Journal of Clinical Monitoring and Computing最新文献

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

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

{"title":"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":"https://doi.org/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":""},"PeriodicalIF":2.0,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","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":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on \"Forecasting intraoperative hypotension during hepatobiliary surgery\".","authors":"Jiajing Wang","doi":"10.1007/s10877-025-01275-1","DOIUrl":"https://doi.org/10.1007/s10877-025-01275-1","url":null,"abstract":"","PeriodicalId":15513,"journal":{"name":"Journal of Clinical Monitoring and Computing","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143572865","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":"Postoperative use of fitness trackers for continuous monitoring of vital signs: a survey of hospitalized patients.","authors":"Philipp Helmer, Sebastian Hottenrott, Kathrin Wienböker, Jürgen Brugger, Christian Stoppe, Benedikt Schmid, Peter Kranke, Patrick Meybohm, Michael Sammeth","doi":"10.1007/s10877-025-01273-3","DOIUrl":"https://doi.org/10.1007/s10877-025-01273-3","url":null,"abstract":"<p><p>Wearables and Internet of Things (IoT) technologies are increasingly incorporated into healthcare, including perioperative settings. These devices offer continuous non-invasive monitoring of vital signs, patient position, and mobilization. Nonetheless, there is currently little information about tolerance and acceptance of wearables in postoperative patients. We therefore assessed opinions and user experience in postoperative patients who used three popular fitness trackers during their entire hospital stay. Specifically, we evaluate the Apple Watch 7, Garmin Fenix 6 Pro, and Withings ScanWatch. We used an investigator-designed patient questionnaire with 11 questions to quantify patient experience and opinions regarding inpatient and home monitoring. Secondarily, we evaluated compliance and the incidence of associated adverse events during daily patient visits. Data were analyzed using descriptive statistics and non-parametric tests. The majority of the answers to the questions (82.1%) were rated positively defined as Likert-Scale Scores 4 or 5 by the 33 analyzed patients, ranging between 72.7 and 97.0% agreement rate. Specific questions related to data sharing for research and overall user experience received high agreement rates (97.0 and 84.8%, respectively). Women reported slightly higher satisfaction with device comfort, as compared to men (LS-Score 4.8 vs. 4.0). No significant differences were found based on the device model or length of hospitalization. The use of wearable devices in healthcare is rated positively by postoperative inpatients, paving the way for future implementation of these devices in healthcare. However, besides validating the measurement accuracy and demonstrating clinical benefits, several regulatory hurdles must be overcome before implementing wearables in routine clinical care.</p>","PeriodicalId":15513,"journal":{"name":"Journal of Clinical Monitoring and Computing","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143572915","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":"Influence of HeartMate 3™ on Bispectral Index™ monitor: a retrospective observational study.","authors":"Seiichi Azuma, Masaaki Asamoto, Shinichi Akabane, Mariko Ezaka, Mikiya Otsuji, Kanji Uchida","doi":"10.1007/s10877-025-01272-4","DOIUrl":"https://doi.org/10.1007/s10877-025-01272-4","url":null,"abstract":"<p><p>Electroencephalogram-derived monitors are affected by various artifacts. HeartMate 3™ operates at frequency bands that overlap with those used for calculating the electromyographic index (EMG) and bispectral index (BIS) on the Bispectral Index™ monitor. This study investigated whether HeartMate 3 elevates these values, a change not predicted with HeartMate II™. This retrospective observational study included data from patients who underwent HeartMate 3 or II implantation between April 2008 and December 2023 as extracted from our institutional database. Patient-wise median EMG and BIS were compared between the pre-LVAD period (from the start of surgery to initiation of cardiopulmonary bypass) and the post-LVAD period (from the end of cardiopulmonary bypass to end of surgery). Data were obtained from 33 and 43 patients who underwent HeartMate 3 and HeartMate II implantation, respectively. Patients with HeartMate 3 implantation showed significant elevation in the EMG (pre-LVAD, mean ± standard deviation, 26.1 ± 1.0 dB; post-LVAD, 39.5 ± 2.8 dB; P < 0.001) without a significant change in the BIS (pre-LVAD, 44.5 ± 8.1; post-LVAD, 45.5 ± 7.1; P = 0.35). In contrast, patients with HeartMate II implantation did not show significant changes in either the EMG (pre-LVAD, 26.1 ± 1.2 dB; post-LVAD, 27.1 ± 4.1 dB; P = 0.16) or BIS (pre-LVAD, 45.1 ± 9.2; post-LVAD, 43.0 ± 8.1; P = 0.071). HeartMate 3 significantly elevates EMG. Anesthesiologists should be aware of this to appropriately interpret EMG elevation in patients with HeartMate 3.Trial registration: Japan Registry for Clinical Trials identifier: jRCT1030230549 (date of registration: January 10, 2024.