Journal of clinical monitoring and computing
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J Clin Monit Comput · Apr 2023
ReviewUltrasound-guided cerebral resuscitation in patients with severe traumatic brain Injury.
Traumatic brain injury (TBI) is a worldwide public health concern given its significant morbidity and mortality, years of potential life lost, reduced quality of life and elevated healthcare costs. The primary injury occurs at the moment of impact, but secondary injuries might develop as a result of brain hemodynamic abnormalities, hypoxia, and hypotension. The cerebral edema and hemorrhage of the injured tissues causes a decrease in cerebral perfusion pressure (CPP), which leads to higher risk of cerebral ischemia, herniation and death. ⋯ Performing a transcranial doppler ultrasound (TCD) allows to estimate cerebral blood flow velocities and identify states of low flow and high resistance. We propose to include TCD as an initial assessment and further monitoring tool for resuscitation guidance in patients with severe TBI. We present an Ultrasound-Guided Cardio-cerebral Resuscitation (UGCeR) protocol in Patients with Severe TBI.
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J Clin Monit Comput · Apr 2023
Randomized Controlled TrialComparative evaluation of King Vision videolaryngoscope channeled and non-channeled blades with direct laryngoscope for intubation performance and skill retention by medical students: a randomized cross over two period study.
A videolaryngoscope(VL) with an intubation conduit like KingVision channeled(KVC) blade may provide an added advantage over a non-channeled VL like a KingVision non-channeled (KVNC) blade and direct laryngoscope (DL) for acquiring and retention of intubation skills, especially in novices. ⋯ KVC performed better in terms of time to intubation, success rate and ease of procedure as compared to KVNC and DL, both for acquisition and retention of skill. Hence, we advocate that KVC should be the preferred device over KVNC and DL for teaching intubation skills to novices.
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J Clin Monit Comput · Apr 2023
Clinical TrialEffects of changes in veno-venous extracorporeal membrane oxygenation blood flow on the measurement of intrathoracic blood volume and extravascular lung water index: a prospective interventional study.
In severe acute respiratory distress syndrome (ARDS), veno-venous extracorporeal membrane oxygenation (V-V ECMO) has been proposed as a therapeutic strategy to possibly reduce mortality. Transpulmonary thermodilution (TPTD) enables monitoring of the extravascular lung water index (EVLWI) and cardiac preload parameters such as intrathoracic blood volume index (ITBVI) in patients with ARDS, but it is not generally recommended during V-V ECMO. We hypothesized that the amount of extracorporeal blood flow (ECBF) influences the calculation of EVLWI and ITBVI due to recirculation of indicator, which affects the measurement of the mean transit time (MTt), the time between injection and passing of half the indicator, as well as downslope time (DSt), the exponential washout of the indicator. ⋯ German Clinical Trials Register (DRKS00021050). Registered 14/08/2018. https://www.drks.de/drks_web/navigate.do?navigationId=trial. HTML&TRIAL_ID=DRKS00021050.
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J Clin Monit Comput · Apr 2023
Clinical performance of lung ultrasound in predicting time-dependent changes in lung aeration in ARDS patients.
To evaluate whether lung ultrasound is reliable bedside tool to monitor changes of lung aeration at the early and late stages of ARDS. LUS was performed in ARDS patients that underwent at least two consecutive CT scan at ICU admission and at least 1 week after admission. Twelve fields were evaluated and graded from 0 (normal) to 3 (consolidation). ⋯ Compared to Equal, Improve and Worse categories had significantly higher (p < 0.01) and lower (p < 0.05) ΔCTair values, respectively. Compared to Equal, Improve and Worse categories had lower (p < 0.01) and higher (p < 0.01) ΔCTnot values, respectively. LUS score had a good correlation with lung CT in detecting changes of lung aeration.
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J Clin Monit Comput · Apr 2023
Device for remote and realtime monitoring of neonatal vital signs in neonatal intensive care unit using internet of things: proof-of-concept study.
Realtime and remote monitoring of neonatal vital signs is a crucial part of providing appropriate care in neonatal intensive care units (NICU) to reduce mortality and morbidity of newborns. In this study, a new approach, a device for remote and real-time monitoring of neonatal vital signs (DRRMNVS) in the neonatal intensive care unit using the internet of things (IoT), was proposed. The system integrates four vital signs: oxygen saturation, pulse rate, body temperature and respiration rate for continuous monitoring using the Blynk app and ThingSpeak IoT platforms. ⋯ The developed DRRMNVS device was cheap and had acceptable measurement accuracy of vital signs in a controlled environment. The system has the potential to advance healthcare service delivery for neonates with further development from this proof-of-concept level.