Novel Methods and Devices for Monitoring in Critical Care

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Point-of-Care Diagnostics and Devices".

Deadline for manuscript submissions: closed (31 December 2023) | Viewed by 3878

Special Issue Editors


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Guest Editor
Department of Critical Care Medicine, Zhongshan Hospital, Fudan University, Shanghai, China
Interests: ICU; mechanical ventilation; respiratory physiology; critical care medicine; intensive care medicine; sepsis; hemodynamics

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Guest Editor
Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
Interests: thrombosis management; anticoagulation therapies; coagulation biomarkers in critical care

Special Issue Information

Dear Colleagues,

The management of critically ill patients necessitates intensive monitoring, such as hemodynamic monitoring, respiratory monitoring, lab exams, etc. In recent decades, significant progress has been made in the development of innovative monitoring systems and equipment for critically ill patients. In terms of hemodynamic monitoring, for instance, great progress has been made in the development of non-invasive and minimally invasive monitoring of macro-hemodynamics. In critically ill patients, however, incoherence between the macro-circulation and microcirculation is prevalent. Recent innovations include video-microscopy, laser flowmetry, and near-infrared spectroscopy (NIRS) for quantification and visualization of microcirculation. In addition, each organ has unique patterns of blood flow due to its unique structure or auto-regulatory capabilities. Therefore, it remains to be determined how to monitor the specific perfusion of vital organs such as the liver, brain, and kidney.

In clinical practice settings, many other novel methods and techniques are also appealing: continuous monitoring of vital signs using cameras, trans pulmonary pressure monitoring, wearable sensors, therapeutic drug monitoring, machine learning tools in prediction models, transcranial Doppler as a screening test to rule out intracranial hypertension, novel biomarkers in early disease detection, critical care ultrasound, etc.

These innovative methods have accelerated the evolution of Critical Care Medicine. This Special Issue on "Novel Methods and Devices for Monitoring in Critically Ill Patients" aims to enlighten all individuals involved in the care of critically ill patients about these developments. We hope you will contribute to this Special Issue, whether your expertise lies in intensive care, emergency medicine, internal medicine, radiology, or artificial intelligence.

Prof. Dr. Guowei Tu
Prof. Dr. Zhongheng Zhang
Prof. Dr. Zhi-Chun Gu
Guest Editors

Manuscript Submission Information

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Keywords

  • hemodynamic monitoring
  • perfusion
  • heart-lung interactions
  • novel biomarkers
  • machine learning
  • ultrasound
  • therapeutic drug monitoring
  • wearable sensors

Published Papers (3 papers)

