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 outcomes following high-risk surgery, after implementation of a perioperative goal-directed therapy protocol. Through a before-after study design, patients undergoing elective high-risk surgery before (before-group) and after implementation of a perioperative goal-directed therapy protocol (after-group) were included. Perioperative goal-directed therapy in the after-group consisted of optimized stroke volume variation or stroke volume index and optimized cardiac index. Additionally, the association of protocol compliance with postoperative complications when using perioperative goal-directed therapy was assessed. High protocol compliance was defined as ≥ 85% of the procedure time spent within the individual targets. The difference in complications during the first 30 postoperative days before and after implementation of the protocol was assessed. In the before-group, 214 patients were included and 193 patients in the after-group. The number of complications was higher in the before-group compared to the after-group (n = 414 vs. 282; p = 0.031). In the after-group, patients with high protocol compliance for stroke volume variation or stroke volume index had less complications compared to patients with low protocol compliance for stroke volume variation or stroke volume index (n = 187 vs. 90; p = 0.01). Protocol compliance by the attending clinicians is essential and should be monitored to facilitate an improvement in postoperative outcomes desired by the implementation of perioperative goal-directed therapy protocols.
journal_name
J Clin Monit Computjournal_title
Journal of clinical monitoring and computingauthors
Boekel MF,Venema CS,Kaufmann T,van der Horst ICC,Vos JJ,Scheeren TWLdoi
10.1007/s10877-020-00585-wsubject
Has Abstractpub_date
2020-09-12 00:00:00eissn
1387-1307issn
1573-2614pii
10.1007/s10877-020-00585-wpub_type
杂志文章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::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::Jaundice of the newborn is a common problem as a consequence of the rapid increment of blood bilirubin in the first days of live. In most cases, it is considered a physiological transient situation, but unmanaged hyperbilirubinemia can lead to death or serious injuries for the survivors. For decades, phototherapy has ...
journal_title:Journal of clinical monitoring and computing
pub_type: 临床试验,杂志文章
doi:10.1007/s10877-006-9016-1
更新日期:2006-06-01 00:00:00
abstract:OBJECTIVE:This study tests the hypothesis that a graphical object display (a data display consisting of meaningful shapes) will affect the ability of anesthesiologists to perform a diagnostic task rapidly and correctly. The diagnostic tasks studied were recognition and differentiation of five etiologies of shock--anaph...
journal_title:Journal of clinical monitoring and computing
pub_type: 杂志文章
doi:10.1023/a:1009914019889
更新日期:1999-01-01 00:00:00
abstract::The mesenteric traction syndrome (MTS) is associated with prostacyclin (PGI2) facilitated systemic vasodilatation during surgery and is identified by facial flushing. We hypothesized that severe facial flushing would be related to the highest concentrations of plasma PGI2 and accordingly to the highest levels of skin ...
journal_title:Journal of clinical monitoring and computing
pub_type: 杂志文章
doi:10.1007/s10877-018-0226-0
更新日期:2019-10-01 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: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::Cerebrovascular autoregulation (CA) is often impaired following traumatic brain injury. Established technologies and metrics used to assess CA are invasive and conducive for measurement, but not for continuous monitoring. We developed a trans-ocular brain impedance (TOBI) method that may provide non-invasive and conti...
journal_title:Journal of clinical monitoring and computing
pub_type: 杂志文章
doi:10.1007/s10877-020-00556-1
更新日期:2020-07-14 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::We tested whether the ratio of alveolar dead space to alveolar tidal volume (VD(alv)/VT(alv)) can detect states of low pulmonary blood flow (PBF) in a non-invasive way. Fifteen patients undergoing cardiovascular surgeries with cardiopulmonary bypass (CPB) were studied. CPB is a technique that excludes the lungs from t...
