Journal of Clinical Monitoring and Computing最新文献

{"title":"Reproducibility of glycocheck measurements in patients under general anesthesia with muscle relaxants: A prospective observational study.","authors":"Takayuki Toki, Kazuyuki Mizunoya, Takashi Soejima, Yasunori Yagi, Naoko Nakamine, Yusuke Itosu, Ryo Takagi, Isao Yokota, Yuji Morimoto","doi":"10.1007/s10877-025-01322-x","DOIUrl":"https://doi.org/10.1007/s10877-025-01322-x","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the inter- and intraobserver reproducibility of sublingual microcirculatory indices measured using the GlycoCheck system, including the perfused boundary region (PBR), vascular density (VD), and red blood cell filling (RBCF), in patients under general anesthesia without any motion artifacts.</p><p><strong>Methods: </strong>Fifty patients who received general anesthesia for laparoscopic gastrointestinal surgery were included in this study. After the induction of general anesthesia, the leading observer and one of the five subobservers took two and one measurements of sublingual microcirculation with the GlycoCheck system, respectively. Inter- and intraobserver reproducibility was assessed using intraclass correlation coefficients (ICC). Interobserver reproducibility was calculated using the first measurements of the leading observer and subobservers, and intraobserver reproducibility was calculated using two consecutive measurements of the leading observer.</p><p><strong>Results: </strong>The interobserver reproducibility of a single measurement was poor for all three parameters. The interobserver ICCs for PBR were 0.13 [95% CI: -0.15, 0.39], for VD was - 0.01 [95%CI: -0.29, 0.27], and for RBCF were 0.31 [95%CI: -0.45, 0.78]. The intraobserver ICCs for PBR was 0.32 [95% CI: 0.05, 0.55] for all 50 cases, 0.17 [95% CI: -0.25, 0.53] for the first 25 cases, and 0.46 [95% CI: 0.09, 0.72] for the second 25 cases. The Bland-Altman plots indicated that the measurement errors were random.</p><p><strong>Conclusion: </strong>In patients under general anesthesia, single PBR, VD, and RBCF measurements using the GlycoCheck system showed poor interobserver reproducibility. Although the intraobserver reproducibility of PBR measurements was poor, improving measurement proficiency might improve reproducibility. Further research is required to establish measurement methods that achieve better reproducibility and adequate observer training.</p>","PeriodicalId":15513,"journal":{"name":"Journal of Clinical Monitoring and Computing","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144600614","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-contact (touchless) monitoring of respiratory rate in a challenging anesthesia setting using a depth camera.","authors":"David B MacLeod, Philip Smit, André Antunes, Dean Montgomery, Paul S Addison","doi":"10.1007/s10877-025-01319-6","DOIUrl":"https://doi.org/10.1007/s10877-025-01319-6","url":null,"abstract":"<p><strong>Aim: </strong>We have developed a non-contact (\"touchless\") system based on depth-sensing camera technology for continuous monitoring of respiratory activity. Previous work from our group has demonstrated high accuracy of the system in monitoring a wide range of respiratory rates and signal morphologies across diverse conditions, including variations in lighting, posture, and coverings. Here, we report on the system's performance in a significantly more challenging anesthesia environment which included a wide range of respiratory rates and respiratory patterns, spontaneous and hand ventilated breathing, patient motion and caregiver interactions in the scene, and, in some cases, the presence of warming blankets covering the torso.</p><p><strong>Methods: </strong>Data was collected opportunistically from 34 healthy volunteers from two separate studies, both of which had the primary objective of investigating the relationship between depth of anesthesia monitoring and anesthetic agents (inhaled and intravenous) across a wide range of anesthetic concentrations and hypnotic states. Depth-sensing information was acquired using an Intel D415 RealSense™ camera and processed to extract frame-by-frame depth changes within the subject's torso region corresponding to respiratory activity. A respiratory rate (RR_depth) was calculated and output once-per-second from the device. This was compared to a combined reference (RR_ref) derived from both a capnograph and an impedance-based respiratory monitor. Three time periods were evaluated: pre-anesthesia, intra-anesthesia and post-anesthesia.</p><p><strong>Results: </strong>The overall RMSD accuracy [bias] obtained for the combined data set was 1.92 [0.30] breaths/min. The performance results stratified according to pre-, intra-, and post-anesthesia stages were 1.71 [0.15], 1.95 [0.39] and 2.13 [0.08] breaths/min, respectively.</p><p><strong>Conclusions: </strong>We have demonstrated the ability to continuously track respiratory rate during challenging conditions within an anesthesia setting using our non-contact, touchless, monitoring technology. We believe that our findings support the potential utility for continuous non-contact monitoring of respiration in clinical areas, such as the post-anesthesia care environment.