Journal of Clinical Monitoring and Computing最新文献

{"title":"First-pass success in video laryngoscopy with transcutaneous infrared illumination in patients with normal airways-a clinical pilot study.","authors":"Abdulrahman Dardeer, Muhammad Firas Alhammad, Khaled J Zaza, Anas N Shallik, Yasser Ali Hammad, El-Sayed Mohamed Elkarta, Nabil A Shallik","doi":"10.1007/s10877-025-01361-4","DOIUrl":"https://doi.org/10.1007/s10877-025-01361-4","url":null,"abstract":"<p><strong>Purpose: </strong>Endotracheal intubation is a critical skill in anesthesia, particularly for patients with compromised airways. This randomized pilot study evaluated the feasibility and impact of the Infrared Red Intubation System (IRRIS^®) on video laryngoscopy performance, first-attempt success rate, and intubation time.</p><p><strong>Methods: </strong>Thirty patients were randomized into two groups: one with the IRRIS device and one without (control). The primary outcome was the impact of IRRIS on first-pass success. Secondary outcomes included glottic visibility, intubation time, and adverse effects.</p><p><strong>Results: </strong>Results showed that both groups demonstrated nearly identical percentages of glottic opening (POGO) and glottic entrance visibility, achieving successful intubation on the first attempt. Although the IRRIS group had a slightly longer intubation time and more instances of required external manipulation, the vocal cords were not visible without IRRIS in the most obese patient in our cohort.</p><p><strong>Conclusion: </strong>The IRRIS device effectively illuminated the laryngeal inlet, enhancing differentiation from surrounding structures, such as the esophagus. This study suggests that IRRIS may be a valuable adjunct for video laryngoscopy in patients with difficult airways, though further research is needed to assess its broader applicability.</p><p><strong>Background: </strong>Endotracheal intubation in patients with compromised airways is a notoriously complex and daunting task for anesthesiologists. Throughout the years, numerous supportive techniques and innovative equipment have been developed to address this challenge. This randomized clinical study sheds light on the potential benefits of utilizing an external pre-cricoid emitting infrared light source, the 'Infrared Red Retrograde Intubation System' (IRRIS^®), which produces a flashing light that can be detected within the airway. By leveraging this technology, anesthesiologists may be able to identify the airway quicker and more accurately, both in terms of time and anatomical level, compared to relying solely on a video laryngoscope/ flexible bronchoscope.</p>","PeriodicalId":15513,"journal":{"name":"Journal of Clinical Monitoring and Computing","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145149179","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":"No right to be wrong: TCI pumps and implementation of pharmacokinetic-pharmacodynamic models-a statement by the European society for intravenous anesthesia.","authors":"Frank H Engbers, Hernan Boveri, Gavin Kenny, Francisco A Lobo","doi":"10.1007/s10877-025-01353-4","DOIUrl":"https://doi.org/10.1007/s10877-025-01353-4","url":null,"abstract":"","PeriodicalId":15513,"journal":{"name":"Journal of Clinical Monitoring and Computing","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145124193","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 of vital sign monitoring using a photoplethysmography upper arm wearable device in postoperative non-cardiac surgery patients: a prospective observational clinical validation study.","authors":"Noa Reijmers, Arthur van Kootwijk, Eric E C de Waal","doi":"10.1007/s10877-025-01358-z","DOIUrl":"https://doi.org/10.1007/s10877-025-01358-z","url":null,"abstract":"","PeriodicalId":15513,"journal":{"name":"Journal of Clinical Monitoring and Computing","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145113409","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 the 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":"Safae Dehbi, Aiman Elfassi, Abdelilah Ghannam, Brahim Elahmadi, Zakaria Houssain Belkhadir, Oussama Ssouni","doi":"10.1007/s10877-025-01362-3","DOIUrl":"https://doi.org/10.1007/s10877-025-01362-3","url":null,"abstract":"","PeriodicalId":15513,"journal":{"name":"Journal of Clinical Monitoring and Computing","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145091571","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":"Correction: Presentation of a novel method to estimate analog mean systemic filling pressure based on cardiac power.","authors":"Enrique Monares-Zepeda, Christopher Barrera-Hoffmann, Ulises Wilfrido Cerón-Díaz, Yesica Ivone Martínez-Baltazar","doi":"10.1007/s10877-025-01360-5","DOIUrl":"https://doi.org/10.1007/s10877-025-01360-5","url":null,"abstract":"","PeriodicalId":15513,"journal":{"name":"Journal of Clinical Monitoring and Computing","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145075409","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":"Post-operative cerebral oximetry for detection of low-cardiac output syndrome after coronary artery bypass surgery.","authors":"Miriam Silaschi, Jacqueline Kruse, Maria Wittmann, Itsuki Osawa, Tadahiro Goto, Markus Velten, Marcus Thudium, Marc Rohner, Marwan Hamiko, David Rowlands, Stefan Kreyer, Marc Coburn, Farhad Bakhtiary","doi":"10.1007/s10877-025-01359-y","DOIUrl":"https://doi.org/10.1007/s10877-025-01359-y","url":null,"abstract":"<p><p>While cerebral near infrared spectroscopy (NIRS) is a valuable diagnostic tool to monitor brain oxygenation during cardiac surgery, its value in low cardiac output syndrome (LCOS) in adults has not been evaluated. This study was prospective and observational. Patients undergoing coronary artery bypass grafting (CABG) with reduced ejection fraction (LVEF < 35%) were included and received NIRS monitoring for up to 48 h after surgery with simultaneous continuous cardiac index (CI) monitoring. The primary endpoint was LCOS by a standard definition. From 2020 to 2023, 82 Patients with severely reduced LVEF undergoing CABG were included. Of these, 44 patients had sufficient NIRS and CI data for further analyses. Median age was 68 years (Interquartile range (IQR) 60-73), 91% (40/44) were male and median EuroSCORE II was 3.2% (1.7-5.4). Median LVEF was 30% (26.5-30.1) and baseline CI was 2.15 L/min/m² (2.05-2.60). CABG was combined with other procedures in 23% (10/44). LCOS rate was 11% (5/44) and in-hospital mortality was 2.2% (1/44). The performance of Lasso-regularized models increased if NIRS was included in LCOS prediction models (AUROC 0.99 [95%CI, 0.98-1.00]) showing that both relative NIRS drop rate and absolute NIRS value were significant predictors of LCOS. Risk of LCOS was high if NIRS drops by > 20% or absolute NIRS drops below < 50. In patients with LCOS, NIRS drop occurred before CI values decreased. NIRS drop was not associated with other adverse events. NIRS is an early and valid indicator of LCOS in patients after cardiac surgery. In selected patients, NIRS may be a substitute for invasive continuous CI measurements. However, we could not show an association of NIRS drop with adverse events. Future studies should compare blinded and non-blinded NIRS monitoring to investigate possible impact on clinical outcomes further.</p>","PeriodicalId":15513,"journal":{"name":"Journal of Clinical Monitoring and Computing","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145053758","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":"Towards reliable prediction of intraoperative hypotension: a cross-center evaluation of deep learning-based and MAP-derived methods.","authors":"Nada Chaari, Greg Winski, Magnus Hallbäck, Niclas Lundström, Håkan Björne, Martin Jacobsson","doi":"10.1007/s10877-025-01357-0","DOIUrl":"https://doi.org/10.1007/s10877-025-01357-0","url":null,"abstract":"<p><p>Intraoperative hypotension (IOH) is associated with an increased risk of heart and kidney complications. Although AI tools aim to predict IOH, their real-world reliability is often overstated due to biased data selection. This study introduces a framework to enhance reliability by: (1) including borderline blood pressure cases (65-75 mmHg, the \"Gray Zone\"), (2) comparing AI model to simple blood pressure threshold, and (3) validating across diverse surgical cohorts, centers and demographics. Using datasets from Karolinska University Hospital (Sweden) and VitalDB (Korea), we found AI model performs better than MAP threshold method in more ambiguous cases. In contrast, when hypotensive and non-hypotensive cases had clearly separated MAP values, both methods performed similarly well. Cross-validation revealed asymmetric generalizability: models trained on datasets containing more borderline (Gray Zone) cases generalized better to datasets with clearer class separation, whereas the reverse struggled. To ensure fair model comparison and reduce dataset-specific bias, we standardized the MAP difference between positive (hypotension) and negative (non-hypotension) samples at the time of prediction. This virtually eliminated the class separation and demonstrated that inflated performance in some datasets can be attributed to selection bias rather than true model generalizability. Age also influenced generalization: Cross-age validation revealed models trained on older patients generalized better to younger cohorts, whereas differences in ASA classification had minimal effect. These findings highlight the need for realistic validation to bridge the gap between AI research and clinical practice.</p>","PeriodicalId":15513,"journal":{"name":"Journal of Clinical Monitoring and Computing","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145040316","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 Analgesia Nociception Index (ANI) as an indicator of discomfort in deeply sedated, prepubescent patients.","authors":"Alexis Barat, Anne Wojtanowski, Hélène Behal, Mathilde Flocteil, Stéphane Leteurtre, Julien De Jonckheere, Morgan Recher","doi":"10.1007/s10877-025-01355-2","DOIUrl":"https://doi.org/10.1007/s10877-025-01355-2","url":null,"abstract":"<p><p>The Analgesia Nociception Index (ANI) has been used to assess discomfort in anesthetized adults. The COMFORT Behavior Scale (CBS) is recommended for assessing discomfort in intubated and sedated children. The primary objective of the present study was to assess the validity and performance of the ANI as an indicator of discomfort in intubated, ventilated children in a pediatric intensive care unit (PICU). A prospective, non-interventional, single-center pilot study was conducted between June 1st, 2021, and November 31st, 2023. Intubated, sedated, prepubescent patients aged between 2 and 10 years (for girls) or between 2 and 12 years (for boys) were included. The instantaneous ANI (ANIi) and the mean ANI (ANIm) were recorded continuously during care procedures. Data were analyzed before (period (P)1), during (P2) and after (P3) care procedures. 