Journal of Clinical Monitoring and Computing最新文献

{"title":"Association of renal regional tissue oxygen saturation and post-procedural acute kidney injury following transcatheter aortic valve implantation.","authors":"Hoo Seung Lee, Youn Joung Cho, Seungho Yoo, Seohee Lee, Jae-Woo Ju, Karam Nam, Yunseok Jeon","doi":"10.1007/s10877-025-01339-2","DOIUrl":"https://doi.org/10.1007/s10877-025-01339-2","url":null,"abstract":"<p><strong>Purpose: </strong>Acute kidney injury (AKI) is a common complication and a strong risk factor for adverse outcomes after transcatheter aortic valve implantation (TAVI). Renal regional tissue oxygen saturation (rSO₂) reflects tissue perfusion and can be measured using near-infrared spectroscopy. We hypothesized that decrease in renal rSO₂ during TAVI would predict post-procedural AKI.</p><p><strong>Methods: </strong>Patients with severe aortic stenosis who scheduled for transfemoral TAVI were enrolled. Patients undergoing emergent procedures, those with severe renal impairment, those with a distance from skin to renal capsule > 4 cm, those on mechanical ventilation, or those who refused to participate were excluded. The primary outcome was the relationship between changes in renal rSO₂ during TAVI and post-procedural AKI. AKI was determined according to the Valve Academic Research Consortium-2 criteria.</p><p><strong>Results: </strong>Sixty-four patients were included and analyzed. The mean (standard deviation [SD]) age of patients was 82 (4) years, and the median [interquartile range] procedure time was 75 [65-90] min. The incidence of post-procedural AKI was 33% (21/64). There was no difference in the mean (SD) time-weighted renal rSO₂ (70% [13%] and 73% [11%]), changes in renal rSO₂ (-14% [10%] and - 15% [13%]), or nadir rSO₂ (55% [17%] and 60% [17%]) during TAVI between patients who developed post-TAVI AKI and those who did not (p = 0.227, 0.157, and 0.333, respectively). In multivariable regression analysis, renal rSO₂ variables were not predictors of post-TAVI AKI.</p><p><strong>Conclusion: </strong>Procedural changes in renal rSO₂ measured using near-infrared spectroscopy did not predict the development of post-TAVI AKI. Further studies are needed to investigate more effective strategies to predict and prevent AKI following TAVI.</p><p><strong>Trial registration: </strong>This study was registered on cinicaltrials.gov (identifier, NCT04921475, registered on June 10, 2021).</p>","PeriodicalId":15513,"journal":{"name":"Journal of Clinical Monitoring and Computing","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144835258","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":"Quantitative pupillometry and ambient light. Response to letters to the editor.","authors":"Johannes Kesti, Jakob Pansell","doi":"10.1007/s10877-025-01337-4","DOIUrl":"https://doi.org/10.1007/s10877-025-01337-4","url":null,"abstract":"","PeriodicalId":15513,"journal":{"name":"Journal of Clinical Monitoring and Computing","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144835259","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":"Analysis of SEF95 derived from two processed EEG devices during pediatric anesthesia for non-cardiac surgery.","authors":"Zaccaria Ricci, Lorenzo Gobbi, Enrica La Rosa, Elena Filippini, Matteo Lui, Maximilan Fischer, Denise Colosimo, Stefano Romagnoli","doi":"10.1007/s10877-025-01338-3","DOIUrl":"https://doi.org/10.1007/s10877-025-01338-3","url":null,"abstract":"<p><p>This study aimed to compare the values of spectral edge frequency at the 95th percentile (SEF95) obtained simultaneously by two different processed electroencephalography monitors (BIS^® and SedLine^®) in pediatric patients of varying ages undergoing non cardiac surgery to determine whether they remain reproducible regardless of the equipment used. Tertiary Pediatric Hospital. We conducted a prospective observational study involving pediatric patients aged 12 months to 18 years. Patients were excluded if the sensor fit was inadequate or if artifacts interfered with the data collection. Anesthesia was administered by anesthesiologists according to their preferences. A total of 51 children were enrolled, yielding 402 paired BIS/SedLine SEF95 values. These values showed an r² of 0.73 at linear regression analysis (p < 0.0001), with a bias of 0.62 (2.4) Hz and 95% limits of agreement (LoA) ranging from - 4.08 to 5.32 Hz in Bland-Altman analysis. Median SEF95 deltas (i.e., differences of paired BIS/SedLine SEF95 values) across the analyzed time points showed significant differences (p = 0.0017) between values at 15 min and 60 min after skin incision compared to extubation. A delta SEF95 within the ± 2 Hz range was observed in 267 cases (66%), within ± 3 Hz occurred in other 67 measurements (17%) and within ± 4 Hz in further 48 (12%). The remaining 20 measurements showed a higher delta. SedLine SEF95 was higher than BIS in 40 cases, while BIS was higher than SedLine in 96 cases. SEF95 monitored by BIS or SedLine pediatric patients showed some differences, with deltas up to ± 4 Hz. Values appeared to be closer during the anesthesia maintenance phase. The clinical relevance of these findings should be further confirmed.