Abstract:
:Near-infrared spectroscopy (NIRS) has been used to detect in vivo microvascular alterations by means of a vascular occlusion test. We sought to analyse by NIRS the microcirculatory profile of patients undergoing prolonged tourniquet-induced bloodless condition for extremity surgery, and compare the results with time of ischemia and comorbidities. We conducted a prospective observational study on 42 patients undergoing upper limb surgery. Regional anaesthesia was achieved and ischemia was induced by a tourniquet cuffed at 250 mmHg. The probe of a NIRS monitor (InSpectra 325, Hutchiston, USA) was placed on the brachial muscle, and muscle oxygen saturation (StO2) was recorded continuously before anaesthesia, during and after surgery. The following variables were recorded: baseline StO2, StO2 desaturation slope during occlusion (dSlope, units/s), resaturation rate following ischemia (RR, units/s), hyperaemic peak (peak, units), and duration of the hyperaemic period following ischemia (hyperaemic time, s). Values of dSlope were similar among all patients. RR and hyperaemic time were significantly correlated with the duration of ischemia, but not with comorbidities [p = 0.007 CI (-35.64 to -13.1), and p < 0.001 CI (0.049-0.159), respectively]. Grouping patients by duration of ischemia (30, 60, or 90 min), we found a significant decrease in RR after 60 and 90 min (p < 0.001 and p = 0.03, respectively). Hyperaemic peak was lower in the 90 min group (83.9 ± 6.8 vs. 91.2 ± 5.7 %, p = 0.02) whereas the hyperaemic time was significantly increased (595 ± 136 vs. 429 ± 107 min, p < 0.001). Alterations of skeletal muscle microcirculation were correlated with the duration of ischemia, but not with comorbidities. We observed an initial impairment of the microcirculatory recovery at 90 min of ischemia.
journal_name
J Clin Monit Computjournal_title
Journal of clinical monitoring and computingauthors
Tujjar O,De Gaudio AR,Tofani L,Di Filippo Adoi
10.1007/s10877-016-9877-xsubject
Has Abstractpub_date
2017-06-01 00:00:00pages
581-588issue
3eissn
1387-1307issn
1573-2614pii
10.1007/s10877-016-9877-xjournal_volume
31pub_type
杂志文章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:Ventilator-associated pneumonia (VAP) is a common hazardous complication in ICU patients. The aim of the current review is to give an update on the current status and future recommendations for VAP prevention. METHODS:This article gives an updated review of the current literature on VAP. The first part brief...
journal_title:Journal of clinical monitoring and computing
pub_type: 杂志文章,meta分析,评审
doi:10.1007/s10877-010-9228-2
更新日期:2010-04-01 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::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: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::It remains to be discovered whether a formula predicting the subglottic transverse diameter measured by ultrasound (SGDformula) for the selection of an appropriate endotracheal tube (ETT) for children without congenital heart disease (CHD) is useful for children with CHD. A formula for predicting SGD was established a...
journal_title:Journal of clinical monitoring and computing
pub_type: 杂志文章
doi:10.1007/s10877-018-0203-7
更新日期:2019-08-01 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: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: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:OBJECTIVE:The present paper introduces a new perspective on the classical ensemble averaging which can be useful to analyse the Brainstem Auditory Evoked Potentials (BAEPs). The analysis of the dynamics, related to the BAEP, is performed directly after its acquisition from the electroencephalogram (EEG). METHODS:The m...
journal_title:Journal of clinical monitoring and computing
pub_type: 杂志文章
doi:10.1023/b:jocm.0000042919.04719.a7
更新日期:2004-06-01 00:00:00
abstract::The optimal size selection of laryngeal mask airway (LMA) based on body weight is not always applicable. This study was prospectively conducted to evaluate the efficacy of cricoid-mental distance-based method versus weight-based method in optimal size selection of LMA in adults. Seventy-four patients (aged from 18 to ...
journal_title:Journal of clinical monitoring and computing
pub_type: 杂志文章,随机对照试验
doi:10.1007/s10877-019-00308-w
更新日期:2019-10-01 00:00:00
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 ne...
journal_title:Journal of clinical monitoring and computing
pub_type: 杂志文章
doi:10.1023/a:1015426015547
更新日期:2002-01-01 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
abstract::Hypotension subsequent to spinal anesthesia occurs in a significant number of parturients undergoing lower segment caesarian section. Currently available methods to predict the incidence of hypotension, its severity and the outcome are sub-optimal. Many workers have used basal heart rate as one of the predictors. But ...
