Abstract:
:Patient-ventilator asynchrony is associated with intolerance to noninvasive ventilation (NIV) and worsened outcomes. Our goal was to develop a tool to determine a patient needs for intervention by a practitioner due to the presence of patient-ventilator asynchrony. We postulated that a clinician can determine when a patient needs corrective intervention due to the perceived severity of patient-ventilator asynchrony. We hypothesized a new measure, patient breathing variability, would indicate when corrective intervention is suggested by a bedside practitioner due to the perceived severity of patient-ventilator asynchrony. With IRB approval data was collected on 78 NIV patients. A panel of experts reviewed retrospective data from a development set of 10 NIV patients to categorize them into one of the three categories. The three categories were; "No to mild asynchrony-no intervention needed", "moderate asynchrony-non-emergent corrective intervention required", and "severe asynchrony-immediate intervention required". A stepwise regression with a F-test forward selection criterion was used to develop a positive linear logic model predicting the expert panel's categorizations of the need for corrective intervention. The model was incorporated into a software tool for clinical implementation. The tool was implemented prospectively on 68 NIV patients simultaneous to a bedside practitioner scoring the need for corrective intervention due to the perceived severity of patient-ventilator asynchrony. The categories from the tool and the practitioner were compared with the rate of agreement, sensitivity, specificity, and receiver operator characteristic analyses. The rate of agreement in categorizing the suggested need for clinical intervention due to the perceived presence of patient-ventilator asynchrony between the tool and experienced bedside practitioners was 95% with a Kappa score of 0.85 (p < 0.001). Further analysis found a specificity of 84% and sensitivity of 99%. The tool appears to accurately match the suggested need for corrective intervention by a bedside practitioner. Application of the tool allows for continuous, real time, and non-invasive monitoring of patients receiving NIV, and may enable early corrective interventions to ameliorate potential patient-ventilator asynchrony.
journal_name
J Clin Monit Computjournal_title
Journal of clinical monitoring and computingauthors
Tams C,Stephan PJ,Euliano NR,Martin AD,Patel R,Ataya A,Gabrielli Adoi
10.1007/s10877-019-00408-7subject
Has Abstractpub_date
2020-10-01 00:00:00pages
1035-1042issue
5eissn
1387-1307issn
1573-2614pii
10.1007/s10877-019-00408-7journal_volume
34pub_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::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::Detection of hypovolemia prior to overt hemodynamic decompensation remains an elusive goal in the treatment of critically injured patients in both civilian and combat settings. Monitoring of heart rate variability has been advocated as a potential means to monitor the rapid changes in the physiological state of hemorr...
journal_title:Journal of clinical monitoring and computing
pub_type: 杂志文章
doi:10.1007/s10877-013-9434-9
更新日期:2013-06-01 00:00:00
abstract:OBJECTIVE:Serious accidents during hemodialysis such as a large amount of blood loss are often caused by venous needle dislodgement. To develop a bleeding sensor based on a photo sensor for monitoring the needle sites, we studied effects of liquids and porcine blood on light transmission through a thin gauze pad with a...
journal_title:Journal of clinical monitoring and computing
pub_type: 杂志文章
doi:10.1007/s10877-009-9206-8
更新日期:2010-02-01 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::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::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
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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::Arterial blood gas (ABG) analysis is an essential tool in the clinical assessment of acutely ill patients. Venous to arterial conversion (v-TAC), a mathematical method, has been developed recently to convert peripheral venous blood gas (VBG) values to arterialized VBG (aVBG) values. The aim of this study was to test t...
journal_title:Journal of clinical monitoring and computing
pub_type: 杂志文章
doi:10.1007/s10877-018-0197-1
更新日期:2019-08-01 00:00:00
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journal_title:Journal of clinical monitoring and computing
pub_type: 信件
doi:10.1007/s10877-019-00388-8
更新日期:2020-08-01 00:00:00
abstract:OBJECTIVE:Several studies suggest that parameters derived from bispectral analysis of the EEG can be used to characterize specific cortical activation states represented by non linear interaction between brain electrical oscillations. For example, it was shown that so-called bispectral indices can be used to assess the...
journal_title:Journal of clinical monitoring and computing
pub_type: 杂志文章
doi:10.1023/a:1016362209175
更新日期:2002-02-01 00:00:00
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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::Hypothermia is a common perioperative complication. To prevent perioperative hypothermia amongst other things electrical heating mattresses are used. We have made an observation with the use of an electrical heating mattress that may confuse users. In this case the ECG monitoring suddenly showed spikes that looked lik...
journal_title:Journal of clinical monitoring and computing
pub_type: 信件
doi:10.1007/s10877-020-00520-z
更新日期:2020-07-15 00:00:00
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journal_title:Journal of clinical monitoring and computing
pub_type: 杂志文章,随机对照试验
doi:10.1007/s10877-017-0028-9
更新日期:2018-04-01 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
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journal_title:Journal of clinical monitoring and computing
pub_type: 杂志文章
doi:10.1007/s10877-020-00585-w
更新日期:2020-09-12 00:00:00
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journal_title:Journal of clinical monitoring and computing
pub_type: 杂志文章
doi:10.1007/s10877-009-9212-x
更新日期:2010-02-01 00:00:00
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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::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
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journal_title:Journal of clinical monitoring and computing
pub_type: 信件
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更新日期:2020-02-08 00:00:00
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journal_title:Journal of clinical monitoring and computing
pub_type: 杂志文章
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更新日期:2012-02-01 00:00:00
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journal_title:Journal of clinical monitoring and computing
pub_type: 杂志文章
doi:10.1007/s10877-010-9269-6
更新日期:2010-12-01 00:00:00
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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
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journal_title:Journal of clinical monitoring and computing
pub_type: 杂志文章
doi:10.1007/s10877-010-9246-0
更新日期:2010-08-01 00:00:00
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journal_title:Journal of clinical monitoring and computing
pub_type: 杂志文章
doi:10.1007/s10877-009-9181-0
更新日期:2009-08-01 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::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::Recent progress in genomics and experimental biology has brought exponential growth of the biological information available for computational analysis in public genomics databases. However, applying the potentially enormous scientific value of this information to the understanding of biological systems requires comput...
journal_title:Journal of clinical monitoring and computing
pub_type: 杂志文章
doi:10.1007/s10877-005-3463-y
更新日期:2005-10-01 00:00:00
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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
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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