Abstract:
OBJECTIVE:Awareness with recall is a rare but serious complication of general anaesthesia with an incidence ranging from 0.1%-0.7%. In the absence of a reliable depth-of-anaesthesia monitor, attempts have been made to predict awareness from intraoperative haemodynamic monitoring data, with little success. Artificial neural networks can sometimes detect relationships between input and output variables even when conventional methods fail. Therefore, we subjected standard intraoperative monitoring data to both artificial neural models and conventional statistical methods in an attempt to predict awareness with recall. METHODS:Anaesthesia records from 33 patients with awareness and 510 patients without awareness were collected. Summary data (mean, maximum, and minimum) of end-tidal carbon dioxide concentration, arterial blood oxygen saturation, systolic and diastolic blood pressure, and heart rate were calculated for each patient. These data were subjected to an analysis by artificial neural networks and by Poisson regression. RESULTS:The two best neural models both had sensitivity and specificity of 23% and 98%, respectively. The models have high specificity, and in view of the low incidence of awareness, a high negative predictive value. The prediction probabilities P(k) (SE) for the best neural models were 0.66 (0.08) and 0.60 (0.10), respectively. In the Poisson regression, there were significant differences in systolic and diastolic blood pressures and heart rate between patients with and without awareness. CONCLUSIONS:A prediction indicating awareness by the network is very suggestive of true awareness and recall. Blood pressure and heart rate are significantly higher on average in patients with awareness than in patients without. In an individual patient, however, none of our artificial neural models can detect awareness sufficiently reliably.
journal_name
J Clin Monit Computjournal_title
Journal of clinical monitoring and computingauthors
Ranta SO,Hynynen M,Räsänen Jdoi
10.1023/a:1015426015547subject
Has Abstractpub_date
2002-01-01 00:00:00pages
53-60issue
1eissn
1387-1307issn
1573-2614journal_volume
17pub_type
杂志文章abstract::Cigarette smoking is often associated with the development of several respiratory diseases however, if diagnosed early, the changes in the lung tissue caused by smoking may be reversible. Computerised respiratory sounds have shown to be sensitive to detect changes within the lung tissue before any other measure, howev...
journal_title:Journal of clinical monitoring and computing
pub_type: 杂志文章
doi:10.1007/s10877-016-9887-8
更新日期:2017-06-01 00:00:00
abstract::Applying lung protective mechanical ventilation (LPV) during general anaesthesia even in patients with non-injured lungs is recommended. However, the effects of an individual PEEP-optimisation on respiratory mechanics, oxygenation and their potential correlation with the inflammatory response and postoperative complic...
journal_title:Journal of clinical monitoring and computing
pub_type: 杂志文章
doi:10.1007/s10877-020-00519-6
更新日期:2020-05-09 00:00:00
abstract::Closed loop target-control infusion systems using a Bispectral (BIS) signal as an input (TCI Loop) can automatically maintain intravenous anesthesia in a BIS range of 40-60 %. Our purpose was to assess to what extent such a system could decrease anesthesia workload in comparison to the use of a stand alone TCI system ...
journal_title:Journal of clinical monitoring and computing
pub_type: 杂志文章,随机对照试验
doi:10.1007/s10877-013-9453-6
更新日期:2014-02-01 00:00:00
abstract::Numerous factors could contribute to sleep disturbances in women with breast cancer. We hypothesized that stellate ganglion block (SGB) during surgery would preserve sleep after surgery and increase intraoperative regional cerebral oxygen saturation (rSO2) on the blocked side in patients undergoing breast cancer surge...
journal_title:Journal of clinical monitoring and computing
pub_type: 杂志文章,随机对照试验
doi:10.1007/s10877-017-0074-3
更新日期:2018-10-01 00:00:00
abstract::Continual vital sign assessment on the general care, medical-surgical floor is expected to provide early indication of patient deterioration and increase the effectiveness of rapid response teams. However, there is concern that continual, multi-parameter vital sign monitoring will produce alarm fatigue. The objective ...
