Abstract:
OBJECTIVE:To determine whether a simple transcanial Doppler waveform variable-pulsatility difference (systolic - diastolic blood flow velocity) can serve as a measure of critical changes in cerebral perfusion. METHODS:Thirteen pigs were anesthetized (anesthesia maintained with halothane) and ventilated to maintain normoxia and normocarbia. To measure mean arterial pressure, hemoglobin, and blood gases, the right carotid artery was cannulated. The right intracranial lateral ventricle was cannulated to measure and increase intracranial pressure; the right internal jugular vein was cannulated in 8 of 13 pigs to measure jugular venous oxygen saturation and to calculate cerebral arteriovenous oxygen content difference. Intracranial pressure was also monitored continuously with a subdural bolt in the contralateral frontal region, and blood flow velocity in the middle cerebral artery was measured with a transcranial Doppler probe on the right orbital region. Intracranial pressure was increased in increments of 10 to 20 mmHg by infusing saline through the ventriculostomy catheter until the transcranial Doppler indicated that blood flow velocity had ceased, at which point all variables were allowed to return to baseline. If mean arterial pressure failed to return to baseline, epinephrine, 0.01 to 0.1 microg/kg/min, was infused. Useful data were obtained from 8 pigs and were analyzed separately for pigs that received epinephrine (n = 4) and those that did not (n = 4). RESULTS:Transcranial Doppler measurements correlated more closely with cerebral perfusion pressure = (mean arterial pressure - intracranial pressure) than with intracranial pressure. In the range of 30 to 60 mmHg, cerebral perfusion pressure correlated linearly with the pulsatility difference. The closest nonlinear correlation (third order polynomial relationship) was noted between cerebral perfusion pressure and pulsatility difference (r = 0.8, P < 0.001, n = 217), for the animals that did not receive epinephrine. When a cerebral perfusion pressure < 60 mmHg and a cerebral arteriovenous oxygen content difference > 6.5 vol% were used to define limits of abnormal, pulsatility difference was a sensitive and specific indicator of abnormality in either variable. Pulsatility difference of > 70 cm/sec had > 77.1% and 86.7% positive accuracy rate, and < 0% and 14.3% negative accuracy rate for abnormal cerebral perfusion pressure (CPP) and cerebral arterio-venous O2 (C[a-v]O2), respectively. CONCLUSIONS:In pigs with induced diffuse intracranial hypertension, noninvasive transcranial Doppler waveform monitoring of pulsatility difference can identify increased cerebral oxygen extraction and dangerously decreased cerebral perfusion pressure.
journal_name
J Clin Monit Computjournal_title
Journal of clinical monitoring and computingauthors
Sidi A,Messinger G,Mahla MEdoi
10.1023/a:1009993232534subject
Has Abstractpub_date
1999-05-01 00:00:00pages
185-95issue
3-4eissn
1387-1307issn
1573-2614journal_volume
15pub_type
杂志文章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::The recently developed technique for measuring cutaneous mitochondrial oxygen tension (mitoPO2) by means of the Protoporphyrin IX-Triplet State Lifetime Technique (PpIX-TSLT) provides new opportunities for assessing mitochondrial function in vivo. The aims of this work were to study whether cutaneous mitochondrial mea...
journal_title:Journal of clinical monitoring and computing
pub_type: 杂志文章
doi:10.1007/s10877-014-9628-9
更新日期:2015-08-01 00:00:00
abstract:OBJECTIVE:To further elucidate temperature related changes in subcortical components of somatosensory evoked potentials (SEP) in intraoperative monitoring. METHODS:Intraoperative monitoring of subcortical median nerve SEP under deep hypothermia is described in a patient undergoing intracranial giant aneurysm surgery. ...
journal_title:Journal of clinical monitoring and computing
pub_type: 杂志文章
doi:10.1023/a:1020792729242
更新日期:2002-04-01 00:00:00
abstract::In mechanical ventilation, a careful setting of the ventilation parameters in accordance with the current individual state of the lung is crucial to minimize ventilator induced lung injury. Positive end-expiratory pressure (PEEP) has to be set to prevent collapse of the alveoli, however at the same time overdistension...
journal_title:Journal of clinical monitoring and computing
pub_type: 杂志文章,多中心研究
doi:10.1007/s10877-014-9562-x
更新日期:2014-12-01 00:00:00
abstract:OBJECTIVES:Optimizing cerebral oxygenation is of paramount importance in certain intraoperative situations. There is, however, a paucity of published data pertaining to changes in cerebral oxygenation seen with increases in the inspired fraction of oxygen (FIO2) or end-tidal carbon dioxide (PETCO2) in anesthetized pati...