</p>","PeriodicalId":15513,"journal":{"name":"Journal of Clinical Monitoring and Computing","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144835257","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":"Does capnography improve safety in moderate-deep sedation for gastrointestinal endoscopic procedures provided by anaesthesiologists? A prospective cohort study.","authors":"Isabel Valbuena, Azahara Sancho, Estíbaliz Alsina, Nicolás Brogly, Fernando Gilsanz","doi":"10.1007/s10877-025-01299-7","DOIUrl":"10.1007/s10877-025-01299-7","url":null,"abstract":"<p><p>This study aimed to determine whether the use of capnography reduces the incidence of respiratory and cardiovascular adverse events during procedural sedation and analgesia (PSA) for gastrointestinal endoscopic procedures (GEP) provided by experienced anaesthesiologists. A prospective cohort study was conducted, including patients undergoing GEP under PSA. Patients were divided in two groups: Group A (pulse oximetry) and Group B (capnography with Capnostream^™ monitor plus pulse oximetry). Interventions undertaken to resolve hypoxaemia, airway obstruction, or apnoea were recorded. Age, comorbidities, ASA Classification, sedative drugs, respiratory and cardiovascular adverse events, recovery Aldrete Scale value, and patient satisfaction were also recorded. Both parametric and non-parametric tests were applied. A total of 1,146 patients were included: Group A, n = 538, and Group B, n = 608. Diagnostic colonoscopy was the most frecuent procedure (49.7%), followed by diagnostic gastroscopy (22.5%) and therapeutic colonoscopy (22.2%). Apnoea < 60 s was detected only in patients monitored with capnography (35.4% vs. 0%, p < 0.000). The use of capnography significantly reduced the incidence of moderate hypoxaemia (3% vs. 6.5%, p = 0.004). Severe hypoxaemia was significantly reduced with capnography only in patients with cardio-respiratory comorbidities (2.2% vs. 4.4%, p = 0.032). The capnography group showed a lower incidence of cardiovascular events. Respiratory adverse events, such as desaturation and airway obstruction, increased with age and ASA classification, as did the need for airway maneuvers. Prolonged apnoea and intubation were rare in both groups. Mandibular traction manoeuvres were significantly more frequent in Group B (9.9% vs. 3%, p < 0.000), reducing the need for other interventions. Patient satisfaction at discharge was higher when capnography was used (p < 0,000). Moderate-deep sedation for GEP performed by experienced anaesthesiologists, combined with capnography, enhances safety, with extremely rare major complications. Capnography monitoring allowed the timely identification and resolution of apnoea and airway obstruction, avoiding severe desaturation and cardiovascular adverse events.</p>","PeriodicalId":15513,"journal":{"name":"Journal of Clinical Monitoring and Computing","volume":" ","pages":"731-737"},"PeriodicalIF":2.2,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144142661","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 PEEP selection by pressure-based capnography: a proof of concept study.","authors":"Gerardo Tusman, Matías Nicolás, Alejandro Carmona, Fernando Suarez Sipmann, Ulises Tusman, Peter Kremeier, Stephan H Böhm","doi":"10.1007/s10877-025-01318-7","DOIUrl":"10.1007/s10877-025-01318-7","url":null,"abstract":"<p><strong>Purpose: </strong>We aimed to test a new method to determine the positive-end expiratory pressure (PEEP) that maintains the lungs open after a recruitment maneuver (RM).</p><p><strong>Methods: </strong>In eleven anesthetized patients, we compared the standard RM searching for the optimal PEEP based on the highest respiratory compliance (PEEP_Crs), with a new method. This method performs a RM during a slow pressure-volume curve and detects the optimal PEEP using the novel barometric capnography curve (BCap); i.e. the plot of expired carbon dioxide versus airway pressure. The lungs' closing pressure was detected when the slope of phase III of the BCap changed along this slow expiration (PEEP_BCap). The main objective was to compare PEEP_BCap with the reference PEEP_Crs. As a secondary objective, we explored the association between PEEP_BCap and the polarity change in end-expiratory transpulmonary pressure (PEEP_PL) during the deflation phase of a slow flow PV curve.