurosurgical patients.
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J Clin Monit Comput · Dec 2024
Respiratory rate measurement by pressure variation in the high flow nasal cannula-system in healthy volunteers.
This study tests if the pressure variation in the HFNC-system may allow for monitoring of respiratory rate and the pressure difference during breathing may be a marker of respiratory effort. ⋯ The pressure variation in the HFNC system allows for respiratory rate and effort monitoring, but requires further development to increase precision.