Journal of clinical monitoring and computing
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J Clin Monit Comput · Dec 2024
Prediction of intraoperative hypotension using deep learning models based on non-invasive monitoring devices.
Intraoperative hypotension is associated with adverse outcomes. Predicting and proactively managing hypotension can reduce its incidence. Previously, hypotension prediction algorithms using artificial intelligence were developed for invasive arterial blood pressure monitors. This study tested whether routine non-invasive monitors could also predict intraoperative hypotension using deep learning algorithms. ⋯ A deep learning model utilizing multi-channel non-invasive monitors could predict intraoperative hypotension with high accuracy. Future prospective studies are needed to determine whether this model can assist clinicians in preventing hypotension in patients undergoing surgery with non-invasive monitoring.
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J Clin Monit Comput · Dec 2024
Relationships between the qNOX, qCON, burst suppression ratio, and muscle activity index of the CONOX monitor during total intravenous anesthesia: a pilot study.
Processed electroencephalographic (EEG) indices can help to navigate general anesthesia. The CONOX (Fresenius Kabi) calculates two indices, the qCON (hypnotic level) and the qNOX (nociception). The CONOX also calculates indices for electromyographic (EMG) activity and EEG burst suppression (BSR). Because all EEG parameters seem to influence each other, our goal was a detailed description of parameter relationships. ⋯ We could describe relationships between qCON, qNOX, EMG, BSR, ceP, and ceR, which may help the anaesthesiologist better interpret the information provided. One major finding is the dependence of qCON > 80 on EMG activity. This may limit the possibility of detecting wakefulness in the absence of EMG. Further, qNOX seems generally higher than qCON, but high opioid doses may lead to higher qCON than qNOX indices.
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J Clin Monit Comput · Dec 2024
Randomized Controlled Trial Comparative StudyComparing the haemodynamic effects of high- and low-dose opioid anaesthesia: a secondary analysis of a randomised controlled trial.
Post-induction hypotension (MAP < 65 mmHg) occurs frequently and is usually caused by the cardiovascular adverse effects of the anaesthetic induction drugs used. We hypothesize that a clinically significant difference in the incidence and severity of hypotension will be found when different doses of propofol and remifentanil are used for induction of anaesthesia. ⋯ Induction of anaesthesia with different predicted equipotent combinations of propofol and remifentanil did result in statistically different but clinically irrelevant differences in haemodynamic endpoints during induction of anaesthesia. Our study could not identify preferable drug combinations that decrease the risk for hypotension after induction, although they all yield a similar predicted PTOL.
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J Clin Monit Comput · Dec 2024
Observational StudyPost-anesthesia care unit hypotension in low-risk patients recovering from non-cardiac surgery: a prospective observational study.
Intraoperative hypotension is common and associated with organ injury. Hypotension can not only occur during surgery, but also thereafter. After surgery, most patients are treated in post-anesthesia care units (PACU). ⋯ The median volume of crystalloid fluid patients were given during PACU treatment was 200 (100 to 400) ml. None was given colloids or a vasopressor during PACU treatment. In low-risk patients recovering from non-cardiac surgery, the incidence of PACU hypotension was very low and the few episodes of PACU hypotension were short and of modest severity.