Journal of clinical monitoring and computing
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J Clin Monit Comput · Jun 2023
Clinical TrialChanges of the nociceptive flexion reflex threshold in patients undergoing cardiac surgery-a prospective clinical pilot study.
Opioid dosage for general anaesthesia and sedation relies on surrogate parameters such as heartrate and blood pressure. This implies the risk of both under- and overdosing. A promising tool to provide target-oriented opioid dosing is measuring the nociceptive flexion reflex threshold (NFRT). ⋯ Unless measurements are not prevented by technical issues NFRT-assessment appears to be a future tool to target analgesics in patients not able to self-report pain. Trial registration Study registration: DRKS00021617. https://www.drks.de/drks_web/navigate.do?navigationId=trial. HTML&TRIAL_ID=DRKS00021617 (registered retrospectively).
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J Clin Monit Comput · Jun 2023
Non-contact respiratory rate monitoring using thermal and visible imaging: a pilot study on neonates.
Respiratory rate (RR) monitoring is essential in neonatal intensive care units. Despite its importance, RR is still monitored intermittently by manual counting instead of continuous monitoring due to the risk of skin damage with prolonged use of contact electrodes in preterm neonates and false signals due to displacement of electrodes. Thermal imaging has recently gained significance as a non-contact method for RR detection because of its many advantages. ⋯ The average absolute error between the proposed and belt-based contact method in healthy adults reached 0.1 bpm and for more challenging conditions was approximately 1.5 bpm and 1.8 bpm, respectively. In the case of neonates, the average error is 1.5 bpm, which are promising results. The Bland-Altman analysis showed a good agreement of estimated RR with the reference method RR and this pilot study provided the evidence of using the proposed approach as a contactless method for the respiratory rate detection of neonates in clinical settings.
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J Clin Monit Comput · Jun 2023
Observational StudyPreoperative assessment of optic nerve sheath diameter and heart rate variability to predict intraoperative brain condition in patients with supratentorial tumors: a prospective observational study.
Brain relaxation is an important requirement in intracranial neurosurgical procedures and optimal brain relaxation improves the operating conditions. Optic nerve sheath diameter (ONSD) is a non-invasive bedside surrogate marker of intracranial pressure (ICP) status. Elevated ICP is often associated with marked autonomic dysfunction. ⋯ A receiver operating curve was constructed to determine the cut off to predict intraoperative brain bulge. A CT grade more than 2, ONSD of greater than 0.63 cms and ratio of low frequency to high ratio (LF/HF) of more than 1.8 were good predictors of brain bulge. The changes in ONSD and HRV parameters, with the CT findings can be used as surrogate markers of increased ICP to help predict intraoperative brain condition.
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J Clin Monit Comput · Jun 2023
Oxygen saturation in intraosseous sternal blood measured by CO-oximetry and evaluated non-invasively during hypovolaemia and hypoxia - a porcine experimental study.
This study intended to determine, and non-invasively evaluate, sternal intraosseous oxygen saturation (SsO2) and study its variation during provoked hypoxia or hypovolaemia. Furthermore, the relation between SsO2 and arterial (SaO2) or mixed venous oxygen saturation (SvO2) was investigated. ⋯ Sternal blood has an oxygen saturation suggesting a mixture of venous and arterial blood. Changes in SsO2 relate well with changes in SvO2 during hypovolaemia or hypoxia. Further studies on the feasibility of using non-invasive measurement of changes in SsO2 to estimate changes in SvO2 are warranted.