Journal of clinical monitoring and computing
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J Clin Monit Comput · Apr 2019
Low temperature increases capillary blood refill time following mechanical fingertip compression of healthy volunteers: prospective cohort study.
Capillary refill time has been accepted as a method to manually assess a patient's peripheral blood perfusion. Recently, temperature has been reported to affect capillary refill time and therefore temperature may interfere with accurate bedside peripheral blood perfusion evaluation. We applied a new method of analysis that uses standard hospital pulse oximetry equipment and measured blood refill time in order to test whether lowered fingertip temperature alters peripheral blood perfusion. ⋯ A generalized linear mixed-effects model revealed that lower temperature (OR 0.63 [95% CI 0.61-0.65], p < 0.001) rather than age (OR 1.00 [0.99-1.01], p = 0.395) was the independent factor most associated with increased blood refill time. Lowered fingertip temperatures significantly increase blood refill time which then returns to baseline when the fingertip is rewarmed. In our limited number of population, we did not find an association with age after the adjustment for the fingertip temperature.
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J Clin Monit Comput · Apr 2019
Measurement of blood-oxygen saturation using a photoacoustic technique in the rabbit hypoxemia model.
The golden standard method to obtain accurate blood oxygen saturation is blood gas analysis that needs invasive procedure of blood sampling. Photoacoustic technique enables us to measure real-time blood oxygen saturation without invasive procedure. The aim of this study is to use the photoacoustic technique, an optical method, for accurately determining oxygen saturation in vivo. ⋯ The oxygen saturation calculated using calibration curves 1 and 2 showed strong correlations with the reference standard in regression analysis (R = 0.965, 0.964, respectively). The Bland-Altman analysis revealed better agreement and precision with calibration curve 2, whereas there was significant underestimation of values obtained using calibration curve 1. Photoacoustic measurement of oxygen saturation using calibration curve 2 provided an accurate estimate of oxygen saturation, which was similar to that obtained using a portable blood-gas analyzer.
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J Clin Monit Comput · Apr 2019
Influence of tetanic stimulation on the staircase phenomenon and the acceleromyographic time-course of neuromuscular block: a randomized controlled trial.
During neuromuscular monitoring, repeated electrical stimulation evokes muscle responses of increasing magnitude ('staircase phenomenon', SP). We aimed to evaluate whether SP affects time course and twitches' values of an acceleromyographic assessed neuromuscular block with or without previous tetanic stimulation. Fifty adult patients were randomized to receive a 50 Hz tetanic stimulus (S group) or not (C group) before monitor calibration. ⋯ TOFr showed no differences between groups at any time point. T1 at maximum recovery showed a stronger correlation with post-stabilization T1 compared to baseline. (ρ = 0.80 and ρ = 0.85, for C and S groups.) Standard calibration does not ensure twitch baseline stabilization and prolongs onset time of neuromuscular block. TOF ratio is not influenced by SP.
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J Clin Monit Comput · Apr 2019
Comment LetterIn response: Blood CO2 exchange monitoring, Haldane effect and other calculations in sepsis and critical illness.
Abstract
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J Clin Monit Comput · Apr 2019
Comment LetterIn response: "A novel cause of rebreathing carbon dioxide related to removed CLIC-seal on the Dräger Apollo© Anesthesia Machine" from B. Nikman et al. in this issue of JCMC.
Abstract