Journal of clinical monitoring and computing
-
J Clin Monit Comput · Dec 2016
ReviewCerebral near-infrared spectroscopy in the care of patients during cardiological procedures: a summary of the clinical evidence.
Patients undergoing cardiological procedures generally have significant cardiovascular morbidity, and therefore these patients might be at risk for major periprocedural complications. The ability to closely monitor the hemodynamic status would present a major advantage to optimize patient care in this setting. The aim of this review is to assess the available evidence for the use of near-infrared spectroscopy (NIRS) in the care of patients during cardiological procedures. ⋯ Six studies evaluated NIRS during supraventricular and ventricular arrhythmias, one during transcatheter aortic valve implantations, and four studies assessed the use of NIRS in pediatric catheterization procedures. Overall, the studies demonstrated that NIRS provides a very quick representation of cerebral oxygen saturation and that it might identify changes that could not be predicted from standard hemodynamic monitoring. However, the evidence is currently too low to conclude that NIRS can optimize patient care during cardiological procedures.
-
J Clin Monit Comput · Dec 2016
Effect of using a Planecta™ port with a three-way stopcock on the natural frequency of blood pressure transducer kits.
Blood pressure transducer kits are equipped with two types of Planecta™ ports-the flat-type Planecta™ port (FTP) and the Planecta™ port with a three-way stopcock (PTS). We reported that FTP application decreased the natural frequency of the kits. However, Planecta™ is an invaluable tool as it prevents infection, ensures technical simplicity, and excludes air. ⋯ The insertion of ≥2 FTPs in pressure transducer kits should be avoided, as they markedly decrease the natural frequency and lead to underdamping. However, the effect of PTS insertion in pressure transducer kits on the frequency characteristics is minimal. Thus, we found that the use of PTS markedly improved the frequency characteristics as compared to the use of FTP.
-
J Clin Monit Comput · Dec 2016
Trending autoregulatory indices during treatment for traumatic brain injury.
Our goal is to use automatic data monitoring for reliable prediction of episodes of intracranial hypertension in patients with traumatic brain injury. Here we test the validity of our method on retrospective patient data. We developed the Continuous Hemodynamic Autoregulatory Monitor (CHARM), that siphons and stores signals from existing monitors in the surgical intensive care unit (SICU), efficiently compresses them, and standardizes the search for statistical relationships between any proposed index and adverse events. ⋯ The PRx index, however, lacked sufficient resolution as a real-time predictor of IH in this patient. CHARM streamlines the search for reliable predictors of intracranial hypertension. We report statistical evidence supporting the predictive potential of the pressure reactivity index.
-
J Clin Monit Comput · Dec 2016
Multi-parameter vital sign database to assist in alarm optimization for general care units.
Continual vital sign assessment on the general care, medical-surgical floor is expected to provide early indication of patient deterioration and increase the effectiveness of rapid response teams. However, there is concern that continual, multi-parameter vital sign monitoring will produce alarm fatigue. The objective of this study was the development of a methodology to help care teams optimize alarm settings. ⋯ Plots of vital sign distributions in the cloud-hosted database were similar to other large databases published by different authors. The cloud-hosted database can be used to run simulations for various alarm thresholds and annunciation delays to predict the total alarm burden experienced by nursing staff. This methodology might, in the future, be used to help reduce alarm fatigue without sacrificing the ability to continually monitor all vital signs.
-
J Clin Monit Comput · Dec 2016
Randomized Controlled TrialChanges in intraocular pressure during surgery in the lateral decubitus position under sevoflurane and propofol anesthesia.
Intraocular pressure (IOP) has been shown to change with body position. Several studies have shown that the lateral decubitus position (LDP) is associated with a significant increase in IOP in the dependent eye. However, whether anesthetic agents alter IOP in the LDP remains unclear. ⋯ The number of patients in whom IOP increased to ≥28 mmHg was greater in the sevoflurane group than in the propofol group. Propofol may be better than sevoflurane for the maintenance of anesthesia in the LDP. Monitoring of IOP in the LDP might help avoid ophthalmic complications.