Journal of Clinical Monitoring and Computing最新文献

{"title":"A novel index for trending sepsis and inflammatory response using processed EEG and Heart Rate Variability.","authors":"Jaume Millán I Ichon, Montserrat Vallverdú-Ferrer, Erik Weber Jensen, Carolina Frederico Avendaño, Joy Nnagbo, Laia Yébenes-Serra, Michel M R F Struys, Gertrude J Nieuwenhuijs-Moeke","doi":"10.1007/s10877-026-01472-6","DOIUrl":"10.1007/s10877-026-01472-6","url":null,"abstract":"<p><p>Early detection of systemic inflammation and sepsis is essential for improving patient outcomes. Heart rate variability (HRV) has been proposed as a non-invasive marker of inflammation; however, its specificity is limited, particularly under anesthesia or sedation. This study introduces the Trend of Sepsis and Inflammation (TSI), a novel index combining HRV and electroencephalogram (EEG)-derived parameters to better isolate inflammation-related autonomic changes.A post-hoc observational analysis was conducted in two cohorts: surgical patients undergoing general anesthesia (N = 41) and septic patients admitted to the intensive care unit (N = 21). Continuous EEG and ECG recordings were obtained using a multimodal monitoring system. HRV parameters from time and frequency domains, together with an EEG-derived Brain Activity Index, were integrated using an Adaptive Neuro-Fuzzy Inference System (ANFIS) to compute the TSI. TSI values were compared across three conditions: awake baseline, post-surgical inflammation, and sepsis. Statistical analysis employed non-parametric tests, while discriminative performance was assessed using prediction probability (Pk) and concordance with predefined interpretation ranges.TSI values increased progressively across conditions. Median values were 2.29 (IQR: 0.00-13.74) at baseline, 24.68 (18.50-32.00) post-surgery, and 65.59 (52.38-76.25) in sepsis, with significant differences (p < 0.0001). The TSI demonstrated strong discriminative ability (Pk = 93.58%) and high overall concordance (92.6%). HRV spectrograms and EEG-compensated analyses supported physiological consistency.The TSI distinguishes between baseline, post-surgical inflammatory, and septic states. By compensating for anesthesia-related autonomic suppression, it provides a continuous, non-invasive measure of inflammatory burden, supporting its potential use in perioperative and critical care settings. Further validation against established biomarkers is warranted.</p>","PeriodicalId":15513,"journal":{"name":"Journal of Clinical Monitoring and Computing","volume":" ","pages":"975-986"},"PeriodicalIF":2.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13562165/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148578902","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":"Automated estimation of the logistic curve model of cerebral CO₂ vasomotor reactivity.","authors":"R B Panerai, J Ince, A Alshehri, R H Clough, T G Robinson, J S Minhas","doi":"10.1007/s10877-026-01466-4","DOIUrl":"10.1007/s10877-026-01466-4","url":null,"abstract":"<p><p>An automated method is presented to derive the logistic curve model (LCM), to express the simultaneous effects of partial pressure of arterial CO₂ (PaCO₂) on cerebral blood flow (CBF) and cerebral autoregulation, without the need for operator assistance. Measurements of middle cerebral artery blood velocity (MCAv, transcranial Doppler), arterial blood pressure (Finometer) and end-tidal CO₂ (EtCO₂, capnography) were performed in 106 healthy subjects. Hypercapnia was induced with breathing 5% CO₂ and hypocapnia was induced with hyperventilation. Dynamic autoregulation was expressed by the Autoregulation Index (ARI). Confidence limits for the fitting error were obtained with a surrogate bootstrap approach for both MCAv and ARI. An algorithm for the gradual removal of outlier values was implemented to identify optimal number of samples that minimises the fitting error. Induction of hyper- and hypocapnia was demonstrated by the range of EtCO₂ values achieved (28.4 ± 6.0 to 47.7 ± 5.8 mmHg, p < 0.001). LCMs meeting confidence limit requirements were obtained for MCAv (n = 98/106) and ARI (104/106). Females showed an upwards shift of their LCM for MCAv (p = 0.001) compared to males and their ARI model was shifted laterally towards lower values of EtCO₂ (p = 0.0053). Automated identification of the LCM for MCAv and ARI, with rigorous confidence limits of the fitting error is feasible and can identify differences due to biological sex.</p>","PeriodicalId":15513,"journal":{"name":"Journal of Clinical Monitoring and Computing","volume":" ","pages":"987-1000"},"PeriodicalIF":2.