Journal of clinical monitoring and computing
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J Clin Monit Comput · Oct 2018
Comparative StudyThe pressure exerted on the tongue during intubation with simultaneous cervical spine immobilisation: a comparison between four videolaryngoscopes and the Macintosh laryngoscope-a manikin study.
Excessive pressures exerted on the tongue during intubation may be associated with serious complications and may make intubation more difficult. The aim of this study was to evaluate five different intubating devices in the hands of experienced anaesthetists during simulated conditions of reduced cervical spine mobility. Forty senior anaesthetists participated in the study (female = 18, male = 22). ⋯ Their use may be associated with less complications. Furthermore, male anaesthetists exerted higher pressures on the soft tissues although this was neither statistically nor clinically significant. There was higher failed intubation rate in the male anaesthetist group.
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J Clin Monit Comput · Oct 2018
Comparative StudyComparison of the accuracy of noninvasive hemoglobin monitoring for preoperative evaluation between adult and pediatric patients: a retrospective study.
We measured noninvasive hemoglobin (SpHb) levels during the pre-anesthesia visit in patients planning elective surgery. Differences between SpHb and laboratory-measured hemoglobin (Hblab) were compared between adult and pediatric patients. In the pre-anesthesia visiting office, we routinely monitor noninvasive Hb levels with oxygen saturation and heart rate using Masimo Radical-7® Pulse CO-Oximetry (Masimo Corp., Irvine, CA, USA). ⋯ The correlation coefficient between the bias and Hblab was - 0.81 in adults and - 0.54 in pediatric patients (P < 0.001). SpHb and Hblab measured during pre-anesthesia visits showed a smaller difference in pediatric than in adult patients. Lower Hblab corresponded to higher accuracy.
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J Clin Monit Comput · Oct 2018
Observational StudyLow minute ventilation episodes during anesthesia recovery following intraperitoneal surgery as detected by a non-invasive respiratory volume monitor.
An electrical impedance-based noninvasive respiratory volume monitor (RVM) accurately reports minute volume, tidal volume and respiratory rate. Here we used the RVM to quantify the occurrence of and evaluate the ability of clinical factors to predict respiratory depression in the post-anesthesia care unit (PACU). RVM generated respiratory data were collected from spontaneously breathing patients following intraperitoneal surgeries under general anesthesia admitted to the PACU. ⋯ Low respiratory rate was a poor predictor of LMVe (sensitivity = 11.8%). Other clinical variables (e.g., obstructive sleep apnea) were not found to be predictors of LMVe. Using RVM we identified that mild, clinically nondetectable, respiratory depression prior to opioid administration in the PACU was associated with the development of substantial subsequent respiratory depression during the PACU stay.
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J Clin Monit Comput · Oct 2018
Observational StudyValidation of simplified postoperative nausea and vomiting intensity scale in Taiwan.
This study determined whether the Simplified Postoperative Nausea and Vomiting Impact Scale (SPONVIS), could be used to predict clinically important PONV in Taiwanese. In this prospective, observational study, SPONVIS, simplified Apfel PONV Risk Scores, post-operative anti-emetic drug use, total PONV score, and 3-month recall score for PONV were recorded from Taiwanese patients who had undergone general anesthesia and surgery. With antiemetic use and 3-month recall score as validations of clinical significance, we determined whether the elements and cut-off points used in the original SPONVIS study could be used in Taiwanese patients. ⋯ The SPONVIS cut-off points 3 and 5 were statistically significant predictors of anti-emetic drug use. However, a cut-off point of 3 had a higher OR (24.08) than a cut-off of 5 (14.26) for prediction of anti-emetic drug use. SPONVIS and both construct elements (the nausea and vomiting impact scores) are useful predictors of clinically important PONV in Taiwanese.
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J Clin Monit Comput · Oct 2018
Observational StudyEvaluation of a wireless, portable, wearable multi-parameter vital signs monitor in hospitalized neurological and neurosurgical patients.
Unrecognized changes in patients' vital signs can result in preventable deaths in hospitalized patients. Few publications or studies instituting routine patient monitoring have described implementation and the setting of alarm parameters for vital signs. We wanted to determine if continuous multi-parameter patient monitoring can be accomplished with an alarm rate that is acceptable to hospital floor nurses and to compare the rate of patient deterioration events to those observed with routine vital sign monitoring. ⋯ Similar measures of comparison units did not change over the same period. Although unplanned patient deaths in the study unit were also reduced during the intervention period, this was not statistically significant. Continual, multi-parameter vital signs monitoring can be customized to reduce a high alarm rates, and may reduce rapid response team calls.