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Research

13 pages, 2157 KiB  
Article
Prehospital Targeting of 1-Year Mortality in Acute Chest Pain by Cardiac Biomarkers
by Daniel Zalama-Sánchez, Francisco Martín-Rodríguez, Raúl López-Izquierdo, Juan F. Delgado Benito, Irene Sánchez Soberón, Carlos del Pozo Vegas and Ancor Sanz-García
Diagnostics 2023, 13(24), 3681; https://doi.org/10.3390/diagnostics13243681 - 16 Dec 2023
Viewed by 725
Abstract
The identification and appropriate management of patients at risk of suffering from acute chest pain (ACP) in prehospital care are not straightforward. This task could benefit, as occurs in emergency departments (EDs), from cardiac enzyme assessment. The aim of the present work was [...] Read more.
The identification and appropriate management of patients at risk of suffering from acute chest pain (ACP) in prehospital care are not straightforward. This task could benefit, as occurs in emergency departments (EDs), from cardiac enzyme assessment. The aim of the present work was to derive and validate a scoring system based on troponin T (cTnT), N-terminal pro B-type natriuretic peptide (NT-proBNP), and D-dimer to predict 1-year mortality in patients with ACP. This was a prospective, multicenter, ambulance-based cohort study of adult patients with a prehospital ACP diagnosis who were evacuated by ambulance to the ED between October 2019 and July 2021. The primary outcome was 365-day cumulative mortality. A total of 496 patients fulfilled the inclusion criteria. The mortality rate was 12.1% (60 patients). The scores derived from cTnT, NT-proBNP, and D-dimer presented an AUC of 0.802 (95% CI: 0718-0.886) for 365-day mortality. This AUC was superior to that of each individual cardiac enzyme. Our study provides promising evidence for the predictive value of a risk score based on cTnT, NT-proBNP, and D-dimer for the prediction of 1-year mortality in patients with ACP. The implementation of this score has the potential to benefit emergency medical service care and facilitate the on-scene decision-making process. Full article
(This article belongs to the Special Issue Novel Methods and Devices for Monitoring in Critical Care)
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11 pages, 1511 KiB  
Article
Lactate versus Phosphate as Biomarkers to Aid Mechanical Circulatory Support Decisions in Patients with Out-of-Hospital Cardiac Arrest and Return of Spontaneous Circulation
by Dragos Andrei Duse, Fabian Voß, Laura Heyng, Georg Wolff, Christine Quast, Daniel Scheiber, Patrick Horn, Malte Kelm, Ralf Westenfeld, Christian Jung and Ralf Erkens
Diagnostics 2023, 13(9), 1523; https://doi.org/10.3390/diagnostics13091523 - 24 Apr 2023
Cited by 1 | Viewed by 1102
Abstract
Aims: Identifying patients who may benefit from mechanical circulatory support (MCS) after out-of-hospital cardiac arrest (OHCA) and return of spontaneous circulation (ROSC) remains challenging; thus, a search for helpful biomarkers is warranted. We aimed to evaluate phosphate and lactate levels on admission regarding [...] Read more.
Aims: Identifying patients who may benefit from mechanical circulatory support (MCS) after out-of-hospital cardiac arrest (OHCA) and return of spontaneous circulation (ROSC) remains challenging; thus, a search for helpful biomarkers is warranted. We aimed to evaluate phosphate and lactate levels on admission regarding their associations with survival with and without MCS. Methods: In 224 OHCA patients who achieved ROSC, the initial phosphate and lactate levels were investigated to discriminate in-hospital mortality by receiver operating characteristic (ROC) curves. According to the Youden Index (YI) from the respective ROC, the groups were risk stratified by both biomarkers, and 30-day mortality was analyzed in patients with and without MCS. Results: Within the entire collective, MCS was not associated with a better chance of survival. Both phosphate and lactate level elevations showed good yet comparable discriminations to predict mortality (areas under the curve: 0.80 vs. 0.79, p = 0.74). In patients with initial phosphate values > 2.2 mmol/L (>YI), 30-day mortality within the MCS cohort was lower (HR 2.3, 95% CI: 1.4–3.7; p = 0.0037). In patients with lower phosphate levels and groups stratified by lactate, 30-day mortality was similar in patients with and without MCS. Conclusions: We found a significant association between survival and MCS therapy in patients with phosphate levels above 2.2 mmol/L (Youden Index), and a similar discrimination of patient overall survival by lactate and phosphate. Prospective studies should assess the possible independent prognostic value of phosphate and its clearance for MCS efficiency. Full article
(This article belongs to the Special Issue Novel Methods and Devices for Monitoring in Critical Care)
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11 pages, 2701 KiB  
Article
Tablets as an Option for Telemedicine—Evaluation of Diagnostic Performance and Efficiency in Intracranial Arterial Aneurysm Detection
by Elif Can, Pimrapat Gebert, Elisa Birgit Sodemann, Johannes Kolck, Thula Canon Walter-Rittel, Anna Maaßen, Christopher Güttler, Juliane Stöckel, Georg Bohner and Georg Böning
Diagnostics 2022, 12(10), 2461; https://doi.org/10.3390/diagnostics12102461 - 11 Oct 2022
Viewed by 1086
Abstract
Purpose: To evaluate a commercially available mobile device for the highly specialized task of detection of intracranial arterial aneurysm in telemedicine. Methods: Six radiologists with three different levels of experience retrospectively interpreted 60 computed tomography (CT) angiographies for the presence of intracranial arterial [...] Read more.
Purpose: To evaluate a commercially available mobile device for the highly specialized task of detection of intracranial arterial aneurysm in telemedicine. Methods: Six radiologists with three different levels of experience retrospectively interpreted 60 computed tomography (CT) angiographies for the presence of intracranial arterial aneurysm, among them 30 cases with confirmed positive findings. Each radiologist reviewed the angiography datasets twice: once on a dedicated medical-grade workstation and on a commercially available mobile consumer-grade tablet with an interval of 3 months. Diagnostic performance, reading efficiency and subjective scorings including diagnostic confidence were analyzed and compared. Results: Diagnostic performance was comparable on both devices regardless of readers’ experience, and no significant differences in sensitivity (66–87.5%) and specificity (79.4–87%) were found. Results obtained with tablets and medical workstations were also comparable in terms of subjective assessment across all reader groups. Conclusions: There was no significant difference between tablet and workstation readings of angiography datasets for the presence of intracranial arterial aneurysm. Sensitivity, specificity, efficiency and subjective scorings were similar with the two devices for all three reader groups. While medical workstations are 10 times more expensive, tablets allow higher mobility especially for radiologists on call. Full article
(This article belongs to the Special Issue Novel Methods and Devices for Monitoring in Critical Care)
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