Vegetative reactions are common during neurosurgical procedures. Known effects are mainly cardiovascular, including tachy- and bradyarrhythmia, hyper- and hypotonia as well as cardiac arrest. Computer...

Purpose Stroke volume variation (SVV) is a dynamic parameter used to assess fluid responsiveness in mechanically ventilated patients. This study aimed to evaluate the agreement and trending ability of...

Respiratory rate is an important early sign of clinical deterioration but the current practice of counting breaths manually is time-consuming and prone to error. We aimed to determine the concordance ...

Journal of Clinical Monitoring and Computing -

Background Accurately identifying surgical patients who will have an increase in stroke volume following fluid administration remains challenging when utilizing noninvasive bedside methods. This study...

Reduce sevoflurane consumption during anaesthesia remains an economic and environmental challenge. This case study analyzed retrospectively a large cohort of procedures using end-tidal (ET) Control to...

Burn shock is a major early complication in the treatment of severely burned patients, and precise and timely fluid management is essential for survival. Traditional clinical indicators such as urine ...

Background Despite the substantial advancements in mechanical ventilation (MV), mortality remains high. Mechanical power (MP), MV forces are associated with outcomes. Real-time monitoring of MP and the adjustment of MV according to MP may result in ventilation with lower MP. Methods Randomized controled trial conducted at the ECMO Centre Ostrava, Czech Republic, from March 2023 to March 2024 enrolled adult patients on MV (with or without extracorporeal membrane oxygenation, ECMO) with acute respiratory failure. A system for real-time MP monitoring (geometric method and simplified Becher´s formula) has been developed. In the intervention arm, the physician was able to observe the MP in real time and adjust the MV parameters accordingly. In the control group, the MP was concealed. Results A total of 494 subjects were screened and 33 patients were randomized (further 7 ECMO patients). There was no significant difference between the control and intervention groups. Median MPGeom was 3.22 J/min (maximum 15.2 J/min) and MPBecher of 5.94 J/min (maximum 18.4 J/min). Only a weak (but significant, p = 0.0001) correlation between MPGeom and MPBecher was observed. A highly significant difference was observed in MP between day and night (6 a.m. − 6 p.m.) with higher MP at night. Conclusion Although real-time MP measurement is feasible, there was no significant difference in MP between the control and intervention groups with low MP in both groups. Experience physicians was capable of safe MV, even if they do not know the exact MP value. The night shift was a high-risk period for developing lung damage due to elevated MP. Trial registration ClinicalTrials NCT06035146.

Journal of Clinical Monitoring and Computing - Elevated intracranial pressure (ICP) contributes to poor neurological outcomes in brain injured patients but relies on invasive approaches with...

Purpose This randomised controlled trial investigated the effect of Surgical Pleth Index (SPI) guided sufentanil administration on intraoperative sufentanil consumption compared to routine care in patients with a combination of general anaesthesia and regional anaesthesia having trauma and orthopaedic surgery. Methods Eighty patients with a combination of general anaesthesia and regional anaesthesia undergoing trauma or orthopaedic surgery were randomised into two groups to receive either sufentanil guided by SPI monitoring or by routine care (Control). The primary endpoint was intraoperative sufentanil consumption. Secondary endpoints were postoperative pain level, opioid consumption, incidence of nausea, duration of time in the post-anaesthesia care unit (PACU) and quality of recovery. Results The median intraoperative sufentanil administration adjusted to bodyweight and surgery duration did not differ between the groups: SPI guided group 2.29 (interquartile range, IQR 0.29 to 6.91), Control 1.65 (IQR 0.83 to 2.63) µg·kg−1·min−1*1000 (P = 0.906). The relative risk for receiving intraoperative sufentanil was RR 0.909 (95% CI 0.723 to  1.143, P = 0.414). Median morphine equivalents administered in the 24 h after discharge from the PACU were 3.8 (IQR 0.0 to 22.5) in the SPI guided group and 19.1 (IQR 3.8 to 30.0) mg (P = 0.021) in the control group without adjustment for multiple testing. Other secondary endpoints showed no differences. Conclusion SPI guided sufentanil administration did not reduce intraoperative sufentanil consumption compared to routine care in patients having trauma and orthopaedic surgery with a combination of general anaesthesia and regional anaesthesia. Trial registration Clinicaltrials.gov identifier NCT06040307 (registered September 8, 2023).

Purpose 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. Methods 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. Results 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. Conclusion 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. Background 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.

Journal of Clinical Monitoring and Computing - Vital sign monitoring in patients is essential for the early detection of deterioration of vital signs and timely medical intervention especially on...

Journal of Clinical Monitoring and Computing - This letter is a statement from the European Society for Intravenous Anaesthesia discussing the recent discovery of an incorrect implementation of a...

We are pleased to announce that Journal of Clinical Monitoring and Computing will become a fully open access (OA) on 1 January 2026. As a result, all ...

Purpose 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 (Sc...

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Journal of Clinical Monitoring and Computing - Whether the thoracic fluid content (TFC) estimated by bioimpedance actually reflects the thoracic water content and tracks its changes has not been...

Opioid-induced respiratory depression (OIRD) remains a critical safety concern, particularly in older adults, yet timely, reliable detection methods are limited. Decline of pupillary unrest in ambient...

Purpose 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 (...

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®) ...

Optimal intraoperative fluid management is essential to improve surgical outcomes and reduce complications. The Pleth Variability Index (PVI), a dynamic and non-invasive indicator of fluid responsiven...

In critical care settings, continuous vital sign monitoring is crucial to ensure patient safety and timely intervention. While traditional patient monitor threshold alarm systems have been life-saving...

Introduction Haemoglobin measurement is an essential parameter for quantifying anaemia and often used for guiding transfusion decisions. Conventional methods require blood sampling and are invasive. R...

Journal of Clinical Monitoring and Computing -

Optimizing oxygenation for patients necessitates a delicate balance between sufficient oxygen delivery and mitigating the potential hazards of hyperoxemia. We hypothesized that integrating Oxygen Rese...