Journal of clinical monitoring and computing
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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
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.
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J Clin Monit Comput · Oct 2015
Comparative StudyNoninvasive assessment of peripheral microcirculation by near-infrared spectroscopy: a comparative study in healthy smoking and nonsmoking volunteers.
Smokers are exposed to early endothelial dysfunction. This microcirculatory damage can be demonstrated by near-infrared spectroscopy (NIRS). The aim of this study was to compare microvascular reactivity by NIRS during a dynamic vascular occlusion test in healthy smokers and nonsmokers volunteers. ⋯ It was the same for the rate of resaturation [smokers 30.4%·min(-1) (range 14.2-51.6) and nonsmokers 30.5%·min(-1) (range 18.6-44.5); p = 0.82]. NIRS study of microvascular reactivity during a dynamic vascular occlusion test did not reveal any difference between smokers and nonsmokers. Therefore, NIRS could not be sensitive enough to highlight endothelial dysfunction in healthy subjects exposed to tobacco smoke.
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J Clin Monit Comput · Oct 2015
Randomized Controlled TrialUltrasound guided bilateral cervical plexus block reduces postoperative opioid consumption following thyroid surgery.
Thyroid surgery may cause severe postoperative pain and discomfort for patients. Superficial cervical plexus block (SCPB) is one of the regional anesthesia techniques that can provide postoperative analgesia for thyroid surgery. The purpose of this study was to evaluate analgesic effect of ultrasound (US) guided SCPB in patients undergoing thyroid surgery. ⋯ Seven patients in the SCPB and none in the control group had hoarseness. Our study has shown that US guided SCPB has a significant analgesic effect in patients undergoing thyroid surgery. Further studies are required to search for the optimal LA dose during US guided SCPB.