</p>","PeriodicalId":15513,"journal":{"name":"Journal of Clinical Monitoring and Computing","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144600613","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 the mitral velocity-time integral changes induced by a passive leg raising test as a marker of fluid responsiveness in critically ill patients.","authors":"Younes Aissaoui, Mathieu Jozwiak, Ayoub Bouchama, Hamza Bennjakhoukh, Bassam Bencharfa, Mehdi Didi, Redouane Abouqal, Ayoub Belhadj","doi":"10.1007/s10877-025-01320-z","DOIUrl":"https://doi.org/10.1007/s10877-025-01320-z","url":null,"abstract":"<p><strong>Background: </strong>Assessing fluid responsiveness is crucial in managing critically ill patients. Echocardiography, particularly passive leg raising (PLR)-induced changes in the velocity-time integral of the left ventricular outflow tract (VTI_LVOT), is widely used for this purpose. We hypothesized that PLR-induced changes in the mitral valve velocity-time integral (VTI_Mi) could serve as a reliable alternative.</p><p><strong>Methods: </strong>This prospective single-center study included septic ICU patients requiring fluid responsiveness assessment. VTI_LVOT and VTI_Mi were measured at baseline and after PLR. Fluid responsiveness was defined as a PLR-induced increase in VTI_LVOT ≥10%. The ability of PLR-induced VTI_Mi changes to predict fluid responsiveness was assessed via ROC curve and gray zone analyses.</p><p><strong>Results: </strong>Fifty consecutive patients were included (median age 65 years [IQR: 57-73], APACHE II score 22 [IQR: 18-27]). Septic shock was present in 27 (54%), 21 (42%) were mechanically ventilated, and 23 (46%) were classified as responders. PLR-induced changes in VTI_Mi and VTI_LVOT were significantly correlated (ρ = 0.656, p < 0.001). The area under the ROC curve for VTI_Mi was 0.927 (95% CI: 0.849-1, p < 0.001). A 10% increase in VTI_Mi predicted fluid responsiveness with a sensitivity of 83% (95% CI: 61-95) and specificity of 96% (95% CI: 83-99). The gray zone ranged between 5% and 8%, encompassing 16% of the cohort.</p><p><strong>Conclusion: </strong>PLR-induced changes in VTI_Mi reliably predict fluid responsiveness in critically ill patients. VTI_Mi represents a viable alternative to VTI_LVOT for fluid responsiveness assessment, contributing to individualized hemodynamic management.</p><p><strong>Trial registration: </strong>NCT05538637.</p>","PeriodicalId":15513,"journal":{"name":"Journal of Clinical Monitoring and Computing","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144584071","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":"Accuracy and trending ability of non-invasive pulse-wave transit time-based cardiac output monitoring (esCCO) in critically ill children.","authors":"Raísa Sanches Uzun, Humberto Magalhães Silva, Nayara Hillebrand Franzon, Victoria Carneiro Lintz, Isabel de Siqueira Ferraz, Roberto José Negrão Nogueira, Tiago Henrique De Souza","doi":"10.1007/s10877-025-01316-9","DOIUrl":"https://doi.org/10.1007/s10877-025-01316-9","url":null,"abstract":"","PeriodicalId":15513,"journal":{"name":"Journal of Clinical Monitoring and Computing","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144505857","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":"Prediction of surgery start for automated anesthesia using draping detection from surveillance videos.","authors":"Akihito Ito, Sho Mitarai, Kazumasa Kishimoto, Chang Liu, Goshiro Yamamoto, Yukiko Mori, Moritoki Egi, Tomohiro Kuroda","doi":"10.1007/s10877-025-01314-x","DOIUrl":"10.1007/s10877-025-01314-x","url":null,"abstract":"<p><p>One of the primary goals of automated anesthesia is to reduce human intervention and reduce the workload of anesthesiologists. However, switching modes before the start of surgery still requires manual operation. The present study aims to develop a system that predicts the start of surgery by analyzing the actions of medical staff in the operating room using surveillance camera footage, thereby enabling automated mode transitions in anesthesia systems. We analyzed 110 surveillance videos of elective laparoscopic surgeries at Kyoto University Hospital. Key medical staff actions to predict the start of surgery were identified, and the time intervals between each action and skin incision were recorded. We then developed a detection system to identify draping, the best key action, and evaluated it by comparing system-detected draping times with manually annotated times in 96 videos. Five key actions were identified: hand washing, sterilization, light activation, bed cradle set-up, and draping. The start of draping had the shortest median time interval to the skin incision (7.71 min, interquartile range: 5.89-9.72), which was significantly shorter than that of the other actions (p < 0.05), and also had the shortest interquartile range. In the system evaluation, the median time error for detecting draping was 19.0 s (interquartile range: 16.0-50.0). The start of draping is a reliable predictor of the start of surgery, and the draping detection system demonstrated high accuracy. These results support advances in anticipatory automated anesthesia systems, enhancing workflow efficiency and patient safety in the operating room.