ACUTE ELECTRODERMAL ACTIVITY CHANGES TO SHORT-TIME NOISE STIMULATION IN ADULT INTENSIVE CARE UNIT PATIENTS

The electrical properties of the skin, also known as electrodermal activity (EDA), are considered as an indirect measure of autonomous nervous system. Along with that, the effects of noise-induced stress in intensive care units, is well explored. This study explores the noise-induced acute electrodermal activity changes in adult critical care patients and to compare these changes with cardiovascular effects of the same stress (noise) stimulus. Skin conductance variability, noise level, selected hemodynamic and respiratory parameters were monitored during 4 hour routine daytime intensive care nursing and treatment in an adult Intensive Care Unit. Average ambient noise levels during the time window (4 min) before the stimulation were 54.33(2.65) dB for Group A and 55.65(3.31) dB, while the noise stimulation was on average for Group A 70.8 (1.98) dB, and for Group B: 71.31(3.31) dB. EDA changes to noise stimulus were more distinct than hemodynamic and respiratory parameters. Yet, a weak relation was found between all EDA parameters and the particular noise level changes. Noise-induce stress causes more distinct EDA changes when measured immediately post stimulus. In addition, sedation level seems to affect the intensity of these changes. However, further studies are needed in to order to reach a definite conclusion. Continue reading →

Category: 2019, 2019a, Clinical Studies
Keywords: Electrodermal Activity, Intensive Care, Noise, Stress
Authors (a/b order): Aslanidis Th., Chatzisotiriou A., Grosomanidis V., Karakoulas K.

Workload during a complex ICU monitoring task: the effect of level of patient’s sedation level and repetion of the task

Patient care in Intensive Care Units is characterized by high demanding tasks, which leads in daily high workload. The aim of the study is to evaluate the effect of patient’s sedation level to workload for the certain task. It also examines whether workload lowers over time, as an effect of the experience gained by the repetition of the task. NASA- TLX tool was used as workload assessments method during a complex monitoring task in an adult Intensive Care Unit environment. The latter included monitoring and recording of skin conductance variability, noise level, hemodynamic and respiratory parameters were monitored during 4 hour routine in two groups of patients. The group was defined by the sedation level (Ramsay sedation score); otherwise no major differences were spotted in their characteristics. Both raw and weighted data of the NASA-TLX tool were included in the analysis, which was performed with MS Excel 2007 (Microsoft Co, USA) and Rstudio® IDE v.0.99.903 (Rstudio Inc, Boston, MA, USA). Patients’ sedation level did not affect NASA-TLX measured workload. The former was valid both for raw values and weighted data of the subscales of the NASA-TLX tool. In the second part of the analysis where the raw values were treated as time series data, it was shown that some subscales (Ment, Phys) had a tendency towards lower values, others (e.g. Temp, Ef) had a relative stability and others (Per) increased over time. The total workload (OW) did not seem to lower over time. While the patient’s sedation level does not affect workload of the specific task, several subscales of the NASA-TLX index do reveal a tendency over time; a fact that may be used as learning curve/ experience assessment for a given task. However, further studies are needed in order to define its future utility.

Continue reading →

Category: 2017, 2017b, Clinical Studies
Keywords: Intensive Care, monitoring task, NASA TLX index, workload
Authors (a/b order): Aslanidis Th., Chatzis A., Chatzisotiriou A., Grosomanidis V., Karakoulas K., Kontos A.

Cardiovascular effects of different PEEP levels in a clinical setting of increased abdominal pressure

The interaction between increased Intra Abdominal Pressure (IAP) and Intrathoracic Pressure under different Positive End Expiratory Pressure (PEEP) levels is intriguing, since these two conditions coexist frequently in several clinical settings. The aim of our study was to investigate the interaction between different PEEP levels and increased IAP during laparoscopic cholecystectomy. In fifty two patients, who underwent scheduled laparoscopic cholecystectomy, cardiovascular parameters were determined by an Oesophageal Doppler Monitor device during two different time periods, before and after pneumoperitoneum, and under five conditions: (i) PEEP 0 cmH₂O (ii) PEEP 5cm H₂O (iii) PEEP 10cm H₂O (iv) PEEP 15cm H₂O and (v) in the absence of PEEP or ventilation. Cardiac output and stroke volume showed a statistically significant decrease compared to the baseline value after the application of different PEEP levels, when there was no pneumoperitoneum (p<0.05). However, both parameters increased, when PEEP and pneumoperitoneum were applied together (p<0.001). Corrected flow time, peak flow velocity in the descending thoracic aorta and mean acceleration showed similar alterations but not at all PEEP levels. Finally, αt the no PEEP or ventilation phase, the negative effects of increased IAP on the cardiocirculatory function were predominant. According to these results, application of PEEP seems to counterbalance the negative hemodynamic effects of increased IAP. Moreover, it could also be concluded that ‘ideal’ PEEP level might be the one that borders the IAP level, since the best cardiac output and stroke volume values were reported at that point.

Continue reading →

Category: 2016, 2016b, Clinical Studies
Keywords: Hemodynamic effects, increased intra-abdominal pressure, laparoscopic cholecystectomy, positive end expiratory pressure
Authors (a/b order): Fyntanidou B., Grosomanidis V., Karakoulas K., Kolettas A., Kotzampassi K., Oloktsidou E., Ourailoglou V., Theodosiadis P., Veroniki F.

Apneic oxygenation; pulmonary and cardiovascular effects

Apneic oxygenation is an adjunct „ventilation‟ technique that involves insufflation of oxygen at varying flows through a catheter that is inserted through the endotra-cheal tube and is positioned above the carina. Apneic oxygenation improves gas exchange efficiency and preserves the arterial oxygenation at an acceptable level.

Continue reading →

Category: 2010
Keywords: Apneic oxygenation, pulmonary gas exchange, Tracheal Gas insufflation
Authors (a/b order): Aidoni Z., Fyntanidou B., Grosomanidis V., Karakoulas K., Kolettas A., Kolettas V., Kotzampassi K., Mitos G., Theodosiadis P., Vasilakos D.

Alteration in the pulmonary capillary pressure after endotoxin administration in pigs

Pulmonary capillary pressure (Pcp) is the primary driving force determining the fluid flux across pulmonary capillary wall. Alterations of Pcp have been described in systemic inflammation, sepsis, ARDS, hypoxaemia and acute heart failure. The purpose of this study was to examine the Pcp alterations after lipopolysaccharide (LPS) intravenous administration in pigs. LPS has been administered (150μg/Kg BW) in the right atrium of 8 anesthetized and mechanical ventilated pigs (Group A) and the Pcp was calculated from pulmonary artery pressure tracings using the Gaar equation before, after LPS infusion and in 20min intervals for two hours.

Continue reading →