{"title":"The transition to fully open access: a new era for the Journal of Clinical Monitoring and Computing.","authors":"Moritz Flick, Francisco A Lobo","doi":"10.1007/s10877-025-01342-7","DOIUrl":"10.1007/s10877-025-01342-7","url":null,"abstract":"","PeriodicalId":15513,"journal":{"name":"Journal of Clinical Monitoring and Computing","volume":" ","pages":"797-799"},"PeriodicalIF":2.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12474627/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144821507","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Clemens Miller, Anselm Bräuer, Johannes Wieditz, Marcus Nemeth
{"title":"What is the minimum time interval for reporting of intraoperative core body temperature measurements in pediatric anesthesia? A secondary analysis.","authors":"Clemens Miller, Anselm Bräuer, Johannes Wieditz, Marcus Nemeth","doi":"10.1007/s10877-024-01254-y","DOIUrl":"10.1007/s10877-024-01254-y","url":null,"abstract":"<p><p>Given that perioperative normothermia represents a quality parameter in pediatric anesthesia, numerous studies have been conducted on temperature measurement, albeit with heterogeneous measurement intervals, ranging from 30 s to fifteen minutes. We aimed to determine the minimum time interval for reporting of intraoperative core body temperature across commonly used measurement intervals in children. Data were extracted from the records of 65 children who had participated in another clinical study and analyzed using a quasibinomial mixed linear model. Documented artifacts, like probe dislocations or at the end of anesthesia, were removed. Primary outcome was the respective probability of failing to detect a temperature change of 0.2 °C or more at any one measurement point at 30 s, one minute, two minutes, five minutes, ten minutes, and fifteen minutes, considering an expected probability of less than 5% to be acceptable. Secondary outcomes included the probabilities of failing to detect hypothermia (< 36.0 °C) and hyperthermia (> 38.0 °C). Following the removal of 4,909 exclusions, the remaining 222,366 timestamped measurements (representing just over 60 h of monitoring) were analyzed. The median measurement time was 45 min. The expected probabilities of failing to detect a temperature change of 0.2 °C or more were 0.2% [95%-CI 0.0-0.7], 0.5% [95%-CI 0.0-1.2], 1.5% [95%-CI 0.2-2.6], 4.8% [95%-CI 2.7-6.9], 22.4% [95%-CI 18.3-26.4], and 31.9% [95%-CI 27.3-36.4], respectively. Probabilities for the detection of hyperthermia (n = 9) were lower and omitted for hypothermia due to low prevalence (n = 1). In conclusion, the core body temperature should be reported at intervals of no more than five minutes to ensure the detection of any temperature change in normothermic ranges. Further studies should focus on hypothermic and hyperthermic ranges.</p>","PeriodicalId":15513,"journal":{"name":"Journal of Clinical Monitoring and Computing","volume":" ","pages":"1101-1108"},"PeriodicalIF":2.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12474714/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142864524","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Moritz Flick, Christina Vokuhl, Alina Bergholz, Kristina Boutchkova, Julia Y Nicklas, Bernd Saugel
{"title":"Personalized intraoperative arterial pressure management and mitochondrial oxygen tension in patients having major non-cardiac surgery: a pilot substudy of the IMPROVE trial.","authors":"Moritz Flick, Christina Vokuhl, Alina Bergholz, Kristina Boutchkova, Julia Y Nicklas, Bernd Saugel","doi":"10.1007/s10877-024-01260-0","DOIUrl":"10.1007/s10877-024-01260-0","url":null,"abstract":"<p><p>The \"Cellular Oxygen METabolism\" (COMET) system (Photonics Healthcare, Utrecht, The Netherlands) non-invasively measures mitochondrial oxygen tension (mitoPO<sub>2</sub>) in the skin. The effects of general anesthesia and major non-cardiac surgery on mitoPO<sub>2</sub> remain unknown. In this pre-planned pilot substudy of the \"Intraoperative blood pressure Management based on the individual blood PRessure profile: impact on postOperatiVE organ function\" (IMPROVE) trial, we measured mitoPO<sub>2</sub> from induction of general anesthesia until the end of surgery in 19 major non-cardiac surgery patients (10 assigned to personalized and 9 to routine intraoperative arterial pressure management). In the overall cohort, the median (25th to 75th percentile) preoperative awake mitoPO<sub>2</sub> was 63 (53 