Journal of Clinical Monitoring and Computing最新文献

{"title":"Intraoperative respiratory exchange ratio to predict complications after cardiopulmonary bypass surgery: a retrospective cohort study.","authors":"Sophia Riesemann, Luca J Wachtendorf, Ben L P Braeuer, Sebastian D Sahli, Béla-Simon Paschold, Theresa Tenge, Carsten Marcus, Peter Santer, Robina Matyal, Maximilian S Schaefer, Mark J Robitaille","doi":"10.1007/s10877-026-01436-w","DOIUrl":"10.1007/s10877-026-01436-w","url":null,"abstract":"","PeriodicalId":15513,"journal":{"name":"Journal of Clinical Monitoring and Computing","volume":" ","pages":"809-819"},"PeriodicalIF":2.6,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13391444/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147690452","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":"Effects of remimazolam and propofol on parasympathetic activity during general anesthesia induction in patients with severe aortic stenosis: a randomized controlled trial utilizing high-frequency variability index.","authors":"Taichi Kotani, Mitsuru Ida, Yusuke Naito, Nobuhiro Tanaka, Masahiko Kawaguchi","doi":"10.1007/s10877-026-01433-z","DOIUrl":"10.1007/s10877-026-01433-z","url":null,"abstract":"","PeriodicalId":15513,"journal":{"name":"Journal of Clinical Monitoring and Computing","volume":" ","pages":"845-855"},"PeriodicalIF":2.6,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13391699/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147592224","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":"Admixture of anaesthetic drugs: editorial fit and safety are distinct concerns.","authors":"Matthew Hart, Stephan Malherbe, Justin Skowno","doi":"10.1007/s10877-026-01445-9","DOIUrl":"10.1007/s10877-026-01445-9","url":null,"abstract":"","PeriodicalId":15513,"journal":{"name":"Journal of Clinical Monitoring and Computing","volume":" ","pages":"959-960"},"PeriodicalIF":2.6,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13391756/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148138019","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":"Beyond processed EEG: Towards brain-informed anaesthesia.","authors":"Reto Basciani, Gabor Erdoes","doi":"10.1007/s10877-026-01468-2","DOIUrl":"10.1007/s10877-026-01468-2","url":null,"abstract":"","PeriodicalId":15513,"journal":{"name":"Journal of Clinical Monitoring and Computing","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148411896","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":"Clinical validation of a novel accelerometer-based respiratory rate monitor.","authors":"O M Steihaug, T E Sjøset, A S Stordal, A D Sleire, O Ødegaard-Olsen, A Tunset, I Jammer","doi":"10.1007/s10877-026-01419-x","DOIUrl":"10.1007/s10877-026-01419-x","url":null,"abstract":"<p><p>Respiratory rate (RR) is a vital sign often unused in clinical practice due to labour-intensive manual counting or capnography limitations in spontaneously breathing patients. This study validated RespX, a novel accelerometer-based wireless sensor, for continuous respiratory rate measurement in hospitalised patients. This prospective, single-centre observational study included hospitalised adults (> 18 years) expected to remain undisturbed for one hour while measuring RR. The RespX sensor, placed on the left chest wall, was compared with continuous capnography and manual counting every 20 min for one hour. The primary endpoint was respiratory rate measured by RespX within ± 3 breaths per minute compared to capnography. Linear mixed-effects models analyzed mean differences between methods. Twenty-nine patients completed the study. The proportion of RespX measurements within ± 3 breaths per minute of capnography was 77% (95% CI: 74.8-79.0%) for raw data and 82.8% (95% CI: 80.7-84.7%) after removing outliers. The proportion of RespX measurements within ± 3 breaths per minute of manual counting was 87,5% (95% CI: 81,1%-93,8%). For the capnography the proportions for the raw data was 87,8% (95% CI: 81,8-93,8%) and 94,5% (95% CI: 90,3%-98,7%) after removing outliers. Linear mixed-effects analysis showed mean differences of -0.40 (p = 0.43) for raw data and 0.39 (p = 0.15) for filtered data between RespX and capnography, supporting their equivalence. RespX demonstrated lower measurement variability (SD: 0.75-3.05) compared to capnography (SD: 0.99-5.19). No adverse events were observed during the study. The wireless RespX accelerometer-based sensor provides a novel and accurate method for assessing the respiratory rate in awake hospitalised patients compared with capnography.Trial registration: NCT06911541.</p>","PeriodicalId":15513,"journal":{"name":"Journal of Clinical Monitoring and Computing","volume":" ","pages":"695-702"},"PeriodicalIF":2.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13194193/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146131964","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":"Intermittent Pneumatic Compression as an Unrecognized Source of Neuromonitoring Oscillations.","authors":"Ricard Valero, Miguel Medina, Alberto Abad, Javier Bellafont, Enrique Cepero","doi":"10.1007/s10877-026-01423-1","DOIUrl":"10.1007/s10877-026-01423-1","url":null,"abstract":"","PeriodicalId":15513,"journal":{"name":"Journal of Clinical Monitoring and Computing","volume":" ","pages":"767-769"},"PeriodicalIF":2.