Integrated Pulmonary Index (IPI) monitorization under sedation in cataract surgery with phacoemulsification technique

Ar, Arzu Yıldırım; Abitağaoğlu, Süheyla; Turan, Güldem; Karip, Ceren Şanlı; Akgün, Nur; Boybeyi, Doğa Meriç; Arı, Dilek Erdoğan

doi:10.1007/s10792-018-1024-x

Cited by 9 publications

(4 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A study compared simultaneous BIS values, respiratory rate, and expired carbon dioxide measurements in healthy volunteers, but these findings were confounded by the application of a tight-fitting facemask and continuous infusions of intravenous sedatives [ 71 ]. Another study monitored serial BIS values, respiratory rate, and expired carbon dioxide measurements; however, these findings were confounded by the need for cataract surgery in moderately sedated participants with varying levels of health status [ 72 ]. In a single study, BIS and skin conductance were shown to significantly decrease during hypnosis; however, the authors provided no correlation analysis between the 2 values [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

Bispectral Index Alterations and Associations With Autonomic Changes During Hypnosis in Trauma Center Researchers: Formative Evaluation Study

Dunham¹,

Burger²,

Hileman³

et al. 2021

JMIR Form Res

View full text Add to dashboard Cite

Background Previous work performed by our group demonstrated that intermittent reductions in bispectral index (BIS) values were found during neurofeedback following mindfulness instructions. Hypnosis was induced to enhance reductions in BIS values. Objective This study aims to assess physiologic relaxation and explore its associations with BIS values using autonomic monitoring. Methods Each session consisted of reading a 4-minute baseline neutral script and playing an 18-minute hypnosis tape to 3 researchers involved in the BIS neurofeedback study. In addition to BIS monitoring, autonomic monitoring was performed, and this included measures of electromyography (EMG), skin temperature, skin conductance, respiratory rate, expired carbon dioxide, and heart rate variability. The resulting data were analyzed using two-tailed t tests, correlation analyses, and multivariate linear regression analyses. Results We found that hypnosis was associated with reductions in BIS (P<.001), EMG (P<.001), respiratory rate (P<.001), skin conductance (P=.006), and very low frequency power (P=.04); it was also associated with increases in expired carbon dioxide (P<.001), skin temperature (P=.04), high frequency power (P<.001), and successive heart interbeat interval difference (P=.04) values. Decreased BIS values were associated with reduced EMG measures (R=0.76; P<.001), respiratory rate (R=0.35; P=.004), skin conductance (R=0.57; P<.001), and low frequency power (R=0.32; P=.01) and with increased high frequency power (R=−0.53; P<.001), successive heart interbeat interval difference (R=−0.32; P=.009), and heart interbeat interval SD (R=−0.26; P=.04) values. Conclusions Hypnosis appeared to induce mental and physical relaxation, enhance parasympathetic neural activation, and attenuate sympathetic nervous system activity, changes that were associated with BIS values. Findings from this preliminary formative evaluation suggest that the current hypnosis model may be useful for assessing autonomic physiological associations with changes in BIS values, thus motivating us to proceed with a larger investigation in trauma center nurses and physicians.

show abstract

Section: Introductionmentioning

confidence: 99%

Bispectral Index Alterations and Associations With Autonomic Changes During Hypnosis in Trauma Center Researchers: Formative Evaluation Study

Dunham¹,

Burger²,

Hileman³

et al. 2021

JMIR Form Res

View full text Add to dashboard Cite

show abstract

“…By giving a real-time analysis of patients' end-tidal carbon dioxide (PetCO2), respiratory rate, pulse, and peripheral oxygen saturation (SpO2) gives the clinician a single value between 1 (immediate intervention required) and 10 (normal) [8]. IPI is used for the early detection of respiratory problems and monitoring of ventilation [9]. Using IPI, it can be determined whether patients need additional clinical evaluation and intervention [10].…”

Section: Introductionmentioning

confidence: 99%

“…Using IPI, it can be determined whether patients need additional clinical evaluation and intervention [10]. It is seen that IPI is generally used to follow ventilation and oxygenation in processes that require sedation [8][9][10]. Within pathophysiological knowledge, cardiovascular and respiratory functions are known to be closely related.…”

Section: Introductionmentioning

confidence: 99%

Comparison of the integrated pulmonary index with cardiac risk scores in acute coronary syndromes