to 82) mmHg and mitoPO<sub>2</sub> after induction of general anesthesia was 42 (35 to 59) mmHg. The intraoperative average mitoPO<sub>2</sub> was 39 (30 to 50) mmHg. Thirteen patients (68%) had intraoperative mitoPO<sub>2</sub> values below 20 mmHg and the median percentage of surgical time with mitoPO<sub>2</sub> < 20 mmHg was 17 (0 to 31)%. MitoPO<sub>2</sub> was weakly correlated with mean arterial pressure (repeated measures correlation (r<sub>rm</sub>(n); r<sub>rm</sub>(984) = 0.26, 95% confidence interval 0.20 to 0.32; P < 0.001), but not meaningfully with heart rate (r<sub>rm</sub>(984) = -0.05, 95% confidence interval -0.11 to 0.01; P = 0.117). There was no important difference in intraoperative average mitoPO<sub>2</sub> between patients assigned to personalized or to routine intraoperative arterial pressure management (P = 0.653). MitoPO<sub>2</sub> under general anesthesia was about a quarter lower than preoperative awake mitoPO<sub>2</sub>, substantially fluctuated during major non-cardiac surgery, and transiently decreased below 20 mmHg in about two-thirds of the patients. Personalized - compared to routine - intraoperative arterial pressure management did not increase intraoperative mitoPO<sub>2</sub>. Whether intraoperative decreases in mitoPO<sub>2</sub> are clinically meaningful warrants further investigation.</p>","PeriodicalId":15513,"journal":{"name":"Journal of Clinical Monitoring and Computing","volume":" ","pages":"813-820"},"PeriodicalIF":2.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12474711/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143370833","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Flora T Scheffenbichler, Bernhard Ulm, Laura Borgstedt, Anna Scholze, Nadine Kretsch, Nadine Zia, Viola Friedrich, Magdalena Marb, Stefan J Schaller, Bettina Jungwirth, Manfred Blobner
{"title":"Precision of electromyography according to the calibration approach of neuromuscular monitoring: a randomised prospective agreement study.","authors":"Flora T Scheffenbichler, Bernhard Ulm, Laura Borgstedt, Anna Scholze, Nadine Kretsch, Nadine Zia, Viola Friedrich, Magdalena Marb, Stefan J Schaller, Bettina Jungwirth, Manfred Blobner","doi":"10.1007/s10877-025-01304-z","DOIUrl":"10.1007/s10877-025-01304-z","url":null,"abstract":"<p><strong>Purpose: </strong>Anaesthesia providers often complain that quantitative neuromuscular monitoring does not accurately assess neuromuscular function, a problem that can be mitigated by appropriate calibration. However, there are only very limited recommendations for the calibration of quantitative neuromuscular monitoring in clinical routine. Therefore, this multicentre prospective agreement study compared the precision of electromyography using three different calibration approaches.</p><p><strong>Methods: </strong>Sixty patients were assigned to one of three investigational calibration approaches: calibration before anaesthesia induction, calibration during anaesthesia induction, i.e., at loss of consciousness and state entropy < 85, or uncalibrated. All patients received electromyography calibration under deep anaesthesia on the second arm (control as recommended for research). The primary endpoint was the repeatability coefficient, which describes the fluctuation of the following train-of-four (TOF) reading. It therefore provides an estimate of the precision of a measurement method. Secondary endpoints included agreement with control calibration and pain at induction.</p><p><strong>Results: </strong>The repeatability coefficient at TOF ratios ≥ 0.8 indicated that electromyography monitoring was less precise when TOF readings were uncalibrated (0.124 ± 0.130) or with calibration during induction (0.087 ± 0.104) but was acceptable after calibration before induction (0.075 ± 0.036) compared to those measured after calibration on the contralateral arm (control: 0.072 ± 0.027, 0.061 ± 0.021, and 0.083 ± 0.063, respectively). Recall of pain at anaesthesia induction did not differ between investigational groups.</p><p><strong>Conclusion: </strong>The findings underline the importance of thoroughly performed calibration for precise TOF readings to reliably exclude residual neuromuscular blockade. Electromyography was most precise when calibration was performed under deep anaesthesia (control). If that approach is not possible in the clinical setting, our data suggest that calibration before anaesthesia induction can be considered if previously discussed with the patient.