journal_title:Journal of clinical monitoring and computing
pub_type: 杂志文章
doi:10.1007/s10877-015-9790-8
更新日期:2016-12-01 00:00:00
abstract::Increasing process complexity in the pediatric intensive care unit (PICU) can lead to information overload resulting in missing pertinent information and potential errors during morning rounds. An efficient model using a novel electronic rounding tool was designed as part of a broader critical care decision support sy...
journal_title:Journal of clinical monitoring and computing
pub_type: 杂志文章
doi:10.1007/s10877-016-9946-1
更新日期:2017-12-01 00:00:00
abstract::The use of sedation for diagnostic procedures including gastrointestinal endoscopy is rapidly growing. Recovery of cognitive function after sedation is important because it would be important for most patients to resume safe, normal life soon after the procedure. Computerized tests have shown being accurate descriptor...
journal_title:Journal of clinical monitoring and computing
pub_type: 杂志文章
doi:10.1007/s10877-018-0134-3
更新日期:2019-02-01 00:00:00
abstract::Recently a novel pain recognition indicator derived from electroencephalogram(EEG) signals, pain threshold index(PTI) has been developed. The aim of this study was to determine whether PTI can be used for prediction of postoperative acute pain while surgical pleth index(SPI) applied as control. Eighty patients undergo...
journal_title:Journal of clinical monitoring and computing
pub_type: 杂志文章
doi:10.1007/s10877-020-00604-w
更新日期:2020-10-12 00:00:00
abstract::Jasiukaitis and Lyon (J Clin Monit Comput, https://doi.org/10.1007/s10877-018-0181-9, 2018) described an motor evoked potential (MEP)amplitude trending system to detect MEP amplitude loss against a background of MEP variability. They found that the end of case value of a running R2 triggered by a set MEP amplitude los...
journal_title:Journal of clinical monitoring and computing
pub_type: 杂志文章
doi:10.1007/s10877-019-00272-5
更新日期:2020-02-01 00:00:00
abstract::Pulmonary air embolism is a well-known consequence of surgery, trauma, diving, and aviation. This article reviews the physiological effects, means of detection and methods of prevention and treatment of pulmonary air embolism. The primary physiological effects are elevated pulmonary artery pressures, increased ventila...
journal_title:Journal of clinical monitoring and computing
pub_type: 杂志文章,评审
doi:10.1023/a:1011455701892
更新日期:2000-01-01 00:00:00
abstract::Electric energy have been in use for the treatment of various ailments, including pain, since the time of Pharaohs. The theoretical basis of electrotherapy of pain was provided by the Gate Control Theory of Melzak and Wall. In 1965, Shealey et al. first introduced electrical stimulation of spinal cord for treating pai...
journal_title:Journal of clinical monitoring and computing
pub_type: 杂志文章,评审
doi:10.1007/s10877-009-9201-0
更新日期:2009-10-01 00:00:00
abstract::Audible pulse tones, based on a variable-pitch frequency scale, allow the anesthesiologist to determine the patient's oxygen saturation without constant visual examination of the monitor display. The ability to reliably detect oxygen saturation levels based on audible pulse tones may be compromised when multiple pulse...
journal_title:Journal of clinical monitoring and computing
pub_type: 杂志文章
doi:10.1023/b:jocm.0000032698.47717.06
更新日期:2004-04-01 00:00:00
abstract:BACKGROUND:The ventricular stroke work refers to the work done by the left or right ventricle to eject the volume of blood during one cardiac cycle, called stroke volume. Sarnoff and Berglund were one of the first to calculate the stroke work from the pressure volume diagram in 1954. However, they published a wrong uni...
journal_title:Journal of clinical monitoring and computing
pub_type: 杂志文章,评审
doi:10.1007/s10877-010-9234-4
更新日期:2010-06-01 00:00:00
abstract::We tested whether the ratio of alveolar dead space to alveolar tidal volume (VD(alv)/VT(alv)) can detect states of low pulmonary blood flow (PBF) in a non-invasive way. Fifteen patients undergoing cardiovascular surgeries with cardiopulmonary bypass (CPB) were studied. CPB is a technique that excludes the lungs from t...
