Comparison of the quality of anesthesia and intraoperative stress responses to noxious stimulus with high opiate, low hypnotic versus low opiate high hypnotic drug administration during anesthesia using endocrinologic and immunologic markers and an off-line, post-hoc calculated surgical stress index during anesthesia with different steady-state concentrations of remifentanil and spectral entropy guided propofol administration

开始日期2006-09-08

申办/合作机构

GE Healthcare Finland Oy

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项与 GE Healthcare B.V. 相关的文献（医药）

2021-10-07·Critical care research and practice

Responsiveness Index versus the RASS-Based Method for Adjusting Sedation in Critically Ill Patients

Article

作者: Pettilä, Ville ; Särkelä, Mika O. K. ; Kaila, Markus M. ; Wennervirta, Johanna E.

Background. Sedation of intensive care patients is needed for patient safety, but deep sedation is associated with adverse outcomes. Frontal electromyogram-based Responsiveness Index (RI) aims to quantify the level of sedation and is scaled 0–100 (low index indicates deep sedation). We compared RI-based sedation to Richmond Agitation-Sedation Scale- (RASS-) based sedation. Our hypothesis was that RI-controlled sedation would be associated with increased total time alive without mechanical ventilation at 30 days without an increased number of adverse events. Methods. 32 critically ill adult patients with mechanical ventilation and administration of sedation were randomized to either RI- or RASS-guided sedation. Patients received propofol and oxycodone, if possible. The following standardized sedation protocol was utilized in both groups to achieve the predetermined target sedation level: either RI 40–80 (RI group) or RASS −3 to 0 (RASS group). RI measurement was blinded in the RASS group, and the RI group was blinded to RASS assessments. State Entropy (SE) values were registered in both groups. Results. RI and RASS groups did not differ in total time alive in 30 days without mechanical ventilation (

p = 0.72

). The incidence of at least one sedation-related adverse event did not differ between the groups. Hypertension was more common in the RI group (

p = 0.01

). RI group patients were in the target RI level 22% of the time and RASS group patients had 57% of scores within the target RASS level. The RI group spent significantly more time in their target sedation level than the RASS group spent in the corresponding RI level (

p = 0.03

). No difference was observed between the groups (

p = 0.13

) in the corresponding analysis for RASS. Propofol and oxycodone were administered at higher RI and SE values and lower RASS values in the RI group than in the RASS group. Conclusion. Further studies with a larger sample size are warranted to scrutinize the optimal RI level during different phases of critical illness.

2020-12-01·Scandinavian journal of surgery : SJS : official organ for the Finnish Surgical Society and the Scandinavian Surgical Society3区 · 医学

Noninvasive Neuromonitoring of Hypothermic Circulatory Arrest in Aortic Surgery

3区 · 医学

Article

作者: Suojaranta, R. ; Viertiö-Oja, H. ; Särkelä, M. O. K. ; Salminen, U.-S. ; Ilkka, V. H. ; Vakkuri, A. P. ; Salmi, T. ; Mäki, K. ; Wennervirta, J. ; Stewart, J. A. ; Vainikka, T. L. S.

Background and Aims::

Circulatory arrest carries a high risk of neurological damage, but modern monitoring methods lack reliability, and is susceptible to the generalized effects of both anesthesia and hypothermia. The objective of this prospective, explorative study was to research promising, reliable, and noninvasive methods of neuromonitoring, capable of predicting neurological outcome after hypothermic circulatory arrest.

Materials and Methods::

Thirty patients undergoing hypothermic circulatory arrest during surgery of the thoracic aorta were recruited in a single center and over the course of 4 years. Neuromonitoring was performed with a four-channel electroencephalogram montage and a near-infrared spectroscopy monitor. All data were tested off-line against primary neurological outcome, which was poor if the patient suffered a significant neurological complication (stroke, operative death).

Results::

A poor primary neurological outcome seen in 10 (33%) patients. A majority (63%) of the cases were emergency surgery, and thus, no neurological baseline evaluation was possible. The frontal hemispheric asymmetry of electroencephalogram, as measured by the brain symmetry index, predicted primary neurological outcome with a sensitivity of 79 (interquartile range; 62%–88%) and specificity of 71 (interquartile range; 61%–84%) during the first 6 h after end of circulatory arrest.

