Journal of clinical monitoring and computing
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J Clin Monit Comput · Apr 2008
Comparative Study Clinical TrialComparison of Narcotrend Index, Bispectral Index, spectral and entropy parameters during induction of propofol-remifentanil anaesthesia.
This study investigated the suitability of various electroencephalogram (EEG) parameters to describe anaesthetic drug effects in propofol-remifentanil anaesthesia. The investigated parameters were the Narcotrend Index (NI), the Bispectral Index (BIS), and standard spectral and entropy parameters. Additionally, it was investigated whether the effect of a fixed dosage of propofol on the attained depth of hypnosis during induction of anaesthesia is different in male and female patients. ⋯ NI and BIS are superior to spectral and entropy parameters in describing changes of propofol concentration during induction of propofol-remifentanil anaesthesia.
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J Clin Monit Comput · Apr 2008
Clinical TrialSpectral entropy as a monitor of depth of propofol induced sedation.
The aim of this prospective, observational study was to evaluate State and Response entropy (Entropy(TM) Monitor, GE Healthcare, Finland), indices as measures of moderate ("conscious") sedation in healthy adult patients receiving a low dose propofol infusion. Sedation was evaluated using: (I) the responsiveness component of the OAA/S scale (Observer's Assessment of Alertness/Sedation scale) and (II) multi-channel electroencephalogram (EEG) interpretation by a clinical expert. ⋯ A statistically significant decrease in SE and RE values was demonstrated in patient/time units in which clinical or EEG evidence of sedation was present. We conclude that spectral entropy offers potential as a monitor of propofol induced sedation.
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J Clin Monit Comput · Apr 2008
Failure of two commercial indexes and spectral parameters to reflect the pharmacodynamic effect of desflurane on EEG.
We compared two PK/PD models, one with and one without a plateau effect. Bispectral (BIS, Aspect Medical Systems, Natick, MA, version XP) and Narcotrend (NCT, MonitorTechnik, Bad Bramstedt, Germany, Version 4.0) indices were used as an electroencephalographic measure of desflurane drug effect. ⋯ BIS and Narcotrend are not useful to differentiate pharmacodynamic changes in the EEG between 4 and 9 vol% desflurane.
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To describe and evaluate a new weaning and decision support system for mechanical ventilation. ⋯ A new weaning and decision support system for mechanical ventilation is presented. The recommendations made by the system were found to be in line with clinical determinations. Further refinements in the FLEX predictions can be easily made by including inputs which represent permissive hypercapnea or increased metabolic demand for selected patients.
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J Clin Monit Comput · Feb 2008
Comparative Study Clinical TrialNear-infrared spectroscopy to monitor peripheral blood flow perfusion.
Non-invasive evaluation of peripheral perfusion may be useful in many contexts including peri-operative monitoring. We validated a novel non-invasive spectroscopy technique to assess peripheral perfusion. This method, which is based on the measurement of tissue saturation variations after an ischemic period, was compared to strain gauge plethysmography and radionuclide plethysmography. The technique uses near-infrared spectroscopy (NIRS) to determine the rate of change of forearm tissue saturation during reactive hyperemia. ⋯ The NIRS technique appears well suited for the non-invasive evaluation of limb perfusion.