Tekin,

Ozlu,

Bayraktar

et al. 2021

Ann Clin Anal Med

View full text Add to dashboard Cite

Aim: In this study, we aimed to investigate the availability of the Integrated Pulmonary Index (IPI) score in predicting the risk of the major adverse cardiovascular event (MACE) in patients with acute coronary syndromes (ACS). Material and Methods: This study was planned as a prospective single-centered study and the cardiac risk scores and IPI were calculated on the arrival of patients with ACS in the emergency department. The Thrombolysis in Myocardial Infarction (TIMI), history, ECG, age, risk factors, troponin (HEART), and global registry of acute cardiac events (GRACE) risk scores were compared with the obtained IPI score. The MACE was defined as death within the last month since its arrival; IPI's prediction rates of MACE risk were investigated. Results: In the study, 381 patients were included and analyzed. MACE was detected in 105 (27.6%) patients. AUC values of TIMI, HEART, GRACE scores, and arrival high-sensitive cardiac troponin I in predicting MACE were 0.819, 0.737, 0.695 and 0.731, respectively, and statistically significant differences were found (p<0.001). There were negative correlations and statistically significant differences with the IPI, TIMI, HEART, and GRACE scores (p<0.001). The IPI score was found to predict MACE with 83.0% sensitivity and 74.3% specificity with >4 breakpoints (AUC=0.799). Discussion: Our study is the first study in the literature in which IPI predicts risk factors in the ACS. The IPI has been found to predict cardiovascular events in accordance with cardiac risk scores at 30-day follow-up, and it is beneficial for emergency physicians to use IPI with other cardiac risk scores in the prediction of MACE in ACS.

show abstract

“…The monitor warns the endoscopic team with a flashing signal surrounding the IPI value as well as an audible alarm. A total of nine studies have either analyzed IPI or used it to predict respiratory complications in different settings [10][11][12][13][14][15][16][17][18].…”

Section: Introductionmentioning

confidence: 99%

Evaluation of the Integrated Pulmonary Index® during non-anesthesiologist sedation for percutaneous endoscopic gastrostomy

Michael

Peveling‐Oberhag

Herrmann

et al. 2020

J Clin Monit Comput

View full text Add to dashboard Cite

Standard monitoring of heart rate, blood pressure and arterial oxygen saturation during endoscopy is recommended by current guidelines on procedural sedation. A number of studies indicated a reduction of hypoxic (art. oxygenation < 90% for > 15 s) and severe hypoxic events (art. oxygenation < 85%) by additional use of capnography. Therefore, U.S. and the European guidelines comment that additional capnography monitoring can be considered in long or deep sedation. Integrated Pulmonary Index® (IPI) is an algorithm-based monitoring parameter that combines oxygenation measured by pulse oximetry (art. oxygenation, heart rate) and ventilation measured by capnography (respiratory rate, apnea > 10 s, partial pressure of end-tidal carbon dioxide [PetCO2]). The aim of this paper was to analyze the value of IPI as parameter to monitor the respiratory status in patients receiving propofol sedation during PEG-procedure. Patients reporting for PEG-placement under sedation were randomized 1:1 in either standard monitoring group (SM) or capnography monitoring group including IPI (IM). Heart rate, blood pressure and arterial oxygen saturation were monitored in SM. In IM additional monitoring was performed measuring PetCO2, respiratory rate and IPI. Capnography and IPI values were recorded for all patients but were only visible to the endoscopic team for the IM-group. IPI values range between 1 and 10 (10 = normal; 8–9 = within normal range; 7 = close to normal range, requires attention; 5–6 = requires attention and may require intervention; 3–4 = requires intervention; 1–2 requires immediate intervention). Results on capnography versus standard monitoring of the same study population was published previously. A total of 147 patients (74 in SM and 73 in IM) were included in the present study. Hypoxic events occurred in 62 patients (42%) and severe hypoxic events in 44 patients (29%), respectively. Baseline characteristics were equally distributed in both groups. IPI = 1, IPI < 7 as well as the parameters PetCO2 = 0 mmHg and apnea > 10 s had a high sensitivity for hypoxic and severe hypoxic events, respectively (IPI = 1: 81%/81% [hypoxic/severe hypoxic event], IPI < 7: 82%/88%, PetCO2: 69%/68%, apnea > 10 s: 84%/84%). All four parameters had a low specificity for both hypoxic and severe hypoxic events (IPI = 1: 13%/12%, IPI < 7: 7%/7%, PetCO2: 29%/27%, apnea > 10 s: 7%/7%). In multivariate analysis, only SM and PetCO2 = 0 mmHg were independent risk factors for hypoxia. IPI (IPI = 1 and IPI < 7) as well as the individual parameters PetCO2 = 0 mmHg and apnea > 10 s allow a fast and convenient conclusion on patients’ respiratory status in a morbid patient population. Sensitivity is good for most parameters, but specificity is poor. In conclusion, IPI can be a useful metric to assess respiratory status during propofol-sedation in PEG-placement. However, IPI was not superior to PetCO2 and apnea > 10 s.

show abstract

Integrated Pulmonary Index (IPI) monitorization under sedation in cataract surgery with phacoemulsification technique

Cited by 9 publications

References 13 publications

Bispectral Index Alterations and Associations With Autonomic Changes During Hypnosis in Trauma Center Researchers: Formative Evaluation Study

Bispectral Index Alterations and Associations With Autonomic Changes During Hypnosis in Trauma Center Researchers: Formative Evaluation Study

Comparison of the integrated pulmonary index with cardiac risk scores in acute coronary syndromes

Evaluation of the Integrated Pulmonary Index® during non-anesthesiologist sedation for percutaneous endoscopic gastrostomy

Contact Info

Product

Resources

About