Abstract：
:We compare the sensitivity and specificity of clinician visual waveform analysis against an automated system's waveform analysis in detecting ineffective triggering in mechanically ventilated intensive care unit patients when compared against a reference label set based upon analysis of respiratory muscle activity. Electrical activity of the diaphragm or esophageal/transdiaphragmatic pressure waveforms were available to a single clinician for the generation of a reference label set indicating the ground truth, that is, presence or absence of ineffective triggering, on a breath-by-breath basis. Pressure and flow versus time tracings were made available to (i) a group of three clinicians; and (ii) the automated Syncron-E™ system capable of detecting patient-ventilator asynchrony in real-time, in order to obtain breath-by-breath labels indicating the presence or absence of ineffective triggering. The clinicians and the automated system did not have access to other waveforms such as electrical activity of the diaphragm or esophageal/transdiaphragmatic pressure. In total, 926 breaths were analyzed across the seven patients. Specificity for clinicians and the automated system were high (99.3% for clinician and 98.5% for the automated system). The automated system had a significantly higher sensitivity (83.2%) compared to clinicians (41.1%). Ineffective triggering detected by the automated system, which has access only to airway pressure and flow versus time tracings, is in substantial agreement with a reference detection derived from analysis of invasively measured patient effort waveforms.
journal_name
J Clin Monit Computjournal_title
Journal of clinical monitoring and computingauthors
Phan TS,Costa R,Haddad WM,Mullis JC,Price LT,Cason AD,Bailey JM,Gholami Bdoi
10.1007/s10877-019-00442-5subject
Has Abstractpub_date
2020-12-01 00:00:00pages
1233-1237issue
6eissn
1387-1307issn
1573-2614pii
10.1007/s10877-019-00442-5journal_volume
34pub_type
杂志文章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：: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：: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：: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: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：: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：:Mathematical models can be deployed to simulate physiological processes of the human organism. Exploiting these simulations, reactions of a patient to changes in the therapy regime can be predicted. Based on these predictions, medical decision support systems (MDSS) can help in optimizing medical therapy. An MDSS desi...
journal_title：Journal of clinical monitoring and computing
pub_type： 杂志文章
doi：10.1007/s10877-013-9502-1
更新日期：2014-12-01 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：:Compared with supine positioning, head-up positioning improves preoxygenation and prolongs the time to oxygen desaturation. We reevaluated benefits of head-up positioning using near-infrared spectroscopy (NIRS) with pulse oximetry in a pig model. Six pigs (mean ± SD weight: 25.3 ± 0.6 kg) were anesthetized with isoflu...
journal_title：Journal of clinical monitoring and computing
pub_type： 杂志文章
doi：10.1007/s10877-019-00456-z
更新日期：2020-01-02 00:00:00
abstract：:To date, most of the studies on safety and efficacy of supraglottic airway devices were done in Caucasian patients, and the results may not be extrapolated to Asian patients due to the different airway anatomy. We conducted this study to compare Supreme™ LMA (SLMA) and Proseal™ LMA (PLMA) size 1.5 in anaesthetized chi...
journal_title：Journal of clinical monitoring and computing
pub_type： 杂志文章,随机对照试验
doi：10.1007/s10877-018-0109-4
更新日期：2018-12-01 00:00:00
abstract：:The aim of this study was to compare the cardiac function index (CFI) and global ejection fraction (GEF) obtained by VolumeView/EV1000™, with the left ventricular ejection fraction (LVEF) by echocardiography in septic shock patients. A prospective observational study was conducted in a medical intensive care unit of a...
journal_title：Journal of clinical monitoring and computing
pub_type： 杂志文章
doi：10.1007/s10877-018-0152-1
更新日期：2019-04-01 00:00:00
abstract：:Low fresh gas flows (FGFs) decrease the use of anesthetic gases, but increase CO2 absorbent usage. CO2 absorbent usage remains poorly quantified. The goal of this study is to determine canister life of 8 commercially available CO2 absorbent prepacks with the Zeus®. Pre-packed CO2 canisters of 8 different brands were t...
journal_title：Journal of clinical monitoring and computing
pub_type： 杂志文章
doi：10.1007/s10877-017-0088-x
更新日期：2018-10-01 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：: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：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：: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：: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：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：:Perioperative goal-directed therapy is considered to improve patient outcomes after high-risk surgery. The association of compliance with perioperative goal-directed therapy protocols and postoperative outcomes is unclear. The purpose of this study is to determine the effect of protocol compliance on postoperative out...
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
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：: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：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：: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：OBJECTIVE:It was hypothesized that somato- sensory evoked potentials can be achieved faster by selective averaging during periods of low spontaneous electroen- cephalographic (EEG) activity. We analyzed the components of EEG that decrease the signal-to-noise ratio of somatosensory evoked potential (SEP) recordings duri...
journal_title：Journal of clinical monitoring and computing
pub_type： 杂志文章
doi：10.1007/s10877-009-9188-6
更新日期：2009-08-01 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: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：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：:Auditory steady state responses (ASSR) may offer an alternative to brainstem auditory evoked potentials for monitoring of the auditory nerve during surgical procedures. In the current study, we evaluated the influence of noise on ASSR characteristics in total intravenous anesthesia (TIVA). Simulated ASSR in real noise...
journal_title：Journal of clinical monitoring and computing
pub_type： 杂志文章
doi：10.1007/s10877-016-9837-5
更新日期：2017-02-01 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：:Amidst controversy about methodology and safety, intraoperative neurophysiology has entered a new era of increasingly routine transcranial and direct electrical brain stimulation for motor evoked potential (MEP) monitoring. Based on literature review and illustrative clinical experience, this tutorial aims to present ...
journal_title：Journal of clinical monitoring and computing
pub_type： 杂志文章,评审
doi：10.1007/s10877-006-9033-0
更新日期：2006-10-01 00:00:00
