Journal of clinical monitoring and computing
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J Clin Monit Comput · Aug 2017
Observational StudyPhotoplethysmography respiratory rate monitoring in patients receiving procedural sedation and analgesia for upper gastrointestinal endoscopy.
The value of capnography during procedural sedation and analgesia (PSA) for the detection of hypoxaemia during upper gastrointestinal (UGI) endoscopic procedures is limited. Photoplethysmography respiratory rate (RRp) monitoring may provide a useful alternative, but the level of agreement with capnography during PSA is unknown. We therefore investigated the level of agreement between the RRp and capnography-based RR (RRc) during PSA for UGI endoscopy. ⋯ In 81 % of all apnoea events, photoplethysmography registered an RRp ≥ 4 brpm. We found a low level of agreement between capnography and the plethysmography respiratory rate during procedural sedation for UGI endoscopy. Moreover, respiratory rate derived from both the capnogram and photoplethysmogram showed a limited ability to provide warning signs for a hypoxaemic event during the sedation procedure.
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J Clin Monit Comput · Jun 2017
Analysis of central venous pressure (CVP) signals using mathematical methods.
Central venous pressure (CVP) is an important clinical parameter for physicians but only the absolute CVP value is typically monitored in the intensive care unit (ICU). In this study, we propose a novel mathematical method to present and analyze CVP signals. ⋯ The statistical features of time and frequency domain, wavelet, and empirical mode decomposition of these signals were extracted. We found no significant difference among the CVP signals regarding sex, smoking, coronary disease, and respiration mode of the samples.
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J Clin Monit Comput · Jun 2017
ReviewThe role of tracheal tube introducers and stylets in current airway management.
Tracheal tube introducers and stylets are highly successful devices for the management of various airway scenarios. Their first-line use is advocated in many difficult airway algorithms. Although they have been used for decades, the shape and design of introducers and stylets as well as their patterns of use are constantly evolving. ⋯ The data was synthesized into a narrative review to provide the clinician with an update on the characteristics, indications and techniques of use as well as the dangers of different intubation aids. Today, numerous tracheal tube introducers and stylets exist with different indications, ranging from general to specific situations. Anesthetists should be familiar with the different devices, their characteristics and indications in order to use the right device at the right time in the right way.
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J Clin Monit Comput · Jun 2017
ReviewUltrasonography in the preoperative difficult airway assessment.
To evaluate the utility of ultrasound for detection of the difficult intubation in a preoperative setting. PubMed, Ovid, CINAHL Plus Full Text, and Google Scholar searches using ["difficult airway" OR "difficult intubation" OR "difficult laryngoscopy" OR "difficult ventilation"] AND [ultrasonography OR sonography OR ultrasound] without date limitations. Abstracts without publications, case reports, letters, textbooks, unrelated topics, or foreign language articles were excluded. ⋯ Significance for sonographic prediction of difficult laryngoscopy occurred at three locations: hyomental distance [52.6 ± 5.8 mm (p < 0.01)], anterior tissue at the hyoid bone [16.9 mm (95 % CI 11.9-21.9) and 15.9 ± 2.7 mm (p < 0.0001)], and the thyrohyoid membrane [34.7 mm (95 % CI 28.8-40.7) and 23.9 ± 3.4 mm (p < 0.0001) and 28.25 ± 4.43 mm (p < 0.001)]. The vocal cords and sternal notch levels have conflicting significance. Limitations include the heterogeneous populations and lack of standard scanning protocols.