</p><p><strong>Clinical trial registration: </strong>Clinical Trials NCT04911088, registered January 6, 2021.</p>","PeriodicalId":15513,"journal":{"name":"Journal of Clinical Monitoring and Computing","volume":" ","pages":"1047-1056"},"PeriodicalIF":2.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12474677/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144174074","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Comparison of quadricep motor evoked potentials between different surgical positions during total hip arthroplasty.","authors":"Wataru Shirahata, Ryohei Takada, Naoto Watanabe, Kazumasa Miyatake, Ayami Sato, Kanako Minegishi, Toshitaka Yoshii, Hideyuki Koga","doi":"10.1007/s10877-025-01308-9","DOIUrl":"10.1007/s10877-025-01308-9","url":null,"abstract":"<p><p>The influence of intraoperative position on femoral nerve palsy after total hip arthroplasty (THA) remains unclear. Therefore, we evaluated the effect of intraoperative position on quadricep motor-evoked potential monitoring in patients undergoing THA using an anterolateral approach. We included patients who underwent primary THA using the anterolateral approach at our hospital between June 2021 and January 2024 with available data on intraoperative quadricep using transcranial electrical stimulation motor-evoked potential. Patient characteristics were compared between the supine and lateral position groups. Intraoperative quadricep MEP were evaluated at the beginning of surgery, after anterior acetabular retractor placement, after acetabular retractor placement, and before wound closure. The MEP amplitude at surgery start was set to 100%, and the change in amplitude at each time point was compared between positions. Ten patients were placed in the supine and lateral positions. Patient background did not differ significantly between the groups, and no postoperative paralysis was observed. The residual rates of quadriceps MEP were significantly lower in the supine position than the lateral position at all three time points (p < 0.05). Intraoperative quadricep motor-evoked potential monitoring in primary THA using the anterolateral approach showed significantly lower MEP amplitude in the supine position than in the lateral position at all three time points. Therefore, the lateral position may decrease femoral nerve palsy risk after THA.</p>","PeriodicalId":15513,"journal":{"name":"Journal of Clinical Monitoring and Computing","volume":" ","pages":"1057-1063"},"PeriodicalIF":2.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12474580/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144258129","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Tommi Bergman, Maija-Liisa Kalliomäki, Mika Särkelä, Jarkko Harju
{"title":"The use of the surgical pleth index to guide anaesthesia in gastroenterological surgery: a randomised controlled study.","authors":"Tommi Bergman, Maija-Liisa Kalliomäki, Mika Särkelä, Jarkko Harju","doi":"10.1007/s10877-025-01262-6","DOIUrl":"10.1007/s10877-025-01262-6","url":null,"abstract":"<p><p>The measurement of nociception and the optimisation of intraoperative antinociceptive medication could potentially improve the conduct of anaesthesia, especially in the older population. The Surgical Pleth Index (SPI) is one of the monitoring methods presently used for the detection of nociceptive stimulus. Eighty patients aged 50 years and older who were scheduled to undergo major abdominal surgery were randomised and divided into a study group and a control group. In the study group, the SPI was used to guide the administration of remifentanil during surgery. In the control group, the SPI value was concealed, and remifentanil administration was based on the clinical evaluation of the attending anaesthesiologist. The primary endpoint of this study was intraoperative remifentanil consumption. In addition, we compared the durations of intraoperative hypotension and hypertension. No difference in intraoperative remifentanil consumption (4.5 µg kg<sup>- 1</sup>h<sup>- 1</sup> vs. 5.6 µg kg<sup>- 1</sup>h<sup>- 1</sup>, p = 0.14) was found. Furthermore, there was no difference in the proportion of hypotensive time (mean arterial pressure, MAP < 65) (3.7% vs. 1.6%, p = 0.40). However, in the subgroup of patients who underwent operation with invasive blood pressure monitoring, there was less severe hypotension (MAP < 55) (0.3% vs. 0.0%, p = 0.02) and intermediate hypotension (MAP < 65) (10.2% vs. 2.6%, p = 0.07) in the treatment group, even though remifentanil consumption was higher (3.5 µg kg<sup>- 1</sup>h<sup>- 1</sup> vs. 5.1 µg kg<sup>- 1</sup>h<sup>- 1</sup>p = 0.03). The use of SPI guidance for the administration of remifentanil during surgery did not help to reduce the remifentanil consumption. However, the results from invasively monitored study group suggest more timely administered opioid when SPI was used.