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13562359/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148396505","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":"Non-invasive evaluation of the respiratory system's static compliance during assisted ventilation at various pressure support levels.","authors":"Hai Zhang, Yueyang Yuan, Yuqing Chen, Qing Chang, Feng Li","doi":"10.1007/s10877-026-01455-7","DOIUrl":"10.1007/s10877-026-01455-7","url":null,"abstract":"<p><p>Spontaneous breathing activity during pressure support ventilation (PSV) is not beneficial for the assessment of static compliance (C_st). We designed a new scheme for determining C_st during PSV and assessed its accuracy using a lung model. A Hamilton C3 ventilator was connected to an ASL5000 lung simulator that simulated different lung mechanics [system's static compliance (C_st), 30 or 60 mL/cmH₂O; airway resistance (R_aw), 5, 10, 15, or 20 cmH₂O/(L·s)]. PSV and volume-controlled ventilation (VCV) underwent activation with tidal volume (V_T) values of 5, 7, and 10 ml/kg. Respiratory mechanics were obtained and corrected with virtual extrapolation by applying RC_exp and relevant equations. The repeated change in pressure support (PS) level was set at ± 1 cmH₂O. C_st-PSV was determined from volume fluctuations resulting from PS level changes. The classic C_st measurement was obtained with the end-inspiration approach during volume-controlled ventilation (C_st-VCV). Comparing the value of C_st-VCV, similar values for C_st-PSV were obtained at low PS level. By changing the PS level, the estimated C_st-PSV resulted in a relatively high error of about 10-15%.The novel scheme provided reliable estimated results for C_st during pressure support ventilation. Despite its limited accuracy affected by the spontaneous effort participation, this scheme may help in non-invasive, uninterrupted monitoring of C_st.</p>","PeriodicalId":15513,"journal":{"name":"Journal of Clinical Monitoring and Computing","volume":" ","pages":"1155-1166"},"PeriodicalIF":2.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13562222/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148271779","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":"Perceptions on artificial intelligence among anaesthesia and intensive care professionals: An international survey on attitudes, expectations and needs.","authors":"Raphael Theilen, Tim Kramer, Martin Scharffenberg, Ian-Christopher Jung, Maria Zerlik, Marcelo Gama de Abreu, Saman Sepehr, Thea Koch, Brita Sedlmayr, Robert Huhle, Jakob Wittenstein","doi":"10.1007/s10877-026-01464-6","DOIUrl":"10.1007/s10877-026-01464-6","url":null,"abstract":"<p><p>Background Artificial intelligence (AI) can enhance diagnostics, treatment, and workflow efficiency. However, successful integration into clinical practice depends on users' acceptance. Objective To investigate benefits, barriers, and challenges of AI applications among anaesthesia and intensive care professionals. Design International online survey. Main outcome measures The survey included items on familiarity and experiences with AI applications, perceived benefits, concerns, and demographic variables. Descriptive analyses, fisher exact tests, χ²-tests, odds ratios, and Spearman rank correlations were used to explore associations between responses and demographics. Results The survey was distributed by the European Society of Anaesthesiology and Intensive Care in 2023. A total of 510 respondents completed the entire survey, primarily from Europe (78%) and Asia (14.5%), and the majority were board-certified anaesthesiologists (86.3%). 86.5% of the respondents were aware of AI applications, but only 36.8% reported regular encounters. Familiarity was higher among males and intensive care specialists. 94.5% expressed interest in AI training, particularly younger and less experienced professionals. 94.7% expressed willingness to use AI applications, citing benefits such as improved decision-making (92.7%), complication anticipation (88.6%), and workload reduction (80.1%). Younger and female respondents were more optimistic about AI's benefits. Key concerns included lack of explainability (68.4%), over-reliance on AI (80.8%), and medico-legal uncertainties (58.4%). Scepticism was attributed to insufficient validation studies and fears of inaccurate outputs, particularly among experienced clinicians. Conclusions This international survey shows cautious optimism among anaesthesia and intensive care professionals regarding AI applications. Adoption in clinical practice requires tailored training that accounts also for demographic-specific concerns, robust validation, and clear ethical and legal frameworks.</p>","PeriodicalId":15513,"journal":{"name":"Journal of Clinical Monitoring and Computing","volume":" ","pages":"1189-1197"},"PeriodicalIF":2.