journal_title:Journal of clinical monitoring and computing
pub_type: 临床试验,杂志文章
doi:10.1007/s10877-010-9265-x
更新日期:2010-12-01 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::The use of processed electroencephalography (EEG) using a simple frontal lead system has been made available for assessing the impact of anesthetic medications during surgery. This review discusses the basic principles behind these devices. The foundations of anesthesia monitoring rest on the observations of Guedel wi...
journal_title:Journal of clinical monitoring and computing
pub_type: 杂志文章,评审
doi:10.1007/s10877-006-9044-x
更新日期:2006-12-01 00:00:00
abstract::Pulse contour analysis techniques are used for beat-to-beat tracking of cardiac output in critically ill patients. However, an adequate pulse pressure waveform signal and identification of the appropriate (i.e. systolic) part of the waveform by the monitor are crucial for correct calculation of continuous cardiac outp...
journal_title:Journal of clinical monitoring and computing
pub_type: 杂志文章
doi:10.1007/s10877-013-9470-5
更新日期:2013-10-01 00:00:00
abstract:OBJECTIVE:To develop an ergonomically designed computerized recordkeeping tool for anesthesiologists that allows the clinician to maintain visual contact with the patient while performing recordkeeping. METHODS:To simplify the human interface software, we developed two general use software components. All purpose menu...
journal_title:Journal of clinical monitoring and computing
pub_type: 杂志文章
doi:10.1023/a:1009972223750
更新日期:1999-08-01 00:00:00
abstract::Central venous cannulation is a commonly preformed procedure in many branches of medicine, particularly in anaesthesia and intensive care medicine. The purpose of this study was to compare the landmark-guided technique to the ultrasound-guided technique for internal jugular vein cannulation in cardiovascular surgery p...
journal_title:Journal of clinical monitoring and computing
pub_type: 杂志文章,随机对照试验
doi:10.1007/s10877-014-9585-3
更新日期:2015-02-01 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:STUDY OBJECTIVES:Electrical impedance tomography (EIT) is able to reflect physiological parameters such as real-time changes in global and regional lung volume. EIT can aid in the assessment of lung recruitment, and its use has been validated in preliminary studies monitoring mechanical ventilation at the bedside. ICU ...
journal_title:Journal of clinical monitoring and computing
pub_type: 杂志文章
doi:10.1007/s10877-006-9021-4
更新日期:2006-06-01 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::In the present investigation, the data sets of NCD (Non Communicable Diseases) risk factors, a standard report of Saudi Arabia 2005, in collaboration with WHO (World Health Organisation) were employed. The Oracle Data Miner (ODM) tool was used for the analysis and prediction of data. The data sets for different age gr...
journal_title:Journal of clinical monitoring and computing
pub_type: 杂志文章
doi:10.1007/s10877-010-9260-2
更新日期:2010-12-01 00:00:00
abstract:OBJECTIVE:Describe reproducibility of a measurement method to investigate deficits in eye-head co-ordination. METHODS:Combined recordings of head and eye rotation using wireless motion sensors and electro-oculography (EOG) were used as an initial step towards a method to quantify eye-head co-ordination deficits. Head ...
journal_title:Journal of clinical monitoring and computing
pub_type: 杂志文章
doi:10.1007/s10877-009-9160-5
更新日期:2009-02-01 00:00:00
abstract::The capnodynamic method is a minimally invasive method continuously calculating effective pulmonary blood flow (COEPBF), equivalent to cardiac output when intra pulmonary shunt flow is low. The capnodynamic equation joined with a ventilator pattern containing cyclic reoccurring expiratory holds, provides breath to bre...
journal_title:Journal of clinical monitoring and computing
pub_type: 杂志文章
doi:10.1007/s10877-017-0021-3
更新日期:2018-04-01 00:00:00
abstract::Changes have been made to the AnaConDa device (Sedana Medical, Stockholm, Sweden), decreasing its size to reduce dead space and carbon dioxide (CO2) retention. However, this also involves a decrease in the surface area of the activated carbon filter. The CO2 elimination and sevoflurane (SEV) reflection of the old devi...
