Journal of clinical monitoring and computing
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J Clin Monit Comput · Dec 2015
Evaluation of near-infrared spectroscopy under apnea-dependent hypoxia in humans.
In this study we investigated the responsiveness of near-infrared spectroscopy (NIRS) recordings measuring regional cerebral tissue oxygenation (rSO2) during hypoxia in apneic divers. The goal was to mimic dynamic hypoxia as present during cardiopulmonary resuscitation, laryngospasm, airway obstruction, or the "cannot ventilate cannot intubate" situation. Ten experienced apneic divers performed maximal breath hold maneuvers under dry conditions. ⋯ Cerebral rSO2 measured re-saturation after termination of apnea significantly earlier (10 s, SD = 3.6 s) compared to SpO2 monitoring (21 s, SD = 4.4 s) [t(9) = 7.703, p < 0.001, r(2) = 0.868]. Our data demonstrate that NIRS monitoring reliably measures dynamic changes in cerebral tissue oxygen saturation, and identifies successful re-saturation faster than SpO2. Measuring cerebral rSO2 may prove beneficial in case of respiratory emergencies and during pulseless situations where SpO2 monitoring is impossible.
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J Clin Monit Comput · Dec 2015
Effect of planecta and ROSE™ on the frequency characteristics of blood pressure-transducer kits.
Pressure-transducer kits have frequency characteristics such as natural frequency and damping coefficient, which affect the monitoring accuracy. The aim of the present study was to investigate the effect of planecta ports and a damping device (ROSE™, Argon Medical Devices, TX, USA) on the frequency characteristics of pressure-transducer kits. The FloTrac sensor kit (Edwards Lifesciences, CA, USA) and the DTXplus transducer kit (Argon Medical Devices) were prepared with planecta ports, and their frequency characteristics were tested with or without ROSE™. ⋯ Planecta ports decrease the natural frequency of the kit. ROSE™ is useful to optimise the frequency characteristics in the kits without or with one planecta port. However, optimisation is difficult with two or more planecta ports, even with the ROSE™ device.
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J Clin Monit Comput · Dec 2015
Observational StudyCerebral oxygenation and processed EEG response to clamping and shunting during carotid endarterectomy under general anesthesia.
Clamping and shunting during carotid endarterectomy (CEA) surgery causes changes in cerebral blood flow. The purpose of this study was to assess and compare, side by side, the cerebral oxygenation (rSO2) and processed electroencephalogram (EEG) response bilaterally to carotid artery clamping and shunting in patients undergoing CEA under general anesthesia. With institutional approval and written informed consent, patients undergoing CEA under general anesthesia and routine carotid artery shunting were recorded bilaterally, simultaneously and continuously with an rSO2 and processed EEG monitor. ⋯ The rSO2 monitor is more reliable in the real-world clinical setting. Future studies should focus on developing algorithms based on these monitors that can predict clamping-induced cerebral ischemia during CEA in order to decide whether carotid artery shunting is worth the associated risks. From the practical point of view, the rSO2 monitor may be the better monitor for this purpose.
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J Clin Monit Comput · Dec 2015
Observational StudyEarly monitoring of ventriculostomy-related infections with procalcitonin in patients with ventricular drains.
Several factors are implicated in the increased vulnerability of multiple trauma victims to infection, especially in intensive care units. The incidence of EVD related infections ranges from 5 to 20%. To assess the accuracy of serum procalcitonin (PCT) in predicting central nervous system (CNS) infection in patients with EVDs. ⋯ Patients with negative CSF cultures had mean serum PCT <2.0 ng/ml, while patients with positive culture had early elevation of serum PCT with mean of 4.18 ng/ml, CRP did not show similar early changes. Patients who acquire CNS infection had prolonged length of stay in hospital and length of ventilation. In absence of other nosocomial infections, early high serum PCT concentrations appear to be a reliable indicator of bacterial CNS infection in patients with EVD.
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J Clin Monit Comput · Dec 2015
A substitution method to improve completeness of events documentation in anesthesia records.
AIMS are optimized to find and display data and curves about one specific intervention but is not retrospective analysis on a huge volume of interventions. Such a system present two main limitation; (1) the transactional database architecture, (2) the completeness of documentation. In order to solve the architectural problem, data warehouses were developed to propose architecture suitable for analysis. ⋯ On the other hand, we increased by 21.1% the data completeness (from 80.3 to 97.2% of the total database) for the start and the end of anesthesia events. This method seems to be efficient to replace missing "start and end of anesthesia" events. This method could also be used to replace other missing time events in this particular data warehouse as well as in other kind of data warehouses.