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13562144/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148387604","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":"Integrated haemodynamic monitoring of fluid responsiveness and fluid tolerance in critical care: from physiology to bedside applications.","authors":"Henrique Mendes, Marc Zentar","doi":"10.1007/s10877-026-01467-3","DOIUrl":"10.1007/s10877-026-01467-3","url":null,"abstract":"<p><p>The framework of fluid responsiveness addresses only whether volume expansion will augment cardiac output, not whether the circulation can accept that volume without producing congestive organ injury. The complementary concept of fluid tolerance has accumulated empirical support over recent years and is integral to understanding patients' fluid status. This narrative review synthesises the physiological basis of fluid responsiveness and fluid tolerance, describes the bedside monitoring tools available to assess each, and considers the clinical implications of their joint interpretation in critical care. We performed a literature search restricted to articles published between 2020 and the date of the search. The retrieved abstracts were evaluated for relevance, and their reference lists were subsequently screened to identify additional pertinent publications. Fluid responsiveness and fluid tolerance are dissociable but physiologically interdependent, sharing determinants such as biventricular function, stressed volume and venous capacitance. Dynamic tests remain the preferred approach for assessing preload responsiveness; each has specific applicability conditions, and many require continuous or rapidly repeated cardiac output monitoring. Emerging tools have been developed to assess fluid tolerance, primarily based on vascular sonography; their interpretation requires concurrent assessment of biventricular function and further validation. Reframing fluid stewardship around the interaction between responsiveness and tolerance shifts the focus from forward-flow alone to net physiological benefit. No single parameter or device fully captures fluid status. An integrated, serial, multi-parametric assessment supported by appropriate monitoring platforms is therefore preferable to reliance on any single measure. At present, these tools support fluid stewardship rather than representing interventions with independently proven survival benefit. Future priorities include defining organ-specific congestion thresholds and testing whether monitoring-informed protocols improve outcomes.</p>","PeriodicalId":15513,"journal":{"name":"Journal of Clinical Monitoring and Computing","volume":" ","pages":"1077-1089"},"PeriodicalIF":2.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13562101/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148421400","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":"Effect of preoperative β-blocker use on Analgesia-Nociception Index during laparoscopic cholecystectomy.","authors":"Joon-Suk Bom, Seongheon Lee, Ye-Chan Yoo, Joungmin Kim","doi":"10.1007/s10877-026-01461-9","DOIUrl":"10.1007/s10877-026-01461-9","url":null,"abstract":"<p><p>Background The Analgesia-Nociception Index (ANI), derived from heart rate variability, reflects parasympathetic activity and is used to assess intraoperative nociception. β-blockers modulate autonomic tone and heart rate variability and may influence responses to nociceptive stimuli. This study investigated whether preoperative β-blocker use was associated with altered intraoperative ANI dynamics during laparoscopic cholecystectomy. Method The data of 49 patients with hypertension who underwent elective laparoscopic cholecystectomy under a standardized propofol-remifentanil anesthetic protocol were analyzed in this prospective observational study. Patients were classified according to chronic β-blocker use (β-blocker group, n = 24; non-β-blocker group, n = 25). Four predefined nociceptive stimuli were applied under stable anesthetic conditions. The minimum ANI value within 2 min after each stimulus (ANI_min) and the change from the pre-stimulus value (ΔANI) were analyzed using repeated-measures analysis of variance. Results Repeated-measures ANOVA demonstrated a significant main effect of time, indicating a consistent decrease in ANI in response to standardized nociceptive stimuli. No significant time × group interaction or main effect of group was observed for ANI_min or ΔANI. The temporal patterns and magnitudes of ANI changes were comparable between groups across all predefined time points. Conclusions Preoperative β-blocker therapy did not substantially alter stimulus-related ANI dynamics during laparoscopic cholecystectomy under propofol-remifentanil anesthesia. These findings suggest that ANI may remain interpretable as a dynamic within-patient autonomic response in chronically β-blocked patients under these anesthetic conditions.