journal_title:Journal of clinical monitoring and computing
pub_type: 杂志文章
doi:10.1007/s10877-012-9358-9
更新日期:2012-06-01 00:00:00
abstract::Sedation in locations outside the operating room (OR) is common. Guidelines for safe patient monitoring have been updated by the American Society of Anesthesiology to include monitoring of ventilation and/or carbon dioxide (CO2). Although technologies exist to monitor these variables, the quality and/or availability o...
journal_title:Journal of clinical monitoring and computing
pub_type: 杂志文章
doi:10.1007/s10877-015-9809-1
更新日期:2017-02-01 00:00:00
abstract::Pulse pressure variation (PPV) and cardiac output (CO) can guide perioperative fluid management. Capstesia (Galenic App, Vitoria-Gasteiz, Spain) is a mobile application for snapshot pulse wave analysis (PWAsnap) and estimates PPV and CO using pulse wave analysis of a snapshot of the arterial blood pressure waveform di...
journal_title:Journal of clinical monitoring and computing
pub_type: 杂志文章
doi:10.1007/s10877-020-00572-1
更新日期:2020-08-04 00:00:00
abstract::The Nexfin device allows for non-invasive beat-to-beat blood pressure monitoring (BP(NXF)). Perioperative hypotension and hypertension have been shown to be associated with poor clinical outcomes. The goal of the present study was to assess the ability of this device to decrease the duration of significant intraoperat...
journal_title:Journal of clinical monitoring and computing
pub_type: 杂志文章
doi:10.1007/s10877-012-9344-2
更新日期:2012-04-01 00:00:00
abstract::With the AnaConDa™ and the MIRUS™ system, volatile anesthetics can be administered for inhalation sedation in intensive care units. Instead of a circle system, both devices use anesthetic reflectors to save on the anesthetic agent. We studied the efficiency of desflurane reflection with both devices using different ti...
journal_title:Journal of clinical monitoring and computing
pub_type: 杂志文章
doi:10.1007/s10877-016-9902-0
更新日期:2018-08-01 00:00:00
abstract::To determine the effect of implementing an algorithm of fluid and blood administration based on continuous monitoring of hemoglobin (SpHb) and PVI (plethysmography variability index) on mortality and transfusion on a whole hospital scale. This single-center quality program compared transfusion at 48 h and mortality at...
journal_title:Journal of clinical monitoring and computing
pub_type: 杂志文章
doi:10.1007/s10877-019-00367-z
更新日期:2020-08-01 00:00:00
abstract::Electrical impedance tomography (EIT) is used in lung physiology monitoring. There is evidence that EIT is linearly associated with global tidal volume (VT) in clinically healthy patients where no positive end-expiratory pressure (PEEP) is applied. This linearity has not been challenged by altering lung conditions. Th...
journal_title:Journal of clinical monitoring and computing
pub_type: 杂志文章
doi:10.1007/s10877-021-00651-x
更新日期:2021-01-25 00:00:00
abstract::Pompe's disease is a glycogen storage disease (type II) characterized by inherited autosomal recessive transmission. The right ventricular (RV) function is a determinant parameter of clinical outcome in patients with heart failure. We sought to characterize the RV function using Doppler-echocardiography completed by D...
journal_title:Journal of clinical monitoring and computing
pub_type: 杂志文章
doi:10.1007/s10877-014-9551-0
更新日期:2014-08-01 00:00:00
abstract:OBJECTIVE:To determine if an automatic algorithm using wavelet analysis techniques can be used to reliably determine respiratory rate from the photoplethysmogram (PPG). METHODS:Photoplethysmograms were obtained from 12 spontaneously breathing healthy adult volunteers. Three related wavelet transforms were automaticall...