journal_title:Journal of clinical monitoring and computing
pub_type: 杂志文章
doi:10.1007/s10877-012-9358-9
更新日期:2012-06-01 00:00:00
abstract::Monitors evaluating the electroencephalogram (EEG) to determine depth of anaesthesia use spectral analysis approaches for analysis windows up to 61.5 s as well as additional smoothing algorithms. Stationary EEG is required to reliably apply the index algorithms. Because of rapid physiological changes, artefacts, etc.,...
journal_title:Journal of clinical monitoring and computing
pub_type: 杂志文章,随机对照试验
doi:10.1007/s10877-014-9553-y
更新日期:2014-12-01 00:00:00
abstract::After introduction of the protoporphyrin IX-triplet state lifetime technique as a new method to measure mitochondrial oxygen tension in vivo, the development of a clinical monitor was started. This monitor is the "COMET", an acronym for Cellular Oxygen METabolism. The COMET is a non-invasive electrically powered optic...
journal_title:Journal of clinical monitoring and computing
pub_type: 杂志文章
doi:10.1007/s10877-016-9966-x
更新日期:2017-12-01 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::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 ...
journal_title:Journal of clinical monitoring and computing
pub_type: 杂志文章
doi:10.1007/s10877-019-00408-7
更新日期:2020-10-01 00:00:00
abstract::While the effects of phenylephrine (PE) and ephedrine (E) on cerebral oxygen saturation (rScO2) already has been studied, the effect on paraspinal oxygen saturation (rSpsO2) is still unexplored. This study aims to assess the effect of PE and E on rScO2 and rSpsO2, measured with near-infrared spectroscopy. A randomized...
journal_title:Journal of clinical monitoring and computing
pub_type: 杂志文章
doi:10.1007/s10877-019-00328-6
更新日期:2020-04-01 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::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::Heart failure is the main cause of poor outcome following open heart surgery and experimental studies have demonstrated that glucose-insulin-potassium (GIK) infusion exerts cardioprotective effects by reducing myocardial ischemia-reperfusion injuries. This randomized controlled trial was designed to assess the effects...
journal_title:Journal of clinical monitoring and computing
pub_type: 杂志文章
doi:10.1007/s10877-019-00280-5
更新日期:2020-02-01 00:00:00
abstract:OBJECTIVE:To test the ability of a microphone recording system, located distal to the respiratory outflow tract, to track the timing of the inspiratory and expiratory phases of breathing in awake healthy subjects. METHODS:Fifteen subjects participated. Breath sounds were recorded using a microphone embedded in a face ...
journal_title:Journal of clinical monitoring and computing
pub_type: 临床试验,杂志文章
doi:10.1007/s10877-011-9307-z
更新日期:2011-10-01 00:00:00
abstract:OBJECTIVES:This study was conducted to determine the response time of the Opti-Q continuous cardiac output (CCO) device to a step change in cardiac. DESIGN:Prospective study. SETTING:University hospital animal lab. MODEL:Female sheep. INTERVENTIONS:In ten animals, cardiac output was altered suddenly by opening and ...
journal_title:Journal of clinical monitoring and computing
pub_type: 杂志文章
doi:10.1023/a:1009934112134
更新日期:1999-12-01 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: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:OBJECTIVE:Bispectral analysis of the electroencephalogram (EEG) has been used to monitor depth of anesthesia. In the majority of publications this has been done using the so called Bispectral (BIS) Index. The exact relation of this index to bispectral quantities like the bispectrum and its normalized version the bicohe...
journal_title:Journal of clinical monitoring and computing
pub_type: 杂志文章
doi:10.1023/a:1026284321451
更新日期:2002-12-01 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::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::An ongoing issue in vascular medicine is the measure of the blood flow. Catheterization remains the gold standard measurement method, although non-invasive techniques are an area of intense research. We hereby present a computational method for real-time measurement of the blood flow from color flow Doppler data, with...
journal_title:Journal of clinical monitoring and computing
pub_type: 杂志文章
doi:10.1007/s10877-016-9953-2
更新日期:2017-12-01 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: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: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: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