</p>","PeriodicalId":15513,"journal":{"name":"Journal of Clinical Monitoring and Computing","volume":" ","pages":"1025-1031"},"PeriodicalIF":2.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13562345/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148271782","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":"Clinical validation of video-based vital sign monitoring in the intensive care unit: a prospective cohort study : Clinical validation of video-based vital sign monitoring.","authors":"Iris Cramer, Rik van Esch, Cindy Verstappen, Carla Kloeze, Jos Twisk, Sander Stuijk, Jan Bergmans, Svitlana Zinger, Ashley De Bie Dekker, Marcel van 't Veer, R Arthur Bouwman, Lukas Dekker, Leon Montenij","doi":"10.1007/s10877-026-01440-0","DOIUrl":"10.1007/s10877-026-01440-0","url":null,"abstract":"<p><strong>Purpose: </strong>Video-based monitoring technologies enable continuous and contactless monitoring of vital signs. This study evaluates the clinical concordance and determinants of performance of contactless video-based heart and respiratory rate monitoring compared with reference standards in a heterogeneous population of critically ill patients.</p><p><strong>Methods: </strong>In this prospective observational study, 35 intensive care unit patients were continuously monitored for 24 h. Video-based heart rate and respiratory rate were compared with the clinical reference standard. Agreement was assessed using Bland-Altman plots, intraclass correlation coefficients (ICC), and error grid analyses. Generalized estimating equations (GEE) identified factors affecting agreement.</p><p><strong>Results: </strong>For heart rate, bias was 2.1 bpm (limits - 33.6 to 37.7), with 81.9% within ± 5 bpm and 99.3% in error grid zones A/B. ICC was 0.43. For respiratory rate, bias was - 2.4 breaths/min (limits - 14.3 to 9.5), with 63.5% within ± 3 breaths and 87.5% in zones A/B. ICC was 0.41. High heart rate, atrial fibrillation, norepinephrine administration, and movement reduced agreement for heart rate; movement reduced agreement for respiratory rate.</p><p><strong>Conclusion: </strong>Video-based monitoring shows promise for detecting abnormal vital signs in critically ill patients, but improved robustness to motion is needed for reliable clinical implementation.</p>","PeriodicalId":15513,"journal":{"name":"Journal of Clinical Monitoring and Computing","volume":" ","pages":"1113-1123"},"PeriodicalIF":2.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13562297/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147930001","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":"Pre-induction nociception indices are associated with post-induction hypotension during general anesthesia in older patients: a prospective observational study.","authors":"Masahiro Kuroki, Rintaro Tsunoda, Tatsuya Hayasaka, Kenya Yarimizu, Ayuka Narisawa, Hiroaki Toyama","doi":"10.1007/s10877-026-01469-1","DOIUrl":"10.1007/s10877-026-01469-1","url":null,"abstract":"<p><p>We investigated whether pre-induction High Frequency Variability Index (HFVI)/Analgesia Nociception Index (ANI) and Nociception Level (NOL) values could predict hypotension during general anesthesia induction in older patients. This prospective observational study included patients aged ≥ 65 years undergoing elective surgery under general anesthesia. After recording HFVI/ANI and NOL values, remifentanil was administered at 0.2 µg/kg/min for 2 min, followed by a rapid intravenous bolus administration of propofol at 2 mg/kg. Noninvasive blood pressure was measured at 1-min intervals over 5 min. Hypotension was defined as mean arterial pressure (MAP) < 65 mmHg. Predictive performance was evaluated using receiver operating characteristic (ROC) curves. Additionally, the area under MAP < 65 mmHg (AUT-65), a continuous metric integrating the depth and duration of hypotension, was calculated and correlated with nociception index values. We analyzed 51 patients (19 men; 22 in the hypotension group and 29 in the nonhypotension group). The hypotension group demonstrated lower HFVI/ANIi values (58.7 ± 11.1 vs. 69.0 ± 15.1, p = 0.010) and higher NOL values (17.2 ± 9.1 vs. 10.7 ± 8.8, p = 0.013). HFVI/ANIi (AUC = 0.72, cutoff = 62.5) and NOL (AUC = 0.71, cutoff = 13.5) moderately predicted hypotension. AUT-65 was significantly correlated with HFVI/ANIi (Spearman rho = - 0.35, p = 0.013) and NOL (rho = 0.47, p = 0.0005). Pre-induction HFVI/ANI and NOL were associated with the occurrence and cumulative burden of post-induction hypotension in patients aged ≥ 65 years, suggesting their potential utility as pre-induction screening tools.Trial registration This study was approved by the Ethics Committee of Yamagata University Hospital on January 18, 2024 (approval number 2023 - 280). Before commencement, the study was registered as a prospective observational study in the UMIN Clinical Trials Registry (UMIN000053529).