</p><p><strong>Results: </strong>We found a PEEP_BCap of 8.5(3.3) cmH₂O that was no statistically different from the PEEP_Crs of 10.0(4.0) cmH₂O (p = 0.72). Both methods correlated well with a Rho of 0.84 (p < 0.001). The Bland-Altman plot showed a bias of 0.19 and LOA of 1.92 cmH₂O (95%CI -0.39 to 0.77 cmH₂O). During the PV slow deflation limb, PEEP_PL was 9.3(4.3), which was statistically similar to PEEP_BCap (p = 0.61). Both pressures were strongly correlated (Rho = 0.93, p < 0.001) with a bias of -0.3 cmH₂O and LOA of 1.52 (95%CI -0.76 to 0.16 cmH₂O).</p><p><strong>Conclusions: </strong>We concluded that BCap is feasible to detect lungs collapse using a constant flow PV curve.</p>","PeriodicalId":15513,"journal":{"name":"Journal of Clinical Monitoring and Computing","volume":" ","pages":"739-744"},"PeriodicalIF":2.2,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144505859","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":"10.1007/s10877-025-01275-1","url":null,"abstract":"","PeriodicalId":15513,"journal":{"name":"Journal of Clinical Monitoring and Computing","volume":" ","pages":"793-794"},"PeriodicalIF":2.2,"publicationDate":"2025-08-01","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":"Feasibility and safety analysis of distal radial arterial catheterization for arterial pressure monitoring in ICU.","authors":"Jian Wang, Jie Zhang, Yi Zhang, Xianglan Liu, Chuanzhe Bai, Renlong Yu, Cheng Zhang, Xiaowen Qiu","doi":"10.1007/s10877-025-01313-y","DOIUrl":"10.1007/s10877-025-01313-y","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the feasibility and safety of distal radial artery (DRA) catheterization compared to conventional radial artery (CRA) catheterization for invasive arterial pressure monitoring in intensive care unit (ICU) patients.</p><p><strong>Methods: </strong>This single-center, prospective, randomized controlled study enrolled 197 ICU patients requiring invasive arterial pressure monitoring between May 2024 and March 2025. Patients were randomly assigned to either the DRA group (n = 99) or CRA group (n = 98). Primary outcome was first-attempt puncture success rate. Secondary outcomes included final success rate, catheterization time, compression time for hemostasis, abnormal waveform frequency, unplanned removal rate, and complications.</p><p><strong>Results: </strong>The DRA group demonstrated significantly lower first-attempt puncture success rates compared to the CRA group (68.69% vs. 82.65%, P = 0.022). With ultrasound assistance, final success rates were comparable between groups (98.99% vs. 97.96%, P = 0.993). Total catheterization time (133.61 ± 35.82s vs. 126.50 ± 36.99s, P = 0.175) and abnormal waveform frequency were similar between groups. The DRA group exhibited significantly shorter hemostasis times (224.45 ± 55.25s vs. 417.56 ± 71.32s, P < 0.001). Both groups had low complication rates with no statistically significant differences (1.01% vs. 3.06%, P = 0.621).</p><p><strong>Conclusion: </strong>Despite lower first-attempt success rates, DRA catheterization provides equivalent monitoring stability to CRA with significantly reduced hemostasis time and comparable safety profiles. DRA represents a viable alternative for invasive arterial pressure monitoring in ICU patients, particularly those requiring rapid hemostasis, preservation of forearm radial artery integrity, and patients in special positioning.</p>","PeriodicalId":15513,"journal":{"name":"Journal of Clinical Monitoring and Computing","volume":" ","pages":"767-774"},"PeriodicalIF":2.2,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144475473","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":"Refining oxygen management through rigorous Oxygen Reserve Index (ORi) monitoring in patients undergoing general anesthesia: a randomized controlled trial : ORi to avoid excessive hyperoxia.","authors":"Tae Kwang Kim, Seok Hun Ko, Hye-Min Sohn","doi":"10.1007/s10877-025-01321-y","DOIUrl":"10.1007/s10877-025-01321-y","url":null,"abstract":"<p><p>Optimizing oxygenation for patients necessitates a delicate balance between sufficient oxygen delivery and mitigating the potential hazards of hyperoxemia. We hypothesized that integrating Oxygen Reserve Index (ORi) monitoring would effectively reduce intraoperative hyperoxemia compared to reliance solely on pulse oximetry. This single-center randomized controlled trial included multiple trauma patients with ASA class 3 or higher undergoing general anesthesia. FiO₂ adjustments to 0.5 started at T0 with arterial blood gas analysis (ABGA) every 30-minutes. Patients were randomized into Group O (ORi monitoring) and Group N (pulse oximetry). In Group O, FiO₂ was reduced if ORi > 0.05; unchanged if ORi was 0-0.05. Group N decreased FiO₂ if SpO₂ was 100%, unchanged if SpO₂ was < 99%, and increased FiO₂ by 0.05 until SpO₂ reached 95% or above. 