</p>","PeriodicalId":15513,"journal":{"name":"Journal of Clinical Monitoring and Computing","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143572870","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":"Electrical impedance tomography for PEEP titration in ARDS patients: a systematic review and meta-analysis.","authors":"Carlos Sanchez-Piedra, Begoña Rodríguez-Ortiz-de-Salazar, Oriol Roca, Francisco-Javier Prado-Galbarro, Lilisbeth Perestelo-Perez, Luis-Maria Sanchez-Gomez","doi":"10.1007/s10877-025-01266-2","DOIUrl":"10.1007/s10877-025-01266-2","url":null,"abstract":"<p><p>To assess the efficacy of electrical impedance tomography (EIT)-guided positive end-expiratory pressure (PEEP) titration in improving outcomes for patients with acute respiratory distress syndrome (ARDS). A systematic review and meta-analysis was conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Randomized controlled trials and observational studies with a control group comparing EIT-guided PEEP titration to other strategies were included. Endpoints analysed included mortality, days of mechanical ventilation (MV), intensive care unit (ICU) length of stay (LOS), weaning success rate, barotrauma, driving pressure (∆P), mechanical power (MP), Sequential Organ Failure Assessment (SOFA) score and adverse events. Pooled results were presented as Risk Ratio (RR) for dichotomous outcomes and standardized difference in means (SMD) for continuous outcomes. A total of 4 studies were identified (3 randomized controlled trials and one observational study). All studies were single-center studies (N total = 271 patients). The main limitations were related to potential bias in selecting reported outcomes. EIT-guided PEEP titration was associated with a significant reduction in mortality among critically ill patients with ARDS (RR = 0.64, 95% CI: 0.45-0.91). No significant differences were found in other outcomes. Our findings suggest that EIT may be a valuable tool for PEEP titration in critically ill patients with ARDS. By optimizing lung mechanics, EIT-guided PEEP titration may potentially reduce mortality rates. While larger, multicenter studies are needed to definitively establish the clinical role of EIT in ARDS management, our results provide promising evidence for its potential clinical impact.</p>","PeriodicalId":15513,"journal":{"name":"Journal of Clinical Monitoring and Computing","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143515831","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":"DiCART^TM 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":"https://doi.org/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_DiCART) and CRT measured clinically (CRT_CLIN). 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_CLIN and CRT_DiCART 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_CLIN and 0.43 (95% CI 0.15, 0.64) for CRT_DICART. Inter observer ICC was 0.86 (95% CI 0.76, 0.92) for CRT_CLIN and was 0.41 (95% CI 0.14, 0,63) for CRT_DICART. 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":""},"PeriodicalIF":2.0,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","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":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"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":"https://doi.org/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 (mitoPO₂) in the skin. The effects of general anesthesia and major non-cardiac surgery on mitoPO₂ 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 mitoPO₂ 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 mitoPO₂ was 63 (53 to 82) mmHg and mitoPO₂ after induction of general anesthesia was 42 (35 to 59) mmHg. The intraoperative average mitoPO₂ was 39 (30 to 50) mmHg. Thirteen patients (68%) had intraoperative mitoPO₂ values below 20 mmHg and the median percentage of surgical time with mitoPO₂ < 20 mmHg was 17 (0 to 31)%. MitoPO₂ was weakly correlated with mean arterial pressure (repeated measures correlation (r_rm(n); r_rm(984) = 0.26, 95% confidence interval 0.20 to 0.32; P < 0.001), but not meaningfully with heart rate (r_rm(984) = -0.05, 95% confidence interval -0.11 to 0.01; P = 0.117). There was no important difference in intraoperative average mitoPO₂ between patients assigned to personalized or to routine intraoperative arterial pressure management (P = 0.653). MitoPO₂ under general anesthesia was about a quarter lower than preoperative awake mitoPO₂, 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 mitoPO₂. Whether intraoperative decreases in mitoPO₂ are clinically meaningful warrants further investigation.</p>","PeriodicalId":15513,"journal":{"name":"Journal of Clinical Monitoring and Computing","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","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":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reversal of neuromuscular block with neostigmine and sugammadex: a retrospective cohort study in two centers using different types of neuromuscular monitoring.","authors":"Cyrus Motamed, Bernard Trillat, Marc Fischler, Morgan le Guen, Jean Louis Bourgain","doi":"10.1007/s10877-024-01192-9","DOIUrl":"10.1007/s10877-024-01192-9","url":null,"abstract":"<p><p>This bicentric retrospective cohort study evaluates reversal of muscle relaxation in real life achieved either by neostigmine or sugammadex in two hospitals using different types of neuromuscular monitoring (acceleromyography and kinemyography). The research question concerns compliance with recommendations. Patients who underwent an abdominal surgery under general anesthesia in the period from January 2017 through December 2020 with a neuromuscular block with rocuronium were included in the study. Data were extracted from the Centricity anesthesia information management system. In total, 2242 patients were assessed: 459 in center 1 (61 having received neostigmine and 398 sugammadex) and 1783 in center 2 (531 and 1252, respectively). Patients' characteristics differed between centers, with more high-risk patients in center 1. The mean train-of-four (TOF) ratio after supramaximal current determination (supramaximal threshold) was higher in center 1 (p < 0.001). Most patients received neostigmine while the TOF ratio was < 40% (68.6% in center 1 and 62.4% in center 2), while extubation was performed while the TOF ratio was > 90% in 61.0% in center 1 and in 32.1% in center 2 (p < 0.001). Patients received sugammadex irrespective of the number of responses to TOF before reversal, and extubation was performed while the TOF ratio was > 90% in 85.0% in center 1 and in 53.6% in center 2 (p < 0.001). No side effect was encountered. Despite guidelines for the TOF ratio before extubation, recommendations were not adequately respected and more vigilance is mandatory. The TOF test before use gave values that were 100% far apart with an underestimation with acceleromyography and an overestimation using kinemyography.</p>","PeriodicalId":15513,"journal":{"name":"Journal of Clinical Monitoring and Computing","volume":" ","pages":"141-148"},"PeriodicalIF":2.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141731249","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}