journal_title:Journal of clinical monitoring and computing
pub_type: 杂志文章
doi:10.1007/s10877-005-9007-7
更新日期:2006-02-01 00:00:00
abstract:OBJECTIVE:We tested whether a newly installed neuromuscular monitoring device (NMT) with a computerized anesthesia recording system, incorporated in all anesthesia stations, could enhance the commitment to objective neuromuscular monitoring in a teaching hospital anesthesia department. METHODS:After 6 months of famili...
journal_title:Journal of clinical monitoring and computing
pub_type: 杂志文章
doi:10.1007/s10877-008-9135-y
更新日期:2008-08-01 00:00:00
abstract:OBJECTIVE:The mid-latency auditory evoked potential (MLAEP) has been used to indicate depth of anaesthesia, and is usually analysed in time-domain. This work compares three techniques: Wave Deformation Parameters (PDO), Auditory Evoked Potential Index (AEPidx) and an automatic Nb-wave latency estimator (Nb), in the ass...
journal_title:Journal of clinical monitoring and computing
pub_type: 临床试验,杂志文章
doi:10.1023/a:1024208827407
更新日期:2002-08-01 00:00:00
abstract::Intraoperative neurophysiological monitoring (IONM) is widely used in spinal cord tumors (SCTs) removal surgery. This study mainly hypothesized that patients with prolonged latency of preoperative somatosensory evoked potentials (preSEPLat) would have more deteriorated intraoperative evoked potentials. Among 506 patie...
journal_title:Journal of clinical monitoring and computing
pub_type: 杂志文章
doi:10.1007/s10877-020-00584-x
更新日期:2020-09-29 00:00:00
abstract:OBJECTIVE:To demonstrate the usefulness of rectus femoris muscle MEPs monitoring in a paraparetic neuromuscular scoliosis case. METHODS:Multiple monitoring modalities including SEPs, MEPs and EMG were performed for an anterior and posterior correction surgery for a neuromuscular scoliosis patient with no motor and sen...
journal_title:Journal of clinical monitoring and computing
pub_type: 杂志文章
doi:10.1007/s10877-011-9325-x
更新日期:2012-02-01 00:00:00
abstract::Studies reveal that the false alarm rate (FAR) demonstrated by intensive care unit (ICU) vital signs monitors ranges from 0.72 to 0.99. We applied machine learning (ML) to ICU multi-sensor information to imitate a medical specialist in diagnosing patient condition. We hypothesized that applying this data-driven approa...
journal_title:Journal of clinical monitoring and computing
pub_type: 杂志文章
doi:10.1007/s10877-019-00307-x
更新日期:2020-04-01 00:00:00
abstract:OBJECTIVE:To compare expert-generated textual summaries of physiological data with trend graphs, in terms of their ability to support neonatal Intensive Care Unit (ICU) staff in making decisions when presented with medical scenarios. METHODS:Forty neonatal ICU staff were recruited for the experiment, eight from each o...
journal_title:Journal of clinical monitoring and computing
pub_type: 杂志文章
doi:10.1007/s10877-005-0879-3
更新日期:2005-06-01 00:00:00
abstract:OBJECTIVE:We present a new physiological model that discriminated between changes in the systemic arterial and venous circulation. To test our model, we studied the effects of dobutamine and hypovolemia in intact pentabarbital-anesthetized piglets. METHODS:Aorta pressure (Pao), central venous pressure (Pcv), mean syst...
journal_title:Journal of clinical monitoring and computing
pub_type: 杂志文章
doi:10.1007/s10877-010-9258-9
更新日期:2010-10-01 00:00:00
abstract:BACKGROUND:The value of the impedance cardiography (IC) method for measuring cardiac output (CO) with the subject in the left lateral position has not yet been established. We compared the CO after a 30 degrees head-up tilt with the subjects in the supine and left lateral position. METHODS:Thirty healthy young volunte...
journal_title:Journal of clinical monitoring and computing
pub_type: 杂志文章
doi:10.1023/a:1009968513512
更新日期:1999-12-01 00:00:00