</p>","PeriodicalId":15513,"journal":{"name":"Journal of Clinical Monitoring and Computing","volume":" ","pages":"957-965"},"PeriodicalIF":2.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12474587/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143006166","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Alexandre Descamps, Matthias Jacquet-Lagrèze, Thomas Aussal, Jean-Luc Fellahi, Martin Ruste
{"title":"DiCART<sup>TM</sup> device to measure capillary refill time: a validation study in patients with acute circulatory failure.","authors":"Alexandre Descamps, Matthias Jacquet-Lagrèze, Thomas Aussal, Jean-Luc Fellahi, Martin Ruste","doi":"10.1007/s10877-025-01271-5","DOIUrl":"10.1007/s10877-025-01271-5","url":null,"abstract":"<p><p>Capillary Refill Time (CRT) is a valuable metric to assess cutaneous perfusion. Its prognostic value in patients with acute circulatory failure has been reported as improved when the measurement is standardized. The DiCART™ device is a fully automated CRT measurement tool requiring validation. We conducted a comparative interventional single-center study including 25 patients with acute circulatory failure, to evaluate the agreement between CRT measured by an automated measurement device (CRT<sub>DiCART</sub>) and CRT measured clinically (CRT<sub>CLIN</sub>). CRT was measured on the fingertip, chest, and knee. Three measurements were performed at each location to obtain an average for each site. The measurements were conducted both clinically and using the DiCART™ device by two different operators, each blinded to the results. Agreement was determined using intraclass correlation coefficient (ICC) and Bland and Altman analysis. The ICC between CRT<sub>CLIN</sub> and CRT<sub>DiCART</sub> was 0.46 (95% Confidence Interval (CI) 0.32, 0.59) across all measurement sites; the mean bias was 0.23s (95% CI -0.17, 0.64), with upper Limit of Agreement (LoA) 2.77s (95% CI 2.44, 3.20) and lower LoA - 2.30s (-2.73, -1.97). Intra observer ICC was 0.85 (95% CI 0.74, 0.91) for CRT<sub>CLIN</sub> and 0.43 (95% CI 0.15, 0.64) for CRT<sub>DICART</sub>. Inter observer ICC was 0.86 (95% CI 0.76, 0.92) for CRT<sub>CLIN</sub> and was 0.41 (95% CI 0.14, 0,63) for CRT<sub>DICART</sub>. The DiCART™ device showed poor agreement with clinical CRT in patients with acute circulatory failure, which does not support its use in routine practice.</p>","PeriodicalId":15513,"journal":{"name":"Journal of Clinical Monitoring and Computing","volume":" ","pages":"831-840"},"PeriodicalIF":2.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12474624/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143515824","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Philippe E Dubois, Fabien Moreillon, Benoit Bihin, Clotilde De Dorlodot, Sabrina Meyer, Adrien Maseri, Philippe A Passeraub, Alain A d'Hollander
{"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":"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":"1037-1045"},"PeriodicalIF":2.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12474715/pdf/","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Vitor Alves Felippe, Roberta Codeceira, Maria Irigaray, Maria Sckaff, Bruno Wegner, Tatiana Nascimento, Carlos Darcy, Lucas Dutra, Bruno Santiago, Julia Buchmann, Marcos Adriano Lessa
{"title":"Non-invasive goal-directed fluid therapy with the pleth variability index (PVI): a systematic review and meta-analysis.","authors":"Vitor Alves Felippe, Roberta Codeceira, Maria Irigaray, Maria Sckaff, Bruno Wegner, Tatiana Nascimento, Carlos Darcy, Lucas Dutra, Bruno Santiago, Julia Buchmann, Marcos Adriano Lessa","doi":"10.1007/s10877-025-01334-7","DOIUrl":"10.1007/s10877-025-01334-7","url":null,"abstract":"<p><p>Optimal intraoperative fluid management is essential to improve surgical outcomes and reduce complications. The Pleth Variability Index (PVI), a dynamic and non-invasive indicator of fluid responsiveness, has been proposed as a tool for goal-directed fluid