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 manually adjusted to fit the same BIS range of 40-60 % (TCI Manual). Patients scheduled for elective vascular or thoracic surgery were randomized to the TCI Loop or TCI Manual method for administering propofol and remifentanil during both induction and maintenance of general anesthesia. Assessment of workload was performed by an independent observer who quoted each time the physician looked at the BIS monitor. The number of propofol and remifentanil target modifications, the percentage of time of adequate anesthesia i.e. BIS in the range 40-60 and hemodynamic data were recorded. Eighteen patients per group were enrolled. Characteristics, duration of surgery and propofol-remifentanil consumption were similar between groups. However, the percentage of time in the BIS range 40-60 % was higher in the TCI Loop versus TCI Manual groups (94 % ± 12 vs. 74 % ± 19, p < 0.001). Mean arterial pressure was lower with TCI Manual (78 ± 6 vs. 88 ± 13 mmHg, p < 0.001). The number of times the anesthesiologist watched the controller or BIS monitor (p < 0.05) and the number of manual adjustments (p < 0.001) performed in each group was lower with TCI Loop group during induction and maintenance of anesthesia. An automated controller strikingly frees the anesthesiologist from manual intervention to adjust drug delivery.
journal_name
J Clin Monit Computjournal_title
Journal of clinical monitoring and computingauthors
Dussaussoy C,Peres M,Jaoul V,Liu N,Chazot T,Picquet J,Fischler M,Beydon Ldoi
10.1007/s10877-013-9453-6subject
Has Abstractpub_date
2014-02-01 00:00:00pages
35-40issue
1eissn
1387-1307issn
1573-2614journal_volume
28pub_type
杂志文章,随机对照试验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: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:OBJECTIVE:An atypical "tails-up" capnograph pattern was noticed in a patient during the use of an accidentally crushed sampling tube with a slit-like hole. We investigated the mechanics involved in the observed capnograph pattern. METHODS:Forty consenting ASA I patients of both sexes presenting for tonsillectomy were ...
journal_title:Journal of clinical monitoring and computing
pub_type: 杂志文章
doi:10.1023/a:1009990210114
更新日期:2000-01-01 00:00:00
abstract::We evaluated the effects of three different inspired oxygen concentrations (40%, 80%, and 100%) at anaesthesia emergence on postoperative lung volumes as measured by global impedance of electrical impedance tomography (EIT). This is a randomised, controlled, and assessor-blinded study in single-centre from May 2017 to...
journal_title:Journal of clinical monitoring and computing
pub_type: 杂志文章
doi:10.1007/s10877-019-00390-0
更新日期:2020-10-01 00:00:00
abstract::Extravascular lung water (EVLW) could increase by permeability pulmonary oedema, cardiogenic oedema, or both. Transthoracic echocardiography examination of a patient allows quantifying B-lines, originating from water-thickened interlobular septa, and the E/Ea ratio, related to pulmonary capillary wedge pressure. The a...
journal_title:Journal of clinical monitoring and computing
pub_type: 杂志文章
doi:10.1007/s10877-014-9582-6
更新日期:2015-02-01 00:00:00
abstract::Bioreactance is a novel non-invasive method for cardiac output measurement that involves the analysis of blood flow-dependent changes in the phase shifts of electrical currents applied across the chest. The present study (1) compared resting and exercise cardiac outputs determined by bioreactance and bioimpedance meth...
journal_title:Journal of clinical monitoring and computing
pub_type: 杂志文章
doi:10.1007/s10877-012-9334-4
更新日期:2012-04-01 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: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::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::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: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 nor...
journal_title:Journal of clinical monitoring and computing
pub_type: 杂志文章
doi:10.1023/a:1009993232534
更新日期:1999-05-01 00:00:00
abstract:OBJECTIVE:Various studies worldwide have found that sound levels in hospitals significantly exceed the World Health Organization (WHO) guidelines, and that this noise is associated with audible signals from various medical devices. The pulse oximeter is now widely used in health care; however the health effects associa...
journal_title:Journal of clinical monitoring and computing
pub_type: 杂志文章
doi:10.1007/s10877-008-9125-0
更新日期:2008-06-01 00:00:00
abstract::FloTrac/Vigileo™ system is based on arterial pressure waveform analysis arterial pressure-based CO (APCO). Therefore, systemic vascular resistance (SVR) can influence the accuracy of APCO. The purpose of this study is to evaluate the relationship between SVR and the accuracy of APCO. We managed 50 consecutive patients...
journal_title:Journal of clinical monitoring and computing
pub_type: 杂志文章
doi:10.1007/s10877-013-9481-2
更新日期:2013-12-01 00:00:00
abstract::Alarms in the operating room remain a major source of annoyance and confusion. Nearly all alarms result from a transgression of certain alarm limits. We surveyed manufacturers at a major meeting of anesthesiologists for their default alarm limits. We also conducted a mail survey of anesthesiologists in the United Stat...
journal_title:Journal of clinical monitoring and computing
pub_type: 杂志文章
doi:10.1023/a:1009992830942
更新日期:1999-02-01 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: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::One of the main goals of hemodynamic support is to preserve tissue perfusion. However issue perfusion is related more to microvascular perfusion than aortic blood flow. Monitoring the microcirculation has long been difficult. Recent technologic advances have made feasible monitoring of the microcirculation at bedside ...
