Journal of clinical monitoring and computing
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J Clin Monit Comput · Oct 2015
Comparative StudyCutaneous microcirculation in preterm neonates: comparison between sidestream dark field (SDF) and incident dark field (IDF) imaging.
Incident dark field imaging (IDF) is a new generation handheld microscope for bedside visualization and quantification of microcirculatory alterations. IDF is the technical successor of sidestream dark field imaging (SDF), currently the most used device for microcirculatory measurements. In (pre)term neonates the reduced thickness of the skin allows non-invasive transcutaneous measurements. ⋯ The perfusion of vessels could be determined more accurately in the IDF images, resulting in a significant lower PPV (88.7 vs. 93.9%, p value 0.002). The IDF video images scored optimal in a higher percentage compared to the SDF video images. IDF imaging of the cutaneous microcirculation in preterm neonates resulted in a higher vessel density and lower perfusion compared to the existing SDF device.
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J Clin Monit Comput · Oct 2015
Using the multi-parameter variability of photoplethysmographic signals to evaluate short-term cardiovascular regulation.
Transient changes in cardiovascular regulatory activities are valuable for clinical monitoring and pathophysiological research. However, there is a lack of effective methods to evaluate short-term cardiovascular regulation. This study explores a photoplethysmography (PPG)-based multi-parameter analytical approach using the period, amplitude and baseline of PPG signals to quantitatively assess cardiovascular regulation over a 30 s period. ⋯ The results showed that compared with spontaneous respiration, SD1 of PPG amplitude increased significantly but the correlations between any two parameters or between the first differences of any two parameters decreased significantly during paced respiration; SD1 and SD1/SD2 of all PPG parameters as well as the correlations of the first differences between any two PPG parameters reduced significantly during breath holding. The results indicate the respiratory induced alterations in cardiovascular autonomic function could be identified by the variability of various PPG parameters or their correlations over 30 s periods. Moreover, the indicators used to quantify the variability of the PPG parameters in this study may provide a feasible and effective way to evaluate short-term cardiovascular regulation.
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J Clin Monit Comput · Oct 2015
Case ReportsUsefulness of near-infrared spectroscopy in thrombectomy monitoring.
Monitoring recanalization and reperfusion during acute ischemic stroke is a challenge for therapeutic assessment. Near-infrared spectroscopy (NIRS) allows continuous monitoring of the brain regional saturation of oxygen (rSO2). We sought to evaluated rSO2 variation during mechanical thrombectomy during acute ischemic stroke. ⋯ When the procedure succeeded, rSO2 in the infarcted side rise (about 10%) and interhemisperic difference decrease (about 7%). When the procedure failed, rSO2 was the same at the beginning and at the end. NIRS may be useful to monitor recanalization during management of acute ischemic stroke.
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J Clin Monit Comput · Oct 2015
Radial artery cannulation decreases the distal arterial blood flow measured by power Doppler ultrasound.
Radial arterial cannulation is a popular technique for continuous hemodynamic monitoring in an area of anesthesia and intensive care. Although the risk for invasive monitoring is considerable, there is scarce information about the change in blood flow of cannulated vessel after the catheterization. In the current investigation, we evaluated the change in the cannulated arterial blood flow. ⋯ Study 2: There was no difference between the diameters of right and left RA, however, the UA was larger [3.4 (0.60) vs. 2.8 (0.83) mm] and the DBRA was narrower [1.4 (0.43) vs. 2.0 (0.47) mm] in the cannulated side. The diameters of DBRA were different between the intact and cannulated side in the patients. Although there is no information of relationships between cause of severe complication and decreased flow, significant reduction of blood flow should be concerned.
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J Clin Monit Comput · Oct 2015
A web-based Italian survey of current trends, habits and beliefs in hemodynamic monitoring and management.
Significant evidence outlines that the management of the high-risk surgical patient with perioperative hemodynamic optimization leads to significant benefits. This study aimed at studying the current practice of hemodynamic monitoring and management of Italian anesthesiologists. An invitation to participate in a web-based survey was published on the web site of the Società Italiana di Anestesia Analgesia Rianimazione Terapia Intensiva. ⋯ The most used parameter in clinical practice to assess the effects of volume loading were an increase in urine output and arterial blood pressure together with a decrease in heart rate and blood lactates. The 45.1% or the respondents outlined that hemodynamic optimization in the high risk patients is of major clinical value. Our study outlines an important gap between available evidence and clinical practice emphasizing the need for a better awareness, more information and knowledge on the specific topic.