Abstract:
:This prospective study evaluates haemodynamic and electroencephalographic effects observed when administering four combinations of effect-site concentrations of propofol (CePROP) and remifentanil (CeREMI), all yielding a single predicted probability of tolerance of laryngoscopy of 90% (PTOL = 90%) according to the Bouillon interaction model. We aimed to identify combinations of CePROP and CeREMI along a single isobole of PTOL that result in favourable hypnotic and haemodynamic conditions. This knowledge could be of advantage in the development of drug advisory monitoring technology. 80 patients (18-90 years of age, ASA I-III) were randomized into four groups and titrated towards CePROP (Schnider model, ug⋅ml-1) and CeREMI (Minto model, ng⋅ml-1) of respectively 8.6 and 1, 5.9 and 2, 3.6 and 4 and 2.0 and 8. After eleven minutes of equilibration, baseline measurements of haemodynamic endpoints and bispectral index were compared with three minutes of responsiveness measurements after laryngoscopy. Before laryngoscopy, bispectral index differed significantly (p < 0.0001) between groups in concordance with CePROP. Heart rate decreased with increasing CeREMI (p = 0.001). The haemodynamic and arousal responses evoked by laryngoscopy were not significantly different between groups, but CePROP = 3.6 μg⋅ml-1 and CeREMI = 4 ng⋅ml-1 evoked the lowest median value for ∆HR and ∆SAP after laryngoscopy. This study provides clinical insight on the haemodynamic and hypnotic consequences, when a model based predicted PTOL is used as a target for combined effect-site controlled target- controlled infusion of propofol and remifentanil. Heart rate and bispectral index were significantly different between groups despite a theoretical equipotency for PTOL, suggesting that each component of the anaesthetic state (immobility, analgesia, and hypnotic drug effect) should be considered as independent neurophysiological and pharmacological phenomena. However, claims of (in)accuracy of the predicted PTOL must be considered preliminary because larger numbers of observations are required for that goal.
journal_name
J Clin Monit Computjournal_title
Journal of clinical monitoring and computingauthors
van den Berg JP,Absalom AR,Venema AM,Kalmar AF,Van Amsterdam K,Hannivoort LN,Proost JH,Meier S,Scheeren TWL,Struys MMRF,Vereecke HEMdoi
10.1007/s10877-020-00540-9subject
Has Abstractpub_date
2020-06-03 00:00:00eissn
1387-1307issn
1573-2614pii
10.1007/s10877-020-00540-9pub_type
杂志文章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::Univent tube (UT) and EZ-blocker were used for one-lung ventilation (OLV). UT is a single lumen tube with a small separate lumen containing a bronchial blocker. EZ-blocker differs with its unique y-shaped double-cuffed distal end. We aimed to compare these two airway devices effects on airway pressures, oxygenation, v...
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::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::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: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::Recent advances in technology have brought many kinds of monitoring devices into the operating room (OR). The information gathered by monitors can be channeled to the operating ward information system via a local area network (LAN). Connecting patients to monitors and monitors to the LAN, however, requires a large num...
journal_title:Journal of clinical monitoring and computing
pub_type: 杂志文章
doi:10.1023/a:1009911208828
更新日期:2000-01-01 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::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:OBJECTIVES:The purpose of this paper is to increase awareness of electrode burns that occur in the operating room (OR), to discuss their causes, warning signs, and methods that may reduce their occurrence. Two general sources of electrical burns are described: 1) Excessive radio-frequency current density usually origin...
journal_title:Journal of clinical monitoring and computing
pub_type: 杂志文章
doi:10.1023/b:jocm.0000025254.73456.db
更新日期:2004-02-01 00:00:00
abstract::To evaluate a compact and easily interpretable 4-parameter model describing the shape of the volumetric capnogram, and the resulting estimates of anatomical dead space (VDAW) and Phase III (alveolar plateau) slope (SIII). Data from of 8 mildly-endotoxemic pre-acute respiratory distress syndrome sheep were fitted to th...
journal_title:Journal of clinical monitoring and computing
pub_type: 杂志文章
doi:10.1007/s10877-019-00451-4
更新日期:2020-12-01 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: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
abstract::The respiration rate (RR) is a vital sign in physiological measurement and clinical diagnosis. RR can be measured using stretchable and wearable strain gauge sensors which detect the respiratory movements in the abdomen or thorax areas caused by volumetric changes. In different body locations, the accuracy of RR detec...