management. This systematic review and meta-analysis aimed to evaluate the effectiveness of PVI-guided fluid therapy compared to conventional fluid management (CFM) in non-cardiac surgeries. A comprehensive search of PubMed, Embase, and Cochrane databases up to January 2024 identified eligible studies. Primary outcomes included total intraoperative fluid volume and crystalloid administration. Secondary outcomes included hemodynamic parameters, renal function markers, acid-base balance, and hospital length of stay (LOS). Random-effects models were applied, and subgroup and sensitivity analyses were performed. Nine studies comprising 1,105 patients were included. Compared to conventional fluid management, PVI-guided therapy significantly reduced total fluid volume (mean difference [MD] - 761.23 mL; 95% CI - 1267.42 to - 255.03) and crystalloid administration (MD - 655.05 mL; 95% CI - 1096.48 to - 213.62), without significant differences in colloid use, urine output, norepinephrine requirement, arterial pressure, acid-base balance, or LOS. Subgroup analysis of abdominal surgeries confirmed the observed reduction in fluid volumes. PVI-guided fluid management allows for a more restrictive and individualized approach without compromising hemodynamic or metabolic stability. While the heterogeneity across studies limits generalizability, these findings support the clinical value of PVI as a non-invasive tool for perioperative fluid optimization, especially in settings where invasive monitoring is not feasible. Further trials are needed to evaluate its impact on long-term outcomes.</p>","PeriodicalId":15513,"journal":{"name":"Journal of Clinical Monitoring and Computing","volume":" ","pages":"917-927"},"PeriodicalIF":2.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12474725/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144799188","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Martine J M Breteler, Ellen Leigard, Lisa C Hartung, John R Welch, David A Brealey, Sebastian J Fritsch, David Konrad, Daniel Hertzberg, Max Bell, Heleen Rienstra, Frank E Rademakers, Cor J Kalkman
{"title":"Reliability of an all-in-one wearable sensor for continuous vital signs monitoring in high-risk patients: the NIGHTINGALE clinical validation study.","authors":"Martine J M Breteler, Ellen Leigard, Lisa C Hartung, John R Welch, David A Brealey, Sebastian J Fritsch, David Konrad, Daniel Hertzberg, Max Bell, Heleen Rienstra, Frank E Rademakers, Cor J Kalkman","doi":"10.1007/s10877-025-01279-x","DOIUrl":"10.1007/s10877-025-01279-x","url":null,"abstract":"<p><p>Continuous vital signs monitoring with wearable systems may improve early recognition of patient deterioration on hospital wards. The objective of this study was to determine whether the wearable Checkpoint Cardio's CPC12S, can accurately measure heart rate (HR), respiratory rate (RR), oxygen saturation (SpO2), blood pressure (BP) and temperature continuously. In an observational multicenter method comparison study of 70 high-risk surgical patients admitted to high-dependency wards; HR, RR, SpO2, BP and temperature were simultaneously measured with the CPC12S system and with ICU-grade monitoring systems in four European hospitals. Outcome measures were bias and 95% limits of agreement (LoA). Clinical accuracy was assessed with Clarke Error Grid analyses for HR and RR. A total of 3,212 h of vital signs data (on average 26 h per patient) were analyzed. For HR, bias (95% LoA) of the pooled analysis was 0.0 (-3.5 to 3.4), for RR 1.5 (-3.7 to 7.5) and for SpO2 0.4 (-3.1 to 4.0). The CPC12S system overestimated BP, with a bias of 8.9 and wide LoA (-23.3 to 41.2). Temperature was underestimated with a bias of -0.6 and LoA of -1.7 to 0.6. Clarke Error Grid analyses showed that adequate treatment decisions regarding changes in HR and RR would have been made in 99.2% and 92.0% of cases respectively. The CPC12S system showed high accuracy for measurements of HR. The accuracy of RR, SpO2 were slightly overestimated and core temperature underestimated, with LoA outside the predefined clinical acceptable range. The accuracy of BP was unacceptably low.</p>","PeriodicalId":15513,"journal":{"name":"Journal of Clinical Monitoring and Computing","volume":" ","pages":"1087-1100"},"PeriodicalIF":2.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12474673/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143657341","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}