Journal of Clinical Monitoring and Computing最新文献

{"title":"Detection of fluid responsiveness by changes of perfusion index and pleth-variability index during passive leg raising in spontaneously breathing post-surgical patients: a prospective interventional study.","authors":"Simon Rauch, Paolo Mario Seraglio, Tomas Dal Cappello, Giulia Roveri, Markus Falk, Matthias Bock","doi":"10.1007/s10877-025-01292-0","DOIUrl":"https://doi.org/10.1007/s10877-025-01292-0","url":null,"abstract":"<p><p>Predicting fluid responsiveness is crucial in treating circulatory failure, as only about half of patients benefit from volume expansion by increasing cardiac output (CO). Dynamic tests like passive leg raising (PLR) are preferred over static parameters. While PLR reliably predicts fluid responsiveness, it typically requires invasive measurement of stroke volume (SV) or CO. The perfusion index (PI) and pleth variability index (PVI) are non-invasive metrics derived from oxygen saturation signals. PI has been shown to correlate with SV, and PVI has predicted fluid responsiveness in mechanically ventilated patients, but their role in spontaneously breathing patients remains unclear. This study aimed to assess whether PI and PVI could predict fluid responsiveness in post-surgical, spontaneously breathing patients during a PLR test. The hypothesis was that PI would increase and PVI would decrease in fluid responders. The prospective study included spontaneously breathing patients after major abdominal surgery in the ICU of Merano Hospital, Italy. SV and CO were measured using the FloTrac™ system, and PI and PVI were assessed using the Radical 7^® monitor. Patients were considered responders if SV increased by ≥ 10% during the PLR test. Of the 47 patients enrolled, 23 (48.9%) were fluid responders. The percentage change in PI from baseline to 60 s into the PLR test was + 41.2% in responders and + 11.3% in non-responders. A PI increase of ≥ 23% predicted responders with 70% sensitivity and 75% specificity, with an area under the ROC curve of 0.74. Twenty-two patients (47%) were inside the grey zone. PVI did not differ significantly between groups. In conclusion, PI could be a helpful non-invasive tool for predicting fluid responsiveness during a PLR test in spontaneously breathing patients, though its diagnostic accuracy appears to be moderate.</p>","PeriodicalId":15513,"journal":{"name":"Journal of Clinical Monitoring and Computing","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143795535","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spontaneous recovery from rocuronium measured by mechanomyography during 100- or 200-Hz tetanic stimulations compared to normalized train-of-four with acceleromyography.","authors":"Philippe E Dubois, Fabien Moreillon, Benoit Bihin, Clotilde De Dorlodot, Sabrina Meyer, Adrien Maseri, Philippe A Passeraub, Alain A d'Hollander","doi":"10.1007/s10877-025-01282-2","DOIUrl":"https://doi.org/10.1007/s10877-025-01282-2","url":null,"abstract":"<p><p>Neuromuscular block recovery was evaluated using high-frequency tetanic ulnar nerve simulations compared to normalized train-of-four (NTOF) in anesthetized patients. Under intravenous general anesthesia, we compared rocuronium-induced neuromuscular recovery using 5 s 100- and 200-Hz tetanic stimulations via isometric mechanomyography to acceleromyographic NTOF in 20 consenting patients. The primary outcome was the comparison by Student's t-tests of 100- and 200-Hz tetanic fade ratios (residual force at the end of the contraction / maximal force reached during the 5 s) before rocuronium administration and at different recovery levels. The secondary outcome was the quantification of any significant fade occurring with 100- and 200-Hz stimulations after reaching the acceleromyographic NTOF ratio of 0.9 during subsequent stages of spontaneous recovery until their fade ratios exceeded 0.9. During early (TOF count ≥ 1) and intermediate (NTOF ratio ≥ 0.5) stages of recovery, both 100- and 200-Hz tetanic fade ratios were similarly low. However, during late recovery when NTOF ratio ≥ 0.9, 200-Hz stimulation induced a significantly deeper muscular fade than 100-Hz (tetanic fade ratio 0.20 ± 0.23 vs. 0.64 ± 0.29, P < 0.001). The delays between the recovery of NTOF ratio 0.9 and 100- or 200-Hz tetanic fade ratio 0.9 were 7.7 ± 7.1 and 43.6 ± 14.6 min, respectively. In anesthetized humans, mechanomyographic 200-Hz tetanic stimulation detects lighter levels of residual paralysis than NTOF and 100-Hz tetanic stimulation during a valuable additional period. Registered in the ClinicalTrials.gov Registry NCT05474638 on July 15th 2022.