</p>","PeriodicalId":15513,"journal":{"name":"Journal of Clinical Monitoring and Computing","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144333184","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":"Balancing efficiency and diagnostic fidelity in SEP monitoring.","authors":"Jongsuk Choi","doi":"10.1007/s10877-025-01315-w","DOIUrl":"10.1007/s10877-025-01315-w","url":null,"abstract":"<p><p>A recent study introduced a patient-specific algorithm designed to reduce the acquisition time required for obtaining somatosensory evoked potentials during spinal surgery. While the approach is promising, its reliance on amplitude and latency thresholds may overlook subtle waveform features that are crucial in high-risk patients. Broader validation, integration of waveform morphology, and cautious application in clinically compromised populations are warranted. Optimizing intraoperative neurophysiological monitoring requires not only speed but also diagnostic fidelity.</p>","PeriodicalId":15513,"journal":{"name":"Journal of Clinical Monitoring and Computing","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144333167","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":"Comparison of supramaximal currents obtained by acceleromyography and electromyography for monitoring the adductor pollicis muscle in pediatric patients.","authors":"Hajime Iwasaki, Kenichi Takahoko, Chihiro Yamagata, Yudai Nambu, Ayaka Suzuki, Yui Takada, Sarah Kyuragi Luthe, Hiroshi Makino","doi":"10.1007/s10877-025-01286-y","DOIUrl":"10.1007/s10877-025-01286-y","url":null,"abstract":"<p><p>The aim of this study was to compare the supramaximal currents obtained simultaneously by acceleromyography (AMG) TOF-Watch^® SX and electromyography (EMG) AF-201P in pediatric patients. Patients aged 2-11 years who underwent elective surgery under general anesthesia were enrolled. AMG and EMG monitors were placed on opposite arms of the patient to stimulate the ulnar nerve and monitor the adductor pollicis muscles following the induction of general anesthesia. After the monitors were calibrated, rocuronium 0.6 mg/kg was administered. Endotracheal intubation was performed when the EMG showed a train-of-four (TOF) count of 0. The primary outcome was the supramaximal current set by each device's calibration. The secondary outcomes were the time from the administration of rocuronium to a TOF count of 0, the baseline and final TOF ratios, and the conditions surrounding intubation. The paired t test and the Wilcoxon signed-rank test were used to analyze parametric and nonparametric data. A P value < 0.05 indicated statistical significance. Clinical data from 25 pediatric patients were analyzed. The supramaximal current was significantly lower with EMG than with AMG (27.4 ± 6.1 vs. 54.2 ± 8.4 mA, p <.001). The time to a TOF count of 0 was significantly shorter with EMG than with AMG (58 [24-170] vs. 75 [26-236] seconds, p <.001). Both the baseline and final TOF ratios were significantly lower with EMG than with AMG. The ease of laryngoscopy was rated as excellent for all patients. The vocal cords were abducted in 76% of patients, and no movement to insertion of the endotracheal tube was confirmed in 96% of patients. We found that the supramaximal current was significantly lower with EMG than with AMG.</p>","PeriodicalId":15513,"journal":{"name":"Journal of Clinical Monitoring and Computing","volume":" ","pages":"625-630"},"PeriodicalIF":2.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143630588","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":"Comment on \"Effect of postoperative peripheral nerve blocks on the analgesia nociception index under propofol anesthesia: an observational study.\"","authors":"Nobuhiro Tanaka, Mitsuru Ida, Masahiko Kawaguchi","doi":"10.1007/s10877-025-01268-0","DOIUrl":"10.1007/s10877-025-01268-0","url":null,"abstract":"<p><p>Kumagai et al. provided valuable insights into the effects of postoperative peripheral nerve blocks (PNB) on the high-frequency variability index (HFVI), a surrogate for nociception monitoring. However, the analysis excluded the impact of different brachial plexus block techniques, particularly the interscalene brachial plexus block (ISB), and role of laterality in HFVI variability. ISB produces a stellate ganglion block-like effect through local anesthetic diffusion, influencing autonomic function and heart rate variability, independent of nociceptive modulation. Provided that this study included various brachial plexus block approaches, stratifying HFVI changes according to technique and laterality could enhance their clinical relevance. Right-sided ISB may have a more pronounced autonomic effect than left-sided ISB. Further research is needed to clarify these effects and optimize the interpretation of HFVI during perioperative monitoring.</p>","PeriodicalId":15513,"journal":{"name":"Journal of Clinical Monitoring and Computing","volume":" ","pages":"651-652"},"PeriodicalIF":2.