Conclusion::

The hemispheric asymmetry of frontal electroencephalogram is inherently resistant to generalized dampening effects and is predictive of primary neurological outcome. The brain symmetry index provides an easy-to-use, noninvasive neuromonitoring method for surgery of the thoracic aorta and postoperative intensive care.

2018-07-01·Clinical EEG and neuroscience4区 · 心理学

Quantitative EEG Parameters for Prediction of Outcome in Severe Traumatic Brain Injury: Development Study

4区 · 心理学

Article

作者: Takala, Riikka S. K. ; Tolonen, Antti ; Särkelä, Mika O. K. ; Frantzén, Janek ; van Gils, Mark ; Müller, Markus ; Posti, Jussi P. ; Katila, Ari ; Tenovuo, Olli

Monitoring of quantitative EEG (QEEG) parameters in the intensive care unit (ICU) can aid in the treatment of traumatic brain injury (TBI) patients by complementing visual EEG review done by an expert. We performed an explorative study investigating the prognostic value of 59 QEEG parameters in predicting the outcome of patients with severe TBI. Continuous EEG recordings were done on 28 patients with severe TBI in the ICU of Turku University Hospital. We computed a set of QEEG parameters for each patient, and correlated these to patient outcome, measured by dichotomized Glasgow Outcome Scale (GOS) at a follow-up visit between 6 and 12 months, using area under receiver operating characteristic curve (AUC) as a nonlinear correlation measure. For 17 of the 59 QEEG parameters (28.8%), the AUC differed significantly from 0.5, most of these parameters measured EEG power or variability. The best QEEG parameters for outcome prediction were alpha power (AUC = 0.87, P < .01) and variability of the relative fast theta power (AUC = 0.84, P < .01). The results of this study indicate that QEEG parameters provide useful information for predicting outcome in severe TBI. Novel QEEG parameters with potential in outcome prediction were found, the prognostic value of these parameters should be confirmed in later studies. The results also provide further evidence of the usefulness of parameters studied in preexisting studies.

项与 GE Healthcare B.V. 相关的新闻（医药）

2022-06-21

·NS Medical Devices

GE Healthcare rolls out Portrait Mobile to track early patient deterioration

The new solution enables continuous monitoring using wearable sensors in general hospital wards to detect patient deterioration earlier than traditional spot check methods and help improve patient outcomes GE Healthcare’s Portrait Mobile wearable monitoring device. (Credit: Business Wire) GE Healthcare has unveiled its wireless patient monitoring system, Portrait Mobile, which provides a real-time personalised view of the patient and helps clinicians detect patient deterioration. Portrait Mobile features patient-worn wireless sensors that connect with a mobile monitor and enables patient mobility while continuously monitoring dual vector RR, SpO2 and PR. Its continuous wireless monitoring feature enables the patients to move about the hospital, without being restricted to the bedside and allows visitors to easily interact with the patient. Patient mobility will help improve patient outcomes and reduce the length of stay, which may lower costs and elevate patient satisfaction, said GE Healthcare. In addition, the device comes with a routable communications architecture that allows hospitals to leverage existing infrastructure, reducing installation and maintenance costs. GE Healthcare Finland engineering director Erno Muuranto said: “In an evaluation clinical study conducted at a London hospital in the UK, 90% of nurses reported that they feel more reassured about their patient’s condition when continuous monitoring is used versus vital signs spot check measuring. “Portrait Mobile provides reliable measurement technology and meaningful alarms in a mobile setting.” The medical technology company developed Portrait Mobile at its global centre of excellence for monitoring solutions in Helsinki, Finland. The site has been a hub for the development of patient monitoring technology for decades. Early detection of patient deterioration may help reduce the length of stay and intensive care unit (ICU) admissions, and improve patient outcomes, said GE Healthcare. The company said that its Portrait Mobile can continuously capture respiration rate, oxygen saturation and pulse rate for general ward and post-surgery patients. Its advanced monitoring device allows caregivers to identify changes that signal cardiorespiratory complications or potential progression of an infectious disease.

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