journal_title:Journal of clinical monitoring and computing
pub_type: 杂志文章,评审
doi:10.1007/s10877-012-9383-8
更新日期:2012-10-01 00:00:00
abstract::The physiology underlying the intracranial pressure (ICP) curve morphology is not fully understood. Recent research has suggested that the morphology could be dependent on arterial cerebral inflow and the physiological and pathophysiological properties of the intracranial cavity. If understood, the ICP curve could pro...
journal_title:Journal of clinical monitoring and computing
pub_type: 杂志文章
doi:10.1007/s10877-019-00342-8
更新日期:2020-06-01 00:00:00
abstract:OBJECTIVE:This study evaluates a method for calibrating mainstream CO(2) analysers in which CO(2) partial pressure (P (CO2)) is calculated as a function of the outputs of CO(2) and O(2) analysers. METHODS:Three mass flow controllers were used to generate 25 different reference mixtures of O(2), N(2) and CO(2). Referen...
journal_title:Journal of clinical monitoring and computing
pub_type: 杂志文章
doi:10.1007/s10877-005-9005-9
更新日期:2006-04-01 00:00:00
abstract::The Sensmart Model X-100 (Nonin Medical Inc, Plymouth, MN, USA) is a relatively new device that possesses two sets of emitters and detectors and uses near infrared spectroscopy (NIRS) to measure regional cerebral oxygen saturation (rSO2). The value of rSO2 obtained by other NIRS devices is affected by physiological an...
journal_title:Journal of clinical monitoring and computing
pub_type: 杂志文章
doi:10.1007/s10877-020-00567-y
更新日期:2020-07-31 00:00:00
abstract::Total shoulder arthroplasty (TSA) is typically performed in the beach-chair position. Maintenance of adequate mean arterial pressure is required to provide appropriate cerebral perfusion pressure and prevent cerebral ischemia. Placement of an arterial line to facilitate invasive monitoring is discretionary, based on c...
journal_title:Journal of clinical monitoring and computing
pub_type: 杂志文章
doi:10.1007/s10877-016-9939-0
更新日期:2017-10-01 00:00:00
abstract::In this paper is presented a brief state of art regarding the multivariable formulation for controlling the depth of anaesthesia by means of two intravenously administrated drugs, i.e. propofol and remifentanil. In a feasibility study of determining a suitable variable to quantify analgesia levels in patients undergoi...
journal_title:Journal of clinical monitoring and computing
pub_type: 杂志文章
doi:10.1007/s10877-013-9535-5
更新日期:2014-12-01 00:00:00
abstract:OBJECTIVES:Bioreactance, the analysis of intrabeat variations in phase of a transthoracic voltage in response to an applied high frequency transthoracic current, was recently introduced for noninvasive cardiac output measurement (NICOM). We evaluated NICOM compared to thermo- dilution (TD) in several clinical settings....
journal_title:Journal of clinical monitoring and computing
pub_type: 杂志文章,多中心研究
doi:10.1007/s10877-008-9112-5
更新日期:2008-04-01 00:00:00
abstract::Severe traumatic brain injury (TBI) patients are monitored with continuous arterial blood pressure (ABP) and intracranial pressure (ICP). The pressure reactivity index (PRx) is a frequently used correlation coefficient between ABP and ICP to inform clinicians at the bedside about trends in global cerebrovascular press...
journal_title:Journal of clinical monitoring and computing
pub_type: 信件
doi:10.1007/s10877-020-00471-5
更新日期:2020-02-08 00:00:00
abstract::To compare the newborn infant parasympathetic evaluation system (NIPE) scores with a validated clinical scale using two different nebulizers in children with bronchiolitis admitted to a PICU. Comfort was evaluated using the COMFORT-behavior scale (CBS) before (T1), during (T2) and after (T3) each nebulization. In orde...
journal_title:Journal of clinical monitoring and computing
pub_type: 杂志文章,随机对照试验
doi:10.1007/s10877-019-00268-1
更新日期:2019-10-01 00:00:00
abstract::Positive end-expiratory pressure (PEEP) can be titrated by electrical impedance tomography (EIT). The aim of the present study was to examine the performance of different EIT measures during PEEP trials with the aim of identifying "optimum" PEEP and to provide possible interpretations of largely diverging results. Aft...
journal_title:Journal of clinical monitoring and computing
pub_type: 杂志文章
doi:10.1007/s10877-019-00396-8
更新日期:2020-10-01 00:00:00
abstract:OBJECTIVE:To evaluate a computerized system for mechanical ventilation of infants. METHODS:FLEX is a computerized system that includes the features of a patented mode known as adaptive-support ventilation (ASV). In addition, it has many other features including adjustment of positive end-expiratory pressure (PEEP), fr...
journal_title:Journal of clinical monitoring and computing
pub_type: 杂志文章
doi:10.1007/s10877-009-9170-3
更新日期:2009-04-01 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::The operating principles and methods for the continuous determination of aortic blood flow (ABF) with the Dynemo 3000 system are described in detail. The system uses a novel transesophageal ultrasonic Echo-Doppler probe simultaneously to measure aortic diameter and blood flow velocity at the same anatomic level, in re...
journal_title:Journal of clinical monitoring and computing
pub_type: 杂志文章
doi:10.1023/a:1009902517388
更新日期:2000-01-01 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