journal_title:Journal of clinical monitoring and computing
pub_type: 杂志文章
doi:10.1007/s10877-019-00285-0
更新日期:2020-02-01 00:00:00
abstract::Central venous pressure (CVP) is an important clinical parameter for physicians but only the absolute CVP value is typically monitored in the intensive care unit (ICU). In this study, we propose a novel mathematical method to present and analyze CVP signals. A total of 44 suitable samples were chosen from a total of 6...
journal_title:Journal of clinical monitoring and computing
pub_type: 杂志文章
doi:10.1007/s10877-016-9882-0
更新日期:2017-06-01 00:00:00
abstract::Supra-sternal Doppler (USCOM Ltd., Sydney, Australia) can be used during anaesthesia to measure cardiac output (CO) and related flow parameters. However, before the USCOM can be used routinely, its utility and limitations need to be fully understood and critical information about its use disseminated. In "Window to th...
journal_title:Journal of clinical monitoring and computing
pub_type: 杂志文章
doi:10.1007/s10877-013-9499-5
更新日期:2014-02-01 00:00:00
abstract:OBJECTIVE:Mixtures of helium and oxygen are regaining a place in the treatment of obstruction of the upper and lower respiratory tract. The parenchymal changes during the course of IRDS or ARDS may also benefit from the reintroduction of helium/oxygen. In order to monitor and document the effect of low-density gas mixt...
journal_title:Journal of clinical monitoring and computing
pub_type: 杂志文章
doi:10.1023/a:1009978816071
更新日期:1998-08-01 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::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::Obstructive sleep apnea (OSA) is a risk factor for perioperative complications, but many OSA patients present undiagnosed. While polysomnography (PSG) is the "gold standard" for diagnosis, its application is technology-intense, time-consuming, expensive, and requires specialists, often delaying surgery. Thus, miniatur...
journal_title:Journal of clinical monitoring and computing
pub_type: 杂志文章
doi:10.1007/s10877-018-0151-2
更新日期:2019-04-01 00:00:00
abstract::An intraoperative automated closed-loop system for goal-directed fluid therapy has been successfully tested in silico, in vivo and in a clinical case-control matching. This trial compared intraoperative cardiac output (CO) in patients managed with this closed-loop system versus usual practice in an academic medical ce...
journal_title:Journal of clinical monitoring and computing
pub_type: 杂志文章,随机对照试验
doi:10.1007/s10877-018-0106-7
更新日期:2018-12-01 00:00:00
abstract::Excessive pressures exerted on the tongue during intubation may be associated with serious complications and may make intubation more difficult. The aim of this study was to evaluate five different intubating devices in the hands of experienced anaesthetists during simulated conditions of reduced cervical spine mobili...
journal_title:Journal of clinical monitoring and computing
pub_type: 杂志文章
doi:10.1007/s10877-017-0095-y
更新日期:2018-10-01 00:00:00
abstract::The American Society of Neurophysiological Monitoring (ASNM) is developing position statements aimed at assisting practitioners and others in making decisions regarding neurophysiological monitoring practice. This paper describes the procedures used in drafting these documents. ...
journal_title:Journal of clinical monitoring and computing
pub_type: 杂志文章
doi:10.1007/s10877-005-9000-1
更新日期:2006-02-01 00:00:00
abstract::Mechanically ventilated patients with ARDS due to the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) seem particularly susceptible to AKI. Our hypothesis was that the renal blood flow could be more compromised in SARS-CoV-2 patients than in patients with "classical" ARDS. We compared the renal resistivit...
journal_title:Journal of clinical monitoring and computing
pub_type: 杂志文章
doi:10.1007/s10877-020-00633-5
更新日期:2021-01-01 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::Leakage of inhalational anesthetic gases is an important issue not only to staff health but awareness during general anesthesia. After inhalation of sevoflurane commenced, the audible and visible alarm of our custom-made air monitoring system was activated. The system measured 2-4 ppm of sevoflurane. A thorough search...
journal_title:Journal of clinical monitoring and computing
pub_type: 杂志文章
doi:10.1007/s10877-013-9479-9
更新日期:2013-12-01 00:00:00
abstract::From home to intensive care units, innovations in pulse oximetry are susceptible to improve the monitoring and management of patients developing acute respiratory failure, and particularly those with the coronavirus disease 2019 (COVID-19). They include self-monitoring of oxygen saturation (SpO2) from home, continuous...
journal_title:Journal of clinical monitoring and computing
pub_type: 社论
doi:10.1007/s10877-020-00550-7
更新日期:2020-06-23 00:00:00