</p>","PeriodicalId":15513,"journal":{"name":"Journal of Clinical Monitoring and Computing","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752977","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Automated mitochondrial oxygen consumption (mitoVO₂) analysis via a bi-directional long short-term memory neural network.","authors":"C J de Wijs, J R Behr, L W J M Streng, M E van der Graaf, F A Harms, E G Mik","doi":"10.1007/s10877-025-01291-1","DOIUrl":"https://doi.org/10.1007/s10877-025-01291-1","url":null,"abstract":"<p><p>Monitoring in vivo mitochondrial oxygen tension (mitoPO₂) enables the measurement of mitochondrial oxygen consumption (mitoVO₂), providing deeper insights into the skin's mitochondrial environment. However, current mitoVO₂ analysis often relies on manual identification of start and end points, which introduces substantial inter-user variability. Addressing this limitation is crucial for broader adoption, comparability, and reproducibility across research groups. Therefore, the aim of this study was to develop a neural network-based software that automatically analyzes mitoVO₂. A Bi-directional Long Short-Term Memory neural network was trained on 125 mitoPO₂ measurement sequences and optimized through Bayesian optimization. It identifies start points and measurement periods, then applies a modified Michaelis-Menten fit to calculate mitoVO₂. This framework, embedded in automated software, was validated against the consensus of 3 raters. Bayesian optimization yielded an overall network performance of 94.2% on the test set. The neural network identified 91% of mitoVO₂ start points within a ± 5-sample range of the manual consensus. Mean mitoVO₂ values for the consensus and software were 6.56 and 6.63 mmHg s^- 1, respectively, corresponding to a bias of -0.057 mmHg s^- 1. Multiple runs of the network on the same dataset produced identical results, confirming consistency and eliminating inter-user variability. The developed neural network-based software automatically and consistently analyzes mitoVO₂ measurements, substantially reducing reliance on subjective judgments. By enabling a standardized approach to mitoVO₂ analysis, this tool improves data comparability and reproducibility across research settings. Future work will focus on further refining precision and extending functionality through multi-center collaborations.</p>","PeriodicalId":15513,"journal":{"name":"Journal of Clinical Monitoring and Computing","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752972","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Non-invasive estimation of beat-by-beat aortic blood pressures from electrical impedance tomography data processed by machine learning.","authors":"Fabian Müller-Graf, Jacob P Thönes, Lisa Krukewitt, Paul Frenkel, Henryk Richter, Sascha Spors, Volker Kühn, Amelie R Zitzmann, Stephan H Boehm, Daniel A Reuter","doi":"10.1007/s10877-025-01274-2","DOIUrl":"https://doi.org/10.1007/s10877-025-01274-2","url":null,"abstract":"<p><p>Hypotension in perioperative and intensive care settings is a significant risk factor associated with complications such as myocardial infarction and kidney injury thereby increasing perioperative complications and mortality. Continuous blood pressure monitoring is essential, yet challenging due to the invasive nature of current methods. Non-invasive techniques like Electrical Impedance Tomography (EIT) have been explored but face challenges in accurate and consistent blood pressure estimation. A machine learning (ML) approach was used to predict aortic blood pressures from EIT voltage measurements in landrace pigs. A convolutional neural network (CNN) was trained on a dataset of 75 298 heartbeats, to predict systolic (SAP), mean (MAP), and diastolic arterial pressures (DAP) of individuals whose arterial pressures were unknown to the algorithm. The Intraclass Correlation Coefficient (3,1) with absolute agreement (ICC) was calculated and the concordance was estimated, comparing reference blood pressure measurements and ML-derived estimates. A risk classification was estimated for the calculated blood pressure as suggested by Saugel et al. 2018. The ML-model demonstrated moderate correlations with invasive blood pressure measurements (ICC for SAP of 0.530, for MAP of 0.563, and for DAP of 0.521.) with a low risk score for 75.8% of the SAP and 64.2% of MAP estimated blood pressures. ML-techniques using EIT-voltages showed promising preliminary results in non-invasive aortic blood pressure estimation. Despite limitations in the amount of available training data and the experimental setup, this study illustrates the potential of integrating ML in EIT signal processing for real-time, non-invasive blood pressure monitoring.