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Novel Methods and Devices for Monitoring and Diagnosing in Critical...
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Novel Methods and Devices for Monitoring and Diagnosing 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: 31 March 2025 | Viewed by 1233

Special Issue Editor

Dr. Zhongheng Zhang

E-Mail Website
Guest Editor
Department of Emergency Medicine, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou 310016, China
Interests: emergency and critical care medicine; AI
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Managing critically ill patients necessitates intensive monitoring, such as hemodynamic monitoring, respiratory monitoring, lab exams, etc. In recent decades, significant progress has been made in developing innovative monitoring systems and equipment for critically ill patients. In terms of hemodynamic monitoring, for instance, great progress has been made in developing 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 blood flow patterns 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 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.

Dr. Zhongheng Zhang
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Diagnostics is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

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

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Published Papers (2 papers)

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11 pages, 1356 KiB  
Article
Near-Infrared Spectroscopy (NIRS) to Assess Infection Complications During the Acute Phase of Acute Pancreatitis
by Nobutaka Chiba, Tsukasa Yagi, Minori Mizuochi, Jun Sato, Takeshi Saito, Atsushi Sakurai and Kosaku Kinoshita
Diagnostics 2024, 14(23), 2647; https://doi.org/10.3390/diagnostics14232647 - 24 Nov 2024
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Abstract
Background: Acute pancreatitis (AP) severity is correlated with systemic infection incidence in the acute phase, and it is important to assess inflammation during the disease course and to recognize infection at an early stage. As in sepsis, inflammation in AP impairs tissue oxygen [...] Read more.
Background: Acute pancreatitis (AP) severity is correlated with systemic infection incidence in the acute phase, and it is important to assess inflammation during the disease course and to recognize infection at an early stage. As in sepsis, inflammation in AP impairs tissue oxygen metabolism and disrupts microcirculation. We performed a vascular occlusion test (VOT) via near-infrared spectroscopy (NIRS), which noninvasively monitors local oxygen in peripheral tissues, to evaluate tissue oxygen metabolism and blood circulation during the acute AP phase. Methods: Tissue oxygen metabolism was measured via an NIRS probe attached to the thenar eminence at admission and 7 days after admission. The upper arm was wrapped with a sphygmomanometer cuff while avoiding brachial artery compression for 3 min. The minimum desaturation value was defined as the minimum tissue oxygen index (TOI), the maximum reactive hyperemia value after release was defined as the maximum TOI, and the difference was defined as the ∆TOI. The time from the minimum TOI to maximum TOI was defined as the TOI interval. Results: Fifteen healthy volunteers, 13 patients with AP, and 12 patients with sepsis were included. The TOI at baseline and ∆TOI (parameter describing tissue oxygen metabolism) decreased in a stepwise manner, and the TOI interval (measure of peripheral vasodilatory capacity) was protracted in a stepwise manner among the three groups. In a subgroup analysis, no significant differences in the NIRS-derived variables between patients with AP complicated by infection and those without infection were observed at admission; however, after 7 days, the groups significantly differed. Additionally, blood lactate concentrations were significantly correlated with the ∆TOI and TOI. Conclusions: Mild tissue oxygen metabolism impairment and tissue perfusion occurred in AP compared with sepsis, and changes similar to those in sepsis occur in AP complicated by infection. Further research is needed to evaluate whether these values can be applied to treating this group of patients. Full article
(This article belongs to the Special Issue Novel Methods and Devices for Monitoring and Diagnosing in Critical Care)
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13 pages, 3827 KiB  
Systematic Review
The Use of the Perfusion Index to Predict Post-Induction Hypotension in Patients Undergoing General Anesthesia: A Systematic Review and Meta-Analysis
by Kuo-Chuan Hung, Shu-Wei Liao, Chia-Li Kao, Yen-Ta Huang, Jheng-Yan Wu, Yao-Tsung Lin, Chien-Ming Lin, Chien-Hung Lin and I-Wen Chen
Diagnostics 2024, 14(16), 1769; https://doi.org/10.3390/diagnostics14161769 - 14 Aug 2024
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Abstract
Post-induction hypotension (PIH) is a common and potentially serious complication of general anesthesia. This meta-analysis (Prospero registration number: CRD42024566321) aimed to evaluate the predictive efficacy of the perfusion index (PI) for PIH in patients undergoing general anesthesia. A comprehensive literature search was performed [...] Read more.
Post-induction hypotension (PIH) is a common and potentially serious complication of general anesthesia. This meta-analysis (Prospero registration number: CRD42024566321) aimed to evaluate the predictive efficacy of the perfusion index (PI) for PIH in patients undergoing general anesthesia. A comprehensive literature search was performed using multiple electronic databases (Google Scholar, EMBASE, Cochrane Library, and MEDLINE). Studies involving adult patients undergoing general anesthesia, with the PI measured before anesthesia induction and reporting PIH incidence, were included. The primary outcome was the diagnostic accuracy of the PI in predicting the probability of PIH. The secondary outcome was the pooled PIH incidence. Eight studies with 678 patients were included. The pooled incidence of PIH was 44.8% (95% confidence interval [CI]: 29.9%–60.8%). The combined sensitivity and specificity of the PI for predicting PIH were 0.84 (95% CI: 0.65–0.94) and 0.82 (95% CI: 0.70–0.90), respectively. The summary receiver operating characteristic (sROC) analysis revealed an area under curve of 0.89 (95% CI: 0.86–0.92). The Deek’s funnel plot asymmetry test indicated no significant publication bias. The PI demonstrates high predictive efficacy for PIH in patients undergoing general anesthesia, indicating that it can be a valuable tool for identifying those at risk of PIH. Full article
(This article belongs to the Special Issue Novel Methods and Devices for Monitoring and Diagnosing in Critical Care)
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