Journal of clinical monitoring and computing
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J Clin Monit Comput · Oct 2015
Comparative Study Controlled Clinical TrialIsocapnic hyperpnea with a portable device in Cystic Fibrosis: an agreement study between two different set-up modalities.
To evaluate the bias and precision of the respiratory muscle training device formulas to predict respiratory minute volume (RMV) and volume of the reservoir bag (BV) on a cohort of subjects with Cystic Fibrosis (CF). CF patients with available pulmonary function tests and maximal voluntary manoeuvres were included in the study. Vital capacity and maximal voluntary ventilation were extracted from subjects' records and then inserted to the manufacturer's formulas to obtain RMV and BV (measured setting). ⋯ Concordance correlation coefficients for RMV were -0.03 in males and 0.02 in females; 0.22 in males and 0.03 in females for BV, reinforcing an unsatisfactory concordance between measured and manufacturer setting. This study shows considerable discrepancies between the two methods, making the degree of agreement not clinically acceptable. This might cause inappropriate setting and disservice to patients with CF.
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J Clin Monit Comput · Oct 2015
Reliability of the volatile agent consumption display in the Draeger Primus™ anesthesia machine.
Knowledge of the consumed amount of volatile anesthetic (VA) expressed in liquid agent is necessary to enable agent sparing dosing measures and for billing purposes. The widespread Draeger Primus™ anesthesia machine displays in its logbook the amount of consumed VA at the end of each anesthesia, but the reliability of this parameter is yet unknown. The objective was to evaluate the precision and reliability of the inbuilt VA consumption display in Draeger Primus™ anesthesia machines as compared with the gold standard of weighing the vaporizer before and after anesthesia. ⋯ The displayed desflurane consumption underestimated the measured values by -3.5 ± 6.3 ml (6.2%). Nine from 10 sevoflurane pairs of values and all desflurane pairs of values were within ±1.96 SD. The displayed VA consumption calculations for sevoflurane and desflurane in the Draeger Primus™ are sufficiently reliable to estimate the pharmacoeconomic impact of VA delivery during inhalational anesthesia.
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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
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
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.