Journal of clinical monitoring and computing
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J Clin Monit Comput · Jun 2019
Comparative Study Observational StudyCardiac output and stroke volume variation measured by the pulse wave transit time method: a comparison with an arterial pressure-based cardiac output system.
Hemodynamic monitoring is mandatory for perioperative management of cardiac surgery. Recently, the estimated continuous cardiac output (esCCO) system, which can monitor cardiac output (CO) non-invasively based on pulse wave transit time, has been developed. Patients who underwent cardiovascular surgeries with hemodynamics monitoring using arterial pressure-based CO (APCO) were eligible for this study. ⋯ The time course had no effects on the biases between CO and SVV. Concordance rates were 80.3 and 75.7% respectively. While CO measurement with esCCO can be a reliable monitor after cardiovascular surgeries, SVV measurement with esCCO may require further improvement.
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J Clin Monit Comput · Jun 2019
A motor evoked potential trending system may discriminate outcome: retrospective application with three cases.
This report presents a method for tracking Motor Evoked Potential (MEP) amplitudes over the course of a case using a moving least squares linear regression (LSMAs). During a case, newly obtained MEP amplitudes are compared to those predicted by a just previous linear regression (least squares moving average or LSMA). When detected by this comparison, a set criterion amplitude loss will then trigger linear regression of ensuing MEP amplitudes on an expanding step function which tracks the persistence of the amplitude loss for the remainder of the case. ⋯ In the third case the tracking method again successfully triggered a predictive R-Square despite the limited number of pre-event trials. The R-Square value of the expanding step function regression appears to have discriminative capability with regard to new post-op deficit. Given the importance of the intra-operative MEP for monitoring motor functioning and the high degree of variability that can affect it, the development of new quantitative, statistical methods to detect real from apparent MEP change will be necessary.
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J Clin Monit Comput · Jun 2019
Comparative StudyNovel mandibular advancement bite block with supplemental oxygen to both nasal and oral cavity improves oxygenation during esophagogastroduodenoscopy: a bench comparison.
Drug-induced respiratory depression is a major cause of serious adverse events. Adequate oxygenation is very important during sedated esophagogastroduodenoscopy (EGD). Nasal breathing often shifts to oral breathing during open mouth EGD. ⋯ The ratio of nasal to oral breathing played an important role in the FiO2 under hypoventilation but less role under normal ventilation. Bite blocks deliver a higher FiO2 during EGD. The ratio of nasal to oral breathing, supplemental oxygen flow, tidal volume, and respiratory rate influenced the FiO2 in most of the supplemental oxygen devices tested, which are often used for conscious sedation in patients undergoing EGD and colonoscopy.