Trending algorithm discriminates hemodynamic from injury related TcMEP amplitude loss.

07:00 EST 6th February 2019 | BioPortfolio

Summary of "Trending algorithm discriminates hemodynamic from injury related TcMEP amplitude loss."

Jasiukaitis and Lyon (J Clin Monit Comput, , 2018) described an motor evoked potential (MEP)amplitude trending system to detect MEP amplitude loss against a background of MEP variability. They found that the end of case value of a running R triggered by a set MEP amplitude loss criterion appeared to discriminate new injury from non-injury in a small sample of three patients. The present study examines the predictive capability of the running R in a larger sample of patients (21 injured and 19 non-injured). It also varies the amplitude loss criterion (50%, 65% and 80%) for triggering the running R and the numbers of points used in the moving linear regression (8, 12 and 16). 40 patients who had undergone correction for lumbar deformity were retrospectively examined. 21 of these woke up with a newly acquired radicular injury, 19 did not but were characterized by hypovolemic hemorrhage. All 40 patients had sufficient MEP amplitude loss sometime during their procedure to cause the monitoring specialist to report this to the surgeon and anesthesia. End-of-case running Rs were significantly larger in the injury group. Using an 80% amplitude loss criterion to trigger the running R proved to be too stringent, causing reduced sensitivity. The running R appeared to have equivalent sensitivity to that of conventional MEP amplitude loss ratios, but superior specificity within this monitoring challenged sample. The different number of points for the moving regressions did not have any significant effect. End-of-case R values greater than 60% appeared to be highly predictive of new post-operative deficit, while values less than 40% appeared to insure no new deficit. The proposed trending system can discriminate injury from non-injury outcomes when compressive radicular injury during correction for lumbar deformity is involved. This discrimination appears to be successful even when MEP amplitude loss for non-iatrogenic reasons (i.e., hemorrhage) is also occurring.


Journal Details

This article was published in the following journal.

Name: Journal of clinical monitoring and computing
ISSN: 1573-2614


DeepDyve research library

PubMed Articles [15934 Associated PubMed Articles listed on BioPortfolio]

Nephrotoxin-Related Acute Kidney Injury and Predicting High-Risk Medication Combinations in the Hospitalized Child.

In the hospitalized patient, nephrotoxin exposure is one potentially modifiable risk factor for acute kidney injury (AKI). Clinical decision support based on nephrotoxin ordering was developed at our ...

Age-specific incidence of injury-related hospital contact after release from prison: a prospective data-linkage study.

In population studies, the risk of injury declines after early adulthood. It is unclear if a similar age difference in the risk of injury exists among people released from prison.

Appropriateness of complementary exams in the initial assessment of acute kidney injury.

Current protocols recommend an initial assessment of acute kidney injury often extensive, not very useful in the majority of cases. A review of the literature allowed us to propose a management algori...

Minimally invasive treatment of biliary tract injury secondary to closed abdominal trauma: Clinical case.

Hepatic and biliary tract injuries due to traumatic causes are rare in pediatric patients. Of the total number of patients with closed abdominal trauma, less than 9 % have liver injury, and the freque...

Employing Machine Learning to Predict Lower Extremity Injury in U.S. Special Forces.

Musculoskeletal injury rates in military personnel remain unacceptably high. Application of machine learning algorithms could be useful in multivariate models to predict injury in this population. The...

Clinical Trials [6524 Associated Clinical Trials listed on BioPortfolio]

Observation of Principal Hemodynamic Variables After Spinal Anesthesia With Non Invasive Hemodynamic Monitoring

The study is aimed at observe how spinal anesthesia modifies the hemodynamic state of the patient after optimization to preload independence with a Goal Directed Therapy algorithm guided b...

Validation of Next Generation INVOS NIRS Cerebral and Tissue Oximeter

The primary objective of the study is to validate that the production equivalent PM7100 System in conjunction with Adult Sensors (PMSENS71-A) meet product requirements for cerebral accurac...

Enduring Exercise Habits: Trending Norms

Learning that most people engage in an activity can be a powerful motivator to adoption. But are there instances in which people can similarly find motivation from learning that only a min...

Advanced Monitoring to Inform and Guide Perioperative Hemodynamic Optimization 1 (AMIGO-1) Study

Serious complications occur in about 16% of major surgeries. Episode of hypotension during surgery may be a leading cause of these complications. Even though hypotension occurs frequently ...

BEtter Control of Blood Pressure in Hypertensive pAtients Monitored Using the HOTMAN® sYstem

The purpose of this study is to demonstrate that monitoring hemodynamic parameters and then applying a predefined algorithm of drug selection (i.e. integrated hemodynamic management - IHM)...

Medical and Biotech [MESH] Definitions

A rare but serious transfusion-related reaction in which fluid builds up in the lungs unrelated to excessively high infusion rate and/or volume (TRANSFUSION-ASSOCIATED CIRCULATORY OVERLOAD). Signs of Transfusion-Related Acute Lung Injury include pulmonary secretions; hypotension; fever; DYSPNEA; TACHYPNEA; TACHYCARDIA; and CYANOSIS.

An injury in which the damage is located on the opposite side of the primary impact site. A blow to the back of head which results in contrecoup injury to the frontal lobes of the brain is the most common type.

Recurrent seizures causally related to CRANIOCEREBRAL TRAUMA. Seizure onset may be immediate but is typically delayed for several days after the injury and may not occur for up to two years. The majority of seizures have a focal onset that correlates clinically with the site of brain injury. Cerebral cortex injuries caused by a penetrating foreign object (CRANIOCEREBRAL TRAUMA, PENETRATING) are more likely than closed head injuries (HEAD INJURIES, CLOSED) to be associated with epilepsy. Concussive convulsions are nonepileptic phenomena that occur immediately after head injury and are characterized by tonic and clonic movements. (From Rev Neurol 1998 Feb;26(150):256-261; Sports Med 1998 Feb;25(2):131-6)

Pulmonary injury following the breathing in of toxic smoke from burning materials such as plastics, synthetics, building materials, etc. This injury is the most frequent cause of death in burn patients.

A physical injury caused by exposure of the body to extremely low ambient temperatures that may lead to loss of body parts, or in extreme cases, death. Examples of cold injury are FROSTBITE and CHILBLAINS.

Quick Search


DeepDyve research library

Relevant Topic

Anesthesia is the loss of feeling or sensation in all or part of the body. It may result from damage to nerves or can be induced by an anesthetist (a medical professional) using anesthetics such as thiopental or propofol or sevoflurane during a surgical ...

Searches Linking to this Article