Journal of clinical monitoring and computing
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J Clin Monit Comput · Dec 2017
Ventilation/perfusion ratio and right to left shunt in healthy newborn infants.
Oxygenation impairment can be assessed non-invasively by determining the degree of right-to-left shunt and ventilation/perfusion (VA/Q) inequality. These indices have been used in sick newborn infants, but normative values have not been reported which are essential to determine the magnitude of the abnormality. We, therefore, aimed to measure the shunt and VA/Q in infants with no history of respiratory conditions and determine if there was any effect of supine or prone position and the reproducibility of the data. ⋯ No significant differences were found in VA/Q in the supine compared to the prone position. The intraclass correlation coefficient of VA/Q between two independent raters was 0.968 (95% CI 0.947-0.980), p < 0.001. Right-to-left shunt and VA/Q ratio in healthy newborn infants were similar in the prone compared to the supine position.
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J Clin Monit Comput · Dec 2017
Individualized assessment of post-arthroplasty recovery by actigraphy: a methodology study.
Previous studies using actigraphy to monitor recovery after total knee arthroplasty (TKA) have reported activity as maximum and average count/min, but not utilized the full potential of the data by stratifying activity into various intensities or analysed the individual development in activity over time. The aim of this study was to describe a novel methodology using actigraphy data to describe specific activity-intensities potentially affected by surgery and patients with poor rehabilitation trajectories. Actigraphy data from 10 patients scheduled for primary unilateral TKA were recorded preoperatively and for 3 weeks postoperatively. ⋯ The inter-individual variation increased with intensified activity. Identification of individual patients with positive, neutral or negative activity trajectories was possible. The methodology should be considered in future interventional studies to improve rehabilitation strategies.
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J Clin Monit Comput · Dec 2017
Parasympathetic tone variations according to umbilical cord pH at birth: a computerized fetal heart rate variability analysis.
Non-reassuring fetal heart rate tracings reflect an imbalance between the parasympathetic and sympathetic nervous systems. In this situation, fetal asphyxia can be suspected and may be confirmed by metabolic measurements at birth like low pH or high base deficit values. The objective of this study was to determine whether fetal asphyxia during labor is related to parasympathetic nervous system activity. ⋯ FSI was measured during the last 30 min of labor before birth and compared between groups. The minimum value of the FSI during the last 30 min before delivery was significantly lower in the group with the lower umbilical cord arterial pH value. In this pilot study during labor, FSI was lower in the group of infants with low arterial pH at birth.
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J Clin Monit Comput · Dec 2017
Comparative StudyComparison of the qCON and qNOX indices for the assessment of unconsciousness level and noxious stimulation response during surgery.
The objective of this work is to compare the performances of two electroencephalogram based indices for detecting loss of consciousness and loss of response to nociceptive stimulation. Specifically, their behaviour after drug induction and during recovery of consciousness was pointed out. Data was recorded from 140 patients scheduled for general anaesthesia with a combination of propofol and remifentanil. ⋯ Furthermore, the qCON showed faster decrease during induction. This behaviour is associated with the hypothesis that the loss of response to stimuli (analgesic effect) might be reached after the loss of consciousness (hypnotic effect). On the contrary, the qNOX showed a faster increase at the end of the surgery, associated with the hypothesis that a higher probability of response to stimuli might be reached before the recovery of consciousness.
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J Clin Monit Comput · Dec 2017
Estimation of breathing rate in thermal imaging videos: a pilot study on healthy human subjects.
Diverse studies have demonstrated the importance of monitoring breathing rate (BR). Commonly, changes in BR are one of the earliest and major markers of serious complications/illness. However, it is frequently neglected due to limitations of clinically established measurement techniques, which require attachment of sensors. ⋯ The higher RMSE in phase B results predominantly from delays between IRT and gold standard in BR transitions: eupnea/apnea, apnea/tachypnea etc. Moreover, this study also demonstrates the capability of IRT to capture varied breathing disorders, and consecutively, to assess respiratory function. In summary, IRT might be a promising monitoring alternative to the conventional contact-based techniques regarding its performance and remarkable capabilities.