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13194211/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147306372","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":"The association between intraoperative hypotension and postoperative acute kidney injury following emergent critical cesarean delivery: a retrospective cohort study.","authors":"Ze-Ping Li, Ji-Qiang Zhang, Hong-Wei Wang, Jian-Jun Yang","doi":"10.1007/s10877-026-01410-6","DOIUrl":"10.1007/s10877-026-01410-6","url":null,"abstract":"<p><p>This retrospective cohort study aimed to investigate the association between intraoperative hypotension (IOH) and postoperative acute kidney injury (AKI) among patients who underwent emergent critical cesarean delivery. We analyzed electronic health records from January 2019 to August 2024. IOH was defined as a mean arterial pressure (MAP) less than 65 mmHg. It was quantified using four metrics: hypotensive event count, cumulative duration, area under the threshold (AUC), and time-weighted average (TWA). Postoperative AKI was defined according to the Kidney Disease: Improving Global Outcomes (KDIGO) clinical practice guidelines, based on serum creatinine levels. We employed multivariable logistic regression to assess the independent association between the primary IOH metric (cumulative duration) and postoperative AKI, adjusting for clinically relevant covariates. Sensitivity analyses were conducted using alternative IOH metrics. Postoperative AKI was diagnosed in 69 of the 508 patients (13.58%). Multivariable logistic regression analysis revealed that all four measures of intraoperative hypotension were independently associated with an increased risk of AKI: hypotensive event count (adjusted OR 2.098, 95%CI [1.180-3.732]; P = 0.012), cumulative duration (adjusted OR 1.036, 95%CI [1.013-1.060]; P = 0.002), AUC (adjusted OR 1.004, 95%CI [1.001-1.007]; P = 0.009), and TWA (adjusted OR 1.557, 95%CI [1.058-2.291]; P = 0.025). Our findings demonstrate that IOH was independently associated with a higher incidence of postoperative AKI in patients who underwent an emergent critical cesarean delivery.</p>","PeriodicalId":15513,"journal":{"name":"Journal of Clinical Monitoring and Computing","volume":" ","pages":"655-661"},"PeriodicalIF":2.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13194229/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145933371","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":"Program of quality improvement for extracorporeal blood purification therapies in the intensive care unit.","authors":"Matteo Cecchi, Diego Pomarè Montin, Antonio Fioccola, Vittorio Bocciero, Caterina Scirè Calabrisotto, Filomena Autieri, Manuela Benelli, Andrea Geppetti, Zaccaria Ricci, Stefano Romagnoli, Gianluca Villa","doi":"10.1007/s10877-025-01396-7","DOIUrl":"10.1007/s10877-025-01396-7","url":null,"abstract":"<p><p>Critically ill patients often require complex extracorporeal treatments, such as extracorporeal blood purification (EBP). At the bedside, there can be reluctance or uncertainty about when to initiate EBP, and there is no standard agreement on which goals to pursue, what prescriptions to use to achieve those goals, or which recommendations to follow to prevent complications. Furthermore, an accurate analysis of why clinical goals are not achieved or how often the patient should be reassessed to readjust the EBP prescription is not currently standardized. This narrative review describes the main actions characterizing a quality improvement program for EBP in the ICU, which took place at the University of Florence and was subsequently adopted at the national level. The pillars of this program were: (1) definition, implementation, and dissemination of information and communication technology tools aimed at objectively measuring results at the bedside, supporting dynamic prescribing and precision medicine, and promoting advances in knowledge in this field; (2) creation of a national multi-professional network of clinical users and researchers in EBP; (3) promotion and maintenance of technical and non-technical skills in EBP based on the reformulation of advanced academic training in this field.</p>","PeriodicalId":15513,"journal":{"name":"Journal of Clinical Monitoring and Computing","volume":" ","pages":"735-745"},"PeriodicalIF":2.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13194202/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145742836","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 Cohort, Semi-Randomized, open label quality improvement patient blood management (PBM) comparison of point of care viscoelastic coagulation monitors in cardiac surgery.","authors":"Bruce D Spiess, Melissa Burger, Mary Jane Michael R N, Stephanie Gore R N, Cynthia Garvan, Peter Pellitier, Marc Zumberg","doi":"10.1007/s10877-025-01406-8","DOIUrl":"10.1007/s10877-025-01406-8","url":null,"abstract":"<p><p>Viscoelastic testing (VET), recommended for heart surgery, lacks adoption due to data reporting times (central laboratory coagulation assay-CLCA and laboratory VET tests) and interpretation (predicate VET devices). Three point of care (POC) -VET devices have now become available. The hypotheses of this quality initiative (QI), patient blood management program-PBM), was that: (1) Clinicians desire timely, easily interpreted