50 patients were included; the median (interquartile range [IQR]) age was 7 [4; 9] years. The ANIi decreased significantly between P1 and P2 (median [IQR]: 59 [45; 80] vs. 33 [26; 42], respectively; p < 0.0001) and increased significantly between P2 and P3 (33 [26; 42] vs. 51 [33; 72], respectively; p < 0.0001). The CBS score increased significantly between P2 and P3 (median [IQR]: 10 [7; 13] vs. 12 [8; 15], respectively; p < 0.0001). The ANIi was able to discriminate between over-analgosedation (defined as a CBS score < 10) and normal analgosedation (AUROC = 0.694 during P1).The ANI might be a good candidate for assessing discomfort in intubated, prepubescent patients in the PICU.Trial Registration: NCT04913038.</p>","PeriodicalId":15513,"journal":{"name":"Journal of Clinical Monitoring and Computing","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145023502","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":"Target controlled infusion in the intensive care unit: a scoping review.","authors":"Michele Introna, Carla Carozzi, Andrea Gentile, Riccarda Girasole, Marco Gemma, Jeroen V Koomen, Michel M R F Struys, Johannes P van Den Berg","doi":"10.1007/s10877-025-01356-1","DOIUrl":"https://doi.org/10.1007/s10877-025-01356-1","url":null,"abstract":"<p><p>Target-controlled infusion (TCI) systems, originally developed for intravenous drug administration of anesthetic drugs, enable precise drug delivery based on pharmacokinetic-pharmacodynamic (PKPD) models. While widely used in the operating room, their application in the intensive care unit (ICU) remains limited despite the complexity of drug dosing in critically ill patients. This scoping review evaluates existing evidence on the use of TCI systems in ICU settings, focusing on sedation, analgesia, and antibiotic administration. A systematic literature search was conducted in Medline and the Cochrane Library up to August 2024. Studies involving adult ICU patients receiving TCI for any drug were included. Data were extracted on study design, PKPD models, performance metrics, and clinical endpoints. A total of 281 studies were identified; 14 focused on sedatives, particularly propofol and remifentanil, using the Marsh and Minto models. TCI was associated with more stable sedation, improved titration, and fewer adverse events. Evidence on dexmedetomidine and midazolam was limited. Only three studies explored antibiotic TCI, mainly for vancomycin and cefepime, showing potential but lacking robust clinical validation. In conclusion, while current findings are promising, the evidence base supporting TCI-especially in the context of newer, generalized pharmacokinetic models and antibiotics-remains insufficient, and its broader application requires further clinical research and model validation.</p>","PeriodicalId":15513,"journal":{"name":"Journal of Clinical Monitoring and Computing","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145023512","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":"Intraoperative renal and cerebral tissue oxygen saturation measurements to predict postoperative acute kidney injury in pediatric cardiac surgery: a prospective observational study.","authors":"Dario Massari, Marco Modestini, Cornelia K Niezen, Lu Yeh, Anna Carina Zoutman, Thomas W L Scheeren, Ryan E Accord, Kai van Amsterdam, Michel M R F Struys, Jaap Jan Vos","doi":"10.1007/s10877-025-01345-4","DOIUrl":"10.1007/s10877-025-01345-4","url":null,"abstract":"<p><strong>Purpose: </strong>Pediatric patients undergoing cardiac surgery are at risk of developing postoperative acute kidney injury (AKI). We hypothesized that a reduction in intraoperative renal (SrO₂) or cerebral (ScO₂) tissue oxygen saturation is associated with postoperative AKI.</p><p><strong>Methods: </strong>We conducted a prospective observational study including fifty pediatric patients with non-cyanotic heart disease undergoing elective surgical repair with cardiopulmonary bypass. Intraoperative SrO₂ and ScO₂ were monitored using near-infrared spectroscopy (O3^® Regional Oximetry). Relative decreases of 10% and 20% from baseline SrO₂ and ScO₂ were analysed, calculating the total time below the threshold, area under the threshold, and time-weighted average. The primary outcome was the association between intraoperative SrO₂ and ScO₂ decreases, and the occurrence of postoperative AKI defined with the 'Kidney Disease: Improving Global Outcomes' criteria. Secondary outcomes included the association between other known or potential risk factors for AKI and postoperative AKI.</p><p><strong>Results: </strong>The incidence of postoperative AKI was 18.4%. There was no association between the duration and extent of intraoperative reductions of SrO₂ and ScO₂ below 10% and 20% from baseline, and postoperative AKI (e.g., area under the threshold for ScO₂ decreases below 10%: 36.8 [11.8 to 419.9] % min in patients with AKI vs. 9.6 [0.6 to 92.8] % min in patients without AKI, P = 0.117). Preoperative serum creatinine, body mass index, intraoperative hypotension, and blood lactate were associated with postoperative AKI.</p><p><strong>Conclusion: </strong>A decrease in intraoperative renal or cerebral tissue oxygen saturation was not associated with postoperative AKI in pediatric patients undergoing surgery for non-cyanotic congenital heart disease.</p>","PeriodicalId":15513,"journal":{"name":"Journal of Clinical Monitoring and Computing","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144956218","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}