</p>","PeriodicalId":15513,"journal":{"name":"Journal of Clinical Monitoring and Computing","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143710260","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pulse rate variability as a predictor for length of stay for patients with bronchiolitis in the pediatric intensive care unit.","authors":"Soon Bin Kwon, Bennett Weinerman, Daniel Nametz, Tammam Alalqum, Isaac S Lee, Murad Megjhani, Son H McLaren, Benjamin Ranard, Yunseo Ku, Andrew Geneslaw, Soojin Park","doi":"10.1007/s10877-025-01287-x","DOIUrl":"10.1007/s10877-025-01287-x","url":null,"abstract":"<p><p>Patients admitted to pediatric Intensive Care Unit (PICU) due to bronchiolitis have unpredictable length of stay (LOS). The aim of this study is to observe the difference in the relationship between pulse rate variability (PRV) and heart rate variability (HRV) for patients with bronchiolitis admitted to the PICU and its association with LOS. The first 12 h of physiologic data after PICU admission were used for analysis. Electrocardiogram (ECG) and photoplethysmogram (PPG) were divided into non-overlapping 5-minute segments, and R-peak and PPG-peak were obtained to calculate PRV and HRV. Correlation was calculated between HRV and PRV for both PICU short-stay and long-stay groups. A total of 119 patients were included in this study, where 66 are short-stay and 53 are long-stay group. For both LOS groups, PRV and HRV parameters were significantly higher HRV parameters compared to PRV. SDSD, SDNN, RMSSD, pNN50, SD1, and SD2 were 13.72, 10.24, 13.72, 0.77, 9.7, 10.6, and 0.85 for HRV. For PRV it was 5.88, 4.83, 5.88, 0.75, 4.16, 5.28, and 0.85. However, in the comparison of the correlations between PRV and HRV parameters, the short-stay group had significantly higher correlation compared to the long-stay group. The correlations in the short-stay group are above 0.72-0.82, whereas for the long-stay group the correlation ranged from 0.29 to 0.67. This study demonstrates that the correlation between the PRV and HRV is lower in patients with longer length of stay, suggesting this can be a potential metric for LOS in PICU.</p>","PeriodicalId":15513,"journal":{"name":"Journal of Clinical Monitoring and Computing","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143710264","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of non-invasive sensors for monitoring core temperature.","authors":"Shavin S Thomas, Katharyn L Flickinger, Jonathan Elmer, Clifton W Callaway","doi":"10.1007/s10877-025-01289-9","DOIUrl":"https://doi.org/10.1007/s10877-025-01289-9","url":null,"abstract":"<p><p>We evaluated the accuracy and precision of zero-heat flux (ZHF) and dual sensor (DS) non-invasive temperature probes in intensive care unit (ICU) patients undergoing hypothermic temperature control, hypothesizing that both devices would accurately estimate core temperature. In a single-center prospective cohort study, we enrolled 35 ICU patients and applied continuous, non-invasive ZHF and/or DS probes to the lateral forehead or anterior chest to collect 358 observations. Conditions potentially influencing temperature estimation were recorded. Using Bland-Altman analysis with multiple paired observations per individual, we compared the bias between non-invasive probes and direct core temperature measurements. Lin's concordance coefficient (LCC) was computed to quantify precision. The mean bias between the ZHF probe and invasive temperature was + 0.98 °C; for the DS probe, it was - 2.19 °C. In hypothermic patients, the ZHF probe's accuracy improved (bias + 0.28 °C, LCC 0.86), while the DS probe remained inaccurate (bias - 2.52 °C, LCC 0.07). Clinical confounders like vasoactive agents or temperature control devices did not consistently affect bias, accuracy, or precision. Neither the ZHF nor DS non-invasive probes provided sufficient accuracy or precision to guide clinical decisions in the ICU. These results contrast with previous studies reporting biases within ± 0.5 °C. However, the ZHF probe showed promising limited deviation, especially in hypothermic patients.