Perioperative Monitoring, An Issue of Anesthesiology Clinics

1st Edition - August 17, 2021

Editors: Gabriella Iohom, Girish P. Joshi

Hardback ISBN:

9 7 8 - 0 - 3 2 3 - 8 3 5 2 6 - 8

eBook ISBN:

9 7 8 - 0 - 3 2 3 - 8 3 5 2 7 - 5

This issue of Anesthesiology Clinics, guest edited by Drs. Gabriella Iohom and Girish P. Joshi, focuses on Perioperative Monitoring. This is one of four issues each year selected… Read more

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This issue of Anesthesiology Clinics, guest edited by Drs. Gabriella Iohom and Girish P. Joshi, focuses on Perioperative Monitoring. This is one of four issues each year selected by the series consulting editor, Dr. Lee Fleisher. Articles in this issue include, but are not limited to: Clinician monitoring, Ventilation monitoring, Measurement of pulmonary mechanics, Hemodynamic monitoring, Tissue perfusion monitoring, Neuromuscular blockade monitoring, Depth of anesthesia monitoring, Antinociception monitoring, Cerebral perfusion monitoring - Brain oxygen saturation monitoring, Coagulation, Ultrasound - the new stethoscope (POCUS), Mobile and Remote monitoring, smart phone use, AI, machine learning, deep learning, and closed loop devices and Telemedicine for anesthesiologists.　

Cover image
Title page
Table of Contents
Copyright
Contributors
Forthcoming Issues
Foreword
Preface
Clinician Monitoring
Key points
History of monitoring
Development of standards
Anesthesia clinician as the first standard of monitoring
Monitoring the clinician
Monitoring the monitors
Future developments
Summary
Clinics care points
Ventilation Monitoring
Key points
Introduction
Pulse oximetry
Monitoring ventilation with capnography
Respiratory rate monitors
Monitoring invasive mechanical ventilation
Postoperative opioid-induced respiratory depression
Detecting patient deterioration with continuous monitoring
Clinics care points
Disclosure
Respiratory Mechanics
Key points
Introduction
What are respiratory mechanics?
Why measure respiratory mechanics?
Physiology of chest mechanics
Concept of mechanical power
Stress
Stress index
Strain
Time constant
Perioperative measurements
Flow and volume
Derived measurements
Airway resistance
Measurement of dead space
Extended monitoring
Best positive end-expiratory pressure ventilation
What is the optimal positive end-expiratory pressure and how is it determined?
Intrathoracic or pleural pressure
Transpulmonary pressure and esophageal pressure
Choice of positive end-expiratory pressure using esophageal pressure
Compliance of lungs and chest wall
Functional residual capacity and end-expiratory lung volume
Why measure lung volumes during invasive ventilation?
Electrical impedance tomography
Mechanical ventilation in special subsets of patients
Summary
Clinics care points
Perioperative Hemodynamic Monitoring: An Overview of Current Methods
Key points
Introduction
Pressure monitoring
Flow monitoring
Volume monitoring
Fluid responsiveness
Discussion
Summary
Clinics care points
Neuromuscular Blockade Monitoring
Key points
Background
Types of assessment
Why is neuromuscular monitoring important
Quantitative neuromuscular monitoring technologies
Challenges with use of quantitative monitoring
Site of monitoring
Paretic extremities
Summary
Clinics care points
Depth of Anesthesia Monitoring
Key points
Introduction
Background
Processed electroencephalograph
Commercially available processed electroencephalographic monitors
Clinical pitfalls
Clinical care points
Processed electroencephalographic monitors and awareness
pEEG monitors and secondary outcomes
Clinical care points
Translation to clinical practice
Intraoperative Nociception Monitoring
Key points
Nociception and pain and their relevance to the state of anesthesia
Physiology of nociception and its effects
Effects of nociception that form the basis of nociceptive monitoring
Benefits of nociceptive monitoring
Understanding the available nociceptive monitoring technologies and their applicability during surgery
Review of existing literature
Limitations and disadvantages
Summary
Clinics care points
Disclosure
Cerebral Perfusion and Brain Oxygen Saturation Monitoring with: Jugular Venous Oxygen Saturation, Cerebral Oximetry, and Transcranial Doppler Ultrasonography
Key points
Introduction
Discussion
Summary
Clinics care points
Perioperative Coagulation Monitoring
Key points
Introduction
Principles of perioperative coagulopathy
Benefit of preoperative coagulation screening test
Coagulation testing in the perioperative setting
Clinical implications
Discussion
Summary
Clinics care points
Ultrasound: The New Stethoscope (Point-of-Care Ultrasound)
Key points
Point-of-care lung ultrasound
Putting it together
Lung pathologies
Clinics care points
Point-of-care gastric ultrasound
Summary
Clinics care points
Supplementary data
Toward Smart Monitoring with Phones, Watches, and Wearable Sensors
Key points
Self-monitoring with smartphones and connected devices
Smartphones applications for perioperative clinicians
Summary
Clinics care points
Machine Learning, Deep Learning, and Closed Loop Devices—Anesthesia Delivery
Key points
Background
What are closed loop systems?
What is artificial intelligence?
Clinical applications of closed loop devices and artificial intelligence
Closed loop devices in anesthesiology
Machine learning in anesthesiology
Challenges and future directions of closed loop devices and artificial intelligence
Clinics care points
Telemedicine for Anesthesiologists
Key points
Introduction
Preoperative care
Intraoperative care
Postoperative care
Equipment
Health Insurance Portability and Accountability Act compliance
Medical licensure and billing
Informed consent
The COVID-19 pandemic
Summary
Clinics care points