Journal of clinical monitoring and computing
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J Clin Monit Comput · Dec 2018
Respiratory changes in subclavian vein diameters predicts fluid responsiveness in intensive care patients: a pilot study.
The present pilot study investigated whether respiratory variation in subclavian vein (SCV) diameters correlates with fluid responsiveness in mechanically ventilated patients. Monocentric, prospective clinical study on fluid responsiveness in adult sedated, mechanically ventilated ICU patient, monitored with the PiCCO™ system (Pulsion Medical System, Germany), and requiring a fluid challenge (FC). A 10-min fluid bolus of 500 mL of 0.9% saline was administered. ⋯ Other parameters, such as SVV and PPV, could not predict fluid responsiveness. The correlation coefficient between CO variation and the SCVvariability index was 0.73 (p < 0.001). The SCVvariability index was a reliable, non-invasive parameter for the prediction of fluid responsiveness at the bedside of mechanically ventilated, critically ill patients in this pilot study.
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J Clin Monit Comput · Dec 2018
Clinical TrialBladder pressure monitoring and CO2 gas-related adverse events during per-oral endoscopic myotomy.
Per-oral endoscopic myotomy (POEM) is a minimally invasive treatment for esophageal achalasia. However, POEM has the potential risk of inducing carbon dioxide (CO2) gas-related adverse events, such as pneumoperitoneum, pneumomediastinum, and pneumothorax. The aim of this study was to evaluate the usability of bladder pressure monitoring as an index of CO2 gas-related pneumoperitoneum. ⋯ Based on postoperative changes on CT scans; the following were the observations: pneumomediastinum (55%), minor pneumothorax (5%), pleural effusion (45%), atelectasis (15%), pneumoperitoneum (85%), and subcutaneous emphysema (15%). No significant clinical status was found among the patients postoperatively. Bladder pressure monitoring might be useful for detecting pneumoperitoneum during POEM.
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J Clin Monit Comput · Dec 2018
Observational StudyCerebral oximetry during preoperative resuscitation in elderly patients with hip fracture: a prospective observational study.
This study explores the association between postadmission and intraoperative cerebral oxygenation (ScO2), reflecting systemic perfusion, and postoperative mortality and delirium. Forty elderly (age > 65 years) patients with hip fractures were included in this prospective observational study. The ScO2 was determined using near-infrared spectroscopy at initial resuscitation after patients were admitted to the hospital and during surgery. ⋯ There were no associations between low blood pressure and postoperative delirium or 30-day mortality. We found that low preoperative ScO2 was better associated with 30-day all-cause mortality in elderly patients undergoing surgery for hip fracture than blood pressure measurements. Future studies in preoperative resuscitation of hip fracture patients should focus on perfusion measures as opposed to conventional haemodynamic.
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J Clin Monit Comput · Dec 2018
ReviewQuantitative measures of EEG for prediction of outcome in cardiac arrest subjects treated with hypothermia: a literature review.
Cardiac arrest (CA) is the leading cause of death and disability in the United States. Early and accurate prediction of CA outcome can help clinicians and families to make a better-informed decision for the patient's healthcare. Studies have shown that electroencephalography (EEG) may assist in early prognosis of CA outcome. ⋯ Given these potential benefits, there have been an increasing interest over the last few years in the development and employment of EEG quantitative measures to predict CA outcome. This paper extensively reviews the definition and efficacy of various measures that have been employed for the prediction of outcome in CA subjects undergoing hypothermia (a neuroprotection method that has become a standard of care to improve the functional recovery of CA patients after resuscitation). The review details the State-of-the-Art and provides some perspectives on what seems to be promising for the early and accurate prognostication of CA outcome using the quantitative measures of EEG.
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J Clin Monit Comput · Dec 2018
LetterOptimizing peripheral venous pressure waveforms in an awake pediatric patient by decreasing signal interference.
The purpose of this technological notes paper is to describe our institution's experience collecting peripheral venous pressure (PVP) waveforms using a standard peripheral intravenous catheter in an awake pediatric patient. PVP waveforms were collected from patients with hypertrophic pyloric stenosis. ⋯ Interference in the PVP waveforms data collection was associated with the following: patient or device motion, system set-up error, type of IV catheter, and peripheral intravenous catheter location. PVP waveforms can be collected in an awake pediatric patient and adjuncts to decrease signal interference can be used to optimize data collection.