</p>","PeriodicalId":15513,"journal":{"name":"Journal of Clinical Monitoring and Computing","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143692338","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Continuous monitoring of intracranial pressure and end tidal carbon dioxide variations in traumatic brain injury: introducing the carbon dioxide reactivity index (CO2Rx).","authors":"Paolo Gritti, Marco Bonfanti, Rosalia Zangari, Ezio Bonanomi, Maria Di Matteo, Davide Corbella, Alessia Farina, Lorenzo Lecchi, Tommaso Togni, Pietro Mandelli, Luigi Andrea Lanterna, Francesco Biroli, Ferdinando Luca Lorini","doi":"10.1007/s10877-025-01285-z","DOIUrl":"https://doi.org/10.1007/s10877-025-01285-z","url":null,"abstract":"<p><strong>Purpose: </strong>The continuous monitoring of cerebral metabolic autoregulation in patients with severe traumatic brain injury (TBI) is poorly documented in the literature and largely absent from clinical practice. This study aimed to assess whether variations in intracranial pressure (ICP) and end-tidal carbon dioxide (ETCO2) can form the basis of an index for cerebrovascular autoregulation reactivity, and whether this index can improve the prediction of clinical outcomes in both adult and pediatric TBI patients.</p><p><strong>Methods: </strong>Data from adult and pediatric patients with severe TBI were retrospectively analyzed. The Carbon Dioxide Reactivity Index (CO2Rx) was introduced as a novel tool to assess cerebrovascular reactivity in response to variations in CO2 and ICP. CO2Rx was calculated by analyzing the relationship between ICP and ETCO2, sampled at approximately 5-minute intervals, using linear correlation within moving time windows ranging from 40 to 180 min in 10-minute increments. The discriminatory power of CO2Rx in predicting clinical outcomes was evaluated through Receiver Operating Characteristic (ROC) curve analysis. The primary outcome measures included in-hospital mortality and the 12-month Glasgow Outcome Scale-Extended (GOSE) score.</p><p><strong>Results: </strong>The study included 218 TBI patients (40 pediatric and 178 adult). CO2Rx values showed a significant correlation with outcomes, with a CO2Rx threshold of 0.28 effectively distinguishing between favorable and unfavorable outcomes. For the fatal/non-fatal outcome, the CO2Rx crude model alone had an Area Under the Curve (AUC) of 0.737. When combined with other predictors (Impact Core + ICP + CO2Rx), this model achieved the highest AUC of 0.929.</p><p><strong>Conclusion: </strong>CO2Rx demonstrated significant predictive value for mortality and unfavorable outcomes in TBI patients, serving as a continuous index of cerebrovascular reactivity to CO2. It holds potential to improve severe TBI management by optimizing the interaction between ventilation and metabolic autoregulation.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov Identifier: NCT NCT05043545.</p>","PeriodicalId":15513,"journal":{"name":"Journal of Clinical Monitoring and Computing","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143692334","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Haemodynamic monitoring and management during non-cardiac surgery: a survey among German anaesthesiologists.","authors":"Benjamin Vojnar, Patrick Achenbach, Moritz Flick, Daniel Reuter, Michael Sander, Bernd Saugel, Ann-Kristin Schubert, Christine Gaik","doi":"10.1007/s10877-025-01284-0","DOIUrl":"https://doi.org/10.1007/s10877-025-01284-0","url":null,"abstract":"<p><p>In 2023, the first German guideline on intraoperative haemodynamic monitoring and management for adults having non-cardiac surgery was published. The aim of this survey was to identify how anaesthetists in Germany managed intraoperative haemodynamics and blood pressure before its publication. In September to October 2023, members of the German Society of Anaesthesiology and Intensive Care Medicine (DGAI) were invited via email to participate in this anonymous online survey. Thirty-one questions covered demographics, clinical experience, approaches to perioperative blood pressure measurement and common thresholds, as well as the use of advanced haemodynamic monitoring and its potential therapeutic implications. 1,079 fully completed questionnaires were included in the analysis. When intermittent oscillometry was used to measure blood pressure, a 3-minute interval was usually applied during induction of anaesthesia (42%; 451/1,079). For invasive blood pressure monitoring, more than half (53%; 574/1,079) inserted an arterial line after induction of anaesthesia. Nearly all (94%; 1,012/1,079) focused on the mean arterial pressure for blood pressure monitoring, with a large majority (77%; 779/1012) considering values below 60-65 mmHg to be critically low. Intraoperative hypotension was managed based on an internal protocol by only 21% (223/1,079). Regarding advanced haemodynamic monitoring, 43% (459/1,079) frequently used pulse contour analysis, while 67% (721/1,079) reported that monitors with finger-cuff technology were not available in their department. 