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143441099","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":"Clot formation risk in the clearing fluid after arterial catheter blood sampling: coagulation factors consumption over time - a prospective pilot study.","authors":"Jerome E Dauvergne, Elodie Boissier, Bertrand Rozec, Karim Lakhal, Damien Muller","doi":"10.1007/s10877-024-01252-0","DOIUrl":"10.1007/s10877-024-01252-0","url":null,"abstract":"<p><p>After blood sampling from an arterial catheter, the reinjection of the clearing fluid (a mixture of saline solution and blood) is proposed to limit blood loss. However, reinjecting clots may cause embolic complications. The primary objective was to assess fibrinogen consumption in the clearing fluid as an indicator of clot formation over time. Additionally, we searched for macroscopic clots, evaluated changes in prothrombin time, factors II and V. In this prospective observational pilot study, we enrolled adult patients in an intensive care unit with a radial artery catheter who required measurements of hemostasis parameters. We used a locally developed closed blood sampling system. Hemostasis parameters were measured in patients' pure blood (reference) and in the clearing fluid, at 2, 3, and 5 min after the complete filling of the reservoir. Thirty patients were included and 120 samples were analyzed. Fibrinogen levels decreased over time: median [interquartile range (IQR)] of 4.3 [IQR:3.1;5.9] as reference level, 3.6 [IQR:2.7;4.7] at 2 min (p < 0.001), 3.4 [IQR:2.1;4.3] at 3 min (p < 0.001) and 3.0 [IQR:1.7;4.1] g/L at 5 min (p < 0.001). No clot was macroscopically detected in any samples. An antiplatelet agent was administered in 11 (37%) patients. Unfractionated heparin anti-Xa activity was higher than 0.10 UI/ml in 17 (57%). Although no macroscopic clots were observed in the clearing fluid, its coagulation factors decreased over the 5 min following reservoir filling, indicating potential initiation of clot formation. Our findings stress the need for further studies assessing the safety of reinjecting clearing fluid as part of patient blood management.</p>","PeriodicalId":15513,"journal":{"name":"Journal of Clinical Monitoring and Computing","volume":" ","pages":"607-612"},"PeriodicalIF":2.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142813150","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":"Comparison of time-series models for predicting physiological metrics under sedation.","authors":"Zheyan Tu, Sean D Jeffries, Joshua Morse, Thomas M Hemmerling","doi":"10.1007/s10877-024-01237-z","DOIUrl":"10.1007/s10877-024-01237-z","url":null,"abstract":"<p><p>This study presents a comprehensive comparison of multiple time-series models applied to physiological metric predictions. It aims to explore the effectiveness of both statistical prediction models and pharmacokinetic-pharmacodynamic prediction model and modern deep learning approaches. Specifically, the study focuses on predicting the bispectral index (BIS), a vital metric in anesthesia used to assess the depth of sedation during surgery, using datasets collected from real-life surgeries. The goal is to evaluate and compare model performance considering both univariate and multivariate schemes. Accurate BIS prediction is essential for avoiding under- or over-sedation, which can lead to adverse outcomes. The study investigates a range of models: The traditional mathematical models include the pharmacokinetic-pharmacodynamic model and statistical models such as autoregressive integrated moving average (ARIMA) and vector autoregression (VAR). The deep learning models encompass recurrent neural networks (RNNs), specifically Long Short-Term Memory (LSTM) and Gated Recurrent Units (GRU), as well as Temporal Convolutional Networks (TCNs) and Transformer models. The analysis focuses on evaluating model performance in predicting the BIS using two distinct datasets of physiological metrics collected from actual surgical procedures. It explores both univariate and multivariate prediction schemes and investigates how different combinations of features and input sequence lengths impact model accuracy. The experimental findings reveal significant performance differences among the models: In univariate prediction scenarios for predicting BIS, the LSTM model demonstrates a 2.88% improvement over the second-best performing model. For multivariate predictions, the LSTM model outperforms others by 6.67% compared to the next best model. Furthermore, the addition of Electromyography (EMG) and Mean Arterial Pressure (MAP) brings significant accuracy improvement when predicting BIS. The study emphasizes the importance of selecting and building appropriate time-series models to achieve accurate predictions in biomedical applications. This research provides insights to guide future efforts in improving vital sign prediction methodologies for clinical and research purposes. Clinically, with improvements in the prediction of physiological parameters, clinicians can be informed of interventions if an anomaly is detected or predicted.</p>","PeriodicalId":15513,"journal":{"name":"Journal of Clinical Monitoring and Computing","volume":" ","pages":"595-605"},"PeriodicalIF":2.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142545767","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}