</p>","PeriodicalId":15513,"journal":{"name":"Journal of Clinical Monitoring and Computing","volume":" ","pages":"1033-1043"},"PeriodicalIF":2.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13562309/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148436891","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":"A wearable cuffless blood pressure monitoring system: real-time measurement using force sensing and waveform analysis.","authors":"Tzu-Hsuan Lu, Yu-Hsuan Fan Chiang, Chuen-Chau Chang","doi":"10.1007/s10877-026-01454-8","DOIUrl":"10.1007/s10877-026-01454-8","url":null,"abstract":"<p><p>This paper introduces a wearable, cuffless blood pressure (BP) monitoring system for continuous, real-time measurement in the operating room. Traditional cuff-based BP monitoring is intermittent and unsuitable for surgery, while intra-arterial measurements are invasive. The system uses a finger clip with a force sensor to detect pressure changes caused by arterial pulsations, with a waveform decomposition analysis algorithm estimating systolic and diastolic BP in real time. A clinical validation study involving 46 patients in the operating room demonstrated the system's accuracy, with reference measurements from an intra-arterial catheter. The reference systolic pressure ranged from 83 mmHg to 194 mmHg, and diastolic pressure from 42 mmHg to 105 mmHg. The error between paired measurements was - 1.44 ± 6.64 mmHg for systolic and 3.35 ± 6.91 mmHg for diastolic, with the device's measurements meeting the ISO 81060-2:2018 accuracy specification of 5 ± 8 mmHg. Pearson correlation coefficients were r = 0.90 (p < 0.01) for systolic and r = 0.78 (p < 0.01) for diastolic, indicating significant correlations with intra-arterial catheter measurements. The data analysis also considered the IEEE 1708 standard, ensuring compliance with guidelines for non-invasive BP monitoring. In collaboration with the device developer, the authors designed the clinical calibration protocol and user interface to ensure compatibility with intra-operative monitoring workflows. This study represents the first clinical validation of a tactile force-sensing cuffless system against intra-arterial reference measurements, demonstrating its feasibility for real-time, non-invasive blood pressure monitoring during anesthesia.</p>","PeriodicalId":15513,"journal":{"name":"Journal of Clinical Monitoring and Computing","volume":" ","pages":"1103-1112"},"PeriodicalIF":2.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13562357/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148217992","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":"Making brain monitoring routine: why processed EEG monitoring should be standard practice.","authors":"Joana Berger-Estilita, Anthony Ray Absalom, Adrian W Gelb","doi":"10.1007/s10877-026-01453-9","DOIUrl":"10.1007/s10877-026-01453-9","url":null,"abstract":"<p><p>Despite major technological advances and a growing evidence base, perioperative electroencephalographic (EEG) monitoring remains underused, even though general anaesthesia is fundamentally a brain-targeted intervention. Processed EEG (pEEG) captures clinically relevant brain physiology and provides actionable information to guide anaesthetic dosing, yet its adoption has been hindered by expectations of outcome certainty that exceed those applied to other standard monitors. Much of the controversy reflects misaligned endpoints-such as movement or binary awareness detection-rather than the domains in which EEG plausibly adds value, including avoidance of excessively deep anaesthesia and optimisation of drug titration. While large trials have produced heterogeneous results and have not demonstrated uniform benefit across broad surgical populations, some analyses have explored the possibility that EEG-guided anaesthesia may be more relevant in selected high-risk groups, particularly older adults vulnerable to postoperative neurocognitive disorders. Continued failure to integrate routine brain monitoring into standard anaesthetic practice may therefore pose a greater patient safety risk than adopting it in the setting of imperfect yet biologically coherent evidence.</p>","PeriodicalId":15513,"journal":{"name":"Journal of Clinical Monitoring and Computing","volume":" ","pages":"965-973"},"PeriodicalIF":2.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13562248/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148163307","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}