47% (504/1,079) cited a lack of experience as one of the main reasons for the infrequent use of cardiac output monitoring. This survey among DGAI members provides important insights into current practices of haemodynamic monitoring and management prior to the publication of the recent German guideline on 'Intraoperative haemodynamic monitoring and management of adults having non-cardiac surgery'.</p>","PeriodicalId":15513,"journal":{"name":"Journal of Clinical Monitoring and Computing","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143692349","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Empirical pharmacodynamic model of phenylephrine and intrathecal bupivacaine for mean arterial pressure prediction in obstetric patients presenting for elective cesarean delivery under spinal anesthesia.","authors":"Sherwin C Davoud, Basak Ozaslan, Eleonora M Aiello, Ricardo Kleinlein, Braden Eberhard, Hassan Hassan, Francis J Doyle, Vesela P Kovacheva","doi":"10.1007/s10877-025-01288-w","DOIUrl":"https://doi.org/10.1007/s10877-025-01288-w","url":null,"abstract":"<p><p>Cesarean delivery under spinal anesthesia may be complicated by hypotension in up to 80% of the patients. The response to standard-of-care prophylactic phenylephrine infusion varies, and there is little guidance on achieving optimal blood pressure control. In this work, we developed a data-driven pharmacodynamic relationship between intravenous phenylephrine, intrathecal bupivacaine, and maternal mean arterial pressure (MAP) in patients presenting for cesarean delivery. In this single-center cohort study, secondary use data were available for normotensive patients presenting for cesarean delivery. Intraoperative MAP, intrathecal bupivacaine, and intravenous phenylephrine doses were recorded prospectively every minute. The recorded data were used to identify and confirm a time series (Autoregressive with Exogenous Input (ARX)) model for predicting the MAP using MATLAB 2021a System Identification Toolbox and the Prediction Error Method. An independent model validation was conducted using a second dataset collected after the model fitting stage. Model identification was performed on 172 patients, using 70% for model fitting and 30% for testing. The final ARX model, which takes the past three data points to make predictions, performed 48.9% better than a mean constant model for one-minute ahead MAP predictions with a root mean square error (RMSE) of 3.6 ± 1.3 mmHg. Similar performance was observed on independent validation using a second dataset (N = 84), yielding an RMSE of 4.2 ± 1.6 mmHg for one-minute ahead MAP predictions. Our ARX model showed good performance at up to a three-minute prediction horizon and could be used for future decision support applications to guide phenylephrine dose titration.</p>","PeriodicalId":15513,"journal":{"name":"Journal of Clinical Monitoring and Computing","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143692336","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to comments on \"Effect of postoperative peripheral nerve blocks on the analgesia nociception index under propofol anesthesia: an observational study.\"","authors":"Motoi Kumagai, Masahiro Wakimoto, Shohei Ogawa, Sho Watanabe, Kenji S Suzuki","doi":"10.1007/s10877-025-01283-1","DOIUrl":"https://doi.org/10.1007/s10877-025-01283-1","url":null,"abstract":"<p><p>Tanaka et al. suggested that the increase in high-frequency variability index (HFVI) after peripheral nerve block (PNB) may result from autonomic effects mediated by the stellate ganglion block when an interscalene brachial plexus block (ISB) is performed. To investigate this, we analyzed patients receiving PNB with (ISB group; n = 8) or without ISB (non-ISB group; n = 22). HFVI increased significantly in both groups to a similar extent. These findings suggest that ISB's direct autonomic influence on HFVI is minimal. Additionally, laterality effects could not be assessed due to limited cases. We conclude that HFVI elevation is more likely due to PNB's analgesic effects rather than ISB's autonomic influence. Further studies are needed to confirm these findings.</p>","PeriodicalId":15513,"journal":{"name":"Journal of Clinical Monitoring and Computing","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143657345","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}