coagulation data (2) Comparison of two (first available) POC-VETs would determine the technology embraced for PBM. To evaluate these hypotheses clinicians were surveyed as to need ease of use, acceptability, and support of the expanding PBM program before and after testing in operating rooms (ORs). This was not a randomized study to examine reduction in transfusion utilization or improved outcome. It was, however, a QI study to examine perception of an existing problem; with investigation of a solution the clinicians would support decision making. Cardiac team members (anesthesia, surgery, and perfusion) were informed, and their written consent was obtained prior to survey. Team members completed QI surveys before and after the use of the technologies. Anesthesiology members were trained by the manufacturers and assessed for proficiency by Laboratory Medicine (LM). The TEG-6s® and the Quantra® QPlus, evaluated in sixty-eight cardiac patients over a six-week period (May 15-June 30, 2021) gave the clinicians direct experience. The time from blood draw (arterial line) until final coagulation data reported were compared between technologies and where available to CLCA/lab testing. Algorithms for coagulation treatments with the POC-VET data were created in consultation with the manufacturers. QI survey data were reported as percentage of answers in categories. Time to data acquisition and blood usage (pilot data only) were examined with chi-square and Wilcoxon rank sum, two sided tests. Cardiac team members (anesthesia, surgery, and perfusion) were informed, and their written consent was obtained prior to survey. Team members completed QI surveys before and after the use of the technologies. Anesthesiology members were trained by the manufacturers and assessed for proficiency by Laboratory Medicine (LM). The TEG-6s® and the Quantra® QPlus, evaluated in sixty-eight cardiac patients over a six-week period (May 15 -June 30, 2021) gave the clinicians direct experience. The time from blood draw (arterial line) until final coagulation data reported were compared between technologies and where available to CLCA/lab testing. Algorithms for coagulation treatments with the POC-VET data were created in consultation with the manufacturers. QI survey data were reported as percentage of answers in categories. Time to data acquisition and blood usage (pilot data only) were examined with chi-square and Wilcoxon rank sum, two sided tests.</p>","PeriodicalId":15513,"journal":{"name":"Journal of Clinical Monitoring and Computing","volume":" ","pages":"747-755"},"PeriodicalIF":2.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146201813","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":"Early heart-rate trajectory phenotypes predict short-term mortality in critically ill patients: a dynamic time-warping cluster analysis.","authors":"Toko Hirano, Masashi Ishikawa, Takuya Nishino, Toru Takiguchi, Yutaka Igarashi, Shoji Yokobori","doi":"10.1007/s10877-026-01415-1","DOIUrl":"10.1007/s10877-026-01415-1","url":null,"abstract":"<p><p>Heart rate (HR) reflects illness severity in critically ill patients, but the prognostic significance of early HR changes is unclear. We aimed to identify HR trajectory phenotypes during the first 24 h of ICU admission and assess their association with short-term mortality. Adults admitted to the intensive care unit (ICU) between January 2018 and December 2024 with ≥ 12 h of HR data were eligible; patients with early discharge/death, mechanical support, or sustained bradycardia were excluded. Hourly HR means from the first 24 h were imputed and clustered via Dynamic Time Warping-based TimeSeriesKMeans; five trajectories were selected using internal validation. Thirty- and 90-day mortality were assessed by multivariable Cox models. A total of 4491 patients were analyzed after applying exclusion criteria. TimeSeriesKMeans identified five early HR trajectory phenotypes: Cluster A (persistently tachycardic), Cluster B (early HR normalization), Cluster C (rising HR), Cluster D (mild tachycardic-normal), and Cluster E (normal HR). Cluster A was associated with a markedly increased risk of 30-day mortality compared with the reference Cluster E (HR 3.21, 95% CI 2.32–4.45; p < 0.001). Cluster C also showed an elevated mortality risk (HR 2.09, 95% CI 1.53–2.85; p < 0.001), whereas clusters characterized by lower or early-normalizing heart-rate trajectories demonstrated more favorable survival profiles. Kaplan-Meier analyses confirmed significant differences in survival across clusters (log-rank p < 0.001). Machine learning-based phenotyping of 24-hour HR trajectories stratified short-term mortality risk and revealed time-dependent patterns potentially reflecting treatment responsiveness. Early adverse heart-rate trajectories, particularly persistent tachycardia, may serve as prognostic signals of physiological stress or poor treatment response during the initial ICU course, supporting early risk stratification and clinical reassessment.</p>","PeriodicalId":15513,"journal":{"name":"Journal of Clinical Monitoring and Computing","volume":" ","pages":"621-633"},"PeriodicalIF":2.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13194305/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146113250","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}