Journal of clinical monitoring and computing
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J Clin Monit Comput · Oct 2010
Clinical TrialReversal of neuromuscular blockade by sugammadex does not affect EEG derived indices of depth of anesthesia.
According to previous studies neuromuscular blockade may affect the depth of anesthesia. One theory states that neuromuscular blockade prevents disturbing EMG signals, arousing from the muscles of the forehead, from falsely elevating bispectral index (BIS)-levels. According to the afferentation theory signals generated in muscle stretch receptors, accessing the brain through afferent nerve pathways, induce arousal. By blocking these signals neuromuscular blockade would increase depth of anesthesia. Arousal has previously been associated with neostigmine reversal. This study investigates the possible effect of sugammadex on the level of anesthesia as defined by BIS and spectral entropy levels. ⋯ Sugammadex does not affect level of anesthesia as determined by BIS or entropy levels.
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J Clin Monit Comput · Oct 2010
Novel automatic endotracheal position confirmation system: mannequin model algorithm evaluation.
A novel endotracheal intubation accurate positioning confirmation system based on image classification algorithm is introduced and evaluated using a mannequin model. ⋯ This fully automatic image recognition system was used successfully to discriminate airway carina and non-carina endotracheal tube positioning. The system had a 100% success rate using a mannequin model and therefore further investigation including live tissue model and human research should follow.
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J Clin Monit Comput · Aug 2010
Masseter muscle oxygen saturation is associated with central venous oxygen saturation in patients with severe sepsis.
This monocentric prospective study was conducted to determine if tissue oxygen saturation measured non invasively over masseter muscle site (Masseter-StO2) can predict the central venous oxygen saturation (ScvO2) level in severe sepsis and septic shock. ⋯ In patients with severe sepsis or septic shock, non invasive recording of Masseter-StO2 was significantly associated with ScvO2 Further studies are required to determine the usefulness of Masseter-StO2 guided management of severe sepsis or septic shock.
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Capnography has become a standard of perioperative monitoring in pediatric anesthesiology. It has also begun to find application in a variety of situations outside the perioperative setting. While the use of capnography has been increasing, the dissemination and acceptability of capnography in all areas of pediatrics has been variable. The purpose of this study was to describe all the applications and interpretations of capnography that have been reported in children. ⋯ Capnography has been proven to be a useful non-invasive perioperative monitor of the physiology and safety of the child. This list of the clinical applications and interpretations of capnography could find use in teaching and simulation in pediatrics.
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J Clin Monit Comput · Aug 2010
Comparative StudySNAP II versus BIS VISTA monitor comparison during general anesthesia.
Effectively monitoring the level of consciousness during general anesthesia is clinically beneficial to both the patient and the physician. An electroencephalogram (EEG)-based level-of-consciousness monitor can help minimize intraoperative awareness as well as the effects of over-sedation. In this study, we compared the SNAP II (Stryker Instruments, Kalamazoo, MI USA) and BIS VISTA (Aspect Medical Systems, Newton, MA USA) monitors' primary metrics (SI and BIS, respectively) in terms of correlation, agreement and responsiveness to return to preoperative baseline in surgical cases involving general anesthesia. ⋯ Although the SI and BIS both can assess a patient's level of consciousness and are correlated, they are not in agreement with each other numerically and therefore are not interchangeable. It is difficult to assess each monitor's true responsiveness to acute changes in consciousness level from our study design. The differences between the metrics we observed in this study are most likely due to differences in signal processing methodologies, EEG frequencies employed and signal filtering utilized in the monitors.