journal_title:Journal of clinical monitoring and computing
pub_type: 杂志文章
doi:10.1007/s10877-020-00481-3
更新日期:2020-02-22 00:00:00
abstract::This study aimed to investigate and compare the performance of the algorithms contained in the newest generation of pulse oximeters (Masimo SET in IVY2000, Nellcor Oxismart N-3000, Agilent M3 rev. B) against a traditional pulse oximeter (Agilent CMS rel. A.0). The benchmark was performed in an efficient and reproducib...
journal_title:Journal of clinical monitoring and computing
pub_type: 杂志文章
doi:10.1023/a:1011420228523
更新日期:2000-01-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:Ventricular late potentials (LP) recording with signal-averaged electrocar- diogram allow identifying patients at risk of sudden death and ventricular tachycardia. Cardiac surgery with cardiopulmonary bypass (CPB) could predispose to the development of myocardial ischemia related to imperfect c...
journal_title:Journal of clinical monitoring and computing
pub_type: 杂志文章
doi:10.1007/s10877-011-9305-1
更新日期:2011-08-01 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::Pompe's disease is a glycogen storage disease (type II) characterized by inherited autosomal recessive transmission. The right ventricular (RV) function is a determinant parameter of clinical outcome in patients with heart failure. We sought to characterize the RV function using Doppler-echocardiography completed by D...
journal_title:Journal of clinical monitoring and computing
pub_type: 杂志文章
doi:10.1007/s10877-014-9551-0
更新日期:2014-08-01 00:00:00
abstract:INTRODUCTION:Effectively monitoring the level of consciousness during general anesthesia is clinically beneficial to both the patient and the physician. An electroencephalogram (EEG)-based level-of-consciousness monitor can help minimize intraoperative awareness as well as the effects of over-sedation. In this study, w...
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
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::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::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::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
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::We aimed at identifying a model that dynamically predicts future need for renal replacement therapy (RRT) in intensive care unit (ICU) patients and can easily be implemented for online monitoring at the bedside. 7290 interdisciplinary ICU admissions were investigated. Patients with <3 days of stay or RRT in the first ...
journal_title:Journal of clinical monitoring and computing
pub_type: 杂志文章
doi:10.1007/s10877-015-9814-4
更新日期:2017-02-01 00:00:00
abstract::The test of the inner tube integrity is an important checklist prior to the safe use of Bain's breathing system. This is because the major concern with the use of Bain's circuit is the potential malfunctioning of the circuit due to avulsion of the inner fresh gas delivery tube at the machine end which will turn the ou...
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
abstract:OBJECTIVE:Pulse-dye densitometry (PDD) could be a suitable, low-invasive alternative to thermodilution using a pulmonary artery catheter (PAC) for monitoring cardiac output. The aim of our study was to assess the reproducibility and validity of PDD compared to PAC-thermodilution. METHODS:In 43 post-cardiac surgery pat...
journal_title:Journal of clinical monitoring and computing
pub_type: 杂志文章
doi:10.1007/s10877-005-6865-y
更新日期:2005-12-01 00:00:00
abstract::The effectiveness of two different methods for calculating the arterial occlusion pressure (AOP) to set tourniquet inflation pressures were assessed in patients underwent knee arthroscopy. Eighty patients were included in this study. Tourniquet inflation pressure was set by adding 20 mmHg of safety margin above the AO...
journal_title:Journal of clinical monitoring and computing
pub_type: 杂志文章
doi:10.1007/s10877-019-00366-0
更新日期:2020-08-01 00:00:00
abstract::The eye lens is one of the most sensitive organs for radiation injury and exposure might lead to radiation induced cataract. Eye lens dosimetry in anesthesiology has been published in few clinical trials and an active debate about the causality of radiation induced cataract is still ongoing. Recently, the Internationa...
journal_title:Journal of clinical monitoring and computing
pub_type: 杂志文章
doi:10.1007/s10877-016-9857-1
更新日期:2017-04-01 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:The mid-latency auditory evoked potential (MLAEP) has been used to indicate depth of anaesthesia, and is usually analysed in time-domain. This work compares three techniques: Wave Deformation Parameters (PDO), Auditory Evoked Potential Index (AEPidx) and an automatic Nb-wave latency estimator (Nb), in the ass...
journal_title:Journal of clinical monitoring and computing
pub_type: 临床试验,杂志文章
doi:10.1023/a:1024208827407
更新日期:2002-08-01 00:00:00