journal_title:Journal of clinical monitoring and computing
pub_type: 杂志文章
doi:10.1007/s10877-016-9906-9
更新日期:2017-08-01 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: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::The composite auditory evoked potentials index (cAAI) uses both cortical electroencephalogram (EEG) and response to auditory stimuli, while the bispectral index (BIS) uses only the cortical EEG and auditory evoked potentials index (AAI) uses only response to auditory stimuli. We expected that the cAAI was more useful ...
journal_title:Journal of clinical monitoring and computing
pub_type: 杂志文章,随机对照试验
doi:10.1007/s10877-013-9441-x
更新日期:2013-06-01 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:Artefact detection is an essential feature of automatic EEG monitoring systems used in anaesthesia. Clinical experience indicates that Narcotrend monitoring (MonitorTechnik, Bad Bramstedt, Germany, version 4.0) excludes more EEG epochs because of artefacts than bispectral index monitoring (BIS, Aspect Medical...
journal_title:Journal of clinical monitoring and computing
pub_type: 临床试验,杂志文章
doi:10.1007/s10877-005-2700-8
更新日期:2004-08-01 00:00:00
abstract::The goal of this study was to evaluate the risk factors associated with positioning-related SSEP changes (PRSC). The study investigated the association between 18 plausible risk factors and the occurrence of intraoperative PRSC. Risk factors investigated included demographic variables, comorbidities, and procedure rel...
journal_title:Journal of clinical monitoring and computing
pub_type: 杂志文章
doi:10.1007/s10877-018-0148-x
更新日期:2019-04-01 00:00:00
abstract::The American Society of Anesthesiologist recommends peripheral physiological monitoring during general anesthesia, which offers no information regarding the effects of anesthetics on the brain. Since no "gold standard" method exists for this evaluation, such a technique is needed to ensure patient comfort, procedure q...
journal_title:Journal of clinical monitoring and computing
pub_type: 杂志文章
doi:10.1007/s10877-017-9998-x
更新日期:2018-02-01 00:00:00
abstract::Near-infrared spectrophotometry assesses cerebral oxygen saturation (ScO2) based on the absorption spectra of oxygenated and deoxygenated hemoglobin, and the translucency of biological tissue, in the near-infrared band. There is increasing evidence that optimising cerebral oxygenation, guided by ScO2, is associated wi...
journal_title:Journal of clinical monitoring and computing
pub_type: 杂志文章
doi:10.1007/s10877-014-9642-y
更新日期:2015-10-01 00:00:00
abstract::To develop and validate a mathematical model for predicting intracranial pressure (ICP) noninvasively using phase-contrast cine MRI (PC-MRI). We performed a retrospective analysis of PC-MRI from patients with communicating hydrocephalus (n = 138). The patients were recruited from Shenzhen Second People's Hospital betw...
journal_title:Journal of clinical monitoring and computing
pub_type: 杂志文章
doi:10.1007/s10877-020-00598-5
更新日期:2020-10-01 00:00:00
abstract::Transesophageal echocardiography of the spine has been difficult to perform, and high-quality images have been difficult to obtain with earlier available technology. New capabilities in hardware and software reconstruction may allow more reliable clinical data to be obtained. We describe an initial successful attempt ...
journal_title:Journal of clinical monitoring and computing
pub_type: 杂志文章
doi:10.1007/s10877-014-9576-4
更新日期:2015-02-01 00:00:00
abstract:OBJECTIVE:Upper airway obstruction is the most rapid and clinically relevant cause of hypoxia during sedation and anesthesia. This study was designed to determine if respiratory inductance plethysmography (RIP) could quantify the degree of upper airway obstruction caused by induction of general anesthesia. METHODS:RIP...
journal_title:Journal of clinical monitoring and computing
pub_type: 杂志文章
doi:10.1023/a:1021246119194
更新日期:2002-07-01 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::In recent years students have increasingly objected to laboratory exercises involving animal subjects. We have replaced the valuable animal experiments with demonstrations using a full-scale human patient simulator. In small groups first-year medical students observe realistic clinical situations such as opioid-induce...
journal_title:Journal of clinical monitoring and computing
pub_type: 杂志文章
doi:10.1023/a:1011401011887
更新日期:2000-01-01 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::Given the benefit of glucose control in the perioperative period, we evaluated the accuracy and performance of the continuous glucose monitoring system (CGMS) depending on different measurement sites in the operating room (OR) and in the intensive care unit (ICU). Patients over 18 years of age scheduled for elective s...
journal_title:Journal of clinical monitoring and computing
pub_type: 杂志文章
doi:10.1007/s10877-015-9804-6
更新日期:2017-02-01 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