54 participants were randomized, and 51 analyzed. Group O demonstrated a significantly higher percentage of normoxemia (80 ≤ PaO₂ < 120 mmHg) (64.4% vs. 40.4%, P = 0.002) across 181 ABGAs. Although baseline PaO₂ (T1) values were comparable within moderate hyperoxemia, at T2, only Group O achieved normoxemia, with consistently lower PaO₂ values at T2, T3, and T4 compared to Group N. ORi values in Group O consistently trended lower from T1 to T4. The positive correlation between PaO₂ and ORi was reaffirmed, establishing cut-off values for PaO₂ ≥ 120mmHg and ≥ 150mmHg at 0.06 and 0.22, respectively. Simultaneous ORi and pulse oximetry reduce intraoperative hyperoxemia through safe and meticulous protocol adherence in patients.</p>","PeriodicalId":15513,"journal":{"name":"Journal of Clinical Monitoring and Computing","volume":" ","pages":"745-755"},"PeriodicalIF":2.2,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144667749","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":"Heart rate variability as a marker of multiple organ dysfunction syndromes: a systematic review.","authors":"Anne Wojtanowski, Maxence Hureau, Mathieu Jeanne, Côme Bureau, Morgan Recher, Julien De Jonckheere","doi":"10.1007/s10877-025-01296-w","DOIUrl":"10.1007/s10877-025-01296-w","url":null,"abstract":"<p><p>Multiple organ dysfunction syndrome (MODS) can be caused by many factors. Assessments of the severity of MODS are currently based on occasional measurements of several clinical variables (laboratory data, vital signs, etc.). The analysis of heart rate variability (HRV) as a guide to autonomic nervous system activity might be of value in the continuous assessment of the severity of MODS. We systematically reviewed publications on the value of HRV variables for the diagnosis of MODS in patients of any age admitted to the ICU. Two investigators independently searched the PubMed, Embase, Cochrane and Science Direct databases for articles in English or French published between 2004 and 2024. Ten studies were included and rated for endpoint bias (MODS or mortality), using the revised Quality Assessment of Diagnostic Accuracy Studies. Nine studies assessed MODS, and six assessed mortality. All the studies evidenced low HRV in patients with MODS and in non-survivors. The results of our review show that HRV indices are influenced by the severity of MODS and might serve as a tool for predicting mortality in patients with MODS. However, patient characteristics, and treatments and HRV processing methods must be taken into account when interpreting the results. In order to clarify the impact of MODS on HRV variables, methodologically rigorous studies are now needed.</p>","PeriodicalId":15513,"journal":{"name":"Journal of Clinical Monitoring and Computing","volume":" ","pages":"717-729"},"PeriodicalIF":2.2,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12304018/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143968402","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 smartphone application for semi-automated QT interval analysis based on a snapshot of an electrocardiogram trace displayed on a patient monitor.","authors":"David Beckmann, Moritz Flick, Karim Kouz, Bernd Saugel","doi":"10.1007/s10877-025-01277-z","DOIUrl":"10.1007/s10877-025-01277-z","url":null,"abstract":"<p><p>We developed a smartphone application (SMART-QT application) that can semi-automatically measure QT and QTc intervals based on a snapshot of the electrocardiogram (ECG) trace and the heart rate displayed on a patient monitor. In this study, we aimed to validate the SMART-QT application. In this prospective single-center method comparison study, we measured QT and QTc intervals with the SMART-QT application (QT_APP and QTc_APP; test method) and simultaneously manually measured QT and QTc intervals from a 12-lead ECG (QT_REF and QTc_REF; reference method) in 57 adult volunteers and patients who had sinus rhythm and no acute or chronic cardiac comorbidities. To investigate the agreement between QT_APP and QT_REF and between QTc_APP and QTc_REF, we performed Bland-Altman analyses and calculated the mean of the differences, the standard deviation, and the 95%-limits of agreement (95%-LOA). We defined clinically acceptable agreement as maximum mean of the differences ± standard deviation of 20 ± 20 ms. The mean of the differences between QT_APP and QT_REF was 14 ± 20 ms (95%-LOA -26 to 54 ms). The mean of the differences between QTc_APP and QTc_REF was 13 ± 15 ms (95%-LOA -16 to 42 ms). The agreement between QT_APP and QT_REF and between QTc_APP and QTc_REF was clinically acceptable in adult volunteers and patients without cardiac comorbidities.</p>","PeriodicalId":15513,"journal":{"name":"Journal of Clinical Monitoring and Computing","volume":" ","pages":"787